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Pilot IDeA Program Announced
ACD Hears Plan to Broaden Distribution of NIH Grants

By Carla Garnett

Although NIH funds medical research or research training in every state in the union, nearly half (23 states plus Puerto Rico) are not participating in research as fully as NIH would like. To help these regions increase their capacity for medical research, NIH will launch a pilot Institutional Development Award (IDeA) program to begin this fall, according to NIH acting director Dr. Ruth Kirschstein, who broached the topic in her report at the 82nd meeting of the advisory committee to the NIH director (ACD) on June 7.

"We have designed a new program of planning and feasibility grants that will be awarded to consortia of institutions of higher education from these states," Kirschstein said, describing the Biomedical Research Infrastructure Network (BRIN), a subcomponent of the IDeA program that has been developed to enhance the capacity of institutions located in states that have not fully participated in medical research, and that are eligible for participation in IDeA.

Providing Seed Money

IDeA is not new, Kirschstein explained. The program was established in 1993 by the National Center for Research Resources to help regions compete better for NIH funding. In fact, the president's budget request for NIH in fiscal year 2002 includes a total of $135 million for the IDeA program, which is an increase of $35 million over FY 2001. The increase will bring NIH's support to a total of $75 million for BRIN, which will provide $2 million a year for 3 years to each region that is determined to be under-performing in NIH-funded medical research. Following the 3-year period, an evaluation will determine if the consortia's grants are eligible for a 3-year renewal.

Several ACD members raised questions about BRIN. "This is a dangerous direction potentially," cautioned Dr. Thomas Cech, president of Howard Hughes Medical Institute. "It could rock the foundation of the review process. Throwing funds on infertile ground is not going to result in anything...Maybe some of these states have pockets of excellence in certain areas that can be nurtured. I'm sure they do. The question is how do we use this money to nurture these areas of excellence."

Kirschstein reiterated that the program is a way to determine if ground in these areas is fertile for medical research or not within 3 years. If in that time, a state consortium's projects do not flourish, then the grant will not be renewed.

Emphasis on Clinical Research

Also announced during the day-long meeting was NIH's new authority to offer loan repayment to individuals who agree to pursue clinical research activities. Similar to the loan repayment program begun in 1989 to individuals studying HIV/AIDS, the loan repayment program for clinical investigators would offer up to $35,000 a year plus tax reimbursements. The program — open to extramural scientists — would begin as a pilot for about 260 individuals and could be put in place as soon as Oct. 1. Updates will be posted to when available.

"The reason for launching it as a relatively small pilot is that we have found that such loan repayment programs are labor-intensive [to administer]," Kirschstein said, explaining that each participant enters with NIH into a contractual agreement that must be carefully monitored and all funds closely tracked. "We're very excited about this program and we see it as one more incentive to move people into clinical research." An additional loan repayment program for investigators studying health disparities is also in developmental stages, she reported.

Several other funding mechanisms — K23 awards, for early career mentors; K24 awards, for mid-career mentors; and K30 awards, curriculum grants for teaching protocol development — are also part of NIH's efforts to reinvigorate its clinical research portfolio.

"The ultimate outcome is that better trained clinical investigators will be more successful in the grants process," said NIH deputy director for extramural research Dr. Wendy Baldwin. "That's the goal, but that takes a long time. Obviously we will have to re-evaluate these programs before we get there."

Genomicists' Work Never Done

Based on a paper, "Human Genome and Beyond," published in Nature in February, Dr. Eric Lander, director of the Whitehead Institute/MIT Center for Genome Research, gave the committee an update on the 15-year-old Human Genome Project. Far from being over now that the human genome map is 95 percent complete, Lander said, a great deal more work must begin to interpret what the data mean.

Aside from the incredible information already gleaned from the project, Lander said "there's one other thing you learn from the genome and it's not about the biology, per se, it's about doing the biology, doing the biomedical research. The other great lesson we can learn from this experience is the tremendous importance of the way we built scientific community. The notion that we should invest in creating scientific infrastructure is not something that was well established 15 years ago. Now I hope it's become religion to all. We can be so much more efficient by having databases, by sharing tools. We also learned the tremendous importance of international cooperation."

Describing the genome as "the world's greatest epidemiological study," Lander said in order to fulfill the promise of genomics the work should not pause simply because the map is nearing completion. He identified several areas such as gene description, comparative genomics, structural genomics, chemical genomics and medical and population genomics that still need exploration. He also said a prodigious amount of bioinformatics will be required to interpret the findings.

"Well, are we there yet?" he asked, rhetorically. "Certainly not. A tremendous amount more investment in infrastructure is still needed. A genomicist's work is never done."

Update on Personnel Issues

Other research advances Kirschstein mentioned at the meeting include extramural studies that found that heart cells can regenerate, and that bone marrow cells can be made into heart muscle cells — both studies done by the same team — and an intramural NIDCD study on the genetic basis of musical pitch.

Budget issues were addressed as well, with particular attention directed to planning for the so-called "soft landing" year — the fiscal year after Congress's 5-year effort to double NIH's budget concludes.

Presiding for the third time over the ACD, Kirschstein said farewell to outgoing ACD members, including Lander and Drs. Steven Chu of Stanford University, Yank Coble of Jacksonville, Fla., and Shirley Tilghman, who was elected president of Princeton University on May 5. Four new members will be named to the ACD in time for its next meeting.

"I cannot thank you all enough for your wise counsel and service to NIH," Kirschstein said, leading a standing ovation for Tilghman, who assumed her new duties officially on June 15.

Announcing personnel changes closer to home, Kirschstein welcomed Drs. Paul Sieving and Barry Kramer. Sieving was appointed director of the National Eye Institute; Kramer was named NIH associate director for disease prevention and will continue as head of the Office of Medical Applications of Research. Longtime NIH'er Dr. Donna Dean was announced as acting director of the newest institute, the National Institute of Biomedical Imaging and Bioengineering. The search for a permanent NIBIB director is expected to be under way later this summer. Kirschstein also mentioned that the search committee for a director of the National Institute of Neurological Disorders and Stroke is "working assiduously" to replace former NINDS director Dr. Gerald Fischbach, who left earlier this year for Columbia University. The next ACD meeting is scheduled for Dec. 6.

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