Scientists Skeptical Of NIH Strategic Plan

While the agency moves to identify long-term goals, critics question the plan's feasibility as well as its fairness More than a year into the process, an atmosphere of fear, mistrust, and even hostility is clouding the formulation of the National Institutes of Health's long-range strategic plan. Although the process is alive and advancing, there are skeptics in the biomedical research community whose perceptions of what a strategic planning process is, what it should be, and what it can accom

May 11, 1992
Bradie Metheny
While the agency moves to identify long-term goals, critics question the plan's feasibility as well as its fairness
More than a year into the process, an atmosphere of fear, mistrust, and even hostility is clouding the formulation of the National Institutes of Health's long-range strategic plan.

Although the process is alive and advancing, there are skeptics in the biomedical research community whose perceptions of what a strategic planning process is, what it should be, and what it can accomplish differ from NIH's. And while an increasing number of individuals now say that the idea of a strategic plan for NIH is good, there are those who doubt that a comprehensive plan actually will evolve.

"From the beginning, there was concern about the way the strategic plan was being developed," says an official in the public affairs division of the American Society for Microbiology. "We now have our concern as to how any plan would be implemented; how will resources be allocated when there is a change in mission and no new funding?

"Of concern is the thrust for maintaining an undifferentiated strong basic research agenda and not losing that thrust in the development of the strategic plan."

* New National Institutes of Health director Bernadine Healy tells the House Appropriations Labor, Health and Human Services, Education, and Related Agencies Subcommittee she intends to develop a plan for NIH.

* Large document, called the NIH Strategic Plan, emerges, encompassing about a dozen areas of scientific endeavor. There is no policy component. There are cost figures included in each area.

* The document is released to the press through Jay Moskowitz, NIH associate director for science policy and legislation. Moskowitz advises the press that the cost figures are not actual, but represent a "wish list from the participants" and probably should not be published at all. In spite of his advice, some in the media publish the figures.

December 1991 and January 1992

* NIH places a public statement in the media denying that a final strategic plan exists and insisting that it wants, and always wanted, the views and concerns of the extramural community.

* The Department of Health and Human Services forces NIH to repackage the material for the San Antonio meeting. The new document is called the "Framework for Discussion of Strategies for the NIH."

February 1992

* Invitation-only San Antonio meeting, cosponsored by HHS, NIH, and the Southwest Foundation for Biomedical Research, is held.

* Public regional meetings are held in Los Angeles and Farmington, Conn.

March 1992

* Regional public meetings are held in Atlanta and St. Louis.

June 1992

* National Task Force of 150 to 200 scientists to meet June 23-25.

July 1992

* Third NIH-wide directors' meeting is scheduled. Some extramural scientists and members of the public are invited.

Fall 1992

* Continued strategic planning meetings will take place.

--B.M. and S.H.

The official requests anonymity, as do almost all of the sources quoted in this story--a reflection, it seems, of the cautious attitude many scientists are taking toward the agency and the planning process.

According to NIH, 1,100 individuals from the scientific community testified at one or more of five meetings held nationally in Texas, Connecticut, Georgia, California, and Missouri to elicit comment on the "Framework for Discussion of Strategies for the NIH," the working title of the plan. In addition, NIH has received 180 written statements. The information is being analyzed and organized into an information resource to be used in the strategic planning, say NIH officials. The document under discussion at the meetings is a modification of an earlier report covering about a dozen areas, but containing no policy component (see story on page 10).

The tone and tenor of the disenchantment within the scientific community became apparent at the first regional meeting, an invitation-only hearing in San Antonio, Texas, in February. An extramural scientist, a cochairman of the main panel, criticized NIH because "background papers and other documents were delivered too late to allow us sufficient preparation time for productive discussion." Another extramural member commented that his panel "could not endorse the trans-NIH documents because they needed much more scientific input and review to be truly valuable to their deliberations."

Referring to the NIH regional planning meetings as "road shows," members of scientific societies question whether large-scale national meetings are an effective way to get the job done. Used to working in small, intense groups in which unlimited discussion and exploration of ideas generate a document that is then circulated among and revised by its authors, the society members say they are somewhat taken aback by the amorphousness of the strategic planning process and its goal.

But NIH officials contend that many of the issues discussed thus far are specific and vital to most basic researchers, and that non-NIH personnel are heavily involved in the effort. As an example, NIH officials point to an in-depth analysis of peer review, begun in November, that addresses problems that were on the minds of scientists who testified at the regional meetings. The peer- review panel, made up of extramural and intramural scientists, is expected to release a report in about a month.

Also as part of the strategic planning process, says Jay Moskowitz, associate director for science policy and legislation at NIH, a study will soon begin to examine how the agency trains future scientists. This examination, he notes, is also to be undertaken by members of the extramural scientific community along with NIH intramural staff.

NIH officials, individual investigators, and society administrators differ over how the process should have begun and when or if it should end. These differences are shaded with doubt and mistrust. A bench scientist from an independent research institution says he "doubts the sincerity of NIH's original intent to involve scientists in the process."

NIH officials say the strategic plan is an ongoing activity. They say it is a dynamic and evolving process that will communicate findings and recommendations in ways ranging from written plans to public hearings, as appropriate, rather than one big, finite plan to be finished at the end of a certain period.

In the extramural community, however, the popular conception is that the process will produce a plan that will become a static management guide to be followed with relatively little change until it is time to enter the next planning cycle.

At the regional meetings, NIH director Bernadine Healy said that "the framework for discussion [the discussion document for the strategic plan] is not a grand design that imposes rigid timetables or predictions about the future. Rather, it is a process for our corporate thinking and for charting a course that will prepare NIH for the future."

However, some members of Congress and leaders in the scientific community believe that Healy's intention in instituting the process is to gain substantial increases for the NIH budget.

Robert Rosenzweig, president of the Association of American Universities, says, "Our biggest worry is that the plan not confuse strategy with tactics in its effort to reach for funding. In short, NIH has to be careful not to overpromise economic benefits."

Some bench researchers continue to question whether NIH really is interested in what the scientist has to say. One geneticist at a Southern California independent research institute "believes the strategic planning process is a closed activity," being scripted by NIH officials.

"The loss of faith occurred early on, when NIH prepared a rather massive document about science in-house without benefit of the outside community's thoughts," adds a member of the Society for Research Administrators, in reference to the earlier document.

In response, Moskowitz points out two more upcoming planning meetings. The first, to be held from June 23 through 25, will bring together 150 to 200 extramural scientists, referred to by both Healy and Moskowitz as "the national task force." The group was called for by a panel at the San Antonio meeting.

Following the June meeting, Moskowitz says, NIH institute and center directors will convene in July. This meeting will include some extramural scientists and others invited to help refine further a strategic planning document that NIH intends to release before the end of this calendar year.

"It [the strategic plan] must reflect the will and resolve of the community, including the various scientific groups and research institutions," says Moskowitz. "There should be no end to the [strategic planning] effort; rather, flexibility must remain part of the plan itself and the plan updated and revised as warranted."

Moskowitz also promises that, while the June and July meetings are the last for this fiscal year, a new round of planning process events will take place beginning in the fall.

In recent testimony before the House Committee on Science, Space, and Technology, Healy reported that some clear themes have emerged from the regional meetings. Following are some of the issues that have been brought out.

* Despite initial skepticism from many sectors, the concept of strategic planning for NIH has been strongly endorsed by the extramural community.

* The fundamental role of investigator-initiated research in the advancement of health science has been reaffirmed. NIH's commitment to the ideas and contributions of individual scientists is regarded as imperative.

* The importance of the current peer-review system also has been emphasized.

* The importance of expanding public-private partnerships in the biomedical research enterprise has been highlighted.

* A strategic plan should address resource allocation issues relative to facilities and instrumentation requirements.

Other discussions emphasized the training and support of new investigators, suggested that advisory council operation and effectiveness be reviewed, and recommended that the NIH mission and goals be modified to reflect a mission of international scope.

Bradie Metheny and Shirley Haley write and publish the Washington Fax, a daily science-policy newsletter.