The feedback received regarding my recent editorial “Rescuing the NIH before it is too late” has been fascinating to read. The opinions expressed illustrate a huge divide between those in charge of the NIH and those who rely on extramural funding to support their research.
Andrew R. Marks
Submitter: Paul R. Marantz | marantz@aecom.yu.edu
Albert Einstein College of Medicine
Published June 21, 2006
To the Editor:
We are writing as leaders of the Association for Clinical Research Training (ACRT), a national organization of K30 program directors and others charged with educating and training the next generation of clinical investigators.
In your June 2006 “response to the response” to your April 2006 editorial, you implied that the entire scientific community stands behind your harsh criticism of Dr. Zerhouni and NIH policies, which you contend are only defended by a small, self-interested group of government bureaucrats. This is not the case. While you recognized that the emails you received (and, remarkably, quoted without attribution) represented a “nonscientific sampling,” your conclusions suggested that you do not fully appreciate that your sampling is biased. The subset of the “scientific community” that reads JCI, a journal that features few articles on clinical research, and then in turn sends personal emails to you, is not a representative sample of the diverse research community. There are many of us at academic medical centers around the country who applaud the vision and courage of Dr. Zerhouni and his colleagues, as they work to keep “health” in NIH by increasing support for clinical and translational research.
The NIH Roadmap seeks to overcome well recognized challenges in the design, conduct, and analysis of clinical and translational research. By “clinical research,” we are not confining our attention to industry- supported trials, but follow the generally accepted NIH definition, which is very often “hypothesis-driven, investigator-initiated research.” In fact, most of the graduates of our NIH (e.g., K30) -funded training programs are engaged in this endeavor. Helping these young investigators to obtain the knowledge and skills to conduct outstanding clinical research and develop successful careers is one of the worthy goals of the Roadmap. ACRT members and many others are meeting this challenge at academic centers around the nation. We welcome the NIH’s help in this important mission, and see the Clinical and Translational Science Award as a major step in that direction.
We are disturbed by your assault on clinical research, which threatens to divide rather than unite basic scientists, translational researchers, and clinical investigators. The full scientific community needs to work together and argue for increased NIH funding for medical research. We should take the stance that “a rising tide lifts all boats” and build bridges between multiple disciplines in medical research, rather than retreating to narrow, seemingly self-interested infighting. Dr. Zerhouni is responding to the public’s call for “outcomes” from our research activities, and we should support his vision and his challenge to transform our academic institutions in a manner that will more quickly and efficiently lead to improved methods of prevention, diagnosis, and treatment of disease.
Sincerely,
Paul R. Marantz, MD, MPH, ACRT President; Albert Einstein College of Medicine, Bronx, NY
Karl E. Anderson, MD, University of Texas Medical Branch, Galveston, TX
Estela S. Estape, MT, PhD, University of Puerto Rico, San Juan, PR
Janice Gabrilove, MD, The Mount Sinai School of Medicine, New York, NY
Wishwa N. Kapoor, MD, MPH, University of Pittsburgh, Pittsburgh, PA
Kurt Kroenke, MD, Indiana University School of Medicine, Indianapolis, IN
Razelle Kurzrock, MD, MD Anderson Cancer Center, Houston, TX
Julio Licinio, MD, University of Miami Miller School of Medicine, Miami, FL
Marian C. Limacher, MD, University of Florida, Gainesville, FL
Paul McKinney, MD, University of Louisville, Louisville, KY
Harry P. Selker, MD, MSPH, Tufts University School of Medicine, Boston, MA
Brian L. Strom, MD, MPH, University of Pennsylvania School of Medicine, Philadelphia, PA