The House Energy and Commerce Subcommittee on Health held a hearing on June 2, titled "Scientific Opportunities and Public Needs: Balancing NIH's Priority Setting Process." This was the fifth in a series of hearings designed to highlight research activities at the NIH. The goal of these hearings is to educate members of Congress about NIH's work so that the committee can assess how to help the agency better meet its mission.

Subcommittee Chairman Michael Bilirakis (R-Fla.) stated that members need to understand how the NIH chooses what research to conduct and how that research is funded. Ranking Subcommittee Member Sherrod Brown (D-Ohio) stated that most members have tried to steer clear of efforts to compromise the flexibility NIH has to allocate its resources.

Rep. Joe Barton (R-Texas), chairman of the House Committee on Energy and Commerce, stated that he wants "the most effective, state-of-the-art NIH for the 21st century that gets the biggest bang for the taxpayers' bucks and the private sector dollars that are coordinated with what NIH does."

Invited to present testimony at this hearing were NIH Director Dr. Elias Zerhouni and the directors of NCI, the National Institute of Allergy and Infectious Diseases, and the National Institute on Drug Abuse. Dr. Zerhouni noted that NIH's goal is "to reduce both the disease burden as we know it today and the potential disease burden as it may occur in the future." He explained how NCI uses the Surveillance, Epidemiology, and End Results (SEER) program to track America's cancer burden.

NCI Director Dr. Andrew C. von Eschenbach told the committee how mortality rates from cancer were declining due to the progress in biomedical research and that achieving the 2015 goal of eliminating suffering and death from cancer will necessitate establishing priorities and investments that are required to achieve this goal. He described the balance of NCI's research portfolio across the discovery, development, delivery continuum, and then explained how the portfolio is managed by a decision- making process that includes external input at multiple points in the process.

The concluding discussion centered on questions about how to optimize the structure of NIH, specifically, whether Congress should reorganize the NIH through legislation or NIH should be given some institutional authority to restructure. Each of the witnesses had the opportunity to offer an opinion; Dr. von Eschenbach suggested that NIH structure should be driven by function and supported, giving the NIH director flexibility to advocate interaction among institutes and centers when appropriate.