Response to: “Rescuing the NIH before it is too late“

1Director, National Institute of Child Health and Human Development.

2Acting Director, National Center for Research Resources.

3Director, National Institute on Deafness and Other Communication Disorders.

4Director, National Institute of General Medical Sciences.

5Director, National Human Genome Research Institute.

6Director, National Institute of Allergy and Infectious Diseases.

7Director, NIH Clinical Center.

8Director, National Institute of Nursing Research.

9Director, National Institute on Aging.

10Acting Director, John E. Fogarty International Center.

11Director, National Institute of Mental Health.

12Acting Director, Center for Information Technology.

13Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases.

14Director, National Institute of Neurological Disorders and Stroke.

15Director, National Institute on Alcohol Abuse and Alcoholism.

16Director, National Library of Medicine.

17Director, National Heart, Lung, and Blood Institute.

18Deputy Director, National Cancer Institute.

19Director, National Institute of Biomedical Imaging and Bioengineering.

20Acting Director, National Institute of Diabetes and Digestive and Kidney Diseases.

21Director, National Center on Minority Health and Health Disparities.

22Director, Center for Scientific Review.

23Director, National Institute of Environmental Health Sciences.

24Director, National Eye Institute.

25Director, National Center for Complementary and Alternative Medicine.

26Director, National Institute of Dental and Craniofacial Research.

27Director, National Institute on Drug Abuse.

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We, the directors of the 27 NIH institutes and centers, wanted to respond to the points made by Andrew Marks in his recent editorial. While we appreciate that the scientific community has concerns, the current initiatives and directions of the NIH have been developed through planning processes that reflect openness and continued constituency input, all aimed at assessing scientific opportunities and addressing public health needs.

Your editorial raises many important issues that affect NIH-funded researchers (1).

However, the personal attack on Dr. Elias Zerhouni is unfair, inappropriate, and obscures discussion of the real issues of concern to the entire NIH research community. We fully appreciate the anxiety and concern that individual investigators feel during periods of severe fiscal constraints. While these concerns are understandable, they must be balanced by the need to move the research enterprise forward strategically, coordinating efforts across the 27 NIH institutes and centers to overcome the major shared impediments to biomedical progress.

In the face of progressive budget tightening and pressure to be held accountable to the American public and members of Congress, Dr. Zerhouni has pursued a forward-looking approach to sustain our commitment to basic research while developing innovative ways to translate basic discoveries into clinical practice.

We who work closely with Dr. Zerhouni know him to be a creative scientist as well as a skillful communicator of science to the Congress and the public. Each of us knows his commitment to innovation and to recruiting and retaining the best minds in biomedical research. Dr. Zerhouni has fought relentlessly to increase NIH funding despite difficult budgetary circumstances for the country as a whole and has articulated the public health mandate for science and the unprecedented opportunities for progress. Witness his most recent testimony to Congress (http://www.nih.gov/about/director/budgetrequest/fy2007directorsbudgetrequest.htm). To blame him for the current budget reflects a poor understanding of his efforts and of the appropriation process.

With regard to your criticism of the Roadmap, there are some facts worth noting. The Roadmap was developed with broad input from the research community and the public. The Roadmap budget represents 1.2% of the total FY06 NIH budget and incorporates built-in constraints on growth. It provides a mechanism by which all NIH institutes and scientists can participate in initiatives that would be difficult to support within single institutes. The Roadmap increases the NIH commitment to innovation, to interdisciplinary research, and to translational medicine and has garnered considerable enthusiasm in Congress from both the Appropriations and Authorizing committees. Finally, we strongly disagree with the premise that clinical trials should only be conducted by pharmaceutical companies. The NIH is funded by taxpayers to whom we have the responsibility and privilege of providing new information that is relevant, unbiased, and fully accessible, including the fruits of clinical trials that industry will not support.

We are acutely aware that these are challenging times for the research community. Despite what remains a robust NIH budget, meritorious opportunities remain unfunded. We are pained to witness the departure of promising, young investigators from science, and this is why the NIH has launched new investigator awards programs. As investigators ourselves, many as members of the ASCI, we share the currents of frustration and anxiety within the research community, and we welcome continued input from the scientific community on such matters of understandable concern.

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Marks, A.R. 2006. . Rescuing the NIH before it is too late. J. Clin. Invest. 116::844-844 doi:10.1172/JCI28364.