Reflections on the NIAAA/NIDA Merger, Part 2

Francis Collins

Part 1 here.

The current merger plan arose out of a request by the U.S. Congress, accompanying the FY2001 appropriations act, that NIH engage the National Academy of Sciences to conduct a study of “whether the current structure and organization of NIH are optimally configured for the scientific needs of the twenty-first century.”(21) The resulting 2003 NAS report sought to define principles via which to better organize and coordinate the research enterprises across NIH’s 27 separate institutes.(22) Collapsing NIAAA and NIDA into a single institute was one of two possible institute mergers suggested for further study in the NAS report.(23) NIH devoted still more energy to the question of optimal organizational structure later in the decade. NIH’s Scientific Management Review Board (SMRB) was created under the National Institutes of Health (NIH) Reform Act of 2006 “…to advise the NIH Director and other appropriate officials on the use of certain organizational authorities reaffirmed under the same act.”

Four working groups were constituted in the SMRB, including the Deliberating Organizational Change and Effectiveness (DOCE) Working Group and the Substance Use, Abuse, and Addiction (SUAA) Working Group.(24) In November, 2010, the SMRB published a report offering a series of guiding principles for organizational change at NIH, developed by the DOCE Working Group.(25) Also in November, 2010, and after considering the assessments and options offered by the SUAA Working Group, the full SMRB issued a report recommending the dissolution of NIAAA and NIDA, and the creation of a new institute “for substance use, abuse, and addiction-related research.”(26) NIH Director Francis S. Collins’ statement of November 18, 2010 recommended the creation of the merged institute and requested NIH Principal Deputy Director Lawrence A. Tabak and National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD) Director Stephen I. Katz to impanel an NIH task force to make recommendations as to which substance use, abuse, and addiction research programs should be imported into the new institute and which current NIAAA and NIDA programs should be relocated to other NIH entities.(27) On September 12, 2011, NIAAA and NIDA advisory councils held their first joint meeting, at which various aspects of merger were discussed.(28) In a presentation dated December 8, 2011, Tabak offered an “action timeline” for the new institute, projecting its launch in October, 2013 (FY2014).(29)

Along the way, NIAAA’s Advisory Council reacted sharply against the evolving merger plan. The Council passed an unopposed resolution (14 favored, 0 opposed, 1 abstained) in February, 2010, “strongly advising NIH against a reorganization that eliminates NIAAA as an independent institute.”(30) (NIDA’s Advisory Council, on the other hand, voted unanimously in favor of merger on March 1, 2010.)(31) The NIAAA Council’s resolution offered fully a dozen reasons for rejecting merger, each discussed in turn: (32)

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