bar harbor, maine

Varmus (top right) addresses a recent hearing in Congress surrounded by young diabetes sufferers. Should research into the disease remain the responsibility of a separate institute? Credit: ASSOCIATED PRESS

Harold Varmus, the director of the US National Institutes of Health (NIH), said last week that it was time to discuss how the huge biomedical agency might be remodelled to increase its effectiveness — for example, by consolidating it into a smaller number of independent institutes and giving an expanded director's office more power.

Speaking at a symposium on the future of genetics organized by the Jackson Laboratory, of Bar Harbor, Maine, and the Johns Hopkins University, Varmus said that the NIH should aim to “organize the science in a rational way”. Rather than continuing to subdivide the $15.6 billion agency — which since its founding in the 1930s has grown into more than two dozen institutes, centres and divisions — he said that more might be achieved by having fewer centres of power.

Under one proposal, put forward, he said, purely for discussion purposes, there might be just five institutes — based on research into cancer, neuroscience, general medical sciences, human development, and microbial and environmental sciences.

A proposed brain institute would encompass the activities of the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse. A revised National Institute of General Medical Sciences would include the work of the National Institute of Diabetes and Digestive and Kidney Diseases and that of the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Under this scheme, a transformed Office of the Director, perhaps called ‘NIH Central’, would oversee the institutes. This would direct policy, oversee the Library of Medicine and the Center for Information Technology, and support training, peer review and activities not handled by the institutes.

Varmus said that the central office should have broader responsibilities and a budget enabling it to support special initiatives, such as developing technologies relevant to research across the institutes. It should also have the flexibility to redirect funding on a project's completion.

The comments came amid rumours that Varmus, who has directed the NIH since 1993, is being considered to head the Memorial Sloan-Kettering Cancer Center in New York. The New York Observer last week quoted the director of another New York cancer centre as saying that the hiring of Varmus is “close to being done”.

Varmus will not confirm or deny reports that he is leaving the NIH. Anne Thomas, his spokeswoman, says that Varmus “has had conversations with Memorial Sloan-Kettering, and with other institutions. He has not made a final arrangement with any.”