NIH Working Group Recommends Opening the Doors of the Clinical Center to External Investigators

by Gillian Parrish, Manager of Alliance Development and Communications
Last week, an eight member working group of the National Institutes of Health’s (NIH) Scientific Management Review Board (SMRB) issued recommendations for improving the fiscal sustainability and utilization of the NIH Clinical Center, which comprises almost 6,000 scientists and constitutes nearly ten percent of the NIH’s budget.

After over a year of deliberation – and consultation with dozens of internal and external stakeholders from research hospital administrators to potential external users of the Clinical Center to key NIH investigators and advisors – the group, chaired by University of Pennsylvania School of Medicine’s Executive Vice President Arthur Rubenstein, offered three core recommendations:

1. That the NIH Clinical Center expand its vision and role to serve as a state-of-the-art national resource for both internal and external investigator use.
2. That the governance structure of the Clinical Center be modified to facilitate the development and implementation of an overall strategic vision for clinical research, including eliminating oversight by the NIH Steering Committee and establishing a new governing board comprised of Institute and Center directors.
3. That the Clinical Center maintain a stable, responsive budget underpinned by priority setting and funded as a line item in the Office of the Director appropriation.

The working group’s recommendations in many ways echoed those set forth by a FasterCures’ task force chaired by Nobel Laureate Dr. David Baltimore, which in January of 2009 called for the IRP to adopt a new, more outcomes-focused mission that was capable of responding quickly to opportunities and challenges in translational research. At the time, the task force called upon NIH to articulate an overarching mission for the IRP and lay out a strategy for meeting goals over the next five years, focused specifically on advancing translational and clinical research in the interest of public health. It also suggested that the SMRB be tasked with reviewing options for funding the Clinical Center to enhance greater utilization and removing the current disincentives for use.

In May of this year – together with 86 other patient organizations – FasterCures again urged the SMRB to open up clinical center facilities to other researchers through a joint letter to the board.

As our nation’s crown research jewel, the Clinical Center features some of the greatest scientific minds using the most advanced medical technologies in the world. It ignites hope and has a distinguished history of discovery, yet remains underutilized due to fiscal and governance constraints. The workgroup’s recommendations chart a path forward for advancing the cause of clinical research, both within and beyond the agency.
We hope to see the NIH leadership act upon these recommendations and continue the focus on advancing translational and clinical research in the interest of public health. They have already demonstrated a commitment to integrating efforts, collaborating across sectors, and working together to meet the goal of getting therapies to patients faster.
Relevant FasterCures Resources:

• Patient Advocacy Letter to NIH Director Calling for Greater Access to the Clinical Center
• Recommendations from the FasterCures Task Force on the Intramural Research Program