FY2009 Budget

DEPARTMENT OF HEALTH AND HUMAN SERVICES

NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute







Organization chart
Org Chart and link to accessible version

For carrying out section 301 and title IV of the Public Health Services Act with respect to cardiovascular, lung, and blood diseases and blood products $2,924,942,000. (Department of Health and Human Services Appropriation Act, 2008)


Amounts Avaliable for Obligation (1)


Source of Funding
FY 2007
Actual
FY 2008
Enacted
FY 2009
Estimate
Appropriation $2,921,757,000 $2,974,900,000 $2,924,942,000
Pay cost add-on 1,172,000 0 0
Rescission 0 -51,972,000 0
Subtotal, adjusted appropriation 2,922,929,000 2,922,928,000 2,924,942,000








Real transfer under Director's one-percent transfer authority (GEI) -538,000 0 0
Comparative transfer to NIBIB -82,000 0 0
Comparative transfer to OD -37,000 0 0
Comparative transfer to NCRR -2,827,000 0 0
Comparative transfers to the Office of the Assistant Secretary for Admin.
and Mgmt. and to the Office of the Assistant Secretary for Public Affairs

-3,000

0

0
Comparative transfer to NIDDK -800,000 -816,000 0
Comparative transfer under Director's one-percent transfer authority (GEI) 538,000 0 0
       
Subtotal, adjusted budget authority 2,919,180,000 2,922,112,000 2,924,942,000




Unobligated balance, start of year 0 0 0
Unobligated balance, end of year 0 0 0

     
Subtotal, adjusted budget authority 2,919,180,000 2,922,112,000 2,924,942,000




Unobligated balance lapsing -68,000 0 0
Total obligations 2,919,112,000 2,922,112,000 2,924,942,000

(1)Excludes the following amounts for reimbursable activities carried out by this account:
FY 2007 - $13,593,000 FY 2008 - $20,000,000 FY 2009 - $20,000,000
Excludes $1,400,000 in FY 2008 and $1,400,000 in FY 2009 for royalties.



Budget Mechanism-Total


MECHANISM
FY 2007
Actual
FY 2008
Enacted
FY 2009
Estimate

Change
Research Grants: No. Amount No. Amount No. Amount No. Amount
Research Projects:
     Noncompeting 2,843 $1,446,190,000 2,801 $1,448,676,000 2,903 $1,473,161,000 102 $24,485,000
     Competing 937 462,749,000 896 446,805,000 842 420,072,000 (54) -$26,733,000
Subtotal, RPGs 3,780 1,908,939,000 3,697 1,895,481,000 3,745 1,893,233,000 48 -$2,248,000
SBIR/STTR 174 73,515,000 169 71,250,000 170 71,500,000 1 $250,000
Subtotal, RPGs 3,954 1,982,454,000 3,866 1,966,731,000 3,915 1,964,733,000 49 -1,998,000
     Research Centers:
     Specialized/comprehensive 55 140,664,000 48 128,750,000 48 128,750,000 0 0
     Clinical research 0 0 0 0 0 0 0 0
     Biotechnology 0 0 0 0 0 0 0 0
     Comparative medicine 0 420,000 0 0 0 0 0 0
     Research Centers in Minority Institutions 0 0 0 0 0 0 0 0
Subtotal, Centers 55 141,084,000 48 128,750,000 48 128,750,000 0 0
Other Research:





      Research careers 534 72,127,000 556 74,834,000 556 74,834,000 0 0
      Cancer education 0 0 0 0 0 0 0 0
      Cooperative clinical research 48 36,622,000 42 32,800,000 42 32,800,000 0 0
      Biomedical research support 0 0 0 0 0 0 0 0
      Minority biomedical research support 4 2,475,000 4 2,500,000 4 2,500,000 0 0
      Other 99 21,233,000 67 21,500,000 67 21,500,000 0 0
           Subtotal, Other Research 685 132,457,000 669 131,634,000 669 131,634,000 0 0
      Total Research Grants 4,694 2,255,995,000 4,583 2,227,115,000 4,632 2,225,117,000 49 -1,998,000


MECHANISM
FY 2007
Actual
FY 2008
Enacted
FY 2009
Estimate

Change
Research Training: FTTPs Amount FTTPs Amount FTTPs Amount FTTPs Amount
Individual awards 174 8,193,000 176 8,250,000 176 8,310,000 0 60,000
Institutional awards 1,789 85,123,000 1,789 85,123,000 1,789 85,600,000 0 477,000
Total, Training 1,963 93,316,000 1,965 93,373,000 1,965 93,910,000 0 537,000







Research & development contracts 204 300,753,000 207 324,500,000 207 324,500,000 0 0
(SBIR/STTR) (5) (1,274,000) (2) (1,000,000) (2) (1,000,000) 0 0







FTEs Amount FTEs Amount FTEs Amount FTEs Amount
Intramural research 413 168,678,000 414 175,134,000 414 177,845,000 0 2,711,000
Research management and support 401 100,438,000 401 101,990,000 407 103,570,000 6 1,580,000
Cancer prevention & control 0 0 0 0 0 0
0
Construction
0
0
0
0
     Total, NHLBI 814 2,919,180,000 815 2,922,112,000 821 2,924,942,000 6 2,830,000
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research



Budget Authority by Program


FY 2005
Actual
FY 2006
Actual
FY 2007
Actual
FY 2007
Comparable
FY 2008
Enacted
FY 2009
Estimate

Change
Extramural Research FTEs Amount FTEs Amount FTEs Amount FTEs Amount FTEs Amount FTEs Amount FTEs Amount
Detail:












Heart and Vascular Diseases
1,607,188,000
1,632,680,000
1,633,337,000
1,632,011,000
1,628,885,000
1,627,986,000
-$899,000
Lung Diseases
631,725,000
600,892,000
601,134,000
600,646,000
599,496,000
599,164,000
-$332,000
Blood Diseases and Resources
442,082,000
417,578,000
417,746,000
417,407,000
416,607,000
416,377,000
-$230,000















Subtotal, Extramural
2,680,995,000
2,651,150,000
2,652,217,000
2,650,064,000
2,644,988,000
2,643,527,000
-1,461,000















Intramural research 405 170,200,000 402 170,736,000 413 169,560,000 413 168,678,000 414 175,134,000 414 177,845,000 0 2,711,000















Res. management & support 391 90,006,000 395 97,864,000 401 100,614,000 401 100,438,000 401 101,990,000 407 103,570,000 6 1,580,000















TOTAL 796 2,941,201,000 797 2,919,750,000 814 2,922,391,000 814 2,919,180,000 815 2,922,112,000 821 2,924,942,000 6 2,830,000

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research



Major Changes in the Fiscal Year 2009 Budget Request

Major changes by budget mechanism and/or budget activity detail are briefly described below. Note that there may be overlap between budget mechanism and activity detail and these highlights will not sum to the total change for the FY 2009 budget request for NHLBI, which is +$2.830 million more than the FY 2008 Enacted, for a total of $2,924.942 million.

Research Project Grants (-$1.998 million; total $1,964.733 million): The NIH Budget policy for RPGs in FY 2009 is to provide no inflationary increases in noncompeting awards and no increase in average cost for competing RPGs. NHLBI noncompeting grants will increase by $24.393 million in FY 2009. Some of the increased number of grants in the noncompeting mechanism ($6 million) are a result of the Pathways to Independence (K99/R00) program, which will be converted to R00s in FY 2009. NHLBI competing RPGs will decrease by $26.733 million from FY 2008. This decrease will result in the institute funding 54 fewer competing awards. Intramural Research and Research Management Support receive modest increases to help offset the cost of pay and other increases. NHLBI will continue to support new investigators and to maintain an adequate number of competing RPGs.

Research Careers (+/- $0; total $74.834 million): NHLBI will continue to support the Pathway to Independence Program by funding an additional 22 awards in FY 2009. Funds are available as the first round of K99s convert to the R00 mechanism.

Systolic Blood Pressure Intervention Trial (SPRINT) (+$3.070 million): This initiative will support a multicenter randomized trial to determine whether treating systolic blood pressure to a lower goal than is currently recommended can reduce cardiovascular disease.

Medical Education for K-12 Teachers and Students (MKITS II) (+$3.025 million): NHLBI will develop a program, under a contract, that enables experienced PIs to help NHLBI disseminate and evaluate K-12 science education curricula, materials, and educational activities that incorporate best practices learned from previous such programs. These objectives remain unchanged from NHLBI’s original program released in FY 2003.

Integrated Analytical Methods for Large-Scale Multi-dimensional Biomarker, Phenotype, and Genotype Data from the Framingham Biomarkers Project (+$4.0 million): This new project will build upon the Framingham Biomarkers Project by supporting the design of new data integration and analysis methods for extensive heterogeneous biological data and their application to large population studies. Such innovative analytical approaches would seek to model biological mechanisms and disease development processes relevant to the NHLBI mission.

Translating Discoveries in the Behavioral Sciences to Reduce Obesity and Promote Cardiovascular Health (+$5.0 million): This research program would seek to translate findings from basic research on human behavior into effective clinical, community, and population interventions to reduce obesity and promote cardiovascular health. NHLBI anticipates funding 7 awards starting in FY 2009.

Summary of Changes

FY 2008 Enacted $2,922,112,000
FY 2009 estimated budget authority 2,924,942,000
Net change 2,830,000


2008 Enacted
Base
Change from Base

CHANGES

FTEs
Budget
Authority

FTEs
Budget
Authority
A. Built-in:
1. Intramural research:
     a. Annualization of January
         2008 pay increase


$64,071,000


$719,000
     b. January FY 2009 pay increase
64,071,000
1,394,000
     c. One less day of pay
64,071,000
(245,000)
     d. Payment for centrally furnished
         services

28,853,000
433,000
     e. Increased cost of laboratory supplies,
         materials, and other expenses       


82,210,000


1,489,000
Subtotal


3,790,000





2. Research management and support:
     a. Annualization of January 2008
         pay increase


$52,421,000


$588,000
     b. January FY 2009 pay increase
52,421,000
1,140,000
     c. One less day of pay
52,421,000
(200,000)
     d. Payment for centrally furnished services
18,095,000
271,000
     e. Increased cost of laboratory supplies,
         materials, and other expenses


31,474,000


562,000
Subtotal


2,361,000





Subtotal, Built-in


6,151,000

2008 Enacted
Base
Change from Base
CHANGES No. Amount No. Amount
B. Program:
1. Research project grants:
     a. Noncompeting 2,801 $1,448,676,000 102 $24,485,000
     b. Competing 896 446,805,000 (54) (26,733,000)
     c. SBIR/STTR 169 71,250,000 1 250,000
Total 3,866 1,966,731,000 49 (1,998,000)




2. Research centers 48 128,750,000 0 0
3. Other research 669 131,634,000 0 0
4. Research training 1,965 93,373,000 0 537,000
5. Research and development contracts 207 324,500,000 0 0
Subtotal, extramural


(1,461,000)

FTEs
Amount
FTEs
Amount
6. Intramural research 414 175,134,000 0 (1,079,000)
7. Research management and support 401 101,990,000 6 (781,000)
8. Construction
0
0
9. Buildings and Facilities
0
0
Subtotal, program
2,922,112,000
(3,321,000)





Total changes 815
6 2,830,000



Fiscal Year 2009 Budget Graphs

History of budget Authority and FTEs

Graph: Funding by FY and link to data tables for this and 3 graphs immediately following: FTEs by FY, Budget Mechanism breakout, and percent change from 08, by mechanism Graph: FTEs by FY and link to data table

Distribution by Mechanism

Graph: distribution by mechanism and link to data table

Change by Selected Mechanism

Graph: change by selected mechanism and link to data table

Justification of Budget Request

Authorizing Legislation: Section 301 and title IV of the Public Health Service Act, as amended.

      FY 2007
      Actual
      FY 2008
      Enacted
      FY 2009
      Estimate
      Increase or
      Decrease
FTE BA FTE BA FTE BA FTE BA
814 $2,919,180,000 815 $2,922,112,000 821 $2,924,942,000 6 $2,830,000

This document provides justification for the Fiscal Year (FY) 2009 activities of the National Heart, Lung, and Blood Institute (NHLBI), including HIV/AIDS activities. Details of the FY 2009 HIV/AIDS activities are in the “Office of AIDS Research (OAR)” Section of the Overview. Details on the Common Fund are located in the Overview, Volume One. Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; Contracts; Direct Federal/Intramural and Other.

DIRECTOR'S OVERVIEW

The NHLBI provides global leadership for a research and education program to promote prevention and treatment of heart, lung, and blood diseases. The vision is to enhance the health of all individuals and thereby enable them to lead longer and happier lives.

To achieve this vision, NHLBI supports and guides research on the prevention, causes, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases. The NHLBI supports individuals in private and public sectors working in fields related to its mission area, and the education of investigators working across the spectrum of scientific discovery. The NHLBI creates and supports a robust, collaborative research infrastructure in partnership with private and public organizations, including academic institutions, industry, and government agencies, to address the scientific and educational needs of the nation. The NHLBI collaborates with individuals, families, communities, physicians, scientists, health care professionals, professional societies, patient advocacy groups, and the media to ensure wide dissemination and maximal use of knowledge to reduce human suffering and benefit individual and public health.

The pursuit of this vision and mission occurs in a spirit of service that exemplifies excellence, innovation, integrity, respect, and compassion.

The NHLBI Strategic Plan

With the extensive involvement of the communities it serves, the NHLBI’s recently completed development of a scientific working plan to guide its activities and initiatives in the near future. Shaping the Future of Research: A Strategic Plan for the National Heart, Lung, and Blood Institute is on the NHLBI Web site at http://apps.nhlbi.nih.gov/strategicplan/.

The plan is structured around three goals that reflect the successive movement of scientific discovery—from “form to function,” “function to causes,” and “causes to cures”—and inform and complement one another. This crosscutting, versus disease-specific, approach highlights areas where the NHLBI is well positioned to make major contributions through investigator-initiated research and through programs that enable and complement investigator-initiated activities.

The plan identifies a number of basic research areas of focus with the intent of delineating normal and pathological biological mechanisms and exploiting the emerging understanding of these mechanisms to identify biomarkers of disease. Such biomarkers—broadly defined as measurable indicators of genotype, biological or pathological processes, or responses to therapeutic intervention—will facilitate identification of disease subtypes and point the way toward new molecular targets for preempting and preventing disease, as well as for diagnosis and treatment.

The plan’s clinical and translational research goal emphasizes transmission of knowledge between basic and clinical research so that findings in one arena rapidly inform and stimulate research in the other. More precise methods of risk-stratification and diagnosis are expected to arise from application of new approaches (e.g., noninvasive imaging, biomarkers) from basic science laboratories. A critical challenge will be to develop personalized preventive and therapeutic regimens based on genetic makeup in combination with developmental and environmental exposures. Insights are already emerging, but robust and efficient means of validating both individualized and population-based treatments will be needed to establish an evidence base to guide medical practice.

The plan acknowledges the need to enhance understanding of the processes involved in translating research into practice and to use that understanding to enable improvements in public health and stimulate further scientific discovery. It places particular emphasis on conducting research in primary prevention and identifying interventions that work in the practice communities that will ultimately constitute the targets for translation and education. As well, continued development and evaluation of new approaches to communicate research advances to the public is an important priority for ensuring full and informed participation of individuals in their health care.

The plan is intended to provide the NHLBI with a guide for its research and training programs over the next 5 to 10 years. It presents broad strategies that the NHLBI will employ to facilitate the conduct of research; enhance interdisciplinary work; speed early-stage translation of basic discoveries; ensure cross-fertilization of basic, clinical, and epidemiologic discoveries, and maximize the resultant public health benefit of the information created. Specific measures to implement the plan will now be developed in consultation with the National Heart, Lung, and Blood Advisory Council and the scientific community. Investigator-initiated research has long constituted the largest share of the NHLBI research portfolio, and we fully expect that much of the plan will be realized through continued support of such research. Institute-initiated investments guided by the plan will be directed largely toward programs that either enable or complement investigator-initiated activities.

As the challenges identified in the plan are met and as new ones emerge, the NHLBI will identify and embrace new strategies. The Institute also will continue to look to its Advisory Council and to the larger research community for guidance to ensure that these strategies are updated as needed to reflect the rapidly changing environments of research and public health issues.

FY 2009 JUSTIFICATION BY PROGRAM DETAIL

Program Descriptions and Accomplishments

Overall Budget Policy: Investigator-initiated research projects and new investigator research and career development remain the Institute’s highest priorities. The NHLBI carefully evaluates investigator-initiated requests to submit grants applications for all large programs. A scientific review is conducted, and the results are presented to the NHLBI Advisory Council to determine level of recommended support, if any. The level of support provided for Institute-initiated projects (e.g. RFAs) is also evaluated. The Institute maintains a balance between solicitations issued to the extramural community in areas that need stimulation and funding made available to support investigator-initiated projects.

Extramural Research

Heart and Vascular Diseases: This program seeks to increase knowledge of the causes of heart and vascular diseases and develop effective strategies to diagnose, treat, and prevent them. Diseases and conditions of interest include coronary heart disease, arrhythmias and sudden cardiac death, congenital heart disease, heart failure, hypertension, and peripheral vascular disease.

In fiscal year 2007, the NHLBI initiated a 5-year program to develop and support a Cardiovascular Disease Research Network. Its purpose is to increase scientific knowledge of cardiovascular diseases—including epidemiology, risk and risk factors, prevention, detection and diagnosis, treatment, and prognosis—in the context of participatory, community-based health-care delivery. The Institute awarded 8 cooperative agreements to establish a network for cardiothoracic surgical interventions in cardiovascular medicine. Panels of experts in the fields of lipids and hypertension were convened to assess the needs and opportunities for new clinical trials of cholesterol and blood pressure lowering to prevent cardiovascular disease. The Institute held working groups to identify future research opportunities in two large-scale epidemiological studies—the Multi-ethnic Study of Atherosclerosis and the Coronary Artery Risk Development in Young Adults Study.

Budget Policy: The FY 2009 budget estimate for the Heart and Vascular Diseases program is $1,627,986,000, a decrease of $899,000 or .055% less than the FY 2008 estimate. During the FY 2009 NHLBI plans to continue to support research on the biology of the development of the heart and vascular system and the relationship between cardiovascular physiology and the function of other organs, particularly the lungs, brains, and kidneys. The NHLBI will continue to fund research that uses systems biology approaches and thereby enhances interactions with programs supported by other NIH components. NHBLI also will continue to support work on improving understanding of the characteristics of stem cells in multiple systems and will emphasize translation of fundamental knowledge of stem cell biology into approaches to repair and regenerate damaged tissues and organs.

Population and community-based studies will be supported to improve the outcomes of resuscitation after myocardial infarction, to enhance the management of acute coronary syndromes, and to develop better biomarkers and imaging approaches for identifying pre-clinical cardiovascular disease and implementing preventive, preemptive interventions. Research ranging from basic investigations to clinical studies that address management of heart failure and understanding of cardiac energetics will be supported.

Portrait of a Program: Framingham Heart Study

FY 2008 Level: $10,800,000
FY 2009 Level: $10,867,000
Change $ 67,000

The Framingham Heart Study (FHS) is a prospective, community-based, family study that began in 1948 among residents of Framingham, Massachusetts. The original group of participants included 5,209 adults between the ages of 30 and 62 at enrollment who visited the research center every two years for medical histories, physical exams, and laboratory tests. In 1971, 5,124 of the original group’s adult children and their spouses were added. A third-generation cohort – 4,095 grandchildren of the original participants – was enrolled in 2002. Over the years, the study has provided a wealth of information regarding the contributions of hypertension, high cholesterol, cigarette smoking, and other risk factors to the development of cardiovascular diseases. Funds budgeted for FY 2009 provide support for part of a 7-year extension of the study that will reexamine the living participants from each of the three cohorts and gather genetic, laboratory, and clinical data for analysis.

The Framingham SNP-Health Association Resource (SHARe) is a comprehensive new effort to pinpoint genes underlying cardiovascular and other chronic diseases. The program builds on the FHS and on other NIH-funded research demonstrating that common but minute variations in human DNA, called single nucleotide polymorphisms (SNPs), can be used to identify genetic contributors to common diseases. It includes data on more than 9,300 FHS participants who had their DNA tested for 550,000 SNPs. In addition, the participants’ clinical information gathered during the study, such as blood pressure or weight, is included. SHARe will enable researchers to relate study participants’ genetic variations with their clinical and laboratory test results and their health outcomes. This represents a milestone in moving toward an era of personalized medicine in which diagnostic, therapeutic, and preventive approaches are tailored to the individual. The FHS SHARe resides in a new NIH database that will make the combined genotypic and phenotypic data available to researchers around the world. The database will help researchers integrate the wealth of information collected over the years in the FHS and other large cohort studies with new genetic data, resulting in an increased understanding of genetic influences on disease risk, manifestation, and progression. Because of its uniqueness in including three generations of subjects with comparable data obtained from each generation at the same age, the FHS is the first study to be included in the SHARe initiative. The NHLBI is currently considering expansion of SHARe to include other large longitudinal studies such as the Jackson Heart Study and the new Hispanic Community Health Study.

 

Lung Diseases: This program seeks to understand the causes and progression of lung diseases and sleep disorders and thereby improve their diagnosis, treatment, and prevention. Research areas include asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, critical care and acute lung injury, developmental biology and pediatric pulmonary diseases, immunology and fibrosis, lung cell and vascular biology, and pulmonary complications of AIDS and tuberculosis. The National Center on Sleep Disorders Research is administered as part of the Lung Diseases program.

In fiscal year 2007, the NHLBI initiated a program to foster research on lung stem cell biology and cell-based therapy for lung diseases. It will support collaborations between basic scientists and clinical investigators to advance these promising areas of investigation. In concert with the National Cancer Institute, the NHLBI convened the workshop “Lung Cancer and COPD, Different Outcomes of a Common Etiopathogenetic Pathway?” to identify areas for joint research efforts. Workshops were also held to discuss the future structure and direction of lung diseases clinical research networks, to explore newly identified cellular components of the lung, and to assess the role of circadian timing in the function of cells that make up heart, lung, and blood tissues.

Budget Policy: The FY 2009 budget estimate for the Lung Diseases program is $599,164,000 a decrease of $332,000 or .055% less then the FY 2008 estimate. Plans for FY 2009 continue to emphasize research on lung development, inflammation, injury and repair. Research topics to be investigated include gene therapy for cystic fibrosis, prenatal origins of asthma, and the early indicators of COPD, as detected by biomarkers and imaging. The ultimate goals are to preempt the development of acquired lung diseases and to enhance early detection and thereby prevent or limit disease progression.

The FY 2009 budget estimate for the National Center for Sleep Disorders Research is $50,560,000 the same level as the FY 2008 estimate. The plan for FY 2009 is to continue to support the area of sleep disorders research.

Portrait of a Program: Asthma Therapy Research Networks

FY 2008 Level: $
FY 2009 Level: $5,800,000
Change $5,800,000

For about 2 decades, NHLBI-supported clinical research networks in asthma have been highly effective in providing a flexible and efficient structure for the rapid development and conduct of clinical trials on important clinical management questions. Each network consists of several clinical centers and a data coordinating center, and is governed by a steering committee with responsibility for identifying important research questions; selecting topics for investigation; designing, developing, overseeing, and monitoring protocols; and participating in data analysis and interpretation and reporting of results. Funds budgeted for FY 2009 provide support for the first of the seven years.

The Asthma Clinical Research Network (ACRN), initiated in fiscal year 1993, is a group of interactive asthma clinical research sites established to facilitate rapid assessment of new treatment methods. The ACRN ensures that findings on optimal management of adult asthmatic patients are rapidly disseminated to practitioners and health-care professionals.

The Childhood Asthma Research and Education (CARE) Network, initiated in fiscal year 1999, has been evaluating current and novel therapies and management strategies for children with asthma. The emphasis is on clinical trials to help identify optimal, more personalized therapy for children with different asthma phenotypes, genotypes, and ethnic backgrounds and children at different developmental stages.

The current funding period is drawing to a close so NHLBI convened a workshop in May 2007 to obtain advice on network structures that would sustain past successes while meeting future clinical research needs. Participants from the research community strongly endorsed the concept of networks and emphasized the need to increase flexibility, facilitate scientific exchange, enhance efficiency, encourage shared use of resources, and promote training. In FY 2009, to preserve the best of past networks while incorporating these recommendations, the Institute will establish the Asthma Therapy Research Network (ATRN), a single entity to replace the ACRN and the CARE. Its focus will remain on important clinical management questions, but will also have the flexibility to conduct ancillary and proof-of-concept studies on topics important to clinical care across the age span. The cooperative development of protocols and standardization of data collections will enable researchers to address questions on the similarities, differences, and relationships between adult and pediatric asthma. Funds previously used to support CARE and ACRN will support the new network.

 

Blood Diseases and Resources: This program supports research on the causes, prevention, and treatment of nonmalignant blood diseases, including anemias, sickle cell disease, and thalassemia; premalignant processes such as myelodysplasia and myeloproliferative disorders; abnormalities of hemostasis and thrombosis such as hemophilia; and immune dysfunction. A major program responsibility is to conduct research to ensure the adequacy and safety of the nation's blood supply.

In fiscal year 2007, the NHLBI initiated a program of Pediatric Transfusion Medicine Academic Career Awards. Its goal is to develop curricula designed to attract new investigators into the field of pediatric transfusion medicine. A working group titled “The Interface Between Thrombosis and Inflammation” was convened to achieve a better understanding of how acute and chronic inflammation leads to thrombosis (blood coagulation) and, conversely, how coagulation affects inflammatory activity.

Budget Policy: The FY 2009 budget estimate for the Blood Diseases and Resources program is $416,377,000 a decrease of $230,000 or .055% less than the FY 2008 estimate. During FY 2009, the program plans to continue its support for studies of bone marrow failure, thrombosis, and coagulation disorders, and intrinsic disorders of red cells, white cells, and platelets. Priorities include development of better hematopoietic stem cell therapies and a clearer understanding of the nature of the stem cells that participate in the development of the hematopoietic and immunologic systems. Considerable new knowledge about the interaction between the vascular wall and the coagulation system has expanded the blood program into study of organ damage that arises from thrombosis. Networks for research on hemoglobinopathies (sickle cell disease and the thalassemias) continue to explore approaches for personalizing assessments of disease severity and prognosis and preventing organ damage related to disordered blood flow and iron overload.

The NHLBI will continue to support work to enhance blood safety and ensure the adequacy of the nation’s blood supply, including studies of improved component therapies, better procurement and testing, and alternatives to transfusion. Supportive care with cellular therapies is also a component of this program. A transfusion medicine network continues innovative work on approaches to improving the global blood supply, emphasizing enhanced access, lower costs, and more effective therapies.

Portrait of a Program: Blood and Marrow Clinical Trial Network

FY 2008 Level: $6,800,000
FY 2009 Level: $6,900,000
Change $ 100,000

The Blood and Marrow Transplant Clinical Trials Network, established in FY 2001, conducts scientifically meritorious multicenter clinical trials to improve outcomes of blood and marrow transplants. It develops and carries out high-quality studies to evaluate promising therapies in an effort to obtain definitive answers to significant problems in hematopoietic stem cell transplantation. The Network is cosponsored by the National Cancer Institute (NCI). It comprises 16 core clinical centers, some of which are consortia of two or more centers, and a data coordinating center formed by collaboration between the Center for International Blood and Marrow Transplant research, the National Marrow Donor Program, and the EMMES Corporation. Over 50 non-core centers are approved to participate in Network clinical trials. In addition, to enhance accrual of patient participants, collaborations with four NCI-funded Cancer Cooperative Groups are being developed.

The Network has a number of protocols, including studies of patients undergoing treatment for multiple myeloma, non-Hodgkin’s lymphoma, leukemia, and aplastic anemia. The program was renewed for a 5-year period in fiscal year 2006. Expanded activities in the second phase include the conduct of phase II trials that provide a basis for phase III studies on transplantation methodologies to improve long-term outcome following transplantation; the conduct of phase II/III clinical trials addressing the needs of pediatric patients and those with rare diseases; and the development of procedures for protocol development, conduct, and data management that will enable collaboration with other NIH-funded cooperative research programs and increase the efficiency of conducting trials in blood and marrow transplant. Recognizing the wealth of expertise in allogenetic transplantation represented by the Network, the National Institute of Allergy and Infectious Diseases has recently provided support for a phase II trial in scleroderma and associated ancillary studies.

 

Intramural Research

The Intramural Research program conducts laboratory and clinical research in heart, vascular, lung, blood, and kidney diseases and develops technology related to cardiovascular and pulmonary diseases. The program comprises four centers (Biochemistry and Biophysics, Cell Biology and Physiology, Genetics and Developmental Biology, and Immunology), four branches (Cardiovascular, Hematology, Pulmonary Critical Care Medicine, and Vascular Medicine), and the Cardiothoracic Surgery Research Program.

Budget Policy: The FY 2009 budget estimate for the Intramural Research program is $177,845,000, an increase of $2,711,000 or 1.5% from the FY 2008 estimate. The program plans for FY 2009, along with expected outputs, are as follows. Increases for salaries and related costs are covered in the budget request. The budget provides support for new programs, which include (a) expansion of the newly formed Pulmonary and Vascular Medicine Branch to include two new tenure track scientists, one working on sickle cell disease, the other in lipid metabolism therapeutics, (b) recruitment of one tenure track scientists in the basic sciences in physical biology, (c) recruitment of one tenure track scientist in the general clinical sciences, (d) using technology developed within the DIR to establish a epigenetic screening center for the human genome, (e) initiation of a state of the art computer tomography system for the study of heart disease, (f) continued expansion of the post-translational modification detection capabilities in the proteomic core, (g) establish a state of the heart cardiovascular phenotyping center for the mouse, (h) further develop systems biology platforms for the analysis of proteomic and genomic data, (i) further develop the in vivo optical microscopy program using adaptive optics, motion compensation and novel detection systems to reach sub-micron resolution in intact animal models, (j) expand the robotic and catheter fabrication capabilities within the DIR to support MRI guided therapeutic approaches applications in man.

Research Management and Support

This activity provides administrative management and scientific direction in the review, award, and monitoring of research grants, training awards and research and development contracts and in the overall planning, coordination, and evaluation of the Institute’s programs.

In fiscal year 2008, the Division of Extramural Research Activities administered the review, processing, award, and scientific performance appraisal of approximately 5,000 research grants, 750 training awards, and 600 contracts. The Division for the Application of Research Discoveries continued its public and professional education activities in cardiovascular diseases and asthma and developed a new educational campaign, “COPD: Learn More, Breathe Better.”

Budget Policy: The FY 2009 budget estimate for Research Management and Support is $103,570,000, an increase of $1,580,000 or 1.5% over the FY 2008 estimate. The program plans for FY 2009, along with expected outputs, are as follows. Increases for salaries and related costs are covered in the budget request, but decreases are planned for operating expenses such as maintenance contracts and information technology costs. The NHLBI Division for the Application of Research Discoveries will continue with the planning and implementation of knowledge networks to support rapid sharing of knowledge and experience between researchers and practitioners. Establishment of the initial Cardiovascular Knowledge Network will be followed closely by the establishment of the Pulmonary Knowledge Network to address asthma and COPD.

In regard to its lifespan approach to addressing prevention and treatment of cardiovascular disease, the Division will conduct activities to follow the issuance of the first-ever integrated guidelines for reduction of cardiovascular risk factors in children ages 2 to 22. FY 09 activities will include implementation of educational efforts directed at health care professionals as well as a consumer-oriented education and outreach campaign to facilitate and enhance participatory medicine.

In the asthma area, the Division will design and implement similar efforts based on the asthma management and treatment guidelines issued in late 2007. Education activities will be developed for children, adolescents, and adults as well as for health care professionals in the two related campaigns.

Budget Authority by Object

  FY 2008
Enacted
FY 2009
Estimate
Increase or
Decrease
Total compensable workyears:




        Full-time employment 815 821 6
        Full-time equivalent of overtime and holiday hours 2 2 0




        Average ES salary $173,560 $178,767 $5,207
        Average GM/GS grade 12.2 12.2 0.0




        Average GM/GS salary $93,549 $96,355 $2,806
        Average salary, grade established by act of July 1, 1944
        (42 U.S.C. 207)

$99,177

$102,153

$2,976
        Average salary of ungraded positions 112,145 115,509 3,364




OBJECT CLASSES

FY 2008
Estimate
FY 2009
Estimate
Increase or
Decrease

Personnel Compensation:



11.1 Full-time permanent $66,869,000 $70,544,000 $3,675,000
11.3 Other than full-time permanent 13,758,000 14,391,000 633,000
11.5 Other personnel compensation 3,068,000 3,209,000 141,000
11.7 Military personnel 1,301,000 1,360,000 59,000
11.8 Special personnel services payments 9,038,000 9,462,000 424,000
Total, Personnel Compensation 94,034,000 98,966,000 4,932,000
12.0 Personnel benefits 21,603,000 22,797,000 1,194,000
12.2 Military personnel benefits 856,000 896,000 40,000
13.0 Benefits for former personnel 0 0 0
Subtotal, Pay Costs 116,493,000 122,659,000 6,166,000
21.0 Travel and transportation of persons 3,197,000 3,070,000 (127,000)
22.0 Transportation of things 295,000 280,000 (15,000)
23.1 Rental payments to GSA 0 0 0
23.2 Rental payments to others 210,000 200,000 (10,000)
23.3 Communications, utilities and
miscellaneous charges

1,413,000

1,375,000

(38,000)
24.0 Printing and reproduction 687,000 660,000 (27,000)
25.1 Consulting services 5,229,000 5,000,000 (229,000)
25.2 Other services 14,832,000 14,200,000 (632,000)
25.3 Purchase of goods and services from
government accounts

210,694,000

211,796,000

1,102,000
25.4 Operation and maintenance of facilities 3,550,000 3,400,000 (150,000)
25.5 Research and development contracts 208,000,000 208,000,000 0
25.6 Medical care 1,055,000 1,010,000 (45,000)
25.7 Operation and maintenance of equipment 6,960,000 6,650,000 (310,000)
25.8 Subsistence and support of persons 0 0 0
25.0 Subtotal, Other Contractual Services 450,320,000 450,056,000 (264,000)
26.0 Supplies and materials 16,271,000 15,600,000 (671,000)
31.0 Equipment 12,723,000 12,000,000 (723,000)
32.0 Land and structures 0 0 0
33.0 Investments and loans 0 0 0
41.0 Grants, subsidies and contributions 2,320,488,000 2,319,027,000 (1,461,000)
42.0 Insurance claims and indemnities 0 0 0
43.0 Interest and dividends 15,000 15,000 0
44.0 Refunds 0 0 0

Subtotal, Non-Pay Costs

2,805,619,000

2,802,283,000

(3,336,000)
Total Budget Authority by Object 2,922,112,000 2,924,942,000 2,830,000
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research




Salaries and Expenses


OBJECT CLASSES
FY 2008
Enacted
FY 2009
Estimate
Increase or
Decrease
Personnel Compensation:
      Full-time permanent (11.1) $66,869,000 $70,544,000 $3,675,000
      Other than full-time permanent (11.3) 13,758,000 14,391,000 633,000
      Other personnel compensation (11.5) 3,068,000 3,209,000 141,000
      Military personnel (11.7) 1,301,000 1,360,000 59,000
      Special personnel services payments (11.8) 9,038,000 9,462,000 424,000
Total Personnel Compensation (11.9) 94,034,000 98,966,000 4,932,000
Civilian personnel benefits (12.1) 21,603,000 22,797,000 1,194,000
Military personnel benefits (12.2) 856,000 896,000 40,000
Benefits to former personnel (13.0) 0 0 0
Subtotal, Pay Costs 116,493,000 122,659,000 6,166,000
Travel (21.0) 3,197,000 3,070,000 (127,000)
Transportation of things (22.0) 295,000 280,000 (15,000)
Rental payments to others (23.2) 210,000 200,000 (10,000)
Communications, utilities and
miscellaneous charges (23.3)

1,413,000

1,375,000

(38,000)
Printing and reproduction (24.0) 687,000 660,000 (27,000)
Other Contractual Services:
      Advisory and assistance services (25.1) 1,779,000 1,550,000 (229,000)
      Other services (25.2) 14,832,000 14,200,000 (632,000)
      Purchases from government accounts (25.3) 22,060,000 14,908,000 (7,152,000)
      Operation and maintenance of facilities (25.4) 3,550,000 3,400,000 (150,000)
      Operation and maintenance of equipment (25.7) 6,960,000 6,650,000 (310,000)
      Subsistence and support of persons (25.8) 0 0 0
Subtotal Other Contractual Services 49,181,000 40,708,000 (8,473,000)
Supplies and materials (26.0) 16,206,000 15,560,000 (646,000)
Subtotal, Non-Pay Costs 71,189,000 61,853,000 (9,336,000)




Total, Administrative Costs 187,682,000 184,512,000 (3,170,000)


Authorizing Legislation graphic and link to description

Appropriations History

Fiscal
Year

Budget Estimate
to Congress
House
Allowance
Senate
Allowance

Appropriation(1)





2000 1,759,806,000 (2) 1,937,404,000 2,001,185,000 2,040,291,000
Rescission


(10,867,000)





2001 2,069,582,000 (2) 2,321,320,000 2,328,102,000 2,299,100,000
Rescission


(875,000)





2002 2,567,429,000 2,547,675,000 2,618,966,000 2,576,125,000
Rescission


(3,063,000)





2003 2,778,728,000 2,791,411,000 2,820,011,000 2,812,011,000
Rescission


(18,278,000)





2004 2,867,995,000 2,867,995,000 2,897,595,000 2,897,145,000
Rescission


(18,454,000)





2005 2,963,953,000 2,963,953,000 2,985,900,000 2,965,453,000
Rescission


(24,252,000)





2006 2,951,270,000 2,951,270,000 3,023,381,000 2,951,270,000





Rescission


(29,513,000)





2007 2,918,808,000 2,901,012,000 2,924,299,000 2,918,808,000





2008 2,894,341,000 2,965,775,000 2,992,197,000 2,974,900,000
Rescission


(51,972,000)





2009 2,924,942,000


1 Reflects enacted supplementals, rescissions, and reappropriations.
2 Excludes funds for HIV/AIDS research activities consolidated in the NIH Office of AIDS Research


Details of Full-Time Equivalent Employment (FTEs)


OFFICE/DIVISION
FY 2007
Actual
FY 2008
Enacted
FY 2009
Estimate
Office of the Director 15 15 15
Office of Biostatistics Research 12 12 12
Office of Science and Technology 18 18 18
Office of Administrative Management 69 69 69
Office of Research Training and Minority Health 4 4 4
Office of Clinical Research 5 5 5
Division of Cardiovascular Diseases 57 57 59
Division of Prevention and Population Sciences 43 43 46
Center for Population Studies 4 4 4
Center for Biomedical Informatics 17 17 18
Division of Lung Diseases 22 22 22
Division of Blood Diseases and Resources 23 23 23
Division of Intramural Research 386 386 386
Division of Extramural Research Activities 104 105 105
Division Application Research Discoveries 35 35 35




Total 814 815 821
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

FISCAL YEAR
Average GM/GS Grade
2005
12.2
2006
13.0
2007
12.1
2008
12.2
2009
12.2

Detail of Positions


GRADE
FY 2007
Actual
FY 2008
Enacted
FY 2009
Estimate
Total, ES Positions 1 1 1
Total, ES Salary 166,102 173,560 178,767
GM/GS-15 97 97 97
GM/GS-14 113 113 113
GM/GS-13 138 139 141
GS-12 94 96 97
GS-11 34 35 36
GS-10 2 2 2
GS-9 55 56 57
GS-8 32 33 33
GS-7 17 17 18
GS-6 11 11 11
GS-5 7 7 7
GS-4 5 5 5
GS-3 1 1 1
GS-2 0 0 0
GS-1 0 0 0
Subtotal 606 612 618




Grades established by Act of
July 1, 1944 (42 U.S.C. 207):
Assistant Surgeon General 1 1 1
Director Grade 7 7 7
Senior Grade 2 2 2
Full Grade 1 1 1
Senior Assistant Grade 0 0 0
Assistant Grade 0 0 0
Subtotal 11 11 11
Ungraded 252 255 258




Total permanent positions 720 727 734




Total positions, end of year 870 879 888




Total full-time equivalent (FTE)


employment, end of year 814 815 821
Average ES salary 166,102 173,560 178,767
Average GM/GS grade 12.1 12.2 12.2
Average GM/GS salary 89,529 93,549 96,355

Includes FTEs which are reimbursed from the NIH Roadmap
for Medical Research

New Positions Requested

 
FY 2009
  Grade Number Annual
Salary
Health Scientist Administrator 13 2 $94,000
Project Manager 13 1 $94,000
Procurement Analyst 14 1 $111,000
Clinical Trial Specialist 13 2 $94,000
       
Total Requested   6  

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