NIH's Newest Institute Gearing Up

WASHINGTON—Two and a half years after a presidential veto of the concept, Lawrence Shulman is taking charge as director of the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS). "There's a lot to do," said Shulman about the 12th and newest institute on the NIH campus, carved out of an existing institute after Congress voted in 1985 to override the Reagan veto. "And Congress has told us to do it." Shulman, 67, joined the NIH a decade ago from Johns Hopkins University School of Medicine, where he had headed arthritis research and education programs. He held administrative posts in the parent institute, the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases (NIADDK), before being named acting director of the new institute in April 1986. An extensive search for a director preceded his permanent appointment in January. In his 1984 veto, Reagan said he was opposed to "unnecessary and expensive new organizational entities" and to Congress' being "overly specific" in managing biomedical research. Such criticism does not bother Shulman, who flourished a copy of Public Law 99-158, which mandates the new institute "to expand, intensify and coordinate the activities of the institute respecting arthritis and musculoskeletal diseases." There is no timetable for such a plan, he said, and he offered no details on the priorities that will emerge. Close observers of the new institute, such as Frederic C. McDuffie, senior vice president for medical affairs of the Arthritis Foundation and a strong institute supporter, estimate it will take Shulman and his staff about two years to put such a plan into effect. The institute's future, of course, is closely tied to money. As is the case throughout NIH, the administration's 1988 budget seeks less for the institute—$123 million—than its current budget of $141 million. The 1987 figure represents a healthy increase from the $113 million it received in its first year, and Congress is expected once again to reward NIH in its final appropriation for the 1988 fiscal year, which begins October 1. Strings Attached For Shulman, however, this increased funding comes with strings attached. Congress has ordered him to create nine Specialized Centers of Research (SCOR) this year, at a cost of $7.7 million. Modeled on similar centers run by other institutes, notably Heart, Lung and Blood, these centers are a new element in arthritis research. The plan is to divide the money equally among rheumatoid arthritis, osteoporosis and osteoarthritis. Shulman said the centers will foster interdisciplinary collaboration between basic science and clinical research, adding that "the clinical imperatives will help direct the basic science." Those run by the Heart, Lung and Blood Institute have shown that advances in basic science can be rapidly applied in the clinic, he said, and that clinical problems can be brought more immediately to scientific attention. Proposals for the centers are being reviewed. Shulman said he hopes to present the recommendations of the study sections to the institute's advisory board in September, and to announce the awards by the end of the fiscal year. The SCOR program, combined with some $4 million in administrative costs to run a separate institute, will make it difficult for the institute to launch any other new projects, said McDuffie. The Arthritis Foundation plans to lobby Congress to provide additional money to fund a greater number of the high-quality grants submitted by researchers. The institute allocates about 70 percent of its budget for research grants, representing $94 million this year. Work on arthritis receives about a half of the NIAMS budget, with about a quarter going for musculoskeletal research and lesser amounts for skin diseases and muscle biology. About 2 percent goes for training. McDuffie, although optimistic about the future of the new institute, believes the intramural program needs to be strengthened. Only 5 percent of the NIAMS budget goes for intramural research, compared with an average of 12 percent for other NIH institutes with intramural programs. "The institute's intramural program doesn't have the same standing in the field as, say, similar programs at the National Cancer Institute or at the Allergy and Infectious Diseases Institute," he said. McDuffie welcomed the appointment of Henry Metzger as scientific director. "He is an excellent scientist," he said, "and I have confidence in his ability to recruit talent. With adequate funds and space, I'm sure he will develop a strong program." Marwick covers NIH for the Journal of the American Medical Association.

NIH's Newest Institute Gearing Up

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