The greatest risk in science is to stop taking risks,? said Elias A. Zerhouni, Director of the National Institutes of Health (NIH), Bethesda, Md.
Risk-taking is just one of the several strategies that Dr. Zerhouni advocates for addressing today?s challenges in medical research. He discussed these challenges and described his vision for the future in ?Medical Research at the Crossroads: NIH Strategies for the Future,? held on Tuesday at Scientific Sessions.
The NIH?s $28.6 billion budget, a total that has changed little over the past three years, poses one of the greatest challenges. Dr. Zerhouni said that this budget is facing a ?perfect storm? that has been created by such factors as federal and trade deficits, defense and Homeland Security spending, Hurricane Katrina, pandemic flu and a call for more focus on physical sciences, among others.
Dr. Zerhouni also explained the paradox of the NIH budget: The budget doubled by 2003, yet the likelihood of a study being funded by the NIH dropped from 30 percent in 2003 to about 20 percent in 2006. In addition, said Dr. Zerhouni, policymakers do not understand why doubling the budget has not met the need.
The budget cannot meet the need because of several factors, according to Dr. Zerhouni. These include a tremendous growth in facilities building and faculty growth at academic research centers, a 100-percent increase in NIH applications and a 75-percent growth in applicants by 2007, budget appropriations below inflation since 2003 and budget cycling phenomenon.
Meeting the challenges in biomedical research requires adaptive strategies based on key principles, said Dr. Zerhouni.
One principle is to protect the core value and mission of the NIH, which is the discovery and generation of new knowledge. Protecting this mission requires a balanced national biomedical research portfolio, which he illustrated by a pyramid, with basic research as the base, translational research forming the center portion and clinical research at the apex. This balance complements that of research in the private sector, which he illustrated as the inverted pyramid.
Another principle is to protect the future of research by encouraging new and junior investigators.
Dr. Zerhouni urged attendees to do everything possible to encourage new and junior investigators to undertake research. The Pathway to Independence Award Program is one NIH effort to attract more investigators early in their career. Launched in the beginning of 2006, the program is designed to provide promising postdoctoral scientists with both mentored and independent research support from the same award. Dr. Zerhouni also called on physicians to be proactive in the community about investing in the NIH.
?We have to enhance awareness about the return on investment in multiple areas of science,? he said.
He described his earlier testimony to Congress about the return on investment for NIH funding in the area of coronary heart disease.
The 63 percent decrease in mortality translates to about 1 million early deaths averted per year, he said.
The economic return is estimated at $1.5 to $2.6 trillion, and this return was achieved with an investment in the NIH that amounted to approximately $3.70 per American per year, or a 30-year investment of approximately $110 per American.
?I think that?s a pretty good return on investment,? he added.
Enhancing awareness must extend beyond the national level.
?We have to heighten awareness at the institutional and local levels as well,? said Dr. Zerhouni.
As evidence of this need, he noted that while a large percentage of Americans think that funding for research is an important issue, less than one-third know that the NIH funds research.
?We need to show our success at the local level.?