Starting from Scratch
By Carla Garnett
On the Front Page...
Charles Campbell designs plastic hinges. Not just any hinges, though. Campbell's hinges are delicate, yet durable. They're so flexible that they move like human joints, so supple they look like human skin. He wonders if there may be a way to use the hinges for something besides the toys and dolls he makes. Would the hinges even be safe or effective in people?
Enter NIH's new National Institute of Biomedical Imaging and Bioengineering (NIBIB), established by Congress last December and officially announced in April. According to acting NIBIB director Dr. Donna Dean, the hypothetical Campbell's invention and the thousands more innovative engineering and imaging ideas with potential medical applications will be just the sort of research NIBIB will seek and support.
"NIBIB will fill in niches and open opportunities that don't currently exist at NIH," said Dean, who has served as a senior scientific advisor in the Office of the Director for the last 3 years. "The institute is a chance to develop such sciences as physics, engineering and math in biomedical research supported by NIH. We see tremendous potential in areas such as materials and device development. There are a lot of intriguing research questions scientists can ask with the establishment of this new institute."
When the President signed the legislation on the last business day of 2000, NIBIB became the 27th independent component of NIH. Immediately it gained a unique place in NIH history: NIBIB is the first modern IC created at NIH without a pre-existing infrastructure. For example, when the National Center on Minority Health and Health Disparities was launched at about the same time last year, its foundation already had been laid by the Office of Research on Minority Health. Similarly, when the National Institute on Deafness and Other Communication Disorders and the National Institute of Arthritis and Musculoskeletal and Skin Diseases were born, major components of the new entities were drawn from veteran institutes NINDS and NIDDK, respectively.
Dr. Donna Dean
In contrast, NIBIB gained instant institute stature, beginning essentially with a blank slate and several years of expectations from the radiology imaging and bioengineering scientists' groups that petitioned Congress for the addition to NIH's family.
"For many, many years 20, at least radiology societies had been interested in establishing an institute on imaging," recalls Dean, who helped implement the recent legislation creating NIBIB. "In the last 5 years or so, they expressed renewed interest."
In fact, in 1995 the Academy of Radiology Research a group of more than 20 imaging professional societies was formed specifically to work towards establishing an NIH institute devoted to the imaging discipline. A similar organization for medical engineers, the American Institute for Medical and Biomedical Engineering, joined the quest.
On its own, NIH had recognized the potential for an expanded, cross-cutting component on bioinformatics, imaging and engineering. In 1997, then-NIH director Dr. Harold Varmus formally created the Bioengineering Consortium (BECON), which consists of senior-level representatives from each IC, in addition to staff from other federal agencies concerned with biomedical research and development. NIH acting director Dr. Ruth Kirschstein sought to expand such efforts and intended to elevate the work to a component of the Office of the Director that was to be called the Office of Bioimaging, Bioengineering and Bioinfor-matics ("OB-cubed," familiarly). Establishment of the entity had been a topic of discussion at biennial meetings of the advisory committee to the NIH director for several years, and was already written into NIH's budget request for fiscal year 2001.
Building an Institute
So, how does one build an institute from the ground up?
"'You've got to be careful if you don't know where you're going, because you might not get there,'" Dean quips, lifting a Yogi Berra-ism. "That's my planning quote. We have to have a vision even if it's only a preliminary one to guide us in these early stages. I don't want to fall into having no view or vision of what we're going to do. Right now, we have several parallel activities under way establishing an advisory council and writing a charter for it, recruiting a permanent director, and setting up such internal administrative functions as hiring executive and administrative officers, staff to handle disbursing the budget and health scientist administrators to work with the grants portfolio."
For the past 2 months, Dean says she has been giving talks and briefings on the new institute.
"There's considerable interest in having NIBIB representatives speak at professional meetings," she says. And while the groups have eagerly anticipated the creation of NIBIB, she notes, they haven't been applying a great deal of pressure for quick results. "They understand the complexities of getting something new up and running."
A current priority is developing the justification for the fiscal year 2002 budget request that all ICs present to the congressional appropriations committee every spring, and then responding to the resulting questions. The President asked Congress to appropriate $40.2 million of new money for NIBIB in fiscal year 2002. At the moment, NIBIB has just 3.5 full-time employees to handle the multitasking.
One building block for the new institute is BECON, which has developed critical new grants mechanisms such as the bioengineering research partnership grants.
"Creating an intramural research entity is not on the front burner at the moment," acknowledges Dean, who came to NIH as a research chemist in biochemical endocrinology following postdoctoral work at Princeton University. In addition, she stresses, disease-specific bioimaging and bioengineering research will stay where it is, among the individual ICs. A task force of IC directors has been appointed to identify existing grants that should be moved to the new institute.
Dr. Dick Swaja and Mollie Sourwein, who operate BECON under the Office of Extramural Research, now manage the consortium for NIBIB. NIDDK's Dr. Joan Harmon is on a part-time detail assignment to the new institute.
In Her Element
Although it's clear her hands are full, what's also clear is that Dean seems to be enjoying every hectic, action-packed minute.
"My days are unpredictable," concludes Dean, who says she relies heavily on her recent experience as NIH's liaison to the Congressional Commission on the Advancement of Women and Minorities in Science, Engineering and Technology Development. "There's a lot of enthusiasm and brainstorming, and a lot of deadlines. The institute has been received very well so far and I've enjoyed a lot of support both inside and outside NIH.
"Dealing with the entire breadth of NIH gives you an appreciation for what NIH does and all the areas of science it covers," she continues, recalling her 15 years of experience in the scientific and administrative management of the agency's initial peer review process. "It has enabled me to see patterns and witness the cross-cutting interaction among the institutes. I think that's where NIBIB's place will be in 5 years or so, when everything's running smoothly and it's generating new and varied research opportunities and initiatives. I have found myself quoting something Dr. Kirschstein has often said, 'We do not think that we can differentiate between science that is relevant to health and science that is not.' We need all the disciplines to help us move toward better health for everyone."
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