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New Vigor in Cancer War

A leading government scientist has a plan to 'turbocharge' research, reward risk-taking and trim bureaucracy. Congress should fund reforms but be watchful.

October 03, 2003

The national "war on cancer" is little closer to victory now than when President Nixon declared it in 1971, and the miracle cures promised by the Human Genome Project have yet to appear on pharmacy shelves. This somehow doesn't stop the steady increases in the budget of the much-lauded but little-understood National Institutes of Health.

The core mission of the $27-billion-a-year agency, based on a sprawling campus in Bethesda, Md., is to turn scientific discoveries into life- enhancing treatments. On Wednesday, NIH Director Elias A. Zerhouni gave Congress cause for optimism about renewing that mission.

He candidly criticized a "silo mentality" that kept scientists from sharing their ideas and promised to attack it by rewarding original thinkers rather than by larding money on clubby networks where old-fashioned ego trumped inventive risk-taking.

He has specifics on how to turn the lumbering bureaucracy into a nimble scientific mystery-busting force. He would, for example, develop uniform, cross-disciplinary standards to measure patient pain (something now assessed by dozens of different criteria), give doctors and nurses access to advanced molecular libraries (now restricted to big-bucks pharmaceutical researchers) and give grants to cross-disciplinary research teams.

Dr. Francis Collins, head of the National Human Genome Research Institute, says scientists focus on ever-narrower specialties, so fewer of them understand how the whole human body works. "It's like the power company workers trying to get the lights back on without knowing which wires are down," Collins says.

Zerhouni will almost certainly fall short of his lofty goal, to "completely reshape the way we are doing clinical research." For one thing, the half a billion dollars a year he plans to spend "turbocharging the NIH," though not small change, won't be enough to overturn deep-seated problems. These include enormous imbalances: Billions of dollars go into pharmaceutical research to develop drugs that slow cancer, yet only a few million dollars go to epidemiology to study substances in communities that may cause cancer.

In his congressional testimony, Zerhouni also promised to embark on other reforms aimed at "removing regulatory roadblocks" that slowed medical discovery. He was vague on details, and that worries some scientists who think it could be shorthand for dismantling regulations aimed at insulating government researchers from market and interest group pressures. Rep. Henry A. Waxman (D-Los Angeles) asserted this year that the Bush administration had stacked scientific advisory committees with industry representatives and let drug firms distort scientific information.

Zerhouni's candid criticisms and reform proposals could do great things if they are not overrun by pharmaceutical industry self-interest. Critics charge that the administration may also be trying to burnish its record on science before next year's presidential election.

Congress should back new funding with oversight to ensure that the reforms serve higher purposes.

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