I just returned from the NIH where I was invited to lecture on translating science into therapies. I had presented my science there before and I was not quite sure how interesting they might find my broader perspective, which I had entitled: “The long course from ‘the Aha!’ to cures: can we do better – together?“
The standing room only audience provided a first clue that emphasis is evolving at the NIH… During the Q&A and in talking individually to several people, I could sense their intense interest and excitement regarding the many challenges – and opportunities – created by the translation of basic science into positive health outcomes. Several independently pointed out that Francis Collins, M.D., Ph.D., took no break from being confirmed to making his first appearance as the new NIH chief where he announced what he hoped to accomplish during his term. The overall underlying message was clear: no time to spare!
For those relying mainly on the funding that comes from the NIH to carry on science, it is very important to understand what the change at the NIH helm might mean for its future directions and priorities to increase chances of successful funding. In the bigger picture, all of us will be affected as the NIH-sponsored research is a major – if not the major – source for the new ideas that become one day life saving treatments. I dare to say that the success of these ideas is in no small measure due to the fact that, throughout various administrations (maybe in spite of?), the NIH has been one of the original and perennial implementers of innovation models, yet not even themselves might think of it that way. For instance, the NIH has a signature initiative called an “RFA” (requests for applications), where they invite independent researchers to submit proposals related to specific scientific and health questions, and they fund the winners. Isn’t this a classic case of “crowd-sourcing”, implemented way before the term was coined? The NIH also has an “RFP” (request for proposals) mechanism by which they contract projects with the various independent winners and create the network needed to sustain the project – isn’t that what is called elsewhere “out-sourcing” and “open innovation”?
I could not find a script of Collins’ speech, but I watched it for you! Here is a short run down of what he announced as his top 5 priorities for the NIH during his term:
1. Apply new high throughput (“comprehensive”) technologies (e.g., nanotechnologies, genome wide-scans, proteomics) to understand fundamental biology questions as well as causes for different diseases.
2. Emphasize translation of basic sciences into treatments, making “discoveries amenable for public benefit”
3. Put science to work for the benefit of the heath care reform: “inform the conversation based on scientific evidence not on prejudice” by performing comparative effectiveness studies (e.g., study effect of life style changes vs. therapies for treatment of diabetes)
4. Put greater focus on global health, including AIDS, malaria, tuberculosis and other major diseases in developing countries, by working with them in research and helping them develop their own capabilities
5. Reinvigorate the biomedical research enterprise by making sure that funds are available to support younger investigators, increase work force diversity, encourage risk taking and innovation.
I for one, cannot but applaud and embrace all these goals. Even as an academic researcher, I have always sought to “begin with the end in mind”, or how I like to refer to it “going back to the future”. In my case, this means starting with examining the real life case (the patient) to formulate the questions to take back to the lab for study in detail, increasing the chance that the answers from our research would be used to alter for the better the patient’s health in future…
Some of the more hard core basic researchers might not entirely feel comfortable with the emphasis on translation. I agree that there is a fundamental need for fundamental research: the pursuit of questions that are so “out there” that no one can really tell where they might lead us or what they might connect with. Yet, after putting a lot of bright dots on… the blue sky, some need to concentrate on seeing patterns and be able to connect them, yet others will need to start figuring out how we might touch upon the new dots and patterns. I see the issue of translating science not as an imposition on fundamental research, but as an invitation to an open intellectual dialogue between basic, applied and clinical scientists, as well as product developers, regulators, and the public, where all can contribute with their own proficiency: the “constructive interference” effect. It is still not easy most of the times, as many places still operate based on narrow definitions of expertise and make make others feel as strangers in a stranger land. Thus, making scientific innovation happen for the benefit of humankind will require skilled, open-minded, and maybe fearless translators who can make sense of various intellectual languages and lands…
Here is a list of related links:
Francis Collins, M.D., Ph.D., inaugural address to the NIH
Nature Medicine: In the land of the monolingual