updated 9/30/2003 12:15:31 PM ET 2003-09-30T16:15:31

From creating drug-hunting databases to including more Main Street doctors in medical research, the National Institutes of Health pledged a series of changes on Tuesday intended to help turn scientific discoveries into better health care, faster. Consider it “turbocharging the NIH,” said Dr. Elias Zerhouni, the agency’s new director.

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THE NIH, WITH a $27 billion budget, is the government agency primarily responsible for conducting and financing medical research. It has spurred crucial science, such as deciphering the secrets of human genetics. But critics have called the giant agency, with its 27 separate institutes and centers, too unwieldy to ensure that research findings quickly benefit the patients who need them most.

With the unprecedented pace and sophistication of new discoveries, “There’s no doubt medical research is at a critical point in its history,” Zerhouni said Tuesday.

His new five-year, $2.1 billion “road map” for NIH lays out plans to ensure the most promising of these complex biological discoveries get the proper attention and to remove barriers that slow transformation of those discoveries into treatments.

‘NOT BUSINESS AS USUAL’

“This is truly not business as usual,” Zerhouni said.

Many of the new initiatives won’t be noticed by the average person — they involve such things as getting scientists from different, highly specialized fields to work together better.

“I think the average person may not tomorrow see an effect,” said Dr. Alan I. Leshner, chief executive of the American Association for the Advancement of Science. But the NIH plans are “laying out an important vision for where biomedical science can and will go, and how to ensure that that gets translated into real-life improvements in the health of the American people. In that case, it’s very significant.”

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And some of the top plans could make it easier to conduct studies of patients.

For example, most patient research currently is conducted by hospitals and universities. NIH hopes to establish a group of community-based physicians trained specially for research such as studies of experimental therapies. They would be part of a series of research networks that could be tapped to conduct important studies rapidly, similar to networks NIH already has set up for cancer and AIDS.

More community doctors could open research to more patients — only 1 percent of people with Parkinson’s disease and 3 to 4 percent of cancer patients ever enroll in studies — and to problems that don’t get enough attention, such as pain, Zerhouni said.

Patient involvement in research can be crucial to improving care, he said. He noted that life expectancy for cystic fibrosis improved from 10 years to 40 years thanks largely to patient groups who helped develop 198 specialized care centers and a nationwide data registry, allowing research to be done more quickly.

ENSURING PATIENT PROTECTION

In addition, NIH wants to standardize regulatory requirements for patient studies so that every researcher follows the same rules — they now differ hospital to hospital — and to standardize databases so that research findings can be more easily shared.

Critics have long warned there is too little oversight to ensure patient protection in many studies. Asked if getting more doctors involved could increase that risk, Zerhouni called the planned new standards and training crucial.

Among NIH’s other plans:

Establishing molecular and chemical libraries open to any scientist, potentially useful in hunting new drug candidates.

Creating biomedical computing centers capable of handling the deluge of new information about genes and proteins.

Helping small biomedical companies tap into the NIH’s resources for more industry collaboration.

Encouraging more creative research with special grants of $500,000 a year for five years for scientists with ideas too risky to win the NIH’s conventional financing but that would mean breakthroughs if the gambles paid off.

Beginning the changes next year will cost $130 million that will come from existing resources pooled by each of the NIH’s institutes, Zerhouni said. He would not detail where the money was siphoned from, but insisted no programs were cut.

© 2003 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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