NIH Director: Promise of Research Huge; Researchers Need to Make the Case
November 05, 2010
The promise of new answers to vexing health problems from scientific research has never been greater, stated Francis S. Collins, MD, PhD, yesterday in a Grand Rounds lecture at Dartmouth-Hitchcock Medical Center, but also never has the value of research been under greater scrutiny. "If we're going to be successful at this time, when research has never been more promising, we have to make the case for why that is so," said Collins, who is Director of the National Institutes of Health.
"It's great fun to do science, but we do it for a purpose," he said. "We have intentions of improving the health of the nation and the world that are quite real. We have to spread that message."
Collins was at DHMC to deliver the First Annual C. Everett Koop Lecture, co-sponsored by the C. Everett Koop Institute at Dartmouth and Dartmouth-Hitchcock Norris Cotton Cancer Center. Acknowledging the 90-year-old Dr. Koop, who was in attendance, Collins called him a "national icon" for U.S. public health. "No one has ever used the bully pulpit of the Surgeon General's office better than Chick," he said.
Collins' lecture, titled "Exceptional Opportunities in Biomedical Research," focused on five areas the NIH Director believes offer the ripest opportunities. They include:
- Taking advantage of new technological developments, such as nanotechnology and high-resolution imaging
- Translating research into clinical medicine
- Benefiting health care reform
- Improving global health
- Reinvigorating and empowering the biomedical research community
These opportunities are "truly breathtaking," Collins told a packed auditorium at DHMC, giving several examples, including research that has revealed the map of the human genomeresearch that Collins himself helped guide and has written extensively about. "Genomics is empowering many different approaches to treating and curing diseases," he noted. Scientific knowledge from research has reached the point, he said, where for the first time "we can ask questions that have the word all' in them. What are all the proteins in a particular cell type? What are all the things that make a cancer cell go malignant?"
As NIH Director, Collins commands a considerable research enterprise. With a fiscal year 2011 budget of $30.9 billion, NIH supports the research of 325,000 scientists and research personnel at 3,000 institutions across the country. Dartmouth received $106 million in NIH funding for FY 2010, and Collins praised the work being doing at the school. The Dartmouth Atlas Project at the Dartmouth Institute for Health Policy and Clinical Practice "is extremely important in guiding the conversation" about health care reform, he said. "There is no greater or more important resource." He is excited, he added, about the new Dartmouth Center for Health Care Delivery Science, co-founded by Dartmouth College President Dr. Jim Yong Kim, which brings together expertise from several Dartmouth schools to address the improvement of the delivery of health care. "Dartmouth is right at the top" of delivery research, he said.
At NIH, Collins is working with the Food and Drug Administration on ways to speed up the process for approval of effective drugs, and he is pushing forward the new Patient Centered Outcomes Research Institute, which was created by the health care reform legislation passed by Congress last year, that will help identify where the greatest research needs might be for better patient outcomes in clinical treatments. The Cures Acceleration Network will distribute up to $500 million through flexible funding mechanisms, and an expansion of the Cancer Genome Project hopes to identify the genomic and epigenomic drivers for at least 20 cancers over the next five years. The NIH's Diabetes Prevention Program is helping find new ways to intervene to improve the health of the estimated 57 million Americans who are at high risk for developing Type II diabetes in their lifetimes.
NIH also helps fund research into rare diseases, of which Collins said there are more than 6,000. "The private sector isn't going to spend a lot of money on research for products where there's such a small market," he commented, "so who is doing to do that?" At present there are treatments for just 200 rare diseases, but research has revealed the molecular causes of more than 2,000. NIH funding is helping develop drugs to combat these rare diseases, which include progeria, an extremely rare advanced aging disease that afflicts perhaps 30 children worldwide per year and which is a special research interest of Dr. Collins'.
Globally, NIH is funding programs that help bring research and care to diseases in low-income nations. Collins noted that contrary to popular belief, the diseases that are becoming increasingly serious problems in Africa and Asia are not infectious diseases such as AIDS and malaria, though these are still serious, but non-infectious diseases such as cancer and cardiovascular disease. And depression, he said, "is the leading cause of disability worldwide." When the United States brings treatment and research to poor nations to combat diseases, it "reaches out with soft power, and that's good diplomacy," he said. "I think our chances to do something very significant in these areas are quite compelling."
Collins was introduced by Duane Compton, PhD, Associate Director for Basic Sciences and director of the Cancer Mechanisms Research Program at Dartmouth-Hitchcock Norris Cotton Cancer Center. Compton described the NIH Director's extraordinary accomplishments, including directing the National Genome Research Institute, which published the first map of the human genome in 2003. "His career is fantastic," Compton said, "and littered with awards," including the Presidential Medal of Freedom and the National Medal of Science.
Prior to delivering the Koop lecture, Collins met with a group of Dartmouth Medical School graduate students and Dartmouth College undergraduate students, fielding questions about the future of scientific investigation and careers in research. "If you're going to spend all of your time working on a problem," he advised the students, "pick something important, because there's never been a better time to tackle important problems." He said he worries that declines in K-12 education in the U.S. might mean young students are no longer feeling "the spark that ignites an interest in science." After being home-schooled through fifth grade, it was a 10th grade chemistry teacher who first got him excited about science, Collins told the Dartmouth students. "He gave us an empty cardboard box and told us to figure out, through experimentation, what was inside without opening it. I'd never realized you could figure something like that out before," he said. Years later, after he had become a pillar in the scientific community, he sought out his old teacher and thanked him.
"We absolutely need young people," he concluded. "The possibilities of science are breathtaking right now. And all of that promise is going to depend on the most important resource: you."
About Norris Cotton Cancer Center
Dartmouth-Hitchcock Norris Cotton Cancer Center combines advanced cancer research at Dartmouth College and Dartmouth Medical School with patient-centered cancer care provided at Dartmouth-Hitchcock Medical Center, at Dartmouth-Hitchcock regional locations in Manchester and Keene, NH, and St. Johnsbury, VT, and at 11 partner hospitals throughout New Hampshire and Vermont. It is one of 40 centers nationwide to earn the National Cancer Institute's "Comprehensive Cancer Center" designation.