Anthony S. Fauci, M.D.
Dr. Fauci opened the Monday afternoon, February 2, session of Council by welcoming visitors to the 128th meeting.
He announced the appointment of four new Council members: Dr. Jorge Benach; Dr. Janis Giorgi; Dr. Thomas Lawley, and Dr. Emil Unanue; and a new ex officio member representing the U.S. Department of Veterans Affairs: Dr. Lawrence Deyton.
Dr. Fauci welcomed the ad hoc Council members: Dr. Mark Davis, Professor, Department of Microbiology and Immunology, Howard Hughes Medical Institute, Stanford University; Dr. Adel Mahmoud, Chairman, Department of Medicine, Case Western Reserve University (Cleveland);
Dr. Lisa Steiner, Professor of Immunology, Massachusetts Institute of Technology; and Dr. Robert Webster, Chairman, Department of Virology and Molecular Biology, St. Jude Children’s Research Hospital (Memphis). Consideration of Minutes of Previous Meeting:
The minutes of the September 8-9, 1997 meeting were considered and approved as written.
Staff and Organizational Changes:
Dr. Fauci announced the departure of Dr. Lawrence Deyton, Acting Director, Division of Extramural Activities (DEA) who left the Institute to accept a position with the U.S. Department of Veterans Affairs as the Director of HIV/AIDS Services and Research. Dr. Deyton will continue to play an active role with NIAID as the VA’s ex officio representative to Council. In addition, he will continue to serve as an attending physician in NIAID’s outpatient HIV clinic. Dr. Fauci expressed his gratitude to Dr. Deyton for a decade of dedicated service to the Institute and to the cause of HIV/AIDS.
Dr. John McGowan has been reappointed as the Director, Division of Extramural Activities and Dr. John La Montagne, Director, Division of Microbiology and Infectious Diseases (DMID), has been appointed Deputy Director, NIAID. Dr. George Curlin, Deputy Director, DMID will serve as Acting Director, DMID until the position is filled.
Dr. Fauci announced the departure of Dr. Steve Schnittman who left the Division of AIDS (DAIDS) to accept a position as Group Director, Clinical Infectious Disease Research at Bristol Myers Squibb.
Review of Operating Procedures for FY 1998:
Operating procedures had been sent to Council members for review. No modifications were suggested; and they were approved.
Budget Update:
NIAID director Dr. Anthony S. Fauci told Council that the President’s FY 1999 budget request calls for unprecedented funding increases for NIH as part of a "21st Century Research Fund." The FY 1999 president’s budget requests $1.15 billion more monies for NIH than we received in FY 1998. An increase in funding of more than 50 percent during the next five years will boost the NIH budget to more than $20 billion by 2003.
NIAID is expected to continue to do well relative to other institutes. One of the reasons is that much of our research falls in NIH director Dr. Harold Varmus’ special emphasis areas. Within the President’s budget, Dr. Varmus would put aside $652 million for these special areas and also for improvements in research infrastructure. The goal is to increase success rates for investigator-initiated applications, beef up training programs, and help integrate new technologies into NIH-supported labs. Further, Dr. Varmus wants to spend another $35 million on the Shared Instrumentation and Biomedical Research Support programs of the National Center for Research Resources and $23 million on extramural construction.
The President’s budget also includes $90 million to continue building the new NIH Clinical Research Center, $126 million for NIH infrastructure, and $9.1 million for building the new Vaccine Research Center (added to the $19.5 million NIH received in FY 1998).
Dr. Fauci assured Council that NIAID would continue its long-standing policy of targeting most of the budget increase to research projects grants (e.g., R01s). The Institute’s success rate would increase to 40.5 percent, up from 36.3 percent in FY 1998. Meanwhile, Intramural Research continues its decline relative to the overall budget despite the additional funds for the Vaccine Research Center.
Other:
NIAID Response to H5N1 Influenza Outbreak
Since the beginning of the outbreak of influenza A H5N1 in Hong Kong, NIAID has been working closely with the FDA, CDC, USDA, and DoD to respond to the research and public health needs associated with the outbreak. NIAID has taken the following steps to advance our understanding of this new strain and prevent further spread:
- Awarded grant supplement to support investigation of the source of H5N1 in Hong Kong – The supplement was awarded to Dr. Robert Webster, who has been conducting animal surveillance in Hong Kong and has isolated H5N1 and other influenza viruses from birds.
- Provided Typing Sera – NIAID shipped 600 vials of antiserum for inclusion in diagnostic test kits that were provided to all WHO Influenza Collaboration Centers and to all U.S. state laboratories. NIAID is the only source of typing reagents for identification of H5N1.
- Provided H5 hemagglutinin for use as a reagent in serological screening, immunogenicity and efficacy studies in chickens.
- Awarded a contract to Protein Sciences Corporation for production of recombinant H5 hemagglutinin vaccine – Within three weeks, the company produced a single lot of vaccine for use in at-risk laboratory and public health personnel. The contract includes options for further production of vaccine.
- Submitted a vaccine clinical protocol for IRB review – The protocol involves immunizing at-risk personnel using a two-dose regimen with three weeks between the first and second dose. Enrollment is projected for the end of January.
NIAID is continuing to work closely with government and industry to address the research and public health needs associated with the avian flu outbreak.
Efforts to Address Antibiotic Resistance
Last September, the Division of Microbiology and Infectious Diseases (DMID) sponsored a consultation on the emergence of drug resistance in Staphylococcus aureus. The purpose was to assemble a panel of outside experts to suggest what steps the Division could take to address the problem of drug resistance in S. aureus in general and, in particular, the recent threat of reduced susceptibility of S. aureus clinical isolates to vancomycin.
DMID developed a "Comprehensive Plan for Staphylococcal and Related Drug Resistance Problems" and has begun to implement several activities delineated in the plan, and Dr. Fauci has provided additional funds from his Director’s Reserve for these efforts.
The Division will soon release a Request for Proposals to establish a Network on Antimicrobial Resistance in S. aureus that will link investigators conducting basic research on resistance and virulence factors with those in clinical microbiology. In addition, DMID has targeted additional funds for grants that address drug resistance in S. aureus received under an existing Program Announcement "Aspergillosis, Ehrlichiosis, and Drug Resistance." The Division also will fund at least one grant application to sequence the genome of different strains of S. aureus
Plans to Strengthen Hepatitis C Portfolio
An estimated 4 million people in the U.S. are infected with HCV, and only 5 percent are aware that they have it. CDC projects that hepatitis C health problems will increase 3-4 fold over the next 2 decades.
NIAID has been addressing HCV in a focused way for several years. In 1996, we established four multidisciplinary, collaborative research units called the HCV Cooperative Research Centers to concentrate on preventive and therapeutic strategies for HCV infection. Last year, we provided additional funding to these Centers to allow for the expansion of a number of research activities, including important work made possible by the successful isolation of an infectious clone of HCV. We are also addressing gaps in pediatric HCV research by funding a combination antiviral trial in children by the long-standing Collaborative Antiviral Studies Group.
NIAID/NIAMS/Arthritis Foundation Joint Initiative on Rheumatoid Arthritis
In September 1997, NIAID joined with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the Arthritis Foundation in establishing the North American Rheumatoid Arthritis Consortium. Twelve research centers participating in the NARAC will search for genes associated with increased susceptibility to rheumatoid arthritis. The Consortium’s first goal in the next 3 to 5 years is to find and begin to study 1000 families with 2 or more affected siblings, and if possible, at least one surviving parent.
NIH Research Ethics Training Initiative
This past year, ethical issues in research received considerable public attention, particularly around the President’s public apology for the Tuskegee syphilis studies. In conjunction with that apology, the President called on DHHS to establish programs to enhance the education and training of scientists in research ethics. In addition to NIH, the CDC, the Health Resources and Services Administration, and the Agency for Health Care Policy and Research will participate in these efforts.
NIAID was asked to take the lead for NIH in developing these initiatives. One of the initiatives seeks to establish "Short-Term Courses in Research Ethics" (using the T15 mechanism) to promote the education of bench and clinical investigators on the ethical issues of medical research. The other initiative, "Mentored Scientist Development Award in Research Ethics" (using the K01 mechanism), will train investigators who want to refocus their research careers to the field of applied research ethics. Both of the programs, released on November 7 as PAs, encourage a varied pool of applicants.
Winter Program Review
On January 12 and 13, NIAID conducted its annual Winter Program Review/Policy Retreat.
Institute managers reviewed data on program announcements collected since NIAID began to emphasize PAs over RFAs. The initial year of data are showing that the use of PAs has been effective in encouraging new meritorious applications. The group also discussed scientific directions for FY 2000. Among these were immune tolerance for transplantation and autoimmune problems, HIV vaccines and new therapeutics, hepatitis C, malaria, and antibiotic resistance.
The meeting also explored opportunities in genome pathogen sequencing and the importance of accelerating sequencing support to take advantage of new technologies. Interest in this was underscored by a guest presentation from Dr. David Relman, Assistant Professor of Medicine at Stanford University, on the role of infectious agents in diseases of unknown etiology.
Finally, participants discussed the growing interest in global health on the part of Congress and federal agencies and explored how to maximize NIAID’s capacity to play a central role in coordinated efforts to address global health.
Council Materials
Copies of the Legislative Update, which describes hearings and bills of interest to the Institute, were distributed. In addition, the NIAID Office of Communications provided Council members with several publications and press releases. back to top |