zation chart, describing the intramural staffing pat- 

 tern and identifying those scientists for whom 

 promotions will be sought over the next year's 

 time. These actions include conversions from 

 temporary "staff fellow" appointments to perma- 

 nent tenure status. A semiannual update of this 

 review is conducted to introduce special actions 

 that may be appropriate for the subsequent six- 

 month period. Such promotions are brought to the 

 assembled Board of Scientific Directors, who 

 conduct an in-depth review of the quality of re- 

 search, the bibliography, and other contributions 

 of the candidate, not merely with respect to the 

 number of publications, but also the quality of the 

 journals in which they have appeared. The Scien- 

 tific Directors vote a recommendation to the 

 Deputy Director for Science, who then has ulti- 

 mate authority to approve or disapprove the pro- 

 posed promotion action. 



A different system obtains in the case of research 

 that is supported extramurally by NIH funds. A 

 different review and management process is used 

 since the external researchers are employees of 

 universities or medical schools, etc. An elaborate 

 peer review system has been established at NIH, 

 comprising Initial Review Groups (e.g.. Study 

 Sections), each oriented around a particular scien- 

 tific area or discipline and composed primarily of 

 outside consultant scientists. These committees 

 usually meet three times annually to consider re- 

 search grant applications submitted to NIH. 



Scientists in an extramural institution make 

 known their research proposals and proposed 

 budgets through a research grant application. 

 Study Sections review these applications, make 

 recommendations as to specific and technical mer- 

 it, and, for applications that they approve, assign 

 priority scores based on the merit of the proposal. 

 This gives a relative ranking of the quality of a 

 proposal as compared with other proposals sub- 

 mitted to NIH. The proposals are then consid- 

 ered by the Advisory Councils of the Institutes 

 for their relevance to the program mission of each 

 Institute. If the Advisory Councils approve the 

 proposed research, the extramural scientific ad- 

 ministrative staff" of the Institute recommends to 

 the Institute Director a funding pattern based on 

 available resources and program needs and priori- 

 ties. The relevance of the proposed research to 

 the Institute mission is an important factor in this 

 regard. 



Current and Future Research 

 Emphasis 



There are several areas of basic research in biol- 

 ogy and medicine which are moving forward rapid- 



ly, are generally considered to be very promising, 

 and are attracting the attention of some of the fin- 

 est minds in biomedical research. Genetics, immu- 

 nology, virology, and cell biology are such areas 

 which are basic to our understanding of virtually 

 all disease processes, and thus are represented in 

 the research programs of most of the Institutes of 

 NIH. The neurosciences also are receiving more 

 attention in view of the enormous potential that 

 research in this area can contribute to physical 

 and mental well-being. 



Genetics. Research in this area includes the fur- 

 ther elucidation of the molecular mechanisms that 

 determine the nature of inheritance as well as the 

 processes that may interfere with the normal trans- 

 mission of information from parent to offspring. 

 Also included are the increasing number of tech- 

 niques that permit the investigator to regulate and 

 control the genetic process and to map the genes 

 along the chromosomes on which they reside. 

 Many diseases (e.g., diabetes, cancer, cystic fibro- 

 sis) are recognized today to have genetic compo- 

 nents, and the understanding of such diseases and 

 their treatment are critically dependent upon our 

 increasing knowledge of genetics. The new recom- 

 binant DNA technology is expected to provide a 

 powerful experimental approach to many of the 

 challenging questions in this area. 



Immunology. Higher organisms have developed 

 elaborate mechanisms — immune responses — by 

 which they react to foreign substances, particular- 

 ly to foreign proteins and complex sugars. Enor- 

 mous strides have been made in the past few 

 years in the understanding of these immune pro- 

 cesses. Much has been learned about the struc- 

 tures of the antibodies the organism makes when 

 a foreign substance is presented to it. Also, a great 

 deal has been learned about the cells that generate 

 antibodies, the nature of the provocation that ini- 

 tiates the process, and the forces that regulate it. 

 It has been learned that there are immunologic 

 aspects to many diseases other than those that 

 have been considered to be frankly infectious. 

 These include many varieties of arthritis as well 

 as cancer. Immunology has thus grown from a 

 subdivision of microbiology into a basic science in 

 its own right. There is every prospect for contin- 

 ued success in attempts to understand better the 

 immunologic process, upon which depends not 

 only the understanding of disease but also, in 

 many instances, the treatment and prevention of 

 disease. 



Virology. This is the study of the smallest, and 

 in some regards, the simplest forms of life. Virus- 

 es characteristically are incapable of independent 

 survival and live as parasites in the cells of higher 

 animals or in bacteria. Because of the rapid devel- 

 opments in chemistry, cytology, immunology, and 



HEALTH, EDUCATION AND WELFARE 109 



