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A few comments: >>NIH directors who addressed the panel suggested one way that might be achieved: by Congress ceasing to burden the agency with legal requirements to spend money on particular diseases. Such constraints "deform" science, they said.<< I love "science" as much as the next guy the NIH is the National Institute of HEALTH not the National Institute of Science. Were it the latter it would be the NIS. I'd hate to "deform" science, but if "deforming" science will reduce suffering faster than leaving science intact then let the "deformation" begin. >>The $338,000 IOM study was ordered last year by Congress. It was prompted by the perennial tug of war between the scientific community, which prefers a free hand in deciding how it spends research dollars, and advocates for dozens of diseases, who argue that their causes are under- funded by NIH in a process that "excludes the public". << Excludes the public? I could have sworn WE ARE the public. What is wrong with an educated public and Congress having a say in how billions are to be spent by a government agency? A democratic republic is all about elected representatives and there appointees who run huge government agencies reacting to the will of the electorate, not just narrowly defined abstract principles. When the public cedes ALL influence over its government's spending on "health" to scientific boards and bureaucrats it is ill-served. >>On the issue of NIH responsiveness to the public, Varmus said he has learned "a lot" from highly educated disease advocacy groups. But he added: "There is a point beyond which the decision has to be reserved" for agency officials.<< Hmm. >>But all the directors conceded an important role for public input into the NIH process. John Alderete, a panel member who is a professor of microbiology at the University of Texas Health Science Center at San Antonio, said NIH needs to be more responsive to the public if it wishes to avoid earmarking of funds.<< Do not give up your right to a say in how your tax dollars are to be spent. After listening to the all of the scientists, the experts, the bureaucrats, the appointees, the Congressmen, the Senators and the President, listen to your own heart and mind, formulate an informed opinion and make yourself heard. Regards, Ken Aidekman Fund the Research. Find the Cure.