Who sets research priorities and goals at the National Institutes of Health? Obviously, scientists who have requisite knowledge of biomedicine play a major role. But a recent study by the Institute of Medicine (IOM) calls for changes at NIH that could give the public a bigger part in setting the scientific agenda. And an IOM report released July 8 is bound to stir debate over priority setting at the nation's single largest source of funds for biomedical research.

In March of this year, IOM, under congressional direction, began hearings to determine whether NIH was responsive to public and political concerns in biomedical research priorities (B. Agnew, The Scientist, 12[7]:1, March 30, 1998). While many advocacy groups claimed that they are essentially locked out of the research priority-setting process, NIH Director Harold Varmus defended the system and invited people who felt left out to E-mail him with their...

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