How a medical revolution may transform Northern Virginia

By Steven Pearlstein
Wednesday, November 18, 2009

Even as Washington policymakers struggle to reform the country's health-care system, about 20 miles away in Fairfax County, Dietrich Stephan is hatching a plot to revolutionize it.

The current system, as everyone knows, is the world's costliest machine for healing you when you get sick, largely by using drugs and devices and surgical procedures that have proven themselves effective with most other people with the same ailment. But what if there were a way, based on your genetic makeup, to anticipate whether you're likely to come down with cancer, heart disease or Alzheimer's and prevent it with a fix specially designed for you?

It's called personalized medicine. And while people have been anticipating it for a decade, ever since the humane genome was mapped out, it's been slow in coming. Now Stephan -- working with the Inova hospital juggernaut, the scientists at George Mason University, and the researchers and health policy experts at George Washington University -- thinks he can foment this health-care revolution and create a new economic engine for Northern Virginia.

Although it's been in the works for months, the official announcement came Monday when Gov. Tim Kaine, with his Republican successor looking on, announced that Virginia had come up with $25 million to finance operations at the new Ignite Institute. If its supervisors approve, Fairfax County will throw in $150 million in financing guarantees to construct a state-of-the-art, 300,000-square-foot research lab somewhere along the Route 28 corridor. At full strength, the institute will have an annual operating budget of $100 million and 400 employees working closely with a new Center for Personalized Medicine at Inova Fairfax Hospital, part of a $1 billion overhaul that Inova has planned for its flagship campus.

You'd be right, of course, to be a bit skeptical. For decades, we've heard how, thanks to the innovation gushing out of the National Institutes of Health and the Johns Hopkins medical complex, the fertile crescent between Rockville and Baltimore was destined to become the Silicon Valley of biotech. Watching that develop has been about as exciting as watching grass grow.

And just as Maryland has plenty of competition from other biotech clusters, Northern Virginia is the latest entry in the individualized-medicine sweepstakes, along with the Translational Genomics Research Institute (a.k.a. T-Gen) in Phoenix, where Stephan himself held the No. 2 position as director of research. Similar efforts are underway at the Institute for Systems Biology at the University of Washington, the Mayo Clinic and Duke University, along with the Broad Institute in Boston, which boasts not only the cachet and intellectual horsepower of Harvard and MIT but also a $400 million gift from Los Angeles real estate billionaire Eli Broad.

Closer to home, genome pioneer J. Craig Venter has his own genomic research empire, with headquarters in both Rockville and San Diego. And from the commercial sector, competition comes not only from every major drug and biotech company, but also from hot start-ups like Navigenics and 23andMe, which for a fee will tell you the diseases to which your genetic makeup is inclined.

Navigenics, in fact, was a spinoff of T-Gen, and Stephan was one of its co-founders. His experiences at both places, and at the genome labs of the National Institutes of Health, convinced him that the best place to launch this revolution is not a pure research lab, or a medical complex or a commercial start-up, but an entity that straddles the divide between nonprofit inquiry and for-profit commercialization and is driven by the everyday collaboration of researchers and clinicians.

Stephan considered locating his new venture in San Francisco or Boston, each of which had the necessary academic, medical and venture capital infrastructure. But in Northern Virginia he found a place where he would not be overshadowed by more-established players, and where he found public and private partners who, like himself, were ambitious and entrepreneurial and eager to break into the next big thing. If he, and they, have any competitive advantage, it is that the shift to individualized medicine will raise a myriad of questions about privacy, medical ethics and financing that will require difficult decisions from policymakers in Washington. Being close will give Stephan and his partners a front-row seat from which to participate in those conversations.

It's way too early to say whether the Ignite Institute will be able to attract superstar talent or big-time funding, or whether its partnerships with Inova and the universities will bear fruit, or whether through new company start-ups it will be able to generate lots of jobs, wealth and tax revenue for the region. But it says a lot about Virginia and Fairfax County that, even in the midst of economic downturn and budget shortfall, they saw the potential, seized the opportunity and invested in the future. Having also won funding for Metrorail's extension out to Dulles and won the headquarters competitions for Hilton, SAIC, CSC and Volkswagen of America, Northern Virginia is now primed to emerge from the economic doldrums and once again lead the region's growth.

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