Summary: The primary source of federal funding of biomedical research is the National Institutes of Health (NIH). Its basic goals are the discovery of the biological bases of health and disease and the development of safe and effective means of disease prevention, detection, diagnosis, and treatment. NIH carries out its research efforts through responsibilities and programs pertaining to each specific institute or cutting across institute lines, and fosters research through contracts, intramural projects, and grants -- primarily the latter. Internal management controls are the key to assuring that activities proceed efficiently, effectively, and economically. GAO reviewed the internal controls of NIH with emphasis on research activities planning and the evaluation of accomplishments.
The NIH consolidated evaluation plan is formed by combining the evaluation plans of the institutes, and is then reviewed by the Public Health Service (PHS) and the Department of Health, Education, and Welfare (HEW). Evaluations are funded jointly by a 1-percent set-aside and NIH research program funds. Because of the breadth of many programs, only a few aspects are evaluated at a time. Since evaluation reviews are lengthy procedures, NIH has often hastened the process by using research funds. Recently, HEW has been disapproving many evaluations accepted by NIH, for reasons of scope, subject, or approach; this is partly due to confusion at NIH as to the proper use of set-aside funds. NIH also staffs research planning more heavily than evaluation and ties evaluation and other functions too closely together. GAO is reviewing the advisory bodies which oversee research grants by the institutes and are comprised of scientists and physicians, interested laymen, and ex-officio representatives of related federal agencies. Problems exist as to appointments to these groups: delays occur in preparing nominations to fill vacancies because of the avowed importance of preserving the greatest possible geographical, ethnic, sex, and professional diversity. Some vacancies remain for 6 months or more. Grant requests submitted to NIH must be approved at several different levels where various actions may be taken, ranging from acceptance to outright rejection.
