February 3, 2003

NIH 'vision' shared in Future Makers lecture


By Eric Rangus erangus@emory.edu

As its giveaway title, “A New Vision for the NIH,” implied, the latest Future Makers Lecture focused on the challenges currently facing the flagship organization for medical research in the United States and how they will be overcome. At the podium was the new National Institutes of Health (NIH) director, Elias Zerhouni.

“We have to refocus our energy on bright ideas and bright people,” said Zerhouni, who was named NIH director by President George W. Bush last May. He spoke to a crowd of around 200 in WHSCAB auditorium, Jan. 28. “We want to move from a project- to a people-oriented structure,” he said.

Zerhouni said the NIH’s current structure does little to reward younger scientists whose work can be more innovative and whose verve could be greater than their more-experienced counterparts.

Under the current system, Zerhouni said, some Nobel Prize-winning scientists under 40 would not have been able to receive grants until after their honored work had been completed.

The keys to his new vision, Zerhouni said, are to explore revolutionary methods of research, to blaze new pathways to discovery, to reform the clinical research enterprise and to come up with a new idea for scientific teams of the future.

Most of the issues, he said, are systemic. There isn’t enough interdisciplinary work, and the boundary-crossing research that does exist fails to properly reward the researchers who do it.

Zerhouni related a story from a meeting with Emory medical school faculty earlier in the day, recalling that one researcher said he felt he was not being properly recognized for his work, which was part of an interdisciplinary research team. The researcher said recognition was important because promotions depend on such notoriety.

“Doctors don’t get enough credit,” Zerhouni said.

While Zerhouni spent a good deal of time identifying problems, he also pointed out a lot of successes. Zerhouni opened his lecture by outlining many of the strengths of the nation’s health care system and how biomedical research has saved tens of thousands of lives.

For instance, at one time the projected number of deaths from AIDS in 2000 was 77,000. The actual number of deaths, because of vastly improved drug treatment was 15,000. Deaths from heart disease, once projected to be 1.3 million in 2000, were less than half that. And where hepatitis resulted from 23 percent of blood transfusions in 1968, today that percentage is 0.3 percent.

Zerhouni sketched out some of the health care crises facing the country, as well. Obesity, diabetes, biodefense, new viruses like West Nile and age-related maladies such as Alzheimer’s disease were some of the new challenges. Zerhouni also touched on the costs of health care, which will continue to rise even as the population gets healthier.

“The more successful you are in preventing disease,” he said, “the more expensive it is to reduce disease over an entire life cycle”

As was appropriate considering the setting, Zerhouni spoke also of the importance of academic research institutions, which receive around $19.3 billion in NIH support each year, 83 percent of its budget. “It is universities that drive us,” he said. University health centers, he added, are particularly important in promoting interdisciplinary research.

Introducing Zerhouni was Michael Johns, executive vice president for health affairs. Their relationship dates to 1990 when Johns was dean of the medical faculty at the Johns Hopkins Medical School and Zerhouni was director of the MRI division in the radiology department.

“He was bright, articulate and engaging,” Johns said. “I’d never met anyone with his optimism, vision and energy. He has an incredible presence.”

A native of Algeria, Zerhouni earned his medical degree at the University of Algiers Medical School and completed residency at Johns Hopkins. He first joined Hopkins’ faculty in 1979 and eventually served as executive vice dean of its school of medicine before being named NIH director.






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