Five months into his tenure as chief of the National Institutes of Health, Elias Zerhouni has begun to settle into the job and to speak out about his scientific and political priorities.
In the past few weeks Zerhouni has initiated visits with a variety of media outlets in an apparent effort to establish himself as a personality and a presence at the top of the nation's largest funder of biomedical research. His message is one of building public and congressional confidence in the NIH -- an institution poised to enjoy its fifth consecutive year of major budget increases and whose portfolio has recently expanded to include bioterrorism and homeland defense.
In a pair of recent interviews, Zerhouni said his top priority is to give the NIH a renewed sense of mission, energy and momentum after a nearly two-year period during which the agency had no permanent director -- to let the world know, he noted, that "the NIH has its act together."
Some of that comes down to bread-and-butter administrative responsibilities such as focusing on budget and personnel issues, a talent for which he amply demonstrated, colleagues say, in his former job as executive vice dean of the Johns Hopkins University School of Medicine.
Zerhouni said he is documenting how the NIH intends to make the most of Congress's recent largesse, and he is on a mission to fill the remaining top-level openings at his agency. Already he has appointed directors for the National Institute of Mental Health and the National Institute on Alcohol Abuse and Alcoholism. Among the high-profile openings yet to be filled are the directorships of the National Institute of Neurological Disorders and Stroke, the National Institute on Drug Abuse and the National Institute of General Medical Sciences.
But Zerhouni said he is also trying to look beyond the institutional boundaries that so define the NIH. He said he is not inclined to impose upon the NIH a major organizational overhaul, as has been called for by his predecessor, Harold Varmus. However, Zerhouni said, he looks forward to reading a National Academy of Sciences report, now in the making and due out in about a year, which will consider the pros and cons of changing the NIH's organizational structure.
'Mentality of Openness'
Meanwhile, he has been speaking informally with many NIH veterans to see if there are areas of promising research that are falling through the agency's bureaucratic cracks.
"I'm looking for areas that are not being addressed or that are bigger than any one institute," he said.
Looking more broadly to the community surrounding the NIH, Zerhouni said he is trying to launch a new era of openness and communication. Earlier this month, he hosted a public meeting on the NIH campus to discuss issues affecting the agency's neighbors, including the controversial construction of a security fence around the campus opposed by local dog walkers and the pending construction of bioterror-related labs on campus.
"I'm trying to communicate as much as possible," he said. "I'm trying to get that mentality of openness."
Zerhouni said he is comfortable with the increased centralization of power over the NIH within the office of the secretary of Health and Human Services, a trend initiated by Secretary Tommy G. Thompson under the motto "One department, one voice." That consolidation, which has already brought many of the NIH's personnel offices under the secretary's direct control and has more recently begun to affect the operation of public affairs offices at the agency, has caused consternation within the ranks of NIH employees. But Zerhouni said he does not feel threatened by the moves.
"I understand very well why the secretary wants to do this," Zerhouni said. "NIH is not a paragon of efficient management. Making decisions has become very complex and fragmented."
Zerhouni said he meets at least weekly with Thompson. "Philosophically, I'm absolutely where the secretary is," he said. "He's a great guy to work with. He's a terrific supporter of research."
He said Thompson has not sought to interfere in the search for a new deputy director -- a search Zerhouni said he has begun to embark upon informally. The current deputy, Ruth Kirschtein, who served as acting director before he arrived and whom Zerhouni praised for her good guidance during his first months on the job, may take a new position as a special consultant within the NIH, Zerhouni said. But in keeping with precedent, he said, he does not expect the post to be filled with a political appointee.
On another topic of some controversy within the NIH -- the growing participation of private industry in the funding and implementation of NIH projects -- Zerhouni expressed confidence that a healthy balance can be found. The issue, which has bubbled to the surface occasionally in recent years, made news soon after Zerhouni arrived when an employee at the National Institute of Environmental Health Sciences was punished for complaining publicly about corporate involvement in the NIH's environmental research.
Zerhouni quickly stepped in to protect the employee as a matter of free speech. However, he said, it is unrealistic to expect the NIH to work in isolation from private industry. Rather than try to maintain a sterile separation, he said, the focus should be on ensuring that such collaborations do not entail blatant conflicts of interest or unduly influence the results of research.
The NIH is primarily an engine for basic discovery, he said, and it needs to work closely with industry if its discoveries are to be translated into useful products.
Zerhouni acknowledged that the NIH's recently expanded role in the world of bioterror research is placing new strains on the agency, including a need to accept higher levels of secrecy and security on the agency's Bethesda campus, which has traditionally operated more like an academic facility than a government agency or military compound. He said he is still struggling with the problem of finding the right balance between the openness that has long characterized the NIH and the new need to be security-conscious.
For example, he said he supports the idea of placing new limits on the distribution of some biomedical research materials, including certain infectious agents, in an effort to keep them out of the wrong hands.
"We need to put in place a system for tracking materials with potential for bioterrorism," he said.
But he expressed some discomfort with the idea of placing restrictions on the publication of "dual use" scientific information that could advance medical science but which terrorists might use for their own purposes.
"My personal bias is that information is something that advances the field," Zerhouni said. "You don't want to discourage the best and the brightest. The great majority of people are out to do good."
Embryonic Stem Cells
On the contentious topic of research on human embryonic stem cells, which roiled the country and the NIH before his arrival, Zerhouni said he was not subjected to any political litmus test to get the job. He said he supports President Bush's decision to restrict federal funding to research on a limited number of cell colonies -- a policy that many scientists have decried as scientifically stifling.
"I want to make sure we advance the field . . . all within the guidelines of the president's policy," he said. The field is still in its earliest stages, he noted, and a lot can be done with what the president has made available to researchers. He declined to predict whether, in the future, that policy will have to be broadened, saying it is scientists' responsibility to prove that need, if there is one.
"Science is science. We have to bring the facts to the table," Zerhouni said. "Here's the policy, and we're going to make an honest effort to put taxpayers' dollars to work to make the most of the science."