'A Watershed Moment'
By Rich McManus
On the Front Page...
Last December, at a White House meeting with the President and Vice President, a group that included Varmus, HHS Secretary Donna Shalala, Office of AIDS Research director Dr. William Paul, NIAID director Dr. Anthony Fauci, CDC representative Dr. Helene Gayle and Patsy Fleming of the White House AIDS Office, discussed the AIDS issue, including hope for a future vaccine. Meanwhile at NIH, a case was being made for locating a major HIV vaccine initiative within the intramural program. It was an idea championed by Paul, who had proposed it initially among colleagues at NIH, and which gathered momentum as officials here recognized that the intramural program's traditional strength has been an ability to respond quickly, and with real muscle, to major research challenges.
"Bill Paul had recommended the historical strength of intramural NIH," said Varmus, "because it can respond quickly and put experts together in a useful, directed way. It can move much faster than grantees can.
"The idea percolated among several of us for awhile as we tried to imagine how to coordinate 15 different intramural programs. Eventually, two highly enlightened ICD directors, Dr. Fauci and Dr. Klausner, agreed to launch a joint venture."
Varmus joked that, on the day of their discussion with the President, Clinton had laryngitis, and was thus disposed to listen rather than talk. "We had an excellent opportunity to catch his attention," he noted.
The idea of a Vaccine Research Center "was rolling along anyway," continued Varmus, but the timing of the announcement by the President, although anticipated by NIH officials, came as something of a surprise. "The pressure is now on all of us to achieve something."
Resources for the new "center without walls" will come from NIAID and NCI through normal budget channels overseen by the Office of AIDS Research, noted Varmus, "but there will be a substantial degree of my office's involvement. I'll be somewhat in the spotlight.
"In fact, the White House has already called to ask 'How's it going?'," he divulged. "They want to know when Clinton can come out to cut the ribbon on a new facility."
Varmus said he anticipates "additional resources for a centralized [vaccine research] effort including space, plain old money, and primates. Requests will undoubtedly outstrip the supply." He said a resource evaluation committee will be named shortly, and will make quick decisions on requests from researchers.
"Where is the center?" he asked rhetorically. "At this hour, in this room. In the next few months, we will identify space on campus for likeminded individuals to gather. There may be some construction in the long term. We are quite committed to finding a residence for the center."
Varmus said a position description is currently being drafted for the new VRC director, a nationwide search for whom will commence soon. "The ideal candidate would be someone with experience in fundamental science, and some practical experience in developing a vaccine." The position will be advertised for 45 days. The newly named AIDS vaccine research committee, chaired by Nobel laureate Dr. David Baltimore, will also serve as a scientific advisory committee for the VRC.
Varmus christened the May 28 meeting as the first of a series of biweekly gatherings at which interested individuals can come to hear speakers and participate in discussion groups. A 7-person steering committee (including NCI's Drs. Jay Berzofsky, Genoveffa Franchini and Larry Arthur; NIAID's Drs. Bernard Moss, Malcolm Martin and Ron Germain; and OAR's Dr. Bonnie Mathieson) will invite speakers and moderate discussions. Varmus said the meetings will likely adopt a regular site and time.
The director then invited each person in the room to rise, identify him or herself and say a few words about HIV-relevant research interests. At the conclusion of this orientation, he remarked, "There's a lot of talent, energy and expertise in the room," and pointed out that it is not the usual thing at NIH for such a heterogeneous group to focus on "a community effort." He challenged the group to find out who among them is "willing to change direction."
OAR's Paul said, "I believe this institution has an enormous amount to offer. We all believe we can make a contribution." He said that, in anticipation that the VRC would come to fruition, OAR's budget preparation for fiscal year 1998 added a total of $10 million, split equally, to NIAID and NCI AIDS research, but acknowledged "we don't yet know what resources will be required." The total FY 1998 proposal for both intra- and extramural AIDS vaccine research is $150 million, an increase of about 33 percent over the past 2 years.
"We hope to get a vaccine for AIDS and also for other infectious diseases," Paul said. "I applaud the willingness of our researchers to join in our discussions and effort. I'm personally delighted to see this process moving forward."
Observed NIAID's Fauci, "There is a really extraordinary amount of good will, collegiality and cooperation" on this project so far. "It's not a superficial commitment. This is a unique, two-institute phenomenon. Rick [Klausner] and I are highly committed to making this center work."
He told the assembly of scientists, "We will be relying very heavily on the input of your ideas on directions, projects, themes. Don't hesitate to offer ideas."
Representing NCI director Dr. Richard Klausner, Dr. George Vande Woude, a special advisor to Klausner, said, "This is a watershed moment for the institutes at NIH to provide an environment for this talented body of scientists to work together. I'm very touched by it. After many, many years here, it's impressive."
"This is the time, and this is the place to develop an HIV vaccine," declared Dr. Michael Gottesman, NIH deputy director for intramural research. "We'll do everything we can to make it easy, and possible, to make this center a reality."
Varmus said an email net will link interested intramural parties in the VRC, and emphasized that membership was by no means limited to those present; indeed, all of the officials who spoke welcomed helpful input from any quarter.
In response to a series of questions from the audience, Varmus and others assured that precedents exist for collaborating with industry on an eventual product, and that he and Paul can devote discretionary funds to the VRC. Varmus said ancillary goals on the way to creating an AIDS vaccine might include cleverer ways of making use of the human immune response so that vaccines might eventually be crafted for such diseases as tuberculosis and malaria.
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