Department of Health and Human Services
Public Health Service
National Diabetes and Digestive and Kidney Diseases
Advisory Council
September 9-10, 1999
I. Call to Order
Dr. Gorden called to order the 151st National Diabetes and Digestive and Kidney Diseases Advisory Council meeting on September 9, 1999, at 8:40 a.m.
A. Attendance
Council Members Present (See Attachment A)
Dr. Edward J. Benz, Jr. (Ad hoc)
Dr. D. Montgomery Bissell, Jr.
Dr. Judith Bond
Dr. Jeffrey I. Gordon
Ms. Ruby R. Haughton
Dr. Barbara E. Hayes
Dr. C. Ronald Kahn
Dr. S. Robert Levine
Dr. John McConnell
Dr. Kristen McNutt
Dr. Eric G. Neilson
Dr. Daniel Podolsky
Dr. Daniel Porte (Ex Officio)
Dr. Barbara Rolls (Ad hoc)
Dr. Joseph T. Spence (Ex Officio)
Dr. Ming-Jer Tsai
Dr. Dana Weaver-Osterholz
Dr. Robert W. Schrier
Dr. Rena R. Wing
Council Members Absent:
Ms. Genevieve R. Jackson
Dr. James E. Rothman
B. Staff and Guests
In addition to Council members, others in attendance at the meeting included NIDDK staff members, representatives of the NIH Office of the Director (OD), Center for Scientific Review (CSR), Scientific Review Administrators, and other NIH staff members. Guests were present during the open parts of the meeting. Attendees included the following:
David Badman, NIDDK
Jeff Ball, NIDDK
Pamela Belton, NIDDK
Johnny Bladen, NIDDK
Josephine Briggs, NIDDK
Ben Burton, NIDDK
Victor Buyny, NIDDK
Francisco Calvo, NIDDK
Dolph Chianchiano, National Kidney Foundation
Cheryl Chick, NIDDK
Paul Coates, NIDDK
John C. Cody
Catherine Cowie, NIDDK
Leslie Curtis, NIDDK
Charlenia Daniels, NIDDK
Florence Danshes, NIDDK
Jane DeMouy, NIDDK
Nancy Dixon, NIDDK
Richard Eastman, NIDDK
Linda Edgeman, NIDDK
Gayla Elder-Leak, NIDDK
Bill Elzinga, NIDDK
Jay Everhart, NIDDK
Richard Farishian, NIDDK
Ned Feder, NIDDK
Carol Feld, NIDDK
Bill Foster, NIDDK
Judith Fradkin, NIDDK
Sandy Garfield, NIDDK
John Garthune, NIDDK
Phillip Gorden, NIDDK
Janet Gregory, NIDDK
Roberta Haber, NIDDK
Ann Hagan, NIDDK
Frank Hamilton, NIDDK
Joan Harmon, NIDDK
Mary Harris, NIDDK
Maureen Harris, NIDDK
Barbara Harrison, NIDDK
Gladys Hirschman, NIDDK
Terri Holmes, NIDDK
Jay Hoofnagle, NIDDK
Van S. Hubbard, NIDDK
Donna Huggins, NIDDK
Desiree Johnson, NIDDK
Camille Jones, NIDDK
Kieran Kelley, NIDDK
Ma Khan, CSR
| Amy Kiesel, MWE/AGA
Sooja Kim, CSR
Paul Kimmel, NIDDK
Krish Krishman, CSR
John Kusek, NIDDK
Maren Laughlin, NIDDK
L. Earl Laurence, NIDDK
Kim M. Law, NIDDK
Alec Liacouras, CSR
Barbara Linder, NIDDK
Billie Mackey, NIDDK
Denise Manouelian, NIDDK
Ronald Margolis, NIDDK
Winnie Martinez, NIDDK
Dan E. Matsumoto, NIDDK
Ken May, NIDDK
Catherine McKeon, NIDDK
Barbara Merchant, NIDDK
Marjorie Mitchell, NIDDK
Neal Musto, NIDDK
Denise Payne, NIDDK
Judith Podskalny, NIDDK
Sharon Pope, NIDDK
Carmen Robinson, NIDDK
Alice Robinson, NIDDK
Charles Rodgers, NIDDK
Lakshmanan Sankaran, NIDDK
Sheryl Sato, NIDDK
M. James Sherbenske, NIDDK
Jose Serrano, NIDDK
Angela Sharpe, Consortium of Social Sciences Assocs.
Elizabeth Singer, NIDDK
Philip F. Smith, NIDDK
Larry Soler
Jane Spencer, NIDDK
Robert Star, NIDDK
Walter Stolz, NIDDK
Tommie S. Tralka, NIDDK
Ana Vely, OFMA
Charles A.Wells, NIDDK
Nola Whitfield, NIDDK
Shan S.Wong, NIDDK
Susan Yanovski, NIDDK
Rita Yeager, NIDDK
Elaine Young, Juvenile Diabetes Foundation
Charles Zellers, NIDDK |
C. Conflict of Interest Statement (See Attachment B)
Dr. Gorden called to the attention of the Council the Confidentiality and Conflict of Interest Statements. After discussing the scope of confidentiality and conflict of interest, he requested that Council members comply with the requirements. He reminded Council members to avoid a conflict of interest by leaving the room when the Council discussed individual applications in which an actual or perceived conflict of interest might occur. Members were asked to sign a statement to this effect. This did not apply to "en bloc" actions.
Dr. Gorden announced that the Council meeting would be open to the public in accordance with the provisions of Public Law 92-463 on Thursday, September 9, 1999, from 8:40 a.m. to 12:30 p.m., closed from 1:30 p.m. until 5:00 p.m., closed on Friday, September 10, 1999 from 8:30 a.m. until 10:30 a.m. for review, discussion, and evaluation of grant applications, and open from 10:30 a.m. to 1:00 p.m.
II. Consideration of the Summary Minutes of the Previous Meeting
Dr. Gorden announced that the NDDK Advisory Council Summary Minutes of the last Council meeting were not yet available for review and would be provided to them for their review and approval at an early date via e-mail.
III. Future Meeting Dates
Dr. Gorden asked for consideration of meeting dates for future NDDK Advisory Council meetings, and the following meeting dates were proposed and accepted:
- February 2-3, 2000
- May 31-June 1, 2000
- September 20-21, 2000
- February 7-8, 2001
- May 30-31, 2001
- September 20-21, 2001
IV. Director's Report
Dr. Gorden began his report by welcoming former Council member, Dr. Barbara Rolls, who would serve as an Ad Hoc Council member and introducing Dr. Daniel Porte as a new Council member representing the Department of Veterans Affairs. He introduced a new staff member, Ms. Barbara Merchant, Acting Executive Officer, NIDDK.
Dr. Gorden gave the highlights of the NIH Director's 2-day meeting. He said that trans-NIH projects and their management, such as the trans-institute mouse genome project, were becoming more and more important to be addressed in the NIDDK's annual planning process. He said the handling of conflict of interest was a concern, both with respect to hiring people into the Federal government and with respect to the review of grants. He pointed out that in the review of grants, it often seemed as if either you had no peers reviewing the grants, or you had potential conflicts, and that these would be ongoing issues and difficult to resolve.
V. Reports and Discussions
A. Wrap-up of FY 1999 Activities (See Attachments C and D)
Mr. Laurence presented Dr. Gorden with a gavel to commemorate the 13 years that Dr. Gorden had led the Institute. This would be Dr. Gorden's last time to chair the NDDK Advisory Council as he was leaving the directorship of the Institute.
Mr. Laurence reviewed the 1999 Operating Plan. He pointed out that 1999 had offered many opportunities to move forward and to initiate new projects. He said that programs had grown, and the total portfolio of grants illustrated the growth with an increase to 2,467 regular research grants funded in FY 1999. He pointed out that the payline had been held at the 25th percentile for new grants and the 27th percentile for competing continuation grants, and that the Institute was able to reduce the size of administrative reductions by 5 percentage points. He reported that with all of these accomplishments, the Institute was still able to meet its funding targets in diabetes research and prostate cancer research. He described some of the new initiatives that had been accomplished, including announcements of RFAs, the SHOW Trial, new research centers, and the 25 percent increase in stipends in research training programs. Within the NIDDK Intramural Research Program, he described the new transplant program that had been established.
Dr. Stolz summarized the accomplishments in the career awards over the past 2 years. He pointed out that the number of competing awards made in FY 1999 would be almost twice that made in FY 1998, and he attributed the increase to the changes in career program that the Council had suggested and the Institute had implemented.
B. Perspectives on FY 2000
Dr. Gorden described the growth in numbers of grants, new centers, and career awards that the Institute would have in FY 2000, and he described some of the accomplishments that would be ongoing in FY 2000. He pointed out the issues in continued growth that would need discussion and decisions. He said that the obligatory mandated programs in diabetes and prostate cancer research were underway. He asked Council members for their opinions on the issues of raising career stipends vs. funding more grants and on increasing grant sizes vs. funding more grants. He said that all of these options depended on the growth rate of the budget.
Discussion
A Council member inquired about the funding of the K23, and whether it was the priority score that impacted the funding of the K23 grants. He expressed concern about the way these grants were reviewed in study sections. Dr. Gorden pointed out that these new grant mechanisms would have a clearer picture with more data.
A Council member pointed out that a critical piece of information was to decide whether there were too many career development awards, too few, or the right number being funded to maintain a steady state of new talent coming into research. He said information was needed about the numbers of physician scientists and Ph.D. scientists in the Institute portfolio or grant pool. He said it was important to know, if a shrinkage occurred, whether it was from the physician scientist pool or the Ph.D. pool. He pointed out that since Council members were concerned about the balance of Ph.D. scientists and clinical investigators, they might want to favor one over the other if they found that one was losing ground over the other one. He asked if that type of analysis would be possible. Dr. Stolz responded that the Institute tried to do an analysis every 5 to 10 years. He said that there were many assumptions and issues they could not control. He said that one-third to one-half of the Institute's grantees were traditionally supported by other NIH components or the National Science Foundation during their research training. Similarly, a large proportion of trainees supported by NIDDK end up in careers in research or related to research that are outside the purview of the NIDDK. This makes it very difficult to model the training and career development process and make decisions regarding the allocation of resources on the basis of those models.
A Council member pointed out that the Institute had made a big investment in the K08 awards and asked how many were clinical investigators and what had been their success rate in obtaining R01s. He said that the ideal outcome for the K08 would be a conversion to an R01 grant. He asked if there were any projections on what would be the success rate for that group, and if the K08 grantees were planned for in the numbers of new R01 grants. Dr. Stolz said that the answer to the first question depended on the definition of a clinical investigator. He said that if one only counts as "clinical investigators" those who are doing research involving interventions on live human beings, then fewer than 10 percent of K08 grantees qualify as clinical investigators. Dr. Stolz also said that several studies, done a number of years ago, showed that career awardees have a high probability of going on to be productive investigators.
Dr. Gorden said that it was difficult to distinguish between clinical and non-clinical research. He said that the Institute was committed to monitoring new investigators to maintain a pool of new investigators in the grant portfolio. He asked for Council members to consider the level they wanted maintained.
A Council member praised the Institute for supporting the K23 and K24 awards. One pointed out that once these investigators completed their training, they should be supported for the opportunity they offered to take research from the bench to the bedside. He said that he had heard that the NIDDK put 5 to 6 percent of the budget into clinical research while other institutes put 15 to 20 percent of their budget into clinical research. He pointed out that a number of opportunities were not being met to impact disease in areas such as kidney disease due to hypertension. He said that after their K08, without opportunities, their other option would be to go to private industry where they would not be asking the important questions. He said that no one in industry would be researching ACE inhibitors vs. angiotensin receptor blockers because angiotensin receptor blockers were patented and ACE inhibitors were not. He said that industry would not be researching non-patent drugs vs. their patented drugs, and he recommended that the Institute needed to show leadership and to make available funds for these clinical investigators. He recommended loan forgiveness as an incentive to help retain the clinical investigators in research. He pointed out that many went into private practice in order to pay off their loans. Dr. Gorden pointed out that loan forgiveness would require legislation and that the clinical panel that advises the NIH Director had recommended this as well.
A Council member said that the future of clinical investigation programs such as the K23 and K24 were important, and that many of the clinical investigators focusing on individual patients were disappearing, and that these clinical investigators were needed. Council members pointed out that the environment in the academic community was a major factor in the loss of the physician scientist. It was pointed out that the HMOs had impacted on academic scientists and those in practice. Council members pointed out that the typical physician scientist had a heavy clinical load and recommended that 100 percent of the physician scientist's time needed to be protected for research.
Council members expressed concerns about keeping young investigators in research. They pointed out that a heavy investment had been made in the K08 awards and now the new K23 and K24 awards. They pointed out that it would take a while before these new awards could be assessed, and they recommended that the numbers of K08 awardees that moved on to R01 grants be counted. They said it would be helpful information in order to keep people in the pipeline as they continued to evolve in their careers and to extend the half-life of investigators.
Council members were concerned about the transition from training to the R01 grant. They said that retaining these investigators when the pool was shrinking in great numbers due to the strenuous competition was a challenge. They said that the half-life of the investigator was about 5 years, and a way was needed to favor the longevity for those people just getting started. Otherwise, a Council member said, the result would be an aging group doing research. They said it was important that new investigators not "fall off a cliff" and run up against expanding competition for a limited number of grants. It was suggested that consideration of a more favorable payline for K08 awardees applying for their first R01 might help. It was recommended, given the Institute's investment in training these new investigators, that a transition for people already in the pipeline was important. On the other hand, a Council member pointed out that with good training and mentorship, K08 graduates should be able to compete and stand on their own. Council members recommended increasing the numbers of R01s, at least modestly, to help retain young investigators in a critical mass.
A Council member said he doubted if there were a former K08 grant holder participating as a clinical investigator in the clinical trials supported by NIDDK, and he recommended that a mechanism be designed to encourage people putting together large multi-center clinical trials to incorporate investigators with K08 and K23 grants into that clinical trial infrastructure. As an example he suggested it could be accomplished through wording of the RFA. He pointed out that it would not cost any more since NIDDK would be supporting the clinical trial anyway.
Council members said it was difficult to know how many new investigators would be needed for the future to maintain the necessary numbers of investigators. They expressed concern about a reduction in the total number of grants and the impact that might have on retaining researchers in the future. They pointed out the impact of wide swings in grant funding in the past. They said there needed to be some proportionality between funding career awards and an increase in the amount of funds available for R01 grants.
Council members recommended that a plan be developed to assess the new K23 and K24 awards. One Council member recommended developing some models for the training programs recognizing that the training programs needed to be in place some years before analyzing the success of the programs. Another Council member recommended that this would be an ideal time to set up parameters and baselines for analysis.
Council members commented on the competing numbers of grants staying the same and the dollar amounts going down as a consequence of the non-competing grants going up, and that it was a dangerous trend if the object was to get trained researchers as a component of the competing pool into the system in a healthy manner. A Council member recommended not fully funding and cutting the dollars in type 2 grants as an alternative with the additional funds used to grow the number of type 1 grants.
Council members commented on the issue of the amount of support needed today to do research. Council members said that it was important not to reduce awards so much that research could not be done. Also, there was concern about the use of out-sourcing and the overall impact on the research capability and training in that academic environment. They said that much of the hypothesis-driven research was out-sourced to companies that offered cost-effective services and that there was more and more cash going to these services. They raised the question of how much of the research dollar was going for research within the universities and how much for the out-sourcing and that the amount of funds spent on out-sourcing should be monitored. It was pointed out that some of the SBIR funds could go to companies to promote the development of such service centers for the larger scientific centers. Council members recommended encouraging the use of SBIR funds to support research functions where appropriate. Other Council members suggested some discussion of how the SBIR funds could be used most effectively and said that, in the corporate world, small businesses were where the innovations and creativity were emerging. They said it was important to get the most out of the 2.5 percent of the budget that was available for SBIR grants.
Dr. Gorden said that he understood that the Council members did not want the grant numbers to drop and that the Council members wanted to preserve the career mechanisms. He said that if the budget was adequate, the Institute would try to maintain the competing grant numbers at levels that would maintain current pay lines. In response to the discussion on out-sourcing, Dr. Gorden pointed out that the Institute did not want to dictate how research was conducted.
A Council member said he applauded the cooperation among institutes. He pointed out that support from the bench to the bedside could be supported through workshops that brought together such disciplines as biodynamics, epidemiology, statistics, and clinical trial design. He said that the present workshop program was woefully under-represented regarding research opportunities, the numbers of workshops that were ongoing, and the numbers of groups that were being brought together to talk about those opportunities, and he recommended focusing on that area.
A Council member said that the study sections were told to deal with the science of the grant applications and that the budget would be dealt with elsewhere, but the Council member pointed out that the study section got involved with the budget anyway. She said that the budget was not thoroughly analyzed, and that it should be analyzed in the more expensive grants where the budget possibly was much higher than what it would cost to do the work requested. She said that the budget categories needed to be analyzed as to what it would cost to do the critical work since some researchers were more eloquent than others in justifying their budgets. She said that some of the funds saved in the budget categories would be better spent on new investigators. Other Council members mentioned that the budget analysis was important as it sometimes was cut so drastically that sufficient resources were not available to do the work. Other Council members were concerned about the time allowed to complete the work and recommended that the grant length be scrutinized.
Update on NIDDK Strategic Planning Activities (See Attachment E)
Carol Feld, Associate Director for Scientific Program and Policy Analysis, gave an overview of how the strategic planning activities were evolving in preparation for completing the plan and sending it to Dr. Varmus by December 31, 1999. She described the process for developing the plan, the framework, and the working groups that were drafting various parts of the plan. She pointed out that there were several cross-cutting themes, which included identifying scientific opportunities and needs, uniting NIDDK programs, promoting trans-NIH collaborations, using disease examples as illustrations, and complementing existing Institute planning efforts. She described the chapters to be included in the plan and gave the scope of the plan. She pointed out that a critical part was the involvement of public input into the planning process.
The working groups included the topics: Genes and Disease (chaired by Dr. Josephine Briggs), Cells (chaired by Dr. Judith Fradkin), Disease Injury (chaired by Dr. Jay Hoofnagle), Prevention and Treatment (chaired by Dr. Richard Eastman), and Infrastructure (chaired by Dr. Walter Stolz). Each working group chairperson gave an overview of the salient features of their chapters.
Discussion
Council members asked about prioritizing goals in the strategic plan, and suggested both prioritizing and giving examples as well as having measurable goals for 5 years. Dr. Gorden responded that it was not necessary to prioritize the goals. Ms. Feld pointed out that it would be better to have more qualitative than quantitative goals. She said it was important to identify barriers to achieving the goals, and how to remove the barriers.
Council members pointed out that since this was an exercise, it was important to have some results with measurable outcomes.
Council members were concerned about moving research information not only from bench to bedside, but also from bedside back to the laboratory. They recommended that it should be patient-to-bench-to-patient program with appropriate examples in the report.
Council members expressed concerns about how the plan would be used in the future if it were not a priority setting document, particularly if it would be used as a guide for the Institute to invest its limited dollars. Dr. Gorden responded that for the last 2-3 years, special emphasis areas similar to the topics in the plan had been developed by the NIH, and that new NIDDK initiatives had been made that fit within these areas.
Council members recommended that the plan should give the NIH goals and priorities, as it would be important to document the accomplishments.
VI. Scientific Presentation: Sphingolipid Biology and Disease
Dr. Richard L. Proia from the NIDDK Intramural Division gave the scientific presentation. He described a family of metabolic diseases involving sphinogolipids that included Tay-Sachs and Gaucher diseases that he described as lysosomal storage diseases. He said that these were neurologic diseases and caused severe neurodegeneration. He said that in these patients, a class of molecules known as sphingolipids or glycosphingolipids accumulate in the lysosomal cells in the patients' bodies due to the absence of a degradative enzyme. He said that his work focused on the pathogenesis of these diseases and on the function of the sphingolipid molecule that is stored. He said the molecule was found on the cell membrane of every cell in the body, and he described the molecule and the fact that it attracts signaling proteins. He described knockout mouse models of the diseases. He gave the results of the experiments with the different knockout mice. He described some potential therapies for these diseases.
Division Director's Report
A. Division of Extramural Activities
Dr. Stolz gave his Division report and described the increase in the numbers of applications received. He said that the Center for Scientific Review had helped with some of the reviews by reviewing over 300 applications that normally would have been reviewed by the Institute. He pointed out that with the large FY 1999 budget it took a lot of work to get the applications awarded.
B. Division of Diabetes, Endocrinology, and Metabolic Diseases
Dr. Eastman gave the Division report. He began his report by commenting that when he became Division Director, his first task was to set up a major clinical trial on prevention of type 2 diabetes. Dr. Sandy Garfield gave an update on this trial, the Diabetes Prevention Program (DPP), by reviewing some of the background on the study, the goals of the trial, and the progress made to date.
Dr. Maren Laughlin reported on a meeting called Metabolism for the Millennium, co-sponsored with NIGMS. Dr. Eastman reported on other meetings to be sponsored by the Division.
Discussion
A Council member asked about guidelines for the DPP study for blood pressure control. Dr. Eastman responded that specific recommendations had been developed for blood pressure control and diabetes control and were being provided to the primary care physicians.
A Council member asked if the participants had received information as to what they could expect from the trial; if not, he recommended that the Institute provide this information.
A Council member mentioned that high protein diets were being generally recommended and asked whether the effect of high protein diets should be assessed. Dr. Eastman said that dietary intake information was being monitored and that the effects of high protein diets would be picked up.
C. Division of Digestive Diseases and Nutrition
Dr. Hoofnagle gave the Division report and said that this past year, the Division had several RFAs. He described the "SHOW" clinical trial, designed to measure the long-term health outcomes of intentional weight loss. He said that they were able to obtain funds from other institutes to help support this program.
Other RFAs mentioned as being implemented were for the development of an endoscopy database to do epidemiology studies of digestive diseases, and for research on GI motility disorders.
D. Divsion of Kidney, Urologic, and Hematologic Diseases
Dr. Briggs gave the Division report and began with initiatives and RFAs being sponsored by the Division. She described several, including the topics of nephropathy susceptible genes, PKD, and urinary incontinence. She gave an update on the Division's trans-NIH activity relating to the Zebrafish program. She described 3 workshops that would be held: Advances in Membrane Transport, Women and Renal Disease, and Epidemiology of Chronic Renal Insufficiency. She reported on a scientific success story involving the sodium-proton exchange (NHE) in which the introduction of sodium-proton exchangers into a plant had a remarkable effect on its salt tolerance.
VII. Consideration of Review of Grant Applications
Summary Table 1
| Applications Taken to Council |
All Applications by
Budget Category | Scored | NRFC | Deferred | No Action | Total |
Regular Research*
(P01, R01, R21,
R24, R37, R41, R42,
R43, R44, U01, U19) | 1,036 | - | 3 | - | 1,309 |
Other Research*
(R03, R13, R15, R18, K01,
K08, K23, K24) | 134 | - | - | - | 134 |
| Centers (P50) | 8 | - | - | - | 8 |
Training*
(T32, T35) | 15 | - | - | - | 15 |
| Totals | 1,193 | - | 3 | - | 1,196 |
* Includes both DK primary and secondary.
Summary Table 2
| Applications Taken to Council |
| Applications by Support Mechanism | Scored Application | NRFC | Deferred | No Action | Totals |
| Program Projects (P01) | 7 | - | - | - | 7 |
| Research (R01) | 733 | - | 3 | - | 736 |
| MERIT (R37) | 1 | - | - | - | 1 |
| STTR (R41) (R42) | 6 4 | - - | - - | - - | 6 4 |
| SBIR (R43) (R44) | 71 13 | - - | - - | - - | 71 13 |
| Cooperative Agreements (U01) (U19) | 62 9 | - - | - - | - - | 62 9 |
| Small Grants (R03) | 24 | - | - | - | 24 |
| Conferences (R13) | 20 | - | - | - | 20 |
| AREA (R15) | 17 | - | - | - | 17 |
| RDDP (R18) | 1 | - | - | - | 1 |
| Exploratory/Develop. (R21) | 122 | - | - | - | 122 |
| RR Research Project (R24) | 8 | - | - | - | 8 |
| Careers (K01) | 22 | - | - | - | 22 |
| CIA (K08) | 27 | - | - | - | 27 |
| PSA (K23) (K24) | 12 11 | - - | - - | - - | 12 11 |
| Special Centers (P50) | 8 | - | - | - | 8 |
| Training (T32) (T35) | 10 5 | - - | - - | - - | 10 5 |
| Totals | 1,193 | - | 3 | - | 1,196 |
Summary Table 3
| Applications Not Taken to Council |
| Applications by Support | Bottom-Tier | NRFC Applications | Excluded by Institute Staff | Non-Competing | Total |
| Traditional Research (R01) | 7 | 1 | - | 511 | 519 |
| STTR Phase I (R41) | - | - | - | 7 | 7 |
| STTR Phase II (R42) | - | - | - | 3 | 3 |
| SBIR Phase I (R43) | - | - | - | 60 | 60 |
| SBIR Phase II (R44) | - | - | - | 6 | 6 |
| Small Grants (R03) | - | 4 | - | 1 | 5 |
| AREA Grants (R15) | - | - | - | 4 | 4 |
| Exploratory Grants (R21) | - | - | - | 92 | 92 |
| RR Research Projects (R24) | - | 1 | - | - | 1 |
| Cooperative Agreements (U01) (U19) | - - | 1 - | - - | 9 1 | 10 1 |
| CIA (K08) | - | 1 | - | - | 1 |
| Totals | 7 | 8 | - | 694 | 709 |
VIII. Adjournment
Dr. Gorden thanked the Council members for their attendance and advice. There being no other business, Dr. Gorden adjourned the 151st meeting of the NDDK Advisory Council on September 10, 1999, at 11:15 a.m.
I hereby certify that, to the best of my knowledge, the foregoing summary minutes and attachments are accurate and complete.
Phillip Gorden, M.D.
Director, National Institute of Diabetes and Digestive and Kidney Diseases
and
Chairman, National Diabetes and Digestive and Kidney Diseases Advisory Council
