Q&A: Proposed reforms to NIH may have ‘significant impact’ on vision research
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In June, the House Energy and Commerce Committee published recommendations to reform the NIH, including consolidating the National Eye Institute into a Neurological Science and Brain Institute.
“We will always work to ensure that the National Eye Institute is an independent and distinct institute within the NIH, because we believe that appropriately reflects the value and importance of vision, as well as the advancements in vision research,” Dan Ignaszewski, executive director at the National Alliance for Eye and Vision Research, told Healio.
Healio spoke with Ignaszewski about the danger these proposed reforms pose to vision research and how people can voice concerns about the proposal.
Healio: What are the proposed reforms?
Ignaszewski: There are a few different reform recommendations that are in the proposal. The biggest concern that we have is really centered around that consolidation of the National Eye Institute into a broader Neuroscience and Brain Research Institute. It would combine the National Institute of Dental and Craniofacial Research and the National Institute of Neurological Disorders and Stroke, along with the National Eye Institute, into this broader institute.
The concern is that there are a lot of aspects of vision research that don’t apply just to the nervous system, and if a consolidation like this were to move forward, there’s concern that it would have a significant impact on the prioritization of vision research as a whole.
The proposal also has recommendations for term limits for the directors and some recommendations in terms of reporting requirements from NIH and some of the institutes themselves. There are requirements around more transparency and accountability for the institutes, the grantees and the staff at the institutes, which we understand and are open to more of a dialogue on with Congress.
The big thing is this consolidation effort brings together all three of those institutes, reducing the overall number of centers from 27 to 15. Seeing vision research reclassified under this broader scope could impact the future of vision research funding.
Healio: What hurdles will this create for research funding?
Ignaszewski: The main concern is that it could allow for significant shifts in priorities. What I mean by that is when you consolidate these three institutes and you create this new institute around neuroscience and brain, in theory, they would come up with a new mission, and that mission likely would not include vision directly the way that the National Eye Institute has focused on vision.
What that would lead to is the potential for a director coming into that institute who would have a lot of decisions to make in terms of how they’re going to fund research within their space, and that could shift not only from administration to administration, but also from director to director or from year to year. A director may decide they’re going to fund almost all the research in neuroscience and brain, and front of the eye gets nothing.
Now having a dedicated institute, with the National Eye Institute, you have a mission that aligns with the focus of vision research as a whole: improving vision, improving vision care and vision outcomes for patients, including the front of the eye, the back of the eye, the neuro piece, all of it.
It’s not clear that there will be a place for research on a lot of the diseases, like vascular disorders, uveitis, corneal injuries and dry eye disease under this reform proposal, if the director or whoever led that new institute didn’t see that as aligning with their mission. This could significantly reduce or hamper future vision research funding for front and back of eye.
Healio: How could this affect practicing clinicians?
Ignaszewski: I think there are probably two ways. They would likely experience more challenges in securing research funding for those clinicians that also conduct research. If they apply for grants, they will have a much broader competition base that’s not just in vision research, but in all of neuroscience and brain.
From a practicing clinician standpoint, they may not see significant changes initially or immediately, but with the potential impact on vision research as a whole, there would be long-term applications and implications in the advancement of careers. There would be fewer advancements in diagnosis, treatment methodologies and clinical care, frankly, that can improve patient outcomes.
You’re going to see fewer of those advancements over the long run, because you’re not going to have the clinical science funding that is going to be focused enough on vision research to be able to advance those things. You’ll see fewer advancements from the pharmaceutical industry because the pipelines will not be developed in the same way or at the same levels with less funding.
Healio: How likely is this proposal to pass?
Ignaszewski: These proposals are not likely to pass this year, but there is a chance that this could see the light of day again next year and in future years, depending on the makeup of who controls what branches of government.
I would say that broadly, there’s a bipartisan interest in looking at how to reform and make adjustments to NIH and have NIH be more efficient and effective. We support those efforts. We want to see transparency and accountability and make sure that tax dollars are going to the right things and that we’re funding things appropriately. The NIH as a whole is doing very well at that, but in Congress there is bipartisan support to continue to improve government operations, and that includes the NIH.
This specific proposal is divided right now along party lines. This proposal was produced by Republican leadership. Those in favor have been Republican and those opposed have been Democrat. One of the Democratic leaders, Rep. Rosa DeLauro from Connecticut, emphasized in her testimony of the subcommittee that when discussing NIH reform we need to engage stakeholders, we need to have public hearings and we need to come to a bipartisan consensus on how we can make these reforms.
Healio: What can eye care professionals do to advocate and generate awareness about this?
Ignaszewski: We’ve actually drafted a sign-on letter that we’re going to submit to all stakeholder groups, so we’re seeking input from professionals, professional organizations, provider networks, nonprofit organizations and associations, and industry companies. We want to try and make a robust argument that we’re concerned about this consolidation effort. We’ll be sending that to Congress with as many sign-ons as we can get before the Aug. 16 deadline, expressing our concern about the consolidation.
The first step is getting practitioners to either have their practice sign on or share it within their networks. The second thing that we have done is that we have drafted a template response letter for the Energy and Commerce Committee. They’ve asked for submissions of comments about their proposal and recommendations by Aug. 16. We have an online tool with a template letter that can be submitted to that inbox to submit formal comments.
We’re advising the entire vision community, providers, researchers, everybody, come together and support some of the concerns that we’re going to raise in that template letter. The more people who can take action, the more opportunity we have to express our concerns with the consolidation effort.
Reference:
- Reforming the National Institutes of Health framework for discussion. https://d1dth6e84htgma.cloudfront.net/NIH_Reform_Report_f6bbdca821.pdf. Accessed Aug. 9, 2024.
For more information:
Dan Ignaszewski is executive director of the National Alliance for Eye and Vision Research and the Alliance for Eye and Vision Research. He can be reached at advocacy@eyeresearch.org.
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