In response to the emergence of the HIV/AIDS epidemic in the early 1980s, the NIH received an infusion of funds appropriated by Congress earmarked for AIDS research. Most of the earliest AIDS research was conducted by the National Cancer Institute (NCI) and the National Institute of Allergy and Infectious Diseases (NIAID), which, by 1985 was the lead Institute sponsoring AIDS research. The challenges posed by AIDS, however, exceeded the mission of any individual Institute. AIDS is a multi-system and multi-organ disease, involving malignancies, opportunistic infections, and cardiovascular, neurological, gynecological, ocular, oral, dermatological, and gastrointestinal complications. It affects people across the life span from infancy to old age. Behavioral and biomedical interventions are required to prevent new infections. Consequently, virtually every NIH Institute and Center (IC) became involved in conducting or supporting AIDS research.
This burgeoning effort required coordination. The OAR was established in 1988 for this purpose. The Office was established first by the Assistant Secretary of Health and later codified in the Health Omnibus Programs Extension of 1988 (Public Law 100-607).
As the AIDS research program grew, greater coordination and budget authority was required. However, its limited authority hindered its ability to fully coordinate the diverse AIDS-related research carried out by the ICs. In turn, this limited the ability of NIH to set overall scientific priorities, manage the vast research endeavor, and evaluate and assess progress against the disease.
One solution to coordinate this diverse research might have been to establish a new Institute dedicated to AIDS research. However, such an action would have involved considerable disruption of ongoing science. It became clear to many concerned scientists, legislators, and community representatives that greater authority was needed to strengthen the OAR so that it would function as an “Institute without walls” as a part of the Office of the NIH Director. Congress subsequently passed the NIH Revitalization Act of 1993, which significantly strengthened the OAR, providing it with the authority to plan, coordinate, and evaluate AIDS research, to set scientific priorities, and to determine the budgets for all NIH Institute and Center AIDS research.
The OAR has established trans-NIH Coordinating Committees for each of the major scientific areas of AIDS research. The Coordinating Committees provide input during the annual planning process and in the development of special initiatives. These committees are composed of NIH intramural scientists and extramural Health Scientist Administrators from ICs with AIDS research portfolios in each of the specific areas. In addition, each IC has a designated AIDS Coordinator to facilitate communication and collaboration with OAR.