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
“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
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
“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