skip navigation nih record
Vol. LXVII, No. 1
January 2, 2015
cover

previous story

next story


‘A Hot One’
ACD Highlights Support for IRP, Deems NCS Infeasible

On the front page...

NIH director Dr. Francis Collins (l) at ACD
NIH director Dr. Francis Collins (l) at ACD
Not all biannual meetings of the advisory committee to the NIH director (ACD) are created equal, and the 109th version, held Dec. 11-12, lived up to NIH director Dr. Francis Collins’s prediction that it would be “a hot one.” Amid a welter of reports drawing impassioned comments, the NIH Intramural Research Program gained a hearty endorsement while the embattled National Children’s Study was closed down in favor of more nimble and focused investments to achieve its aims.

Continued...

“The Intramural Research Program is a real treasure of our country,” said Dr. Cato Laurencin of the University of Connecticut, who co-chaired the ACD working group charged with envisioning the IRP’s next 10 years. “It is an extremely important and valuable resource. We were highly impressed by what we saw.”

Nonetheless, Laurencin said, the standing of the IRP in the scientific community has decreased in the past 20 years and NIH “is not fully capitalizing” on the resources it has, most notably the Clinical Research Center. He got the impression that “the CRC is very much underutilized, in terms of patient beds, when we visited it.” He also lamented that, while he did meet with NIH senior leadership from underrepresented groups, “I don’t think I met one African-American or Hispanic principal investigator in my whole 4 months” of conducting the study.

Dr. Moncef Slaoui, chairman of research and development at GlaxoSmithKline, applauded NIH’s creation of candidate Ebola vaccines and called for more of them, worldwide.

Dr. Moncef Slaoui, chairman of research and development at GlaxoSmithKline, applauded NIH’s creation of candidate Ebola vaccines and called for more of them, worldwide.

The IRP should focus on “great scientific challenges,” said Laurencin, whose group recommended a trans-NIH innovation fund of approximately 1 percent of the IRP budget.

Federal limitations on travel for NIH scientists work against recruitment and retention of the best intramural scientists, he warned. “We were told that for every dollar of travel cost, there was an associated administrative burden of a dollar—that is the triumph of bureaucracy over reason,” Laurencin said.

Collins noted that the administrative burden for NIH travel involving some 200 employees in the past year was $12 million. “All for zero added value—is that ridiculous or what?” he said. “It is offensive that [science-related travel] is perceived as a perk.” The restrictions now in place “are not serving the needs of the country or anyone else.”

On the meeting’s second day, the ACD voted unanimously that the NCS, as currently outlined, is not feasible. Collins accepted the findings immediately and said that NIH would work with the administration and Congress to discontinue the study. He appointed Dr. David Murray, director of NIH’s Office of Disease Prevention, to begin closing the books on the study, which Congress had asked NIH to conduct in 2000. The study was supposed to enroll 100,000 children and follow them to age 21, but “encountered numerous roadblocks and hurdles” along the way, said Collins.

Collins (l) chats with Dr. Reed Tuckson, managing director of Tuckson Health Connections, who made the final appearance of his term as an ACD member. “NIH scientists really are underappreciated heroes,” Tuckson said, “and I intend to carry on that message as loud as I can scream it.”

Collins (l) chats with Dr. Reed Tuckson, managing director of Tuckson Health Connections, who made the final appearance of his term as an ACD member. “NIH scientists really are underappreciated heroes,” Tuckson said, “and I intend to carry on that message as loud as I can scream it.”

Photos: Bill Branson

“It was seen as becoming all things to all people,” said Collins, who also used the metaphor of a Christmas tree on which so many ornaments had been hung that the tree tipped over.

Collins had put the bulk of NCS, which has cost $1.2 billion in the past 14 years, on hold last June while a working group led by Drs. Russ Altman and Phil Pizzo, both of Stanford University, studied its feasibility. The group commended the longitudinal study’s aims, but cited excessive cost and flawed design as reasons to dissolve the effort.

Pizzo, former chief of NCI’s Pediatric Branch and a pediatrician for 40 years, explained that the NCS was born at a time when the NIH budget was doubling; the pediatric community felt “this is our chance” to do something bold. But in the intervening years, science has raced ahead, leaving both NCS’s size and tools behind.

“I mean, why not enroll 10 million people?” said Pizzo, noting that social media had not yet been invented when NCS was first built. Added Altman, “This study was designed before we all started saying ‘microbiome’ at the breakfast table.”

Collins said he endorses strongly the principles that originally motivated the NCS. “It is not only meritorious, but also highly worthwhile,” he said. But he recommended a diversity of approaches rather than a monolithic, single-study effort.


In other ACD items:

  • Dr. W. Ian Lipkin of Columbia University participates in a discussion on safety issues surrounding so-called “dual use research of concern,” warning that too many labs around the world are engaged in it. He also said he wouldn’t be surprised if smallpox virus were not confined, worldwide, to the two facilities allowed to have it.

    Dr. W. Ian Lipkin of Columbia University participates in a discussion on safety issues surrounding so-called “dual use research of concern,” warning that too many labs around the world are engaged in it. He also said he wouldn’t be surprised if smallpox virus were not confined, worldwide, to the two facilities allowed to have it.

    In his presentation on the “perfect storm” of the Ebola crisis in West Africa, which is 6 times greater than all previous outbreaks combined, NIAID director Dr. Anthony Fauci offered a stark portrait of the failings of the medical infrastructure in that part of the world: “I didn’t know what ‘limited health infrastructure’ meant until I realized that there are more doctors on a single floor of a building on K St. than there are in some whole countries in West Africa.”

  • The omnibus bill that funds NIH for FY 2015 has changed the name of the National Center for Complementary and Alternative Medicine to the National Center for Complementary and Integrative Health. The change took effect Dec. 17.

  • Collins announced that Bldg. 4 will be renamed in honor of former Sen. Lowell P. Weicker Jr. (D-CT) early in 2015. Weicker’s name had graced Bldg. 36 on campus since 1991, but that building was later demolished to make way for the Porter Neuroscience Research Center.

  • Collins acknowledged the service of National Library of Medicine director Dr. Donald Lindberg, who will retire in March after having led NLM since 1984. “He has been an incredible leader over a long period of amazing growth,” said Collins. He also announced the formation of a new ACD working group charged with formulating a new vision for NLM over the next decade. It will be chaired by Dr. Harlan Krumholz of Yale University and NHGRI director Dr. Eric Green.

back to top of page