NATIONAL ADVISORY COUNCIL ON AGING
The Sixty-Ninth Meeting
Summary Minutes:
September 26-27, 1996
National Institutes of Health
Building 31, Conference Room 6
Bethesda, Maryland 20892
CONTENTS
- Call to Order
- Director's Status Report
- Consideration of Minutes of Last Meeting
- Future Meeting Dates
- Review of Applications
- Report on the Advisory Committee to the Director, NIH and Meeting of Council Representatives
- Working Group on Program
- Minority Task Force Report
- Alzheimer's Disease Centers
- Comments from Retiring Council Members
- Adjournment
- Certification
Department of Health and Human Services
Public Health Service
National Institutes of Health
National Institute on Aging
NATIONAL ADVISORY COUNCIL ON AGING
SUMMARY MINUTES
September 26-27, 1996
The 69th meeting of the National Advisory Council on Aging (NACA) was convened on Thursday, September 26, at 9:00 a.m. at the Hart Senate Office Building to observe the hearing of the Senate Special Committee on Aging and the Senate Committee on Appropriations on Investing in Medical Research: Saving Health Care and Human Costs. Three panels of witnesses testified at the Hearing: Panel 1 included persons personally affected by illness or injury. Members of Panel 1 included Travis Roy of Maine; a young man with a severe spinal injury; Zenia Kim of Oregon, a student concerned about careers in medical research; Joan Samuelson of California, Parkinson's disease patient and advocate; Rod Carew of California who lost a daughter to leukemia; and General Norman Schwarzkopf of Florida, a cancer patient. Panel 2 was composed of persons involved with medical research. Dr. Richard Hodes, Director, National Institute on Aging (NIA), National Institutes of Health (NIH) was a witness. Council members expressed their appreciation for the opportunity to attend the Hearing.
Following the Hearing, the meeting resumed in Building 31, Room 10 on the NIH campus. New members were introduced. They are: Mr. Hugh Downs, ABC News, Dr. James Jackson, University of Michigan, and Dr. William Hazzard of Bowman Gray Medical School. Dr. Helen Blau of Stanford University and Dr. Jeffrey Bluestone, University of Chicago, also are new members of the Council but were unable to attend this meeting. Dr. Hodes introduced and welcomed Dr. Marcelle Morrison-Bogorad who will shortly become Associate Director, Neuroscience and Neuropsychology of Aging Program.
In accordance with the provisions of Public Law 92-463, the meeting was open to the public on Thursday, September 26, from 2:00 to 3:00 p.m. and on Friday, September 27, from 8:30 a.m to 12:00 noon. The meeting was closed on Thursday, September 26, from 3:00 p.m. to recess for the review, discussion, and evaluation of grant applications in accordance with the provisions set forth in Sections 552(b)(c)(4) and 552(b)(c)(6), Title 5, U.S. Code, and Section 10(d) of Public Law 92-463. 1
Council Participants:
Dr. Carol A. Barnes Mr. Jorge J. Lambrinos
Dr. Robert N. Butler Dr. Gerald E. McClearn
Ms. Norma M. Downey Dr. John Q. Trojanowski
Mr. Hugh Downs Dr. Robert B. Wallace
Dr. William Hazzard Dr. Eugenia Wang
Dr. James Jackson Dr. Anne B. Young
Ex Officio Participant:
Dr. George F. Fuller
The Council Roster, which gives titles, affiliations, and terms of appointment, is appended
to these minutes as Supplement A.
Members of the Public Present:
Nancy Aldrich, Aging Research and Training News
Gail Harris, IQ Solutions, Inc.
Al Nugent, MRI
Angela Sharpe, Consortium of Social Science Associations
Paula Skedsvold, Society for the Psychological Study of Social Issues and American
Psychological Society
Sharnin Spencer, American Psychological Society
In addition to NIA Staff, other Federal employees attending were:
Jo Pelham, DRG
Daniel McDonald, DRG
David Shurtleff, NIDA
The Director's Status Report is not currently available.
Budget
Dr. Hodes Reviewed FY 1997 budget proposals. The President's budget is a 2.2% increase over the FY 1996 budget, an increase less than the rate of inflation. The House allowance is a 6.8% increase over FY 1996, and the Senate allowance a 4.1% increase. It is anticipated that a budget bill will be passed and signed by the President early in FY 1997.
Congressional language for NIA is not directive but does urge continued support for Alzheimer's disease, demography and the biology of brain disorders, and urges a training initiative designed to serve researchers in the behavioral sciences. House language urged that increases be for science rather than for administrative support. The House allowance would provide one year funding for construction of the new Clinical Center, while the President's budget allowed for the entire project. The Senate proposed $70 million for the Clinical Center, $20 million less than the House. The Senate also proposed central support for AIDS research, whereas the House did not. The Senate report language for NIA identified as special focus areas: Alzheimer's disease, cardiovascular disease, malnutrition and caloric restriction, osteoporosis and bone biology, and training in the behavioral sciences.
Reacting to remarks made by Senators at the Hearing on Investing in Medical Research, Council members inquired about whether the process by which resources are allocated across NIH merits reconsideration. There was general recognition that the current process is based on historical precedent. Dr. Hodes responded that the issue has arisen, but that he senses no press to alter the process. He went on to say that there is interest in explaining to Congress NIH's planning process for setting priorities and allocating resources. Council members were impressed at the extent to which Members of Congress understand scientific advances and research needs, as well as the need to balance support for training and research, and noted the difficult challenge between supporting science and the drive for a balanced budget, given that only 18% of the budget is for discretionary programs. Council further acknowledged the need to broaden public understanding of science and underlined its commitment to improving communications with the public.
The minutes of the May 22-23, 1996 meeting were approved as submitted.
- January 30-31, 1997 (Thursday-Friday)
- May 22-23, 1997 (Thursday-Friday)
- September 25-26, 1997 (Thursday-Friday)
- February 5-6, 1998 (Thursday-Friday)
- May 21-22, 1998 (Thursday-Friday)
- September 24-25, 1998 (Thursday-Friday)
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This portion of the meeting was closed to the public in accordance with the determination that it was concerned with matters exempt from mandatory disclosure under Sections 552b(c)(4) and 552b(c)(6), Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. Appendix). 2
A total of 489 applications requesting $332,904,028 for all years were reviewed. Council recommended 319 for a total of $200,684,660 for all years. The actual funding of the awards recommended is determined by the availability of funds, percentile ranks, priority scores, and program relevance.
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Dr. Trojanowski, representative to the Advisory Committee to the Director (ACD), NIH reported on the June 17 meeting. The ACD heard Drs. Levine and Paul of the NIH AIDS Research Office present a report on progress made during 15 years of AIDS research supported by NIH. A series of recommendations to enhance the program covered strategies to increase the pace of AIDS research to develop breakthroughs in AIDS prevention and therapies. They included both administrative and scientific topics, such as upgrading the AIDS information system and data base, maintenance of leadership in the Office of AIDS Research, increasing attention to pursuit of alternative therapies for HIV, immunological research, opportunistic infections, networking adult drug trials, and to restructuring drug discovery research efforts.
A second agenda item was discussion of the report "Implementation Proposal on Recommendations by the Commission on Research Integrity," led by Drs. William Raub, Bruce Alberts and Francis Cordova. Discussion emphasized the importance of scientific integrity and efforts to prevent misconduct, but at the same time avoidance of litigious approaches and/or trivial grievances that disrupt persons' lives and impede the conduct of science.
Dr. Michael Gottesman, Deputy Director, Intramural Research, updated the ACD on the status of the NIH intramural research program, including statistics on appointments, promotions, and tenure by gender and ethnic status. He also noted the establishment of inter-institute interest groups to encourage communication among scientists across institutes.
Collaborative funding with other organizations was addressed by Drs. Wendy Baldwin and Sue Shaefer. Specific focus was on recent changes in interactions between NIH and the Howard Hughes Medical Institute that are expected to improve interactions among investigators and introduce flexibility into the grant application, review, funding, and award management process.
The ACD was updated on reinvention activities, particularly on electronic systems, exploration of changes in the conduct of second tier review, and exploration of roles of councils and boards in policy and planning.
Dr. Trojanowski also participated in the National Advisory Councils' Board of Representatives meeting immediately following the ACD. The meeting was a follow-up of an initial meeting conducted in March 1996.
Subcommittees reported as follows: (1) Dr. Newton, Chair of the Intramural Research Review Committee reported that the NIH manual for review of intramural programs and scientific directors was reviewed and found to be outstanding. Only minor suggestions were made. The subcommittee completed its work. (2) Drs. Galler and Gillman reportedon issues related to peer review, including portfolio balance and limitations on funding. The Subcommittee on Advocacy, chaired by Dr. Silverstein, underlined the need for Council members to act as advocates for NIH in many venues. Dr. Graham, reporting for the Strategic Planning Subcommittee, outlined issues concerning the manner in which Council members provide advice on the planning activities of their respective institutes. Dr. Trojanowski commented that although we can learn from other Councils, it was impressive to compare how well NIA does in involving Council members in the planning process compared to other institutes. For example, members of the National Advisory Council on Aging are familiar with program source books and other facets of the planning process. Reports of the subcommittees will be completed and forwarded to Dr. Varmus.
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Dr. Trojanowski reported on the September 25, 1996 meeting of the Working Group on Program. The following items were addressed:
1. Follow-up and Council feedback on NACA review of programs. A summary document was distributed that outlined ways in which the NIA program staff proceeds with its scientific planning process. Notably, there were a number of new ways in which NACA can interact with NIA program staff in this planning process. For example, Council members can use a list serve to communicate new ideas to other Council members and program staff. Further, with the availability of program source books on the internet, it will be possible for Council members to be updated on the contents of the NIA programs' source books. Council discussed the importance of rapid and timely communications among Council members and program staff to disseminate information that could lead to the implementation of new programs or initiatives. Hopefully, the mechanisms discussed will provide a way to accomplish the type of rapid communication that Council members desire.
2. Planning discussion on Alzheimer's Research Centers. Dr. Hodes introduced documents describing the Alzheimer's Disease Centers Program of the NIA and provided a briefing document as background material to a NACA discussion of the future directions of this program. The most difficult issue was to consider how to configure the current Center program utilizing both the P30 and the P50 mechanism in view of a budget that may remain flat or not increase sufficiently to keep pace with inflation. These issues were to be reviewed with NACA.
3. Interim reports: Dr. Trojanowski summarized the status of the NACA interim reports that are being developed or planned for the future. The interim report on frailty was accepted at the previous Council meeting and is being prepared for distribution to Council members as well as to members of the House and Senate. The caloric restriction interim report was reviewed in its amended form and accepted as a final document by NACA. A draft report on sleep disregulation was considered to be thorough, but too detailed and long. Several recommendations for shortening this document were made. This document in its amended form will be presented to the next Working Group Meeting and then to Council. Additional interim reports that are in the planning stage are: (1) disease prevention in the elderly; (2) on minority aging and care arrangements; (3) genetics and aging; and (4) translation research to improve the health care of the elderly.
4. Training: Dr. Robin Barr summarized the efforts to standardize career development award mechanisms across all institutes and reviewed these mechanisms. Training programs will be discussed at the next meeting.
5. Animals and research: A copy of a letter from Dr. Anthony Fauci to all NIH directors was distributed together with a document entitled "Concerns Related to the Use of Animals and Biomedical Research." The letter and the appended document draw attention to the fact that 50% of all grants at the NIH (and approximately the same percentage of grants at the NIA) include animal research at a time when the cost of animal care continues to increase, regulations are becoming burdensome and there is a paucity of academic veterinarians who are in a position to provide expertise on the use of animals to investigators in diverse areas of basic and clinical research. Members appreciated the complexity of this issue and the fact that it affected all institutes at the NIH. Dr. Hodes indicated that measures were being taken by NIH to devise a strategy for dealing with this problem. Council asked staff to keep them informed on these issues.
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Dr. Wang reported on the meeting of the Minority Task Force. NIA is continuing its program of organizing regional meetings to recruit minority scientists into aging research. Recent meetings have been held in Miami and Los Angeles. A meeting will take place in Boston on October 30. Feedback from faculty and students is that both groups feel they profit from meeting staff and from learning about NIA programs.
An intensive Technical Assistance Workshop will be held in Bethesda just prior to the annual meeting of the Gerontological Society of America in November. Participants will present their own research ideas and receive assistance in preparation of research grant applications.
Dr. Barr presented data on the Minority Dissertation RFA in response to a request at the May meeting to evaluate special initiatives designed to increase the cadre of minority researchers in aging. Data were collected on productivity and current careers of Minority Dissertation Award recipients. Overall, about 50% of awardees have completed their dissertations. However, of the 1993 awardees, all have completed their dissertation work (doctoral degrees). Most have remained at the institutions from which they graduated. One works in industry and one works at NIH. It was pointed out that the number of award recipients is small, only 29.
Further discussion was on career development, particularly on the steps to becoming an independent investigator following the postdoctoral experience. Mentoring and networking were noted as important to career development in general. For minority scientists in particular, institutions need to be educated on how to utilize their minority student and faculty resources most effectively. One member raised the issue of whether these well-intentioned programs may be encouraging minority scientists into research careers at a time when jobs and research funding are becoming scarce.
Council members were asked to share successful recruitment and retention experiences. Several noted the importance of mingling with the local community structure and working within that structure.
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The Council was briefed on NIA's Alzheimer's Disease Centers program and advised the Director, NIA about the future of the program. The Alzheimer's Disease Centers program is 13 years old. There are 27 funded Centers. Of these, 14 are P50 centers that include projects, cores, education and dissemination activities, and 13 are P30 or core centers. NIA has decided that open competitions will take place when Centers submit continuation applications. Ongoing Centers will compete with new applicants, and P30 Centers may compete for P50 awards and vice versa. Although the Institute and Council were comfortable with this decision, both recognize that there are problems with level of funding given constant dollars allocated for research centers. Further it was agreed that peer review be stringent, taking into consideration the value of cores and research infrastructure and the quality of the research projects for those Centers that include fully developed projects (P50s). A new element to be included in the Request for Applications will be a requirement for data sharing among Centers.
Several Council members commented or made suggestions to help NIA assess the program. For example, one member asked how the Centers perform with respect to outcomes, productivity of the cores, and public awareness of AD, and what is the relationship between NIA, NIH administration, and OMB with respect to appreciation of the Centers' program and the impact a constant budget for the program is likely to have? The possibility was raised that if Centers are aware of limitations on growth, they may form new partnerships with other funding sources, such as drug companies, or with one another. Dr. Hodes invited Council members to contact him with suggestions about evaluation of the program. He noted that we can collect information about productivity of the Centers and of breakthroughs in science, but we cannot control for what advances would have occurred without the Centers' program. Other issues addressed included conceptualization of a center as building infrastructure and adapted to resource starting. A measure of a Center's effectiveness might be the extent to which it has contributed to research at the university and the extent to which it has leveraged resources to enhance research. It was noted that breakthroughs in communications technology enhance our ability to communicate and share information easily. The option of specialized centers within the program was brought up. Consequently, it was requested that staff catalog the range of activities that need to be present at all centers and present these to Council and to the Center Directors for discussion. It was recommended that NIA not focus only on accomplishments, but also on goals for the Centers during the next 5 years. Further, it was recommended that each Center Director be asked to articulate his or her vision for the Center and to address its developmental course. Council recommended that persons not associated with the Centers program be included in any evaluation activities undertaken. It also was suggested that NIA examine the experience of other Institutes that have Centers programs.
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Council noted with sadness the recent death of Arthur Fleming. He was remembered as an academic leader and as an advocate for aging to whom the field owes a large debt. It was recommended that NIA identify a way to honor his memory.
Council members who completed their terms at this meeting were invited to make remarks. Dr. Ruth Sager was unable to attend the meeting but was thanked for lending her expertise in basic science to the Council and for her energetic participation in Council activities.
Mrs. Norma Downey was termed the prototypical public member. She is dedicated to and involved with older people and spearheaded establishment of the Friends of NIA. Mrs. Downey spoke of her continuing puzzlement as to the role of public members. She explained that a more clearly defined role will capitalize on the many individual talents that each public member brings. She expressed disappointment that the Friends of NIA had not yet received substantial support and urged Council members to recognize the central role such an organization can have in educating the public about aging research, the National Institute on Aging and the National Institutes of Health. She drew inspiration from the Hearing that Council members attended and saw it as an effective model for communicating to Congress the importance of health research on aging.
Dr. Butler first complimented the current NIA leadership and staff on their dedication and performance but then contrasted that effort with the apparent indifference to the revolution in longevity shown by government and society as a whole. He also spoke of his and the late Arthur Fleming's call to create an intergenerational national service core to utilize the talents and energies of the Nation's 40 million seniors to help young people at risk of dropping out of society. He emphasized the continuing need to train new researchers in aging and the need to be responsive to the rapidly changing demographics of the potential research workforce. He urged that NIA and NIH avoid becoming overly reductionistic and recognize the important contributions of systems-oriented, behavioral, economic and social research.
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The 69th meeting of the National Advisory Council on Aging was adjourned at 12:00 noon on September 27, 1996. The next meeting is scheduled for January 30-31, 1997.
Attachments:
A. Roster of Council Members (Not available)
B. Director's Report to the NACA (Not available)
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I hereby certify that to the best of my knowledge the foregoing minutes and attachments are accurate and complete.
Richard J. Hodes, M.D.
Chairman, National Advisory Council on Aging
Director, National Institute on Aging
Prepared by Miriam F. Kelty, Ph.D.
Made Available: 12/4/96
