The Department of Defense (DOD), through the U.S. Army Medical Research and Material Command, has received appropriations since 1992 for programs of biomedical research on breast, prostate, and ovarian cancer, neurofibromatosis, osteoporosis, and other health problems. Appropriations for the Congressionally Directed Medical Research Programs (CDMRP) are used to support peer reviewed extramural research grants.

Recently Congress has become concerned about funding increases for the programs given the demands on the military budget and directed DOD to ask the Institute of Medicine (IOM) to study alternative funding sources, including nonfederal and private sector contributions, that could extend the appropriated funds without biasing the peer review project selection process.

The IOM established a committee with expertise in sources of funding of biomedical research and how such funding can be combined or coordinated to increase the productivity and impact of biomedical research and its applications. This committee

• examined how federal agencies fund research--especially strategies to stimulate nonfederal investments, federal-private research partnerships, and technology transfer of federally funded research results into new methods of prevention, diagnosis, and treatment;
• identified effective federal-nonfederal collaborations that maintain quality through peer review of research proposals; and
• recommended alternative and/or novel strategies for increasing the size and impact of CDMRP while ensuring its quality.

In a time of promising opportunities to make substantial progress against cancer and other deadly diseases, but increased fiscal stringency, the committee's report may have relevance beyond DOD.