Welcome to the National Institutes of Health
We are in challenging times, both for science and for the NIH.
I have been listening to you, our constituents, and it's clear you
are particularly interested in learning more about NIH research
progress. I know you are also interested in the work of the 212,000
scientists we support in more than 3,000 research institutions across
the country and around the world. Recently, I have learned that
you need to hear more from NIH. This is the first of what will be
quarterly updates from me to you. Also, to ensure more timely interaction,
I have set up a special mailbox for learning directly about programs
and projects that are important to you and your organizations. The
email address is: firstname.lastname@example.org.
We are transforming the way medicine is practiced, and
we are doing it strategically, leveraging our research resources
and infrastructure with working scientists
The HapMap, Public Access, the Pathway to Independence Award, and
the new Clinical and Translational Research Centers all reflect
transformation. I find the easiest way to describe this new vision
of medicine as the “Three Ps — Predictive, Personalized,
Predictive. We will be predictive, using the
new tools of genomic sequencing, proteomics and the new understanding
of molecules to identify the susceptibility of patients to develop
disease — and we will be able to do this prediction long
before the first symptom appears.
Personalized. One size does not fit all. There
is really no one-stop shopping. We began to understand this when
we learned to adjust doses of medication or created specialized
emergency room equipment to treat young children or we began to
adjust treatments for individuals in a general way. What the future
must hold is customized treatment; treatment that addresses the
needs of the individual in order to be more strategic in combating
We must also be Pre-emptive. If we know who will
get diabetes, prostate cancer, or arthritis because of genetic
susceptibility or other predisposition to the disease, we will
be able to intercede before it takes its personal and economic
toll. We will no longer diagnose diabetes, then
just wait for diabetes to attack the eyes or feet — or appear
in the next generation.
By being predictive, personalized, and pre-emptive, we can reinvent
the way medicine is practiced. Our medicine of the future will
make strategic use of significant, shared tools and collaborative
teams of scientists. We are in the process of truly reengineering
the medical research enterprise to ensure that the people’s
investment will return to benefit the people.
The research investment in NIH, in fiscal year 2006, is $95 per
person. That is in stark contrast to the growing national health
care expenditure projected to reach $3.6 trillion, approximately
$11,000 per person, by 2014, growing at an annual rate of about
7.0% based on Center for Medicare and Medicaid Services data. What
do we have to show for it? For example, the total death rate from
cancer has decreased for the first time in history, and we have
doubled the rates of cancer survivorship. And do you know
what the size of the investment has been since the launch of the
War on Cancer in 1971? The cumulative investment at the NCI per
American over the past 30 years is about $258 per person. For that
investment, we have reaped enormous results.
Prostate cancer. Just recently, NIH funding has
made it possible to improve early diagnosis of prostate cancer.
Scientists know that cancer patients produce antibodies against
tumors. NIH scientists devised a blood screen for 22 antibodies
produced in men with prostate cancer. This new test is right 92%
of the time, a 20% improvement over the current method. Because
the new test has a much lower rate of false positive results than
PSA, antibody-based screening should translate into a significant
reduction in the number of unnecessary prostate biopsies performed
on the quarter of a million men diagnosed with potential prostate
cancer each year.
Diabetes. Diabetes. An NIH-supported research
study showed that tight blood glucose controls in people with type
1 diabetes, can cut heart disease and stroke by half. We are now
looking at type 2 to see if the results apply there. We can give
patients information that they can use immediately to help themselves.
Avian Flu. Computer models developed by the NIH–funded
Models of Infectious Disease Agent Study (MIDAS) research network
found that a carefully chosen combination of public health measures,
if implemented early, could stop the spread of an avian flu outbreak
at its source. The researchers found that antiviral treatment is
a crucial component of a multi-pronged approach.
Ovarian Cancer. A new treatment for women who
have advanced stage ovarian cancer, the fourth leading cause of
death in women in the U.S., taking more than 20,000 lives each
year, involves the administration of high doses of chemotherapy
directly into the abdomen. This approach is the first significant
advance against this highly lethal cancer in more than a decade,
and it boosts survival by 16 months.
Heart Disease. An undiagnosed syndrome has been
revealed. In as many as 3 million women who have heart disease,
cholesterol plaque may not build up in blockages, but instead spreads
evenly throughout the artery wall. As a result, diagnostic coronary
angiography incorrectly indicates that these women have “clear”
arteries — no blockages. This finding allows alerting doctors
to a significant difference in heart disease found in women that
will require special tests and careful monitoring.
These are just a few examples of recent progress.
I like to believe that the NIH research investment is probably
the very best thing this nation has done, and we’re poised
to do better. We expect to know the causes of the 10 most common
diseases within the next 2 years…that is why I believe that
a complete transformation is occurring. I want us to work together
to build that future, and I have asked the NIH leadership to join
me in regularly reaching out to you to share life-changing information
I hope you find this new desk-to-desk helpful.
For information about NIH programs,
useful health information, and additional resources, see the
NIH web site at www.nih.gov.