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Health Institutes Chief Responds to Criticism

December 28, 2004

In your Dec. 23 editorial "The Sick NIH," you wrongly accuse this administration, the National Institutes of Health and me of complacency in our handling of conflicts of interest at the NIH.

As you well know, we are enacting new stringent rules that I made public at congressional hearings six months ago. In September, I forwarded proposed new rules to the components of the federal government with oversight authority for final action. We are confident that these rules would prevent the recurrence of the permissive activities allowed by the old regulations, which were implemented in 1995.

Our new rules would be strict. They include a total ban on membership on the board of any company. All stock or stock option transactions would be banned, along with any activity that could remotely be construed as product endorsement. There would be a permanent ban on all industry-related outside activities for all senior employees. And there would be maximum public disclosure of all outside activities.

I called for a total ban on all outside activities with industry for a full year to allow the NIH time to review all of its procedures, retrain its staff and establish a rigorous system of oversight.

I believe deeply that building impenetrable barriers between academia, government and industry would slow the development of new and more effective cures and treatments. You imply that all NIH scientists are in the service of industry rather than the public. This is patently wrong. The actions of a few have tarnished the 117-year reputation of the NIH and the more than 5,000 NIH scientists who serve the public with great distinction, and have never engaged in questionable activities.

Elias A. Zerhouni MD

Director, National Institutes of Health

Bethesda, Md.

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Many scientists at the NIH devote themselves full time, heart and soul, to research on the prevention, diagnosis and treatment of disease. But the large private -- and sometimes secret -- payoffs to several NIH scientists create giant conflicts of interest.

Can the scientists' advice on national health policy be trusted? The Times correctly suggests that the answer is no.

During many years at the NIH as a physician, research scientist and administrator, I have watched my institution grow more secretive, more intolerant of criticism and increasingly tainted by money.

One possible remedy: No more paid consultancies with private companies. Another: The resignation of Dr. Elias Zerhouni, the NIH director, to be replaced by someone with more appetite for reform. But these remedies, suggested by The Times, are unlikely to occur in the present political climate.

There is something much easier that could be done at NIH immediately, almost with the stroke of a pen. At present, public criticism of the NIH by its own scientists is discouraged or prohibited. Public criticism should be allowed. In addition, Zerhouni should be held to his repeated promise of "complete transparency" -- full disclosure of the private consultancies, a promise not kept.

With an improvement in the secretive atmosphere at NIH, deeper reforms could then be based on open discussion and solid facts.

Ned Feder

Bethesda, Md.

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