- The Washington Times - Tuesday, September 30, 2003

The National Institutes of Health is reinventing itself, intent on converting a lumbering bureaucracy into a nimble medical strike force.

NIH Director Dr. Elias Zerhouni released a new strategic “road map” for the agency yesterday, emphasizing the initiative would “remove some of the biggest roadblocks that are keeping research findings from reaching the public as swiftly as possible.”

The agency — which employs about 18,000 people and has a $23 billion annual budget — has spent the last year soul-searching about its mission. Hundreds of outside advisers and longtime employees have had a say. There have been forums, focus groups, retreats, conferences and lectures.

NIH has emerged with a hipper edge and marketing savvy.

Dr. Zerhouni talks of his 116-year-old enclave like a contemporary corporate entity, insisting that NIH will “optimize its entire research portfolio” and is “uniquely positioned to spark changes.”

He also insists his new road map — which includes 28 distinct components, three underlying themes and a formidable infrastructure — is not intended to be “business as usual under another name.”

Indeed, the plan has all the hallmarks of a genuine shake-up that could break up traditional research fiefdoms around the Bethesda campus and foster provocative press — not to mention some genuine medical innovations.

The initiative has issued a dramatic call for the United States to “recast its entire system of clinical research,” categorizing such change as the NIH’s most important challenge.

Health and Human Services Secretary Tommy G. Thompson called the plan a “compelling vision” and agrees that NIH “must lead the way.”

The old-fashioned ivory tower and genius ego could become a rarity at NIH. Dr. Zerhouni wants his doctors and scientists to share their information through efficient “interdisciplinary, team-oriented environments.”

He also wants his people to push the investigation envelope. The new plan establishes specific funding “to encourage creative, outside-the-box thinkers” overlooked in the past by an entrenched peer-review process favoring low-risk research proposals.

NIH also plans to encourage partnerships in the private realm and disband what it calls the “cottage industry” model of research, which confined researchers to their own little niches. “Artificial organizational barriers,” NIH noted in a mission statement, “may in some instances impede the pace of scientific discovery.”

Indeed, the new plan seeks to foster the kind of whiz-bang discoveries that intrigue the public and press alike — particularly valuable as NIH faces the grim challenges of bioterrorism.

The agency was picketed recently by irate local residents vexed by an NIH plan to build a bioterrorism lab just a few blocks from their homes.

Meanwhile, the initiative will include a supercomputer-controlled “bioinformation” center, complete with its own specialized software, to track cutting-edge research for the global medical community. NIH also plans to probe the “molecular pathways” that yield good health and dire illness alike.

The new Nanomedicine Centers are sure to get the most notice, however.

The “handful” of interdisciplinary centers will be staffed by biologists, physicians, mathematicians, engineers and computer scientists who will one day develop “body-friendly nanotools” and the medical language and protocols to go with them.

Prototype molecule-size devices — researchers already envision insulin pumps and disease sensors — could become reality in the next decade.

The new NIH plan can be seen at the Institutes’ Web site, at https://nihroadmap.nih.gov

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