Health Agency Taking Steps to Speed Results of Research

The Bush administration announced a new vision for biomedical research on Tuesday that it said would give patients swifter access to the fruits of scientific discovery and foster greater collaboration between the government and private industry.

By ROBERT PEAR NY Times

Dr. Elias A. Zerhouni, director of the National Institutes of Health, said the new initiatives would "transform the way we conduct research" by setting priorities and coordinating the work of an agency known for its highly decentralized management style.

"We are turbocharging N.I.H.," Dr. Zerhouni said.

The institutes’ budget has doubled in the last five years, to $27.3 billion, and Congress is eager to see that the money is well spent. Two Congressional committees plan to hold a joint hearing on the agency on Thursday.

After a huge investment in basic science, lawmakers and taxpayers alike are seeking a tangible payoff: new ways to prevent or treat diabetes, heart disease, cancer, mental illness, Alzheimer’s, Parkinson’s and scores of other conditions.

Senator Arlen Specter, Republican of Pennsylvania, the chairman of the Senate Appropriations subcommittee responsible for health and human services, called the initiatives "spectacular" and said agency officials were "fundamentally reorganizing the way they attack dread maladies, re-engineering clinical research and developing new pathways to discovery."

Dr. Zerhouni, who took office in May 2002, said he had developed the "road map for medical research" after consulting more than 300 experts from universities, industry, government and consumer groups.

While the N.I.H. conducts some research at its headquarters in Bethesda, Md., most of its money is given away in grants to 212,000 researchers at 2,800 universities, medical schools and other institutions.

Dr. Zerhouni laid out a master plan so that rather than passively accepting the priorities of these scientists, the agency will now emphasize specific fields of study and new technology that might produce major breakthroughs.

Under the plan, the institutes could be more involved in the earliest stages of drug development, before drugs are tested in people. In addition, Dr. Zerhouni said, the institutes will provide training in clinical research to community doctors, who can help test treatments and disseminate the findings of biomedical research.

Mary Woolley, president of Research America, a nonprofit group that wants to make health research a higher priority, said: "This is long overdue. It means that more people will be enrolled in clinical trials."

One goal of the institutes’ plan is to catalog the intricate networks that transmit information among genes, molecules and cells. Scientists believe that disturbances in these "biological pathways" can cause disease.

More precise knowledge of the molecular events that lead to health or disease can "revolutionize the practice of medicine," Dr. Zerhouni said.

Another goal is to create a picture gallery showing the three-dimensional structure of all the proteins in the body. Misshapen proteins are the culprits behind many diseases, including cystic fibrosis and Alzheimer’s.

Dr. Zerhouni said he wanted to get away from the notion that every research project has one "principal investigator." The future, he said, will require much more "team science" conducted by interdisciplinary groups of molecular biologists, chemists, physicists, mathematicians, behavioral scientists, pharmacologists and epidemiologists.

In addition, Dr. Zerhouni said he wanted to speed the development of new drugs by creating a public collection of hundreds of thousands of chemical compounds that could be tested by scientists, with advanced technology now available only to pharmaceutical companies.

Data from testing such compounds would go into "a freely accessible public database," Dr. Zerhouni said.

Dr. David Korn, senior vice president of the Association of American Medical Colleges, welcomed this commitment, saying it would establish "public repositories of critically important research tools."

Dr. Zerhouni said his plan would not require additional money, but would rely on contributions made by units of the institutes from their existing budgets: $130 million in 2004 and $2.1 billion over five years.

The "road map" emphasizes research to translate discoveries from the laboratory to the clinic and then into the everyday practice of medicine. Two of Dr. Zerhouni’s initiatives are potentially controversial.

He said he wanted to foster more "partnerships between the public and private sectors." But some members of Congress have expressed concern about such arrangements, saying that the institutes had allowed drug companies to reap large profits from drugs like Taxol developed with public money.

Senator Ron Wyden, Democrat of Oregon, said that when the government invested in drug development, it must get an adequate return in royalties and must ensure that the drug is affordable to patients.

Dr. Zerhouni also said he wanted to "streamline federal requirements pertaining to clinical research," to reduce the burden on researchers. But members of Congress say the government has not adequately supervised or regulated some types of research, like gene therapy.

Alan I. Leshner, chief executive of the American Association for the Advancement of Science, and Carl B. Feldbaum, president of the Biotechnology Industry Organization, a trade group, praised the initiatives, saying they would benefit patients and researchers.