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Zerhouni To Be 15th NIH Director

By Rich McManus

On the Front Page...

Dr. Elias Zerhouni (pronounced eh-LEE-as zer-HOO-nee) was confirmed, by unanimous voice vote of the full U.S. Senate on May 2, to become 15th director of the National Institutes of Health. Two days earlier, at a 75-minute confirmation hearing before the Senate committee on health, education, labor, and pensions chaired by Sen. Ted Kennedy (which also voted unanimously to confirm), Zerhouni offered a preliminary vision of his plans for NIH, which include relying not only on the creative spark of the individual scientist, but also on a "new science" approach emphasizing multidisciplinary teams working in concert.


A successful administrator, entrepreneur, basic scientist and clinician himself during more than a quarter century at Johns Hopkins University School of Medicine, Zerhouni, who appeared with his mother, his wife Nadia and three children, as well as with a friend from his native Algeria whom he has known since the sixth grade, fielded mostly compliments from Kennedy's committee, who called him a "rare find," an encapsulation of the American dream, and a man whose trademark humility should not, in the words of Sen. John Warner (R-Va.), prevent him from "going at it with both fists [in Congress] to get everything you can get for NIH."

Committee members Sen. Paul Sarbanes of Maryland, along with Sen. Barbara Mikulski, also of Maryland, offered introductory biographical details about Zerhouni (see below). Establishing a friendly tone from the outset, Sarbanes even told the hearing that his wife, a schoolteacher, had instructed Zerhouni's daughter Yasmin and gained "a very positive impression of the family."

Dr. Elias Zerhouni
Zerhouni, who was most recently executive vice dean of the Hopkins medical school, chair of its department of radiology and radiological science, and professor of radiology and biomedical engineering, said his experience in Baltimore has taught him that he could not succeed without getting input from many scientific disciplines, from the most basic to the most clinical. With respect to the former, he declared, "I am convinced that further fundamental discovery will help us face future challenges in health care." He added, "We still have to make discoveries that will facilitate the way we deliver health care." Calling for a more rapid translation of the fruits of basic research to patient care, he said, "Biomedical research in the year 2002 is at a turning point that may require new strategies." He then produced two items: a DNA chip, representing a "revolution in technology that is unprecedented in its rate and scale," and a tiny needle whose point was nonetheless larger than an individual cell, which holds "all human DNA — the entire molecular machinery...While we have discovered the component parts of the human genome, the real challenge for the 21st century is to discover how all the parts work together. That is the biggest challenge for medicine." The quest will require multidisciplinary teams and cross-cutting initiatives, he said, as well as the "creative spark of the individual that leads to new knowledge and progress."

Zerhouni — who has also been vice dean for research at Hopkins, as well as a member of the National Academy of Science's Institute of Medicine since 2000, and has served on NCI's board of scientific advisors since 1998 — acknowledged that advances in genome and stem cell science have given rise to "deep moral issues" and that the debate over such issues "can be polarizing." He said he had made a series of personal visits with senators to discuss his views on these and other issues, and concluded, "Disease knows no politics — NIH must serve all of must not be factional, but must remain factual." NIH's role is to present data to inform debate on moral issues, he said.

One of his greatest recent successes at Hopkins was securing funds to establish an Institute of Cell Engineering, which is expected to take advantage of stem cell research, an area where federal funding has lagged to date, he said.

He completed his opening statement by acknowledging the outstanding service of Dr. Ruth Kirschstein, who has been acting NIH director since Jan. 1, 2000 (she was also hailed by virtually every member of the committee, and was recognized with an ovation) and the advice of NIH's last director, Dr. Harold Varmus. "Both have been very helpful to me during this process," said Zerhouni.

Echoing a sentiment he expressed at his Mar. 26 nomination ceremony at the White House, Zerhouni concluded, "As an immigrant, I am very touched by being here today. It says about our great country what no other country can say about itself."

Kennedy began the questioning, asking Zerhouni what he hoped to achieve as director. "I want to reestablish morale and momentum, and provide the vision and energy to recruit a number of institute directors in order to make the agency even more effective than it has been," Zerhouni said. He added that priority-setting would be a major challenge. "Science is evolving at such a pace that cross-cutting initiatives need to be encouraged," he continued. He said he would work to enhance interactions among scientists, identify bottlenecks to research progress and address them.

He also said scientists need more resources, and proposed a National Molecular Library, which could quickly provide researchers with biological molecules of interest. "That's my own notion," he cautioned. "I haven't yet sought the advice of my peers." He also mused about a National Institute of Emerging Biotechnologies, to take advantage of a broad range of breakthroughs in such areas as nanotechnology.

On other issues, Zerhouni said he would live within established guidelines on stem cells and conduct such research in an "open and transparent" manner; emphasized that NIH should play a major role in "ingraining a culture of safety" in trials involving humans; explained that clinical trials have their own "ecosystem" that must be managed and understood; and maintained NIH must do more to understand the self-destructive behaviors that lie behind much preventable disease.

Asked a very broad question by Mikulski concerning managing everything from fire trucks to Nobel Prize winners, along with recruiting and retaining minority investigators, Zerhouni calmly admitted that he didn't have a catch-all answer in his pocket. Mikulski laughed, "I'm sure the White House warned you not to break new ground or break any knuckles today." Zerhouni said the loss of capable minorities was the number-one problem in biomedical training, observing that science does a good job of attracting such trainees, but a poor job of keeping them. "It took me 5 years to break in to being funded by NIH," he commiserated. "I think role models could play an important role in enticing new scientists to stay."

Kennedy ended the hearing by congratulating President Bush on nominating such a strong candidate. "I think our country is very fortunate to have Dr. Zerhouni at the helm of the NIH, and the world is, too."

New Director No Stranger to NIH

President Bush's choice to lead NIH is not a stranger either to the agency or government. In 1985, he was a consultant to the White House, and is currently a principal investigator on three NIH grants and coinvestigator on two others. He also holds five patents, one singularly and four jointly. His 35-page curriculum vitae lists 157 publications as author or coauthor, and 11 book chapters.

According to a biographical sketch prepared by Johns Hopkins, Dr. Elias Adam Zerhouni, 51, was born in Nedroma, Algeria, a small mountain town on French Algeria's western border. He was one of eight children and his dad taught math and physics. He came to the U.S. at age 24, having earned his medical degree at the University of Algiers School of Medicine in 1975. He completed his residency in diagnostic radiology at Hopkins in 1978 as chief resident. Except for a 4-year stint in the department of radiology at Eastern Virginia Medical School, he has spent his entire career at Johns Hopkins.

Dr. Elias Adam Zerhouni

Zerhouni's choice of radiology, says the Hopkins bio, reflects the influence of his maternal uncle, a well-known radiologist who trained in France and Sweden. "He showed Dr. Zerhouni the world's first CT scan images of the brain soon after they were made by England's Dr. Godfrey Hounsfield, prompting his nephew's pursuit of radiology, a field that combined his interests in physics and mathematics with medicine. (A poignant honor for Dr. Zerhouni earlier this year was his appointment as Hounsfield lecturer at the European Congress of Radiology.)"

Zerhouni is credited with having "led efforts at Hopkins to restructure the school of medicine's Clinical Practice Association; developed a comprehensive strategic plan for research; helped reorganize the school's academic leadership and worked with elected officials to plan a major biotechnology research park and urban revitalization project near the Hopkins medical campus...Zerhouni believes that bringing the fruits of biomedical research to the bedside requires integration of discoveries across basic science and clinical disciplines, a departure from traditional specialty 'silos' characteristic of academic medicine. He is known as an innovator with a knack for identifying major trends within complex situations, defining a vision and building consensus for action."

The Hopkins biography concludes, "Married to Nadia Azza, a pediatrician and medical school classmate whom he met when both qualified for the Algerian national swimming team during high school, the couple has three children. Will, 25, is a second-year student at Harvard Law School. Yasmin, 22, just finished her undergraduate work at Columbia University and will pursue a master's degree in education at Columbia. Adam, 16, is a junior at the Severn School in Severna Park, Md., where the family lives. Now fluent in English, French and Arabic, and conversant in German as well, Zerhouni plays lute and piano ('neither very well!' he insists) and shares an enthusiasm for opera and tennis with his wife [who works at the international adoption clinic at Johns Hopkins]." He adds, "Free and scuba diving with the kids is something we love doing, too."

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