>> THOSE AROUND THE TABLE WITH US AND I KNOW IT IS EARLY-MORNING BUT ALSO TAKE THE TIME TO. -- AND THEN TOMORROW FROM NINE TO ABOUT 2:30 P.M. EARN EASTERN TIME. WE WILL RECORD BOTH MEETINGS. THE NEXT COUPLE OF DAYS WILL BE VERY FULL. IT IS A VERY, VERY FULL AGENDA AND WE WILL DO OUR VERY BEST TO STAY ON TIME SO I HAVE ASKED THE ACTING PRINCIPLE DEPUTY DIRECTOR TO KEEP US ON TIME AND BEQUEATH -- >> I FEEL VERY EMPOWERED. [LAUGHTER] SO JUST A REMINDER, THE MEETING IS OPEN TO THE PUBLIC INCLUDING MEMBERS OF THE PRESS. OBVIOUSLY WE ARE IN A HYBRID FORMAT WHERE IT IS THE WEBCAST FOR SOME OF US -- AND SOME OF US ARE IN THE ROOM. THE MATERIALS WILL BE POSTED TO THE WEBSITE SHORTLY AFTER THE MEETING AND THIS MEETING WAS ANNOUNCED IN THE FEDERAL REGISTER ON NOVEMBER 22, 2022. OF NOTE WE DID RECEIVE PUBLIC COMMENT WHICH MEMBERS GO REVIEW ON THE FILE SIGHT AND THE LINK I THINK WE SENT EARLIER THIS MORNING. DIRECTORS AND PRESENTERS ARE USING A HYBRID FORMAT HERE AND ON ZOOM FOR THE ACTIVITIES THE NEXT TWO DAYS SO WE'RE ASKING FOLKS TO KIND OF FACILITATE THE DISCUSSION SO RAISE YOUR HAND VIRTUALLY BOTH THOSE HERE IN THE ROOM AND ONLINE. IF YOU WANT TO RAISE YOUR HAND IN THE ROOM, THAT IS FINE TOO BUT WE'LL TRY TO KEEP TRACK OF THE ORDER BY USING THE VIRTUAL HAND AS MUCH AS POSSIBLE IF YOU HAVE A QUESTION OR WANT TO MAKE A COMMENT. SO WHEN A MEMBER WISHES TO MAKE COMMENT, WE ASK YOU TURN ON YOUR VIDEO AND MIC IF YOU CAN SO WE CAN SEE YOU AND YOUR SMILING FACES BECAUSE WE ARE RECORDING THIS AND IT WILL BE HELPFUL FOR THE RECORDING. >> OKAY, GREAT. WE HAVE IN ADDITION TO MEMBERS OF THE ACD COMMITTEE, MEMBERS OF OUR EXECUTIVE TEAM AND WHEN THEY ARE EITHER MAKING A COMMENT OR PRESENTING, THEY WILL COME TO THE TABLE TO HAVE THEIR NAME CARDS SO YOU KNOW WHO THEY ARE SO THEY CAN BE IDENTIFIED AND SO FORTH. SO THE AGENDA, I DON'T KNOW IF WE CAN DISPLAY THE AGENDA ON SCREEN? IT IS PACKED. THANKS VERY MUCH. SO WE BEGIN WITH THE DIRECTOR'S REPORT AND THAT WILL BE FOLLOWED BY A PRESENTATION BY THE INAUGURAL ARPA-H DIRECTOR AND WE HAVE ALLOTTED QUITE A BIT OF TIME FOR DISCUSSION SO YOU WILL BE ABLE TO, YOU KNOW, ENGAGE WITH RENEE. A BIT OF A SPECIAL TREAT, AS WE SPEAK HERE, THERE IS A GATES NIH WORKSHOP GOING ON ON ANOTHER PART OF THE CAMPUS AND MR. GATES WILL BE WITH US TILL 11: 15 AND HAVE BRIEF COMMENTS FOR ACD AND THEN YOU WILL ENGAGE IN SOME DIALOGUE FOR SURE. WE WILL HAVE A BREAK FOR LUNCH OR WHAT PASSES FOR LUNCH DEPENDING ON WHAT ARRANGEMENTS YOU MADE AND AGAIN, WE WILL BE VERY PRIVILEGED TO HAVE TONY FAUCI WITH US IN WHAT WILL BE HIS LAST ACD MEETING AS NID DIRECTOR. I SUSPECT SOMEHOW HE WILL BE BACK IN OTHER WAYS BUT CERTAINLY HIS LAST MEETING AS AID. AT 1:30 P.M. WE WILL TALK ABOUT PEER REVIS CRITERIA. THAT WAS INTRODUCED TO YOU IN THE NOVEMBER SPECIAL MEETING WE HAD, THE TELECONFERENCE. A BREAK AND THEN HOWARD, ACD MEMBER AND LYRID JORGENSON WHO IS DIRECTOR OF POLICY WILL PROPOSE A NEW WORKING GROUP FOR THE ACD ON NOVEL ALTERNATIVE METHODS AND I AM SURE THAT WILL GENERATE A GREAT DEAL OF DISCUSSION AND IT ACTUALLY COMES AS AN OFFSHOOT OF THE PRIOR WORKING GROUP THAT WE CON SCRIPTED BARBARA WORKING WITH US ON SO THANK YOU FOR DOING THAT. FOLLOWING THE BREAK, THERE WILL BE ANOTHER PROPOSEDACD WORKING GROUP, THIS ONE ON POST-DOCS THAT MEMBERS WILL BE ENGAGED IN. AND THIS CAME AS A RESULT OF SHELLY REACHING OUT TO ME AND SAYING -- SAYING WHAT ABOUT POST-DOCS AND AS IT TURNS OUT, TWO OTHER PEOPLE THAT SAME DAY SAID THE SAME THING TO ME. SO SOLD. SO WE WILL BE WORKING ON THAT. AND THEN WE WILL ADJOURN. SECOND DAY MEETING, THE ACCESS WORKING GROUP WILL REPORT. WE WILL HAVE A PRESENTATION FROM GARY GIBBONS ABOUT THE NIH RECOVER EFFORT RELATED TO PAST COV2 SARS INFECTION, THIS IS THE OPPORTUNITY FOR NIH TO ADDRESS THIS. A BREAK AND THEN SUPPORT OF OPEN DATA WITH A NUMBER OF NIH COLLEAGUES WHO WILL PRESENT. THAT WILL BE FOLLOWED BY AN UPDATE FROM THE ACD WORKING GROUP ON DIVERSITY AND THIS WILL BE A DISABILITY SUBGROUP REPORT AND I UNDERSTAND A COUPLE OF ACD MEMBERS WERE ASKED TO REVIEW THE REPORT AND THEY WILL LEAD THE DISCUSSION ON THIS IMPORTANT TOPIC. A LUNCH BREAK, THEN A UPDATE ON UNITE AND THEN FINALLY SOME CLOSING COMMENTS AND WE WILL ADJOURN. SO IT IS A PACKED AGENDA. OKAY, IF WE COULD PULL THAT DOWN AND GO TO THE SLIDES, PLEASE? SO MANY TOPICS, ALL OF WHICH I HOPE WILL BE FAIRLY QUICK. WE WILL START AS WE TYPICALLY DO WITH APPOINTMENTS AND DEPARTURES. SO WE'RE REALLY SAD TO BE SAYING GOODBYE TO FIVE MEMBERS OF THE ACD WHO HAVE COME TO THE END OF THEIR TENURE AND WILL BE ROTATING OFF AFTER THIS MEETING. WENDY CHAPMAN, REBEKA DR EZEK, CHRISTINA JOHNSON, DEENA KATABI AND JUDITH KIM BELL. I KNOW KRISTINA WAS UNABLE TO JOIN US TODAY BUT WILL JOIN TOMORROW. I KNOW EVERYONE ELSE IS HERE SO THANK YOU ALL FOR YOUR INCREDIBLE DEVOTION TO THIS COMMITTEE AND FOR THE MANY, MANY CONTRIBUTIONS THAT YOU HAVE MADE. I WANT TO OFFER A SPECIAL THANKS TO SHELLY AND ROBERTA AND BARBARA WALSH WHO IN A MOMENT OF -- I DON'T KNOW WHAT TO SAY. [LAUGHTER] WELL, OKAY, I WILL USE THAT. [INDISCERNIBLE] IN A MOMENT OF GREAT GENEROSITY, AGREED TO STAY ON FOR A LITTLE LONGER TO HELP WITH SOME ONGOING WORK. SO THANK YOU TO ALL OF YOU. WE HAVE A NUMBER OF NOTABLE PEOPLE WHO ARE DEPARTING THIS YEAR. I HAVE ALREADY MENTIONED Dr. FAUCI, OF COURSE, WHO WILL BE ENDING HIS TENURE AS DIRECTOR OF THE NAID AT THE END OF THE MONTH AND YOU CAN GIVE HIM THE BUSINESS LATER ON WHEN HE JOINS US. WE'LL BE IN GOOD HANDS DURING THE I WANT INTERIM PERIOD AS WE DO A SEARCH FOR THE NEXT DIRECTOR OF NAID. HUGH AUCHINCLOSS WHO HAS BEEN THE DEPUTY FOR A NUMBER OF YEARS WILL BE THE ACTING DIRECTOR AND IS WELL-SUITED TO STEP INTO THAT ROLE. ANOTHER BITTERSWEET ANNOUNCEMENT THAT WE ARE HAVING TO SAY THAT ANDREA NORRIS WILL ALSO BE RETIRING AT THE END OF THE YEAR, DIRECTOR OF THE CENTER FOR TECHNOLOGY AND NIHCO AND HAS REALLY BROUGHT NIH INFRASTRUCTURE INTO THE MODERN AGE AND WE'RE EXTREMELY GRATEFUL TO HER. SUSA IS ON LOAN FROM MEDICINE SO A GREAT THANKS TO PATTY BRENNAN, DIRECTOR OF THE NLM. YESTERDAY WE ANNOUNCED Dr. ROGER GLASS WILL BE STEPPING DOWN AS DIRECTOR AT THE INTERNATIONAL CENTER AND HE IS THE LONGEST-SERVING DIRECTOR OF FOGARTY. HE WILL REMAIN IN AN EMERITUS CAPACITY AND WE ARE FORTUNATE THE CURRENT DEPUTY AT FOGARTY INTERNATIONAL CENTER WILL STEP IN, KIMAR SELECTED TO STEP IN THAT ACTING ROLE -- PETER KILMARX. EARLIER THIS YEAR, THE DIRECTOR OF PLANNING AND INITIATIVES, DP CPS I, ONE OF THE LARGEST DIVISIONS WITHIN THE OFFICE OF THE DIRECTOR, WE HAVE KNOWN HIM FOR YEARS, JAMES ANDERSON AND ARE FORTUNATE THAT BOB HAS COME BACK TO US AND IS WITH US THIS MORNING TO SERVE AS ACTING DIRECTOR FOR DPSCI AND WILL BE LAUNCHING A SEARCH FOR THE ROLE SHORTLY. GRATITUDE FOR HIS OVER 50 YEARS OF LEADERSHIP AT NIH. WE WILL BE SAYING FAREWELL TO JOHN GALLIN WHO IS CHIEF SCIENTIFIC OFFICER AT NIH CLINICAL RESEARCH CENTER WHERE HE SERVED AS DIRECTOR. BETSY WILL BE STEPPING DOWN AND -- WILDER -- WHO HAS BEEN DIRECTOR OF THE STRATEGIC COORDINATION FOR YEARS. OKAY, SO NOW THAT IS THE END OF THOSE LEAVING, WE HAVE JONITRUTTER WHO HAS BEEN NAMED TO THE DIRECTORSHIP OF NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES AND WE'RE DELIGHTED JONI IS IN THIS ROLE. AND THEN THE DEPUTY DIRECTOR FOR INTRAMURAL RESEARCH, NINA SCHOR, WE ARE DELIGHTED TO HAVE HER IN THAT PERMANENT CAPACITY NOW. WE HAVE RECENTLY WELCOMED THE NEW DIRECTOR OF THE NATIONAL CANCER INSTITUTE. AS YOU KNOW, N CI IS THE PRESIDENTIAL APPOINTMENT AND THE ONLY ONE APART FROM THE PERMANENT NIH DIRECTOR -- OH YES, AND ARPA-H, CORRECT. THERE ARE NOW THREE PRESIDENTIAL APPOINTMENTS, THANK YOU. SO IN THIS INSTANCE, Dr. MONICA BERTAGNOLLI IS THE NEW DIRECTOR AND HAS HIT THE GROUND RUNNING. WE WILL ALL STRUGGLE TO KEEP UP WITH HER BECAUSE SHE IS REALLY MOVING FAST BECAUSE OF THE IMPERATIVE OF, IN PART, THE CANCER MOONSHOT WHICH IS THE PRESIDENTIAL INITIATIVE AND ALSO THERE IS A LOT GOING ON AT THE NCI AS YOU MIGHT IMAGINE SO WE WELCOME HER. AND AS I MENTIONED A LITTLE WHILE AGO, THIS IS REALLY THE INAUGURAL DIRECTOR OF ARPA-H AND SHE WILL BE PROVIDING US AN UPDATE LATER THIS MORNING AND THEN FOUR MEMBERS HERE AT THE NIH SO WE'RE REALLY DELIGHTED FOR ALL OF THESE ACKNOWLEDGEMENTS OF THEIR COME ACCOMPLISHMENTS. A FEW SPECIAL EVENTS. YOU KNOW, I LOOKED AT ALL THE PICTURES AND SO FORTH BUT HERE I AM, GREETING ADMIRAL RACHEL LEVINE, ASSISTANT SECRETARY OF HEALTH, THIRD PERSON FROM THE LEFT AND SHE VISITED THE CLINICAL CENTER AND GAVE A GREAT KEYNOTE ADDRESS AT THE NIH PRIDE EVENT SO THAT WAS REALLY WONDERFUL TO HOST HER HERE TOGETHER WITH A NUMBER OF THE INSTITUTE DIRECTORS OF DC. WE ALSO HAD THE HONOR OF HOSTING SENATOR ROY BLOUNT OF MISSOURI AT THE DEDICATION CEREMONY AT THE NEW ROY BLOUNT CENTER RELATED TO ALZHEIMER'S DISEASE AND RELATED RESEARCH CENTER. I THINK YOU ALL KNOW SENATOR BLOUNT HAS BEEN A LONG TIME CHAMPION FOR NIH IN GENERAL BUT ALSO RESEARCH RELATED TO EXPANDED DEMENTIA RESEARCH AND DESIGNED TO BE A FOCAL POINT AND CATALYST IN THIS FIELD. WE WERE FORTUNATE TO HOST SECRETARY BASERA WHO IS DEAD CENTER IN THE PHOTO ALONG WITH SENATORS BEN CARDIN AND CHRIS VAN HOLLAND, MARYLAND DELEGATION AND REPRESENTATIVE DAVID TROEN IN WHOSE DISTRICT THE NATIONAL CANCER SITE CENTER IS LOCATED. AND WE HAD SOME REALLY OUTSTANDING PRESENTATIONS BY THE NCI STAFF AT FREDERICK AND WE ALSO DISCUSSED THE CANCER MOONSHOT. JUST WANTED TO GIVE YOU A QUICK UPDATE ABOUT EARLY STAGE INVESTIGATORS BECAUSE THIS IS ONE OF THE METRICS THAT WE HAVE BEEN WATCHING VERY, VERY CLOSELY. AND I MUST SAY OVER THE YEARS THE ADVISORY COMMITTEE HAS REALLY, YOU KNOW, URGED US TO CONTINUE, YOU KNOW, THESE EFFORTS. AND SO THE LATEST DATA ARE LISTED HERE AND WE'RE VERY PROUD THAT THE FINAL TALLY FOR 2022 WAS AN ALL-TIME RECORD OF 1589 EARLY STAGE INVESTIGATOR APPLICANTS WERE FUNDED FOR THEIR FIRST R1 OR EQUIVALENT AWARD. AND SO AS YOU SEE, WE KEEP GOING UP AND WE ARE GOING TO WORK HARD AT MAINTAINING -- IT IS ONE PIECE OF WHAT WE ARE GOING TO DO BUT AN IMPORTANT PIECE SO WE WANTED TO DRAW YOUR ATTENTION TO THIS SORT OF BASELINE. WE WANTED AT LEAST 1100 BUT ABLE TO EXCEED THAT VIRTUALLY EVERY YEAR SO I AM REALLY VERY, VERY PLEASED THE CENTER HAS STEPPED UP AND HELPED US. SOME OF YOU KNOW ERA BECAUSE OF COURSE GRANT APPLICATIONS AND SO FORTH. THIS IS AN INCREDIBLE KNOWLEDGE BASE FOR MANY, MANY THINGS AT NIH. IT'S A VERY COMPLEX, INTEGRATED SYSTEM THAT WE TRY AND MAKE AS USER-FRIENDLY AS POSSIBLE BECAUSE OF THE FRONT END NATURE OF WHAT IT DOES IN TERMS OF OUR EXTRAMURAL ACTIVITIES. WE ARE ENHANCING IT EVEN FURTHER BY BEGINNING TO POPULATE INFORMATION RELATED TO CONTRACTS SO AS THE SLIDEEN -- SLIDE ENUMERATES, CONTRACT AWARDS REPRESENT ONLY 8 PERCENT OF OUR MONEY AND UNFORTUNATELY DON'T HAVE A GOOD WINDOW INTO OUR AWARDS PROGRAM. YOU CAN GO IN FOR GRANTS AND FIND ANYTHING YOU WANT BUT CAN'T YET DO THAT FOR CONTRACTS SO LATER THIS YEAR, WE WILL ALLOW CONTRACT AWARDEES TO UPLOAD INFORMATION ON THE SCIENCE THEY ARE DOING INTO ERA COMMENTS SO THIS WILL ALLOW CONTRACT AWARDEES TO ACCURATELY CHARACTERIZE WHAT THEY ARE DOING, IMPROVE TRANSPARENCY TO THE PUBLIC ABOUT OUR CONTRACT DATA AND AGAIN COMMENSURATE WITH WHAT WE DO WITH GRANTS. AND IT WILL REPLACE A VERY ARDUOUS MANUAL PROCESS THAT OUR STAFF NOW USES TO UPLOAD SOME INFORMATION. SO WE VIEW THIS AS A REALLY IMPORTANT STEP FORWARD IN ENHANCING THE TRANSPARENCY OF WHAT THE AGENCY IS DOING AND WE WILL LOOK FORWARD TO ROLLING THIS OUT LATER THIS YEAR. SO JUST TO GIVE YOU A HEADS-UP ABOUT THAT. SO JUST A VERY BRIEF UPDATE ON THE PROGRESS OF THE NIH-WIDE DEIA STRATEGIC PLAN WHICH WE PRESENTED TO YOU DURING THE JUNE MEETING. SO YOU MAY RECALL THAT THIS PLAN WILL ARTICULATE THE VISION THAT NIH HAS FOR STRENGTHENING DIVERSITY, EQUITY AND INCLUSION AND ACCESSIBILITY AND WILL CAPTURE ACTIVITIES THAT THE NIH WORKFORCE HAS TO UNDERTAKE TO IMPLEMENT, TO MEET THE VISION OF THE STRATEGIC PLAN. NOW, WHAT WE HAVE DONE IS WE'VE HARMONIZED THE NIH STRATEGIC PLAN FRAMEWORK WITH THE NIH DEIA PRIORITIES THAT ARE ORGANIZED AROUND THE NEEDS AND CHALLENGES IN THREE AREAS, AND WE HAVE BEEN FOLLOWING A FIVE-PHASED APPROACH TO THE DEVELOPMENT OF THE STRATEGIC PLAN AND THE FIRST PHASE, WE INVOLVE A NUMBER OF OFFICES WITHIN NIH TO LEAD PLANNING EFFORTS. IN THE SECOND PHASE, THE WORKING GROUP DEVELOPED SORT OF A STRAW MODEL STRATEGIC PLAN FRAMEWORK. THE THIRD PHASE EXISTED OF GATHERING INPUT BOTH HERE AT THE NIH AND ALSO THE PUBLIC. THIS INCLUDEK A WEBINAR, RFI SEEKING FEEDBACK, AN NIH DATA CALLED INVENTORY, THE OVER 1700NIH/DEIA ACTIVITIES. THE FOURTH PHASE, THE WORKING GROUP FURTHER REFINED THE NETWORK AND THEN SELECTED A SHORT LIST OF ACTIVITIES TO ILLUSTRATE ASPECTS OF THE PLAN AND THEN THEY FINISHED THE DRAFTING. AND SO WE ARE NOW IN THE FIFTH PHASE WHICH INVOLVES REVIEW AND APPROVAL FOR THE PLAN. SO WE HAVE RECEIVED A LOT OF INPUT FROM THE COMMUNITY AS I MENTIONED, EXTENSIVE INTERNAL ENGAGEMENT -- WORKING GROUP, [ INDISCERNIBLE ] MEETINGS, INVENTORY CALLS, RFI AND SO FORTH AND THEN THE EXTERNAL COMMUNITY GAVE US FEEDBACK VIA RFI AND WEBINAR. AND OF COURSE WE APPRECIATE ALL THE INPUT WE HAVE RECEIVED. THE PLAN HAS NOW BEEN REVIEWED BY THE INSTITUTE CENTER AND NIH LEADERSHIP AND WE'LL BE WORKING TOWARDS A SORT OF FINAL APPROVAL, FINAL SIGNOFF. YOU HAVE REVIEWED THE DRAFT PLAN, AND I KNOW THIS TOOK A LOT OF TIME AND I APPRECIATE THE EFFORT THAT WENT INTO THIS, AND SO WE ARE PLANNING FOR A COMPREHENSIVE APPROACH TOWARDS THE IMPLEMENTATION OF THE PLAN. AND BOTH OF WHO YOU HAVE DONE THESE THINGS AT YOUR HOME INSTITUTIONS KNOW THE PLAN IS JUST THE FIRST PART. THE REAL WORK NOW COMES TO HOW YOU ARE GOING TO IMPLEMENT THINGS AND WE ARE UNDERWAY IN TERMS OF OUR WORKING THROUGH THAT. SO AGAIN, THANKS TO ALL THE COUNCIL MEMBERS WHO PROVIDED INPUT, AND TO ALL OF THE MEMBERS OF THE EXTRAMURAL AND INTRAMURAL COMMUNITIES BECAUSE PEOPLE WERE ENGAGED AND WE'RE VERY FORTUNATE TO HAVE EVERYBODY GET INVOLVED IN THIS. IT A COUPLE OF UPDATES ON SOME INITIATIVES AND AT LEAST TO GIVE YOU A FLAVOR OF WHAT'S GOING ON. SO ONE INITIATIVE WHICH IS ENTITLED THE EATING, SLEEPING AND CONSOLING FOR NEONATAL OPIOID WITHDRAWAL STUDY IS A CONSORTIUM THAT WAS FUNDED BY THE HEAL INITIATIVE AT NIH BUT IT WAS CONDUCTED IN COLLABORATION WITH NICHD'S NEONATAL RESEARCH NETWORK AND ARE IDEA STATES PEDIATRIC CLINICAL TRIAL NETWORK. SO VARIOUS ENTITIES AT NIH CAME TOGETHER. THE STATES HIGHLIGHTED IN WHATEVER COLOR THAT IS, DARKENED COLOR, REPRESENT THE SITES AND SO AS YOU CAN SEE, MANY OF THEM ARE NOT THE TYPICAL PLACES THAT WE DO TRIALS. A VERY GOOD REPRESENTATION FOR EXAMPLE IN THE MIDDLE OF THE COUNTRY. IN ANY EVENT, THE -- AND I KNOW MANY OF YOU ARE FAMILIAR WITH THIS BUT WHEN AN NEONATE IS EXPOSED TO OPIOIDS, YOU CAN PRECIPITATE THE OPIOID WITHDRAWA L SYNDROME OR NOWS. THE NEWBORNS ARE IRRITABLE, DON'T SLEEP WELL AND UNFORTUNATELY SPEND MANY DAYS HOSPITALIZED AND THERE ARE INSTANCES WHERE THERE IS SUFFICIENT SYMPTOMOTOLOGY CLINIC IANS WILL TREAT WITH REPLACEMENT OPIOIDS. WHAT WE FOUND IN SURVEY WORK WAS THERE WAS A SUBSTANTIAL VARIATION IN HOW NOWS CASES WERE MANAGED AND SO -- AND THIS IS A SERIOUS SITUATION FOR THESE INFANTS, THE WITHDRAWAL SYMPTOMS FOR THESE BABIES THAT INCLUDE A NUMBER OF PRESENTATIONS, TREMOR, EXCESSIVE CRYING, IRRITABILITY, POOR SLEEP CYCLE, DIFFICULTIES WITH BREATHING, THIS CAN BE QUITE SERIOUS. AND SO THE OBJECTIVE OF THIS STUDY WAS TO SEE IF THERE IS A BETTER WAY OF APPROACHING THIS, AND THEY DID A STUDY TO SEE IF A SIMPLER APPROACH OF INSURING GOOD EATING, SLEEPING AND CONSOLING WOULD BE AS EFFECTIVE AS FARM -- PHARMACOLOGIC CARE SO THIS INVOLVES HOLDING AND SWADDLING AND ROCKING THE BABY, QUITE A BIT OF CARETAKER INVOLVEMENT. SO THE WORK WAS DONE ACROSS TWO PEDIATRIC CLINICAL TRIAL NETWORKS, WAS A RANDOM INTERVENTION SO AND IT HAS LED TO A WHOLE CHANGE IN THE WAY WE'RE THINKING ABOUT HOW TO TREAT THIS NOW. AND SO -- AND WHAT'S REMARKABLE IS THE NURSES IN THE FRONT LINES OF ALL OF THIS, ABOUT 5000 NURSES WERE TRAINED TO PARTICIPATE AND THREE EARLY STAGE INVESTIGATORS LED THE STUDY WHICH IS REALLY A WONDERFUL THING. THE APPROACH SUBSTANTIALLY DECREASED THE TIME TILL THE INFANTS WERE READY TORE DISCHARGE, SUBSTANTIALLY DECREASED THE NEED FOR PHARMOCOLOGICAL TREATMENT, DID NOT AFFECT SAFETY OUTCOMES THROUGH THREE MONTHS OF AGE AND NOW PROVIDES STRONG SUPPORT FOR STANDARD CARE. THERE WILL BE A NATIONAL MEETING AND FOLLOW UP FOR FAMILY WELL-BEING AND CHILD NEURO DEVELOPMENT. SO I THINK THIS IS AN EXAMPLE WHERE WE HAVE PULLED IN A VARIETY OF EQUITIES HERE TO MAKE THIS HAPPEN AND IT WILL VERY LIKELY LEAD TO MAKE THIS A NEW STANDARD OF CARE. SO WE'RE REALLY VERY PLEASED WITH IT. ANOTHER EFFORT THAT I JUST WANTED TO DRAW YOUR ATTENTION TO IS THE AIM AHEAD EFFORT, AND THIS IS ABOUT CREATING BE A AIML CONSORTIUM TO ADVANCE HEALTH EQUITY AND RESEARCHER DIVERSITY. THIS WAS LAUNCHED A LITTLE OVER A YEAR AGO AND BASICALLY THE IDEA IS TO ENSURE THAT BENEFITS OF AI AND ML ARE MORE SPREAD ACROSS THE UNITED STATES AND TO DO THAT, THIS PROGRAM WILL ENHANCE THE DATA BEING USED TO TRAIN THE ALGORITHMS AND AS IMPORTANT, ENSURE THAT THE LEADERS ARE FROM DIVERSE BACKGROUNDS IN POSING THE QUESTIONS, ANALYZING THE DATA AND SO FORTH. WE ALL UNDERSTAND THAT AI IS VERY POWERFUL BUT IF YOU TRAIN WITH A BIASED DATA SET, AI WILL SIMPLY AMPLIFY THE BIAS AND YOU ARE WORSE OFF THAN WHEN YOU STARTED SO THIS IS ATTEMPTING TO ADDRESS THIS. AND WE HAVE REALLY MADE SOME GREAT PROGRESS SO FAR AND AGAIN, THIS IS ONLY A LITTLE BIT OVER A YEAR OLD, 22 RESEARCH SCHOLARSHIPS, LEADERSHIP FELLOW SHIPS, A SERIES OF TRAINING PRACTICUM AWITH REGARDS MADE TO ENHANCE COMPETENCIES IN AI/ML, GRADUATE STUDENTS FROM INSTITUTIONS, AND THEN THERE IS THE AIM AHEAD VIRTUAL PLATFORM THAT INTERSECTS AI/ML HEALTH EQUITY AND A NUMBER OF WEBINARS AND SYMPOSIA INCLUDING AI FOR HEALTH EQUITY EFFORT. AND SO THIS SHOWS YOU WHERE ALL THE EQUITIES OF ALL THIS PROGRAM ARE CURRENTLY LOCATED AND IT REALLY IS A NATIONAL PROGRAM. I MEAN NOT EVERY STATE IS INVOLVED BUT WE HAVE A PRETTY GOOD REPRESENTATION IN MANY STATES AT LEAST. AND OVER TIME, WE HOPE TO GROW THIS OUT EVEN FURTHER. UNFORTUNATELY, THE PRINT IS TOO SMALL TO READ BUT IT IS IN YOUR SLIDE DECKS THAT YOU RECEIVED. AND OBVIOUSLY WE'RE NOT GOING TO GO THROUGH ALL OF THESE BUT TO GIVE YOU A COUPLE OF EXAMPLES, ONE PROJECT LED BY THE NATIONAL RESEARCH INSTITUTE THAT USES MACHINE LEARNING TO ENHANCE THE KIDNEY TRANSPLANT INDEX BY EXPANDING THE UNDERLYING DATA TO INCLUDE NOVEL AND COMMUNITY LEVEL VARIABLES TO MULTIETHNIC POPULATIONS. ANOTHER PROJECT BY Dr. ALEXANDER STOKES AT UNIVERSITY OF HAWAII USES ML TO ADDRESS UNDER DIAGNOSES AND UNDER REPRESENTATION OF PERSONS AND THEN ANOTHER ONE OUT OF THE UNIVERSITY OF CALIFORNIA IRVINE IN PARTNERSHIP WITH UNIVERSITY OF COLORADO-DENVER TO USE ML TO PREDICT CARDIO METABOLOMIC RISKS OF NATIVE AMERICAN ADULTS WITH DIABETES. THIS IS JUST A SAMPLING AS THESE PROJECTS ARE ALL OF THAT SAME TYPE. AND THEN I JUST WANTED TO GRIFF BRIEF UPDATE ON THE "ALL OF US" PROGRAM WHICH WE HAVE TALKED TO THE COUNCIL ABOUT. AS OF DECEMBER 5TH, A COUPLE DAYS AGO, 559,000 PARTICIPANTS AND CLIMBING. IT IS REALLY QUITE REMARKABLE. WE HAVE ASSEMBLED OVER 339,000 ELECTRONIC HEALTH RECORDS. OF THE GROUP THAT HAVE SIGNED UP, OVER 393,000 HAVE COMPLETED THE INITIAL STEPS OF THE PROGRAM. WE HAVE OVER 400,000 BIOSAMPLES. YOU KNOW, COVID THREW US A CURVE LIKE EVERYTHING ELSE BUT WE HAVE, YOU KNOW, RECOVERED AND ARE WORKING NOW TO DEVELOP ONE OF THE LARGEST AND RICHEST DATA SETS BROADLY AVAILABLE. AND WE ARE ALREADY USING THIS RESOURCE TO INTERROGATE SPECIFIC QUESTIONS AND WHAT IS PARTICULARLY HEARTENING -- WELL, BEFORE I GET TO THAT, GENOMIC RESULTS ARE NOW BEGINNING TO BE RETURNED FOR PILOT TESTING. THIS IS YOU OPT IN, PROVIDE A BLOOD OR IN SOME CASES SALIVA SAMPLE, SEQUENCING IS DONE AND THEN YOU OPT IN WHETHER OR NOT YOU WANT TO RECEIVE THE RESULTS. A VERY IMPORTANT PART OF THIS IS THAT FOR INDIVIDUALS WHO HAVE SOME RISK MARKER NOTED, THIS IS SUPPORTED WITH DISCUSSION WITH GENETIC COUNSELORS SO THAT THE INDIVIDUAL UNDERSTANDS WHAT THIS MEANS AND AS YOU KNOW, SOME OF THESE THINGS CAN BE PRETTY COMPLICATED. AND PEOPLE ARE ALSO ABLE TO VIEW THEIR GENETIC ANCESTRY IF THEY ARE INTERESTED. ALL OF THIS IS OPT-IN IF THEY WANT, IF THEY WANT THE INFORMATION. AND THIS JUST GIVES YOU AN EXAMPLE OF SOME OF THE MATERIALS THAT ARE MADE AVAILABLE. FOR EXAMPLE, IF MUTATIONS ARE NOTED, IT IS IMPORTANT TO SHARE THIS WITH YOUR DOCTOR TOGETHER WITH SOME INFORMATION ABOUT WHAT POTENTIAL RISKS THAT MAY ENTAIL. SO WHAT IS VERY HEARTENING ABOUT THIS ENTIRE PROGRAM IS IT IS LIKELY THE MOST ETHICALLY RACIALLY ENRICHED COHORT THAT NIH HAS EVER ASSEMBLED, PARTICULARLY SOMETHING OF THIS SIZE AND AS YOU CAN SEE FROM THE PIE GRAPH, IT IS CURRENTLY, YOU KNOW, WHITE PARTICIPANTS ARE THE MINORITY WHEN YOU COMPARE THE ENTIRE FILE AND CAREER LEVELS RANGE THE GAMUT. MANY ORGANIZATIONS ARE PARTING INCLUDING 28HBCUS AND 36 HISPANIC SERVING INSTITUTIONS AND WE WILL CONTINUE THIS TO ENSURE THAT WE HAVE AN ETHICALLY AND RACIALLY DIVERSE COHORT. ALL THE OTHER COHORTS THAT HAVE BEEN ASSEMBLED ARE LARGELY EUROPEAN IN NATURE AND SO THIS IS REALLY ENRICHING OUR UNDERSTANDING AND WILL CONTINUE TO DO SO. OKAY, SO NOW I WILL STOP SPEAKING FOR A WHILE WHICH I AM SURE YOU ARE THRILLED ABOUT AND I AM GOING TO ASK MR. SHAPIRO TO COME TO THE TABLE TO GIVE US A BUDGET UPDATE. NEAL IS OUR BUDGET OFFICER. [ OFF MIC ] >> ALL RIGHT, THANK YOU, NEXT SLIDE. GOOD TO GET SOME INSTRUCTIONS. [LAUGHTER] SO WE ARE CURRENTLY, BUDGET-WISE, AT THE BEGINNING, EARLY IN FISCAL 2023. IT STARTED ON OCTOBER 1. AS IS COMMON, WOULD HE DID NOT RECEIVE OUR FINAL APPROPRIATE BY THAT POINT SO WE ARE CURRENTLY UNDER A CONTINUING RESOLUTION. IT LASTS UNTIL THE 16TH, NEXT FRIDAY. AND BASED ON WHERE WE UNDERSTAND CONGRESS IS IN TERMS OF NEGOTIATIONS ON A HOPEFULLY FULL YEAR APPROPRIATION, IT LOOKS LIKE THEY WILL NEED AT LEAST SEVERAL MORE WEEKS SO PROBABLY EARLY JANUARY WOULD BE THE SOONEST THAT WE WOULD BE ABLE TO SEE A COMPLETED BILL AND AS A RESULT, THE LIKELIHOOD IS THAT THEY WILL PASS ANOTHER CONTINUING RESOLUTION AND THEN HOPEFULLY THEY WILL BE ABLE TO FINISH THE JOB BY THEN. SO WE'RE CONTINUING UNDER THE SAME FUNDING LEVEL WE HAD IN '22, PRORATED BASED ON THE PERIOD. AND WHILE CONGRESS IS WORKING ON THAT, AND ADRIAN WILL TELL YOU A LITTLE BIT MORE ABOUT THE OTHER THINGS GOING ON RIGHT NOW, IT COULD POTENTIALLY INCLUDE BOTH AN A APPROPRIATION OMNIBUS AND POTENTIALLY SUPPLEMENTAL APPROPRIATIONS SUCH AS ONES WE HAVE HAD IN THE PAST FOR COVID-19. LAST POINT HERE IS ON THE TYPE 1 DIABETES MANDATORY FUNDS, THAT IS NOT PART OF THE A APPROPRIATION BUT DONE SEPARATELY. IT WAS REAUTHORIZED FOR THREE YEARS FOR 21 TO 23 AND SO BEYOND THAT YEAR, IT WILL NEED ADDITIONAL LEGISLATION TO CONTINUE INTO 2024 BUT THE FUNDS HAVE ALREADY COME. OKAY, SO A LITTLE RUNDOWN ON WHAT HAS HAPPENED SINCE OUR LAST A TV MEETING IN TERMS OF APPROPRIATIONS IN CONGRESS. FIRST IN THE HOUSE, OUR SUBCOMMITTEE WAS ABLE TO GET THROUGH THEIR MARKUP AS WELL AS THE FULL COMMITTEE MARKUP IN JUNE. IT WAS NOT INCLUDED IN A CONSOLIDATED BILL SO CONGRESS TOOK SEVERAL DIFFERENT SUBCOMMITTEE BILLS, COMBINED THEM INTO ONE. WE SOMETIMES CALL THAT A MINI BUS RATHER THAN AN OMNIBUS. THIS HAPPENED LAST YEAR AND OUR BILL WAS INCLUDED SO THERE WAS FLOOR ACTION IN THE VOTE ON THAT LAST YEAR. THIS YEAR, WE WERE NOT PART OF THAT BILL SO WHAT WE HAVE, WHAT CONGRESS IS WORKING OFF IS WHAT WAS APPROVED BY THE FULL COMMITTEE. THE INCREASE OVER 2022 WAS $2.5 BILLION NOT INCLUDING ARPA-H AND THAT INCLUDED ACROSS WILL THE BOARD AN INCREASE OF 3.2%. ARPA-H WAS FUNDED AT 2.75 BILLION, EXCITED ABOUT THAT, AN INCREASE OVER FY202 BUT WAS APPROPRIATED IN HHS BUT OUTSIDE NIH. SO THE ORIGINAL APPROPRIATION HAD IT IN HHS BUT WITH THE AUTHORITY TO TRANSFER TO NIH WHICH THE DEPARTMENT THEN DID BUT APPARENTLY IT HAS BEEN OPERATING WITHIN NIH BUT THAT IS STILL AN ISSUE THAT THE HOUSE AND SENATE HAVE YET TO AGREE ON. NEXT AND AS I NOTED BEFORE, IT IS WITHIN NIH IN THE SENATE MARK ALTHOUGH THEY DID NOT INCREASE THE FUNDING, THE $1 BILLION AND AS THE LAST TWO YEARS, THE SENATE DID NOT GET THROUGH THE SUBCOMMITTEE OR FULL COMMITTEE MARKUPS. SO THE MAJORITY IN THE SENATE APPROPRIATIONS COMMITTEE RELEASED THEIR RECOMMENDED BILL UNDER REPORT LANGUAGE INCLUDING A 2.5 INCREASE FOR NIH, ACROSS THE BOARD INCREASE OF 3.1 PERCENT AS WELL AS SEVERAL RESEARCH AREAS SO THE HOUSE HAD MORE SUPPORT THAN THE SENATE DID. THE OTHER THING THAT WAS INCLUDED WAS THE $16.000000000 OF EMERGENCY SUPPLEMENTAL FUNDING TO HHS FOR COVID-19 WHICH CAN THEN BE DISTRIBUTED TO COMPONENTS OF HHS INCLUDING NIH WHICH HAS SEEN A FAIR SOURCE OF THE COVID-19 FUNDED. SO THIS IS LAYING OUT THE NUMBERS SO YOU CAN SORT OF SEE WHAT THE BIDDING WAS BETWEEN THE ADMINISTRATION, HOUSE AND SENATE. ONE THING I EXPLAINED BACK IN JUNE BUT WILL DO SO AGAIN, BETWEEN THE 2022 ENACTED AND 2023 PRESIDENT'S BUDGET, THOSE TWO WERE BASED ON DIFFERENT STARTING POINTS. CONGRESS DIDN'T PASS THE BILL IN TIME FOR IT TO BE USED AS A BASELINE FOR THE PRESIDENT'S BUDGET SO THAT WAS WORKING OFF A 2022 CR LEVEL, SORT OF WHAT WE'RE DOING NOW WITH 2022, THAT WAS THE 2021 LEVEL BEING APPLIED IN EARLY 2022 AND AT THAT TIME, IT WAS $42.09 BOULLION -- BILLION. SO IT WAS PROPOSING ABOUT THE SAME INCREASE IN THE SAME RANGE AS THE HOUSE AND SENATE PROVIDED IN THE PRESIDENT'S BUDGET BUT FROM DIFFERENT STARTING POINTS. SO FORTUNATELY EVEN THOUGH THERE WASN'T THAT MUCH DIFFERENCE BETWEEN THE PRESIDENT'S BUDGET AND WHAT CONGRESS ENACTED, IN THEIR APPROPRIATIONS ACTION THEY STARTED FROM A NEW POINT WHICH ADDED $2.5 BILLION AS WELL AND THEN THE ARPA-H NUMBERS AS I SHOWED YOU BEFORE. THE OTHER PART OF THE PRESIDENT'S BUDGET WAS A $12.5 BILLION PANDEMIC PREPAREDNESS PROPOSAL THAT WAS MOVING BEYOND COVID-19 TO PREPARE FOR OTHER PANDEMICS IN THE FUTURE, THAT HAS NOT BEEN APPROVED BY CONGRESS SO IT HAS BEEN MORE DEALING WITH CURRENT VERSIONS OF COVID-19 AND POTENTIAL NEW STRAINS TO PREPARE FOR THOSE. SO CURRENTLY THE ADMINISTRATION HAS PENDING FOR HHS, A $9 BILLION SUPPLEMENTAL REQUEST THAT IS NOT BROKEN OUT BY COMPONENTS LIKE NIH BUT IT INCLUDES ACTIVITIES SUCH AS THE RESEARCH AND DEVELOPMENT FOR VACCINES AND THERAPEUTICS AND WELL AS ADDITIONAL FUNDING THAT COULD GO TOWARDS CONTINUING THE RECOVER INITIATIVE FOR LONG-COVID. BOTH OF THOSE, YOU WILL BE HEARING ABOUT LATER TODAY AND TOMORROW SO I WON'T GO INTO TOO MUCH DETAIL. NEXT? AND THIS IS JUST TO GIVE YOU AN IDEA OF SOME -- THIS IS JUST A SAMPLING OF SOME OF THE TARGETED INCREASES THAT WERE IN THE PRESIDENT'S BUDGET, THE HOUSE AND THE SENATE MARK. WANTED TO SHOW THAT IN MANY CASES THE HOUSE AND SENATE HAVE BEEN SUPPORTIVE OF THE PRIORITIES NIH HAS EXPRESSED. SOME OF THESE HAVE BEEN DISCUSSED OVER AND OVER, VERY IMPORTANT THAT WE MAKE PROGRESS ON. THERE WAS SOME ADDITIONAL FUNDING FOR SEVERAL OF THESE IN 2022 AS WELL, FOR OPIOIDS, HEALTH DISPARITIES, BUILDINGS AND FACILITIES. NUTRITION SCIENCE WAS A NEW REQUEST FOR '23 SO GLAD THAT IS GETTING SUPPORT FROM CONGRESS. ALSO WANTED TO NOTE ALZHEIMER'S DISEASE FUNDING HAS BEEN RAMPED UP A GREAT DEAL BY CONGRESS OVER THE LAST SEVERAL YEARS. THIS YEAR THE HOUSE WANTED TO CONTINUE RAMPING UP ALZHEIMER'S FUNDING, THE SENATE DID NOT SO THAT IS A CHANGE FROM WHAT WE HAVE SEEN IN THE LAST SEVERAL YEARS, A LITTLE DIFFERENCE ON OPINION THERE HOW THEY WANT TO PROCEED WITH ALZHEIMER'S. AND WITH THAT, I WILL TURN IT OVER TO AJ. >> HELLO. SO I GET THE VERY FUN JOB TRYING TO EXPLAIN CONGRESS AND WHAT IS HAPPENING. NEXT SLIDE, GO AHEAD. LET'S JUMP IN. SO NORMALLY I WOULD SPEND THE ENTIRE TIME TALKING ABOUT LAME DUCK AND WHAT WILL HAPPEN BUT NO ONE ACTUALLY KNOWS. THERE IS A LONG LIST OF THINGS THAT THEY ARE THINKING ABOUT, THAT THEY WANT TO GET DONE IN THE NEXT 20 DAYS, NOT CLEAR WHAT AND HOW AND WHEN. THE APPROPRIATION GOVERNMENT FUNDING DOES EXPIRE DECEMBER 16TH. THAT IS NEXT WEEK. AT THE MOMENT, WHAT'S HAPPENING IS THAT THE -- THEY CAN'T AGREE ON TOP LINE FIGURES FOR GOVERNMENT SPENDING ACROSS THE BOARD. THERE HAS BEEN AN AGREEMENT ON DEFENSE SPENDING IN LINE WITH WHAT HAS COME OUT OF THE NATIONAL DEFENSE AUTHORIZATION ACT WHICH IS JUST AN AUTHORIZATION, DOESN'T HAVE THE MONEY. A APPROPRIATIONS BILL CARRIES THE MONEY BUT THEY CAN'T AGREE ON EVERYTHING ELSE, THE NONDEFENSE SPENDING. REPUBLICANS ARE ARGUING BECAUSE OF THE RECONCILIATION BILLS THAT HAVE GONE THROUGH, THAT WAS THE BIG INCREASE SO THEY WANT TO KEEP NONDEFENSE LOWER IN THE GENERAL GOVERNMENT FUNDING BILL AND THERE IS A DIFFERENCE IN $25 BILLION AT STAKE RIGHT NOW ACROSS THE NONDEFENSE AGENCIES OF WHICH WE ARE ONE. THERE IS SOME DISCUSSION, AND WE'LL GET INTO WHAT THE LEADERSHIP HAS BUT LEADERSHIP BATTLES ARE IMPACTING THE FACT WE CAN'T GET A LOT OF THESE AGREEMENTS COMING TOGETHER. THERE IS A LOT HAPPENING IN THE LAME DUCK TO DECIDE WHO IS GOING TO CONTROL BOTH HOUSES AND THAT IS IMPACTING THIS. NATIONAL DEFENSE AUTHORIZATION ACT IS HUNG UP OVER ISSUES AROUND COVID, VACCINE MANDATES, SEXUAL HARASSMENT, OTHER SOCIAL ISSUES. WE CARE ABOUT IT BECAUSE IT OFTEN CARRIES POLICIES THAT IMPACT US. ONE THAT IS IN THE DRAFT THAT WE HAVE SEEN IS INTERNATIONAL PREPAREDNESS FOR PANDEMIC. THERE IS SOME PROVISIONS RELATED TO INCREASING THE GOVERNMENT'S POSTURE TOWARD GLOBAL COOPERATION. THERE IS ALSO A SECTION ON PFAS CHEMICALS, THE FOREVER CHEMICALS. SO THERE IS SOME MONEY THERE FOR HHS TO DO SOME STUDY ON HEALTH IMPLICATIONS. THERE IS ALSO A BRAIN HEALTH INITIATIVE TO STUDY AND IMPROVE THE COGNITIVE HEALTH OF THE FORCES. SO THERE ARE A NUMBER OF HEALTH RELATED PROVISIONS AND GOVERNMENT PROVISIONS WE'RE WATCHING. THERE ARE A LOT OF HEALTH BILLS THAT ARE SORT OF FLOATING OUT THERE. THE PREVENT ACT WHICH IS PANDEMIC PREPAREDNESS AGAIN, THE ARPA-A AUTHORIZATION, THE TECHNICAL FIXES THAT PEOPLE WANT TO DO TO THE FDA USER FEES AFTER THIS PAST YEAR, ALL OF THESE THINGS HAVE NEGOTIATING AROUND CONGRESS BUT THE QUESTION IS HOW YOU GET THEM TO THE FINISH LINE. NEXT SLIDE, PLEASE. SO WHY ARE WE IN THIS SITUATION? WELL, WE HAD AN ELECTION. I WILL NOT TALK A LOT ABOUT THE ELECTION. IT HAS BEEN IN YOUR NEWSPAPER AD NAUSEAU THE PAST FEW WEEKS SO NOT TO BEAT A DEAD HORSE BUT THIS IS REALLY INTERESTING. WHEN INCUMBENTS RAN, THEY WON ACROSS THE BOARD SO THIS IS REALLY A SIGNAL, I THOUGHT OF WHAT HAPPENED IN THE ELECTORATE. NEXT SLIDE. [ HEAVY SIGH ] A NEW CONGRESS. HOW CONGRESS WORKS ON A VERY BASIC LEVEL IS THAT IT ENTIRELY REMAKES ITSELF EVERY TWO YEARS. ALL THE RULES GET THROWN OUT, ALL THE STRUCTURES GET THROWN OUT, THEY VOTE ON EVERYTHING. SO ANYTHING IS ON THE TABLE, ANYTHING CAN HAPPEN RIGHT NOW. THEY VOTE ON NEW LEADERS, ABSOLUTELY EVERY STRUCTURE, WHAT COMMITTEES THEY WILL HAVE, HOW MANY MEMBERS WILL BE ON THOSE COMMITTEES. WE THINK OF THESE THINGS AS ENDURING BECAUSE THEY OFTEN MOVE FORWARD JUST LIKE THE PREVIOUS YEAR, BUT IT IS ALL ON THE TABLE. RULES TO WATCH. WE THINK IN THE HOUSE THERE WILL BE SOME CONVERSATION ABOUT WHETHER OR NOT THEY WILL CONTINUE THE PROXY VOTING. A LOT OF MEMBERS LIKE TO BE ABLE TO VOTE FROM CALIFORNIA OR OTHER PLACES. TERM LIMITS, DEBATE ON EARMARKS, WILL WE HAVE THEM, AND A RULE CHANGE FOR HOW TO REMOVE THE SPEAKER. THIS IS SOMETHING YOU SEE FROM SOME OF THE MORE EXTREME FACTIONS IN THE CONGRESS. THERE WILL BE SOME INTERESTING AND VERY PASSIONATE DEBATE, I PREDICT. NEXT SLIDE, PLEASE. MAJORITY SIDE MATTERS. THE MARGINS KEEP GETTING SLIMMER. THERE IS A ONE-SEAT MAJORITY IN THE HOUSE. WHAT DOES THAT MEAN? IF YOU WANT TO HAVE A ONE-SEAT MAJORITY, THESE CAUCUSES, WE CAN THINK OF THEM LIKE FACTIONS, IT IS ALMOST LIKE THEY ARE REPUBLICANS AND SAY THEY HAVE A MAJORITY BUT WHAT THEY HAVE IS REALLY A SORT OF COALITION GOVERNMENT AND THAT IS WHAT YOU SEE ON BOTH SIDES. THEY ARE COALITIONS THAT AGREE TO WORK TOGETHER UNDER AN UMBRELLA AND MOVE FORWARD ON POLICIES BUT YOU WILL HEAR A LOT ABOUT THIS OVER THE NEXT TWO YEARS BECAUSE THESE GROUPS WILL BE PUSHING FOR DIFFERENT POLICIES, DIFFERENT POSTURES, DIFFERENT POWER. IN THE MAJORITY, WE HAVE A SPECIAL ELECTION, A RUNOFF THIS WEEK, THEY GAINED ONE SEAT. WHAT IS INTERESTING ABOUT THIS FOR THE SENATE IS THAT COMMITTEES, SO IN THE HOUSE YOU HAVE 535 MEMBERS, YOU CAN'T HAVE A TIE. IN THE SENATE YOU HAVE 100 MEMBERS, YOU CAN HAVE A TIE. IN THE LAST CONGRESS, WE HAD A 50/50 SENATE WHICH MEANT THEY SHARED POWER HE EQUALLY. IT MEANT NO PARTY COULD SHARE A SUBPOENA. IT MEANT THE MONEY, THE MEMBERS WERE SPLIT EQUALLY. IN THE CASE OF A TIE IN COMMITTEE, NOTHING WENT FORWARD SO THIS ONE SEAT MAJORITY MATTERS A LOT FOR HOW THE SENATE WILL FUNCTION. IT IS STILL REALLY TIGHT AND YOU STILL NEED 60 VOTES TO DO ANYTHING. I LIKE TO TELL MY IC DIRECTORS AT THE END OF THE DAY, THERE ARE 218 IN THE HOUSE, YOU NEED 60 VOTES IN THE SENATE. NEXT SLIDE. SO IN THE HOUSE ON THE DEMOCRATIC SIDE, WE'RE GOING TO HAVE A BIG GENERATIONAL SHIFT. NANCY PELOSI STEPPED DOWN, SIDNEY HOYER STEPPED DOWN. THERE ARE STILL MEMBERS OF THE CAUCUS WHICH WILL BE NICE FOR THE LEADERSHIP TO RELY ON THEM BUT THERE WILL BE A BIG SHIFT. AND SOME OF THE JUNIOR MEMBERS ARE SAYING A LOT OF SENIOR MEMBERS HAVE LEADERSHIP POSTS AND SENIOR COMMITTEE POSTS. LET'S BREAK THAT UP A LITTLE BIT. SO THAT IS A DISCUSSION THAT IS VERY PROMINENT IN THE SENATE DEMOCRATS. NEXT SLIDE, PLEASE. POSTS. SO KEVIN McCARTH Y IS RUNNING FOR SPEAKER. HE HAS A ONE-SEAT MAJORITY AND FIVE MEMBERS OF THE CAUCUS HAVE SAID THEY WILL NOT VOTE FOR HIM. THE GOOD NEWS FOR KEVIN McCARTHY IS THEY HAVEN'T SAID THEY WILL VOTE FOR SOMEBODY ELSE EITHER. THERE IS NOBODY WAITING IN THE WINGS. SO A LOT OF THE POSTURING AROUND APPROPRIATIONS HAVE TO DO WITH HIS KEEPING HIS COALITION TOGETHER. IF HE WINS ONE VOTE ON THE REPUBLICAN SIDE, HE BECOMES SPEAKER. IT IS A MAJORITY VOTE. BUT I THINK KEVIN McCARTHY IS GOING TO GET THE NOD. NEXT SLIDE? THE SENATE, PRETTY STABLE ON THE REPUBLICAN SIDE. THIS TEAM HAS BEEN TOGETHER FOR A WHILE AND THEY ARE PRETTY USED TO WORKING TOGETHER. SO THAT WILL BE A HELP TO KEVIN McCARTHY. NEXT SLIDE, PLEASE. WE HAVE NEW LEADERSHIP SO WHEN WE MOVED ON THE HEALTH POLICY PANEL IN THE SENATE FROM TOM HARKIN TO PATTY MURRAY, FROM LAMAR ALEXANDER TO RICHARD BURKE, THEY WERE VERY STABLE AND ALIGN. MOVING FROM PATTY MURRAY, THEY ARE NOT IN THE SAME PLACE SO WE ARE WATCHING FROM THE NEW MEMBERS WHAT THEY WANT TO DO WITH THE NEW GAVEL. BERNIE SANDERS WILL FOCUSES ON UNIVERSAL HEALTH, LOWERING COST OF PRESCRIPTION DRUGS, INCREASING ACCESS TO HIGHER EDUCATION AND PROTECTING WORKERS RIGHTS. ON THE OTHER SIDE, YOU CAN SEE THE AGENDA. I THINK WE WILL HAVE A NOMINEE AND ALL THOSE NOMINATIONS GO THROUGH HEALTH SO WE DO EXPECT TO WORK WITH THE HEALTH COMMIT PRETTY CLOSELY. HOUSE LEADERS, THIS HAS BEEN IN THE NEWS A LOT HAS SAID WHAT WE WANT TO DO IS FOCUS ON OVERSIGHT. SO WHAT DOES THAT MEAN? JIM JORDAN IS THE EXPECTED CHAIRMAN OF THE HOUSE JUDICIARY COMMITTEE, HE SEEMS PRESS COY ABOUT WHAT EXACTLY HE WANTS TO FOCUS ON. THE SECRETARY OF THE HOUSE OVERSIGHT, WANTS TO WATCH THE MONEY, SEE WHERE THE MONEY WENT. NEXT SLIDE. ROGERS, THE NEW EXPECTED TO BE CHAIRWOMAN OF THE HOUSE ENERGY AND COMMERCE COMMITTEE HAS SAID THREE THINGS. AND I THINK THAT WILL BE THE NEXT THREE THINGS. WHAT WILL WE BE DOING? WELL, WE HAVE HAD A RECORD NUMBER OF RETIREMENTS NOT JUST IN THIS PAST ELECTION BUT THE ELECTION BEFORE THAT AND THE ELECTION BEFORE THAT SO THE VAST MAJORITY OF MEMBERS OF CONGRESS PARTICULARLY IN THE HOUSE REALLY ONLY KNOW NIH FROM COVID. THEY KNOW OUR VACCINE, KNOW US WELL IN TERMS OF COVID BUT DON'T KNOW ALL THE VAST AMOUNTS OF RESEARCH WE DO AND HOW WE WORK WITH THEIR CONSTITUENTS, HOW WE PLAY OUT IN THEIR DISTRICTS OTHER THAN COVID. WE ARE GOING TO NEED TO DEVELOP MORE CHAMPIONS. AS THE CONVERSATION GETS BROADER THAN COVID, WE'RE GOING TO BE LOOKING FOR PEOPLE WHO WANT TO CARRY WATER FOR US AND THIRD, WE'RE ALWAYS ON LOOKOUT FOR A NOMINEE AND WORKING WITH HHS TO GET THAT PERSON TO CONFIRMATION. NEXT SLIDE, PLEASE. >> THANKS TO BOTH OF YOU. I GUESS WE'LL HOLD QUESTIONS JUST FOR A MOMENT BECAUSE I JUST WANT TO SPEND LITERALLY A COUPLE OF MINUTES TALKING TO YOU ABOUT, YOU KNOW, LEADING THROUGH TURBULENT TIMES, OKAY? EVERY SINGLE DAY, SOMEBODY ASKS ME HOW AM I DOING. AND I DON'T THINK THEY ARE MAKING A COMMENTARY ABOUT MY HEALTH AND SO FORTH. YOU KNOW, HOW ARE YOU DOING IN TERMS OF THE CURRENT ROLE I AM PLAYING. AND I TELL PEOPLE DEPENDING ON THE TIME OF DAY, I AM HANGING IN, DOING OKAY OR I AM DOING FINE. AND I WANT TO REASSURE THE ACD THAT I AM REALLY DOING FINE AND THE REASON I AM DOING FINE IS I HAVE A REMARKABLE TEAM OF PEOPLE TO WORK WITH. PRINCIPLE DEPUTY DIRECTOR, MEMBERS OF THE EXECUTIVE COMMITTEE WHO ARE SITTING AROUND THE TABLE AND AROUND THE ROOM, IT IS REALLY A REMARKABLE GROUP OF PEOPLE. AND SO, YOU KNOW, AS LONG AS THEY, YOU KNOW, CONTINUE TO DO THEIR GREAT WORK, NIH IS GOING TO BE JUST FINE. WE HAVE 27 DIRECTORS, WORLD-CLASS EXPERTS IN EVERY SINGLE TOPIC YOU CAN THINK OF, LITERALLY FROM A TO Z. THEY ARE AN EXTRAORDINARY GROUP OF PEOPLE WHO WORK SO CLOSELY WITH US. AND THEN THERE IS JUST THE FOLKS HERE AT NIH WHO, YOU KNOW, HAVE CONTINUED TO STEP UP, WHO HAVE DEMONSTRATED THAT WHATEVER IS THROWN AT THEM, THEY ARE GOING TO DELIVER WHATEVER IS NECESSARY. IF YOU THINK ABOUT ALL THE THINGS THAT WE HAVE DONE IN ADDITION TO THE COVID RESPONSE, BECAUSE EVERYBODY FOCUSES ON THE COVID RESPONSE SO I UNDERSTAND WHY BUT IF YOU THINK ABOUT ALL THE THINGS THAT THE TEAM HAS ACCOMPLISHED IN ADDITION TO THE COVID RESPONSE, IT IS REALLY QUITE REMARKABLE. SO WE DO NOT YET HAVE A NOMINEE. YOUR CRYSTAL BALL IS AS GOOD AS MY CRYSTAL BALL, PROBABLY NOT QUITE AS GOOD AS ADRIAN'S CRYSTAL BALL BUT PERHAPS A LITTLE MORE REFINED THAN CERTAINLY MINE. BUT YOU KNOW OBVIOUSLY AT SOME POINT, WE WILL HAVE A PERMANENT DIRECTOR BUT UNTIL THAT TIME, UNDERSTAND THAT IT THE INSTITUTION IS IN GREAT SHAPE. AND IT IS IN GREAT SHAPE BECAUSE OF THE REMARKABLE EFFORT OF ALL THE FOLKS THAT I HAVE MENTIONED AND THOSE THAT TIME DOESN'T ALLOW ME TO MENTION. SO WE ARE FINE. WE ARE MOVING AHEAD WITHOUT SEARCHES, WE ARE MOVING AHEAD WITH APPOINTMENTS BECAUSE THE SCIENCE CAN'T WAIT, OUR PATIENTS CAN'T WAIT AND AS I TELL EVERYBODY, I COME IN IN THE MORNING, IF THE KEY STILL FITS IN THE LOCK, I SIT DOWN AND DO MY WORK. ONE DAY I WILL COME IN, THE KEY WON'T FIT AND I WILL GO AND DO SOMETHING ELSE AND THAT IS FINE. BUT UNTIL THAT TIME, YOU KNOW, I JUST WANT TO THANK TARA, THE AMAZING EXECUTIVE COMMITTEE, THE AMAZING STAFF THAT WE HAVE WITHIN THE OFFICE OF THE DIRECTOR, ALL THE SUBDIRECTORS, YOU KNOW, THE WHOLE TEAM. BECAUSE AGAIN, I KNOW EVERYBODY IS FOCUSED ON COVID BUT THINK OF ALL THE OTHER THINGS WE HAVE ACCOMPLISHED DURING THIS TIME PERIOD. AND IT REALLY IS A COLLECTIVE LEAD. SO WITH THAT, I KNOW WE'RE 8 MINUTES OVER SO I AM EATING INTO YOUR BREAK AND I APOLOGIZE BUT LET ME OPEN IT UP IF THERE IS ANY QUESTIONS OR COMMENTS THAT MEMBERS OF THE COMMITTEE HAVE AND IF YOU COULD USE YOUR EITHER REAL HAND OR VIRTUAL HAND, TARA CAN NAVIGATE AS TO WHO GOES FIRST. >> YEAH, SO IT HAS BEEN A YEAR SINCE FRANCIS COLLINS STEPPED DOWN AND I WOULD LIKE TO HAVE SOME CLARITY ABOUT WHAT IS GOING ON. >> I FEEL THINGS ARE MORE ART THAN SCIENCE AND I THINK THEY -- THERE HAS BEEN A WAR IN UKRAINE, A LOT GOING ON, THE PRESIDENT HAS A LOT ON HIS PLATE SO I DON'T -- I HAVE A CRYSTAL BALL BUT I DON'T HAVE A MAP, IF THAT MAKES SENSE. >> SO CAN YOU SAY FOR EXAMPLE HOW MANY PEOPLE HAVE BEEN ASKED AND TURNED IT DOWN? >> NO, WE'RE NOT PRIVY TO THAT. >> NO, BUT I FEEL LIKE THERE IS SOMETHING BROKEN IN THE SYSTEM BECAUSE IT IS NOT THE PRESIDENT WORKING ON UKRAINE THAT IS HOLDING THINGS UP. >> I MEAN UKRAINE, THIS PRESIDENT CARES A LOT ABOUT BIOMEDICAL SCIENCE AND I DO THINK THAT DECISIONS AND APPOINTMENTS AT THAT LEVEL DO GO VERY HIGH IN THE WHITE HOUSE AND I THINK THIS WHITE HOUSE HAS HAD ENORMOUS CHALLENGES AROUND THE WORLD AND ALSO AT HOME. I MEAN, IT HAS BEEN A TURBULENT TIME ON A NUMBER OF FRONTS. IT IS NOT AN EXCUSE BUT IT IS A REALITY. >> LET ME REMIND YOU THAT DURING THE PERIOD BETWEEN ELIAS AND FRANCIS, THERE WAS A SIMILAR GAP. IT WAS A SIMILAR GAP. -- [OFF MIC ] >> YEAH, SO WE'RE NOT QUITE AT A YEAR YET, NOT QUITE AT A YEAR. YOU KNOW TWO WEEKS FROM NOW OR NEXT WEEK WE ARE AT A YEAR, WHENEVER IT IS, SO I THINK PEOPLE NEED TO PUT THAT INTO THEIR -- >> SO LET ME JUST SAY THANK YOU LARRY AND THANK YOU FOR THE ENTIRE STAFF AND EXECUTIVE COMMITTEE FOR HOLDING ON FOR TWO YEARS AND FOUR MONTHS AND MAYBE EVEN LONGER SO THANK YOU. >> NO, WE'RE NOT PROJECTING TWO YEARS AND FOUR MONTHS DURING THE CURRENT CIRCUMSTANCE. I JUST BRING THAT UP TO SHOW THAT IT IS NOT THAT UNUSUAL. AND I MUST SAY WITHOUT ANY KNOWLEDGE, BECAUSE I HAVE ZERO KNOWLEDGE ABOUT IT, I DO KNOW BECAUSE I HAVE SPOKEN TO THE PRESIDENT DIRECTLY ABOUT NIH AND HE IS PASSIONATE ABOUT NIH AND HE IS, YOU KNOW, PASSIONATE ABOUT ARPA-A, PASSIONATE ABOUT THE NCI MOONSHOT. SO I SUSPECT THIS IS SOMETHING THAT HE WILL HAVE -- >> BUT AM I RIGHT IN THINKING FRANCIS IS IN CHARGE OF THE PERSON IN THE SEARCH? >> THERE ARE MANY STREAMS OF INFORMATION GATHERING SO DON'T ASSUME ANYTHING. >> OKAY, IS THAT ON? YES, I WANT TO ADD MY THANKS TO LARRY AND TARA. IT IS CONTINUING SEAMLESSLY, IT SEEMS, SEEMS TO BE, SO THAT'S GREAT. I WANTED TO SPECIFICALLY CONGRATULATE ON THE REPORT ON THE ESI NUMBERS. THAT'S AMAZING. AND IT IS SO GREAT TO HEAR THAT AND I AM WONDERING, IT IS MAYBE A LITTLE BIT IN THE WEEDS BUT I AM WONDERING IS THERE GOING TO BE FOLLOW UP ON WHAT HAPPENS TO THEM NEXT? BECAUSE I THINK WEARING MY HAT NOW IN THIS NEW WORKING GROUP, THE YOUNGER PEOPLE COMING UP ARE LOOKING AT WHAT HAPPENS TO, YOU KNOW, OF COURSE ARE THEY GOING TO GET JOBS AND THEN AFTER THEY GET JOBS, IF THEY ARE SUCCESSFUL, ARE THEY GOING TO CONTINUE TO BE SUCCESSFUL AND WE ALL HEAR THAT IT IS THAT, YOU KNOW, IF YOU WANT TO CALL IT A VALLEY OF DEATH RIGHT AFTER EARLY STAGE, I WONDER IF YOU COULD SPEAK TO THAT. >> YEAH, SO I KNOW MIKE LAUR HAS JOINED US VIRTUALLY. WOULD YOU LIKE TO ADDRESS THAT QUESTION PLEASE? >> THANK YOU, SHELLEY THAT QUESTION IS ABSOLUTELY SPOT-ON. THERE HAS BEEN -- WE PREVIOUSLY LOOKED AT WHAT TOPS INVESTIGATORS WHEN THEY GET FUNDID BY NIH THE FIRST TIME, HOW LONG THEY STAY IN THE SYSTEM, THE LOSS RATE AT VARIOUS POINTS SO THAT IS SOMETHING WE WILL CONTINUE TO PAY ATTENTION TO AND WILL STAY VERY CLOSE IN TOUCH. THE SECOND THING IS WE HAVE ANOTHER CATEGORY OF PEOPLE WE PAY PARTICULAR ATTENTION TO AND THOSE ARE WHAT WE CALL AT-RISK INVESTIGATORS. THESE ARE INVESTIGATORS WHO HAVE SUBMIT AS LEAST ONE MERITORIOUS PROPOSAL AND IF THEY DON'T GET FUNDED THIS YEAR, WE WILL LOSE ALL FUNDING AS OF NEXT YEAR AND SO THIS IS A GROUP THAT WE ARE DRAWING ATTENTION TO OR DRAWING ATTENTION TO THE IC ELECTORATE AND AS YOU MIGHT IMAGINE, MANY ARE EARLY STAGE INVESTIGATORS WHO HAVE RECEIVED THEIR FIRST GRANT AND RIGHT NOW ARE LIVING OFF OF ONE GRANT SO THOSE ARE SOME OF THE -- THE QUESTION IS SPOT-ON AND THOSE ARE SOME OF THE EFFORTS WE HAVE UNDERWAY. >> GOOD, THANKS VERY MUCH. >> THANKS, MIKE. OTHER COMMENTS OR WITH QUESTIONS FROM PEOPLE? YES? [ OFF MIC ] >> COULD YOU TURN YOUR MICROPHONE ON? >> YEAH, SORRY, THIS IS A FOLLOW UP ON THE SI MATTER. FIRST OF ALL, THE QUESTION, THE NUMBERS GOING UP LOOKS GREAT BUT THE AMOUNT PER GRANT, ARE WE ALSO KEEPING TRACK OF THAT? AND ARE THESE OF THE SIZE THAT CAN RELY PROPEL AN EARLY INVESTIGATOR? >> SO MIKE IF YOU WOULD LIKE TO SPEAK TO THAT, PLEASE? >> WE HAVE DONE SOME INDEPTH ANALYSIS ON THE COST PER BRANT, TOTAL COST PER GRANT. ACTUALLY WE HAVE A PREGRANT ARCHIVE AND A PAPER CURRENTLY IN REVIEW. THE BOTTOM LINE IS AFTER ADJUSTING FOR INFLATION OVER THE LAST TEN YEARS OR SO, REAL COSTS, REAL DOLLARS REMAINED ABOUT THE SAME, MAYBE HAS GONE UP A LITTLE BIT. THERE HAVE BEEN CHANGES IN THE COMPOSITION OF GRANTS OVER TIME. WE ALSO ARE SUBSTANTIALLY LESS THAN WHERE WE WERE AT THE TIME OF THE DO PPLING AND I CAN PUT A LINK IN. >> THANKS. SO WE'RE AT TIME BASICALLY, 10:14 A.M. ON MY COMPUTER, 10:15 A.M. IN THE ROOM. THIS IS THE TIME WE ARE SUPPOSED TO BE COMING BACK FROM THE BREAK SO WHY DON'T WE TAKE LIKE A TWO TO THREE MINUTE BREAK, TRY TO BE BACK HERE BY 10: 18 AND THEN WE WILL GET STARTED WITH RENEE'S PRESENTATION >>> OKAY, I THINK EVERYONE IS BACK AND GETTING SETTLED. MAKE SURE WE ARE NOT MISSING ANYONE. OKAY, SO THE NEXT PRESENTATION WILL BE FROM Dr. RENEE, NAG AL DIRECTOR NEEDLESS TO SAY OF ARPA-H. IF YOU RECALL RECALL, ARPA-H WAS CREATED INCLUDING LANGUAGE AND RESOURCES IN THE FY22 OMNIBUS IN MARCH SO I THINK THE UPDATE WAS PROVIDED AT THE JUNE MEETING BUT THAT WAS PRIOR TO RENEE BEING APPOINTED IN HER POSITION SO WE'RE REALLY GLAD TO HAVE HER HERE TODAY, WORKING TIRELESSLY TO CONTINUE TO BUILD UP THE ORGANIZATION AND OUTLINE SOME OF THE PROGRESS SHE HAS MADE. >> NOTE: WEGRZYN. >> THANKS TARA AND LARRY FOR HELPING US GET THE ORGANIZATION STARTED. YOU MAY NOT KNOW WE CALL TARA OUR ASSOCIATE DIRECTOR FOR HER WORK AND WE'RE REALLY EXCITED TO SHARE WHAT WE'RE BUILDING BUT KNOWING IT HAD A GREAT FOUNDATION BEFORE I GOT THERE JUST EIGHT WEEKS AGO. SUBMISSION OF AR PA-H IS TO ACCELERATE A BETTER HEALTH OUTCOME FOR EVERYONE. TARA TALKED A LITTLE ABOUT THE HISTORY. PRESIDENT BIDEN WHEN HE CAME INTO OFFICE HAD THIS VISION TO LAUNCH ARPA-H, AN ORGANIZATION MODELED AFTER THE BUSINESS MODEL OF DARPA BUT TO PURSUE IDEAS THAT BREAK THE MODEL ON HOW WE NORMALLY SUPPORT FUNDAMENTAL RESEARCH. SO THIS IS INCLUDED IN THE FUNDING ECOSYSTEM AND I WILL TALK A LITTLE ABOUT OUR STRUCTURE AND WHERE WE SIT. SO WITH THOSE FAMILIAR WITH THE ORIGINAL ARPA OR DARPA, IT WAS LAUNCHED IN RESPECT TO SPUTNIK. THE UNITED STATES WAS VERY SURPRISED WITH THAT TECHNOLOGY AND WANTED TO BE ABLE TO CREATE AND PREVENT POWERFUL BIOLOGICAL FACTORS AND LIVING IN AN ERA OF COMPLEX TECHNOLOGIES WITH MASSIVE ECONOMIC AND SOCIAL DISRUPTIONS AND NOT ONLY TO STUDY THESE FACTORS BUT TO SOLVE THEM, WORKING TO SOLVE SOME OF THE TOUGHEST CHALLENGES IN HEALTH AND I WILL WALK THROUGH HOW WE LOOK AT PROJECTS TO WORK ON AND MOVING FORWARD. SO TO THINK ABOUT THE TYPES OF PROBLEMS AND CHALLENGES WE WANT TO FACE, I WOULD LIKE TO START WITH A LITTLE IMAGINE STATEMENT, IMAGINE IF THERAPIES COULD BE BUILT AND ASSEMBLED ON DEMAND. SO NOT TO BE FOCUSED ON ANY SINGLE DISEASE BUT WHAT ARE THE PLATFORMS THAT COULD BE BUILT TO BROADLY ADVANCE BRINGING BETTER HEALTHCARE FORWARD. WHAT IF MRIS COULD BE DELIVERED IN THE COMFORT OF YOUR OWN HOME? THIS WAS INSPIRED BY THE ACTING DEPUTY WHO HAS A LOT OF EXPERIENCE WITH MRIS AND WOW, WHAT YOU COULD DO AT HOME TO CHANGE AND MEET PEOPLE WHERE THEY ARE AT AND BRINGING IN AN EQUITABLE WAY HEALTHCARE TO FOLKS. AND THEN WHAT IS A CANCER VACCINE COST THE SAME AS A CUP OF COFFEE? JUST LAST WEEK ANOTHER GENE THERAPY CAME OUT AT THREE AND A HALF MILLION FOR A SINGLE DOSE. WE COULD DO A LOT BETTER AND ARPA-H CAN HELP GET US THERE. JUST A NOTE ON THE ORGANIZATION, WHERE WE SIT, AND I INTERESTINGLY REPORT DIRECTLY TO SECRETARY BACERA, HE IS MY BOSS BUT I TELL MY TEAM WE ARE A BILLION DOLLAR STARTUP AND CAN HIT THE GROUND FOCUSED ON THE PROBLEMS WE WANT TO SOLVE BECAUSE WE CAN LEAN ON THE NIH INFORMATION WITH IT AND ALSO ACCESS TO SUBJECT MATTER, TO BE THERE AS A RESOURCE TO MAKE SURE THE CHALLENGES WE ARE WORKING ON MAKES THE MOST SENSE AND COULDN'T OTHERWISE BE FUNDED AT NIH OR ELSEWHERE. SO WE WON'T HAVE ANY INTERNAL RESEARCH LABS, EXCLUSIVELY EXTRAMURAL AND DISEASE AGNOSTIC. WE HAVE A PROGRAM MANAGER DRIVING IDEAS FORWARD AND VERY LEAN AND NIMBLE IN THE MANAGEMENT STRUCTURE. THERE IS REALLY TWO SIDES OF THE HOUSE HERE. THE BUSINESS TEAM MEMBERS AND BY THAT I MEAN THE CONTRACTING TEAM, LEGISLATIVE TEAM, FOLKS LIKE MYSELF WHO ARE HERE TO MAKE SURE PROGRAM MANAGERS CAN FOCUS ON SOLVING THAT PROBLEM. SO WE ARE GOING TO WORRY ABOUT SUPPORTING THEIR BUDGETS AND CONTRACTING AND WE ARE GOING TO WORRY ABOUT THE SCIENTIFIC PROBLEMS. THEY CAN PURSUE THAT VERY HIGH RISK, HIGH CONSEQUENCE RESEARCH. SO THE WAY THE MODEL WORKS, IT STARTS WITH A PROGRAM MANAGER WHO IS AN EXPERT IN THEIR FIELD, GREAT DOER AND COLLABORATOR BUT THEY ALSO COME AND BRING THAT CHALLENGE. SO MY FOCUS IN RECRUITING IS NOT ONLY FINDING AMAZING STAFF BUT STAFF WHO HAVE THAT CRYSTAL CLEAR AND WELL FORMED PROBLEM IN HEALTH THEY WANT TO SOLVE SO IT IS THE MAGIC COMBINATION OF THE TWO THAT ARE REQUIRED TO BRING SOMEBODY IN TO ARPA-H, TAKE SOME TIME TO FORM LATE THE PROGRAM AND THAT TAKES ENGAGEMENT WITH PROBABLY ABOUT A HUNDRED EXPERTS IN THE FIELD THEY ARE WORKING IN AND WORKING TOWARDS BUT STAKEHOLDERS WHO WILL REALLY BE IMPORTANT IN BRINGING THIS FORWARD. THE LAUNCH FOR SOLICITATION FOR PROPOSALS AND THEN BRINGING IN DIFFERENT TEAMS EACH WITH A DIFFERENT SOLUTION THEY WANT TO PURSUE AND SOLVE AS A BIG PROBLEM IN HEALTH. BECAUSE IT IS A VERY HIGH RISK ENVIRONMENT AND HIGH RISK PROGRAMS THAT WE'LL PURSUE, THE PROGRAM MANAGEMENT IS VERY ACTIVE. SO IT THINK ABOUT THEY ARE WORKING TOWARDS THIS GOAL, IT IS NOT FOR BASIC FUNDAMENTAL RESEARCH, IT IS REALLY SOLVING A PROBLEM. SO ON A WEEKLY, SOMETIMES DAILY, MONTHLY, THEY WILL BE CHECKING IN WITH THE TEAM TO SEE IF WE ARE MAKING PROGRESS FOR THOSE GOALS AND IF NOT, THE PROJECT CAN BE TERMINATED. SO THAT IS A VERY IMPORTANT PART OF THE MANAGER'S JOB TO MAKE SURE THAT IF SOMETHING IS NOT WORKING, PIVOT THOSE RESOURCES TO ANOTHER PROJECT. SO HOPEFULLY SOME OF THE BIG RISKS WILL PAY OFF AND WE WILL HAVE PROGRAMS THAT ARE SUCCESSFUL AND LAST BUT NOT LEAST, THE MOST REALLY IMPORTANT PART P-F -- OF AR PA MODEL IS TO GRAD THE RISK AND OTHER PLACES, INDUSTRY, VERY IMPORTANT TO TRANSITION AND BRING THIS INTO THE REAL WORLD. SO SUCCESS AT ARPA-H IS NOT MEASURED BY THE NUMBER OF PAPERS YOU HAVE BUT CAN IT ACTUALLY SURVIVE IN THE WILD, IS HOW WE TALK ABOUT IT IN-HOUSE. SO WHEN THE PROGRAM MANAGER COMES IN, THEY WILL BE HERE ONLY A SHORT PERIOD OF TIME. SO WE HAVE HAD TO KEEP OF A PROGRAM MANAGER FLYWHEEL AND AS THEY BRING IN AN IDEA, THEY WILL PROBABLY ONE TWO TO FOUR PROGRAMS. I WAS AT DARPA AND RAN FOUR PROGRAMS IN THE FOUR AND A HALF YEARS I WAS THERE SO I STARTED ON DAY 1 AND T-MINUS 1 DAY FROM DEPARTING, SOMEONE ELSE TOOK THAT PROGRAM OVER. SO ONE YEAR FROM NOW WHEN WE HAVE THE NEXT UPDATE, YOU WILL HEAR ABOUT THE PORTFOLIO PROGRAMS WE ARE GOING TO BE FUNDING. FIVE YEARS FROM NOW, YOU WILL HEAR ABOUT A TOTALLY DIFFERENT PORTFOLIO BECAUSE THE PROGRAMS ARE FINISHED, NEW PROGRAM MANAGER IS MOVING FORWARD SO THIS IS AN IMPORTANT DISTINCTION BETWEEN THE FACILITATOR AT NCI THAT WORKED ON SOMETHING TEN YEARS AGO AND ARE STILL WORKING ON IT NOW. SO THIS IS VERY DIFFERENT. IT IS NOT MEANT TO REPLACE BUT BE A CATALYST TO ACCELERATE INNOVATION IN HEALTH. IT IS FOR OUR CUSTOMERS, AMERICAN PEOPLE, HEALTHCARE PROVIDERS, INFORMATION GROUPS, ACADEMIA INDUSTRY AND THEN OUR STAKEHOLDERS. A PROGRAM LIFE CYCLE, SO THIS WILL BE THE FORMULA THAT PROGRAMS ARE BORN AND GROW AT ARPA-H. THE INITIAL DESIGN, THEY HAVE TO BE ARPA-HARD PROGRAMS AND CAN'T EXIST ANYWHERE ELSE IN THE ECOSYSTEM. THEY ARE HIGH RISK WHICH I WILL WALK YOU THROUGH ON THE NEXT SLIDE AND THIS IS MAKING SURE THE PROGRAM IS AMBITIOUS. WE HAVE GOOD METRICS FOR THIS AND THIS IS SOMETHING SOMEBODY WANTS TO BUY AND USE ON THE OTHER SIDE. ONCE THEY ARE ACCOUNTED, THE PM WILL FIND THE BEST PERFORMERS IN THE INDUSTRY AND ACADEMICS TO SOLVE IT, REALLY BUILD A NEW COALITION SO EVEN IF THE PROGRAM LEAVES ARPA-H, THEY CAN START NEW COMMUNITIES THAT WILL LONG OUTLAST ARPA-H AS A PROGRAM. THINK OF THE PROGRAM MANAGER AS CEO. THEY ARE RESPONSIBLE FOR THOSE RISKS. WE WILL ALL OWN PART OF ARPA-H AS TAXPAYERS SO MAKING SURE WE ARE DILIGENT AND HAVE BEST USE OF THOSE FUNDS SO IT IS READY TO PIVOT ON THE BACK END THE RESOURCES IF NEEDED. SO LEARN AND GROW, AND COMMERCIALIZING AND TRANSITIONING OUT OF ARPA-H INTO THE FOLLOW-ON FUNDER. WE HOPE THAT WE WILL SPIT OUT A LOT OF COMPANIES, TOO SO THAT WILL BE PART OF OUR ECOSYSTEM. WE HAVE THIS WHOLE OFFICE WE WILL TALK ABOUT IN A MOMENT TO ASSIST SOME OF THOSE TEAMS TO GET TO THAT POINT. WHILE I WON'T BE DICTATING ANY SPECIFIC PROGRAMS, WE WANTED TO INDICATE OUT TO FUTURE PROGRAMS TO MEMBERS OF CONGRESS AND OTHERS SOME OF THE PROGRAMS WE THINK ARE RIGHT FOR FUNDING AND GOOD LEVERS IN HEALTH WHERE INVESTMENT COULD CHANGE THE STATE-OF-THE-ART. SO FIRST IS HEALTH SCIENCE FUTURES AND ARE WHEN SOMEONE ASKS ME WHAT DISEASES IS ARPA-H WORKING ON, I SAY ACTUALLY WE'RE DEVELOPING THE TOOLS, TECHNOLOGY AND PLATFORM RECOGNIZED AS THE HOLY TRINITY SO IF A CELL MANAGER HAS A PROGRAM, THEY MAY SELECT PERFORMERS WHEN THEY HAVE THE FUNDING. SCALABLE SOLUTIONS ARE MEANT TO REACH EVERYONE QUICKLY. THERE ARE INCREDIBLE THAT HAVE PROOF OF CONCEPT ALREADY BUT MANY HAVE DIFFICULTY MAKING IT TO THE LAST MILE. HOW DO YOU HAVE SCALE IN TERMS OF YOUR PANEL COST EFFECTIVE BUT ALSO HOW DO YOU GET A BILLION DOSES OF SOMETHING REALLY QUICKLY AND SO THESE ARE THINGS TO THINK ABOUT, GEOGRAPHY, DISTRIBUTION, OTHER ECONOMIES OF SCALE WILL BE INVESTMENTS IN THIS AREA. PROACTIVE HEALTH. KEEPING PATIENTS FROM BECOMING PATIENTS IN THE FIRST PLACE OR IF THEY ARE A PATIENT, PROLONGING THEIR BEST LIFE THROUGH INVESTMENTS IN DIAGNOSTICS, PREVENTION BUT ALSO BEHAVIORAL SCIENCE. TALKING IN OUR PIPELINE THINGS WE THINK WILL MAKE AN IMPACT IN THAT REGARD. AND THE LAST STRUCTURE IS RESILIENT SYSTEMS IS MORE OF A SYSTEM-LEVEL TYPE OF FOCUSES AREA WHERE SOME PEOPLE ON THE TEAM LIKE TO CALL THIS THE SILO BREAKING MISSION FOR US WHERE IF YOU THINK OF SOMETHING LIKE RAD X WHERE THERE HAS BEEN A LOT OF INNOVATION AND INVESTMENT IN DIAGNOSTICS, THIS COULD PROVIDE AN OPPORTUNITY TO INTEGRATE THOSE, HAVE A DATA LAYER AND BE ABLE TO REPORT OUT TO DECISION MAKERS. JUST ONE EXAMPLE OF THE TYPE OF INVESTMENTS THAT COULD COME FROM AN AREA LIKE THIS. SO MY BIGGEST JOB, MY TOP, TOP PRIORITY IS HIRING THOSE PROGRAM MANAGERS. CONGRESS HAS GIVEN US A BILLION DOLLARS TO START AND I CAN'T SPEND THIS FUND UNLESS WE HAVE PROGRAM MANAGERS IN-HOUSE AND WATCHING THOSE PROGRAMS. SO THE POSITION IS TIMEBOUND, THREE TO SIX YEARS, THREE YEAR BASE RENEWABLE FOR UP TO SIX YEARS AND I HAVE DIRECT HIRING AUTHORITY. SO COMPETITIVE SALARY AND YOU CAN GO TO THE WEBSITE AND THAT STARTS THE CONVERSATION, WE GET FEEDBACK VERY QUICKLY TO START TO DEVELOP SOME OF THE CONCEPTS AND THEN IF WE DEEM THE PERSON AND THE IDEA WORTHY OF ARPA-H, WE HOPE TO START TO BRING THEM IN AND START WORKING ON THE PROGRAMS. AND THEN BUILDING THE FULL BUSINESS TEAM AND SO WHEN THEY JOIN THERE IS A WHOLE TEAM THERE TO SUPPORT THEM MOVING FORWARD. AND I WOULD LOVE FOR THE FOLKS HERE TO THINK ABOUT THE ONE OR TWO PEOPLE IN THEIR NETWORK THAT MIGHT MAKE EXCELLENT PROGRAM MANAGERS. PEOPLE OFTEN ASK WHAT MAKES A GOOD PROGRAM MANAGER SO THEY ARE UNCOMMON PEOPLE WITH COMMON TRAITS, THEY ARE NOT AFRAID TO FAIL, THEY HAVE TECHNICAL HONESTY AND INTEGRITY. REMEMBER, THESE FOLKS HAVE TO BE ABLE TO LOOK AT AN EFFORT AND SAY IS IT WORKING OR NOT AND STOP THAT EFFORT AND PUT OFF THOSE RESOURCES IF NEEDED. THEY ARE GREATER COLLABORATORS WITH A GREAT TRACK RECORD, NO SILO ONE SOLUTION BUT TEAM WORK THAT GETS THIS DONE AND THEY ARE VERY DRIVEN. THEY HAVE HERE ONLY FOR THREE YEARS, THEY ARRIVE AND THE BRIDGE IS ALREADY BURNING DOWN SO THEY ARE QUICKLY MOVING FORWARD. AND THEY MIGHT BE A PROBLEM SOLVER, TINKERER, SEE WHAT SURVIVES IN THE WORLD, THEY COULD BE EARLY IN THEIR CAREER, UNBIASED, UNJADED. STATUS QUO, SOME MID-CAREER WHO JUST IS FRUSTRATED WITH THE SPEED OF HOW THINGS WORK OR NOBODY HAS SEEN A CLARITY OF VISION TO PULL TOGETHER A SOLUTION OR SOMEBODY LATE CAREER. I WORKED WITH AN INDIVIDUAL WHO CAME TO DARPA THREE TIMES BECAUSE HE KEPT SEEING THESE PROBLEMS AND WOULD JUMP BACK TO DARPA AND SAY I NEED A BIG INFLUX OF CASH, TYPICALLY 50 TO $150 MILLION. SO THIS IS HOW WE WILL DEFINE OUR PROBLEMS AND COMMUNICATE THEM TO OUR COLLEAGUES AND THE WORLD. FIRST AND FOREMOST, WHAT ARE YOU TRYING TO DO. AND SO THE DIRECTOR AT DARPA A LONG TIME AGO HAS ANTICIPATED HIS SET OF QUESTIONS AND SO THE FIRST QUESTION IS WHAT ARE YOU TRYING TO DO, WHAT HEALTH PROBLEM ARE YOU TRYING TO SOLVE? NO JARGON, HOW DO YOU COMMUNICATE THIS TO THE CONGRESS AND PUBLIC, WHAT YOU ARE WORKING ON, HOW IS IT DONE TODAY, WHAT IS THE STATUS QUO AND WHAT IS NEW? SO YOU ARE DRIVEN TO COME TO ARPA-H BECAUSE YOU ARE AWARE OF TECHNOLOGIES THAT ARE COMING, EVOLVING. AND THEN WHO CARES? WHAT ARE THE RISKS? WE WILL TAKE BIG RISKS BUT NEED TO MITIGATE THE RISKS ALONG THE WAY AND MAKE SURE THAT IT IS PHYSICS THAT WILL BE THE CHALLENGE, NOT THINKING ABOUT THE POLICY OR REGULATIONS ON THE BACK END. PRACTICAL THINGS LIKE HOW LONG WILL IT TAKE, HOW MUCH WILL IT COST AND HAVE WHAT ARE YOUR EVALUATIONS ALONG THE WA I TO MAKE SURE YOU ARE PROCEEDING, A MONTHLY CHECK-IN WITH TEAMS AND THEN FOR ARPA-H, WE HAVE ADDED TWO QUESTIONS, FIRST TO ENSURE EQUITABLE ACCESS FOR EVERYBODY, HOW WILL THE MANAGER WORK COST, ACCESSIBILITY AND USER EXPERIENCE FROM THE INITIAL DESIGN OF THE PROGRAMS. SO IT IS TOO LATE IF THEY HAVE TON THE PROJECT, HAVEN'T TALKED TO USERS, HAVEN'T THOUGHT ABOUT SUPPLY CHAIN AND HOW TO BRING COSTS TOWN. I WILL NOT GIVE THEM A BANK ACCOUNT TO PURSUE THEIR PROGRAM UNLESS THEY ARTICULATE THAT. AND THEN HOWTHE PROGRAM BE MISPERCEIVED OR MISUSED? SO I THINK WITH SOCIAL MEDIA AND HOW QUICKLY INFORMATION GETS OUT, WE HAVE TO BE REALLY THOUGHTFUL ABOUT HOW WE ARE TALKING ABOUT OUR PROGRAMS AS SCIENTISTS SO IF WE WANT THEM TO SURVIVE IN THE WORLD, WE HAVE TO TAKE THIS INTO ACCOUNT AS WELL. SO THE WAY TO FIND SUCCESS, MIGHT BE A LITTLE DIFFERENT IN OTHER PLACES, FIRST AND FOREMOST, OUR SOLUTIONS ARE NOT FUNDED THROUGH RESEARCH GRANTS. THEY WILL BE VERY ACTIVELY MANAGED AND TO THEY SUCCEED IN THE WILD WHERE PEOPLE SAY THAT IS THE SOLUTION I NEED, I WANT TO ADOPT IT. AND THEN TAKE THINGS THAT LOOK IMPOSSIBLE AND MAKE THEM IMPROBABLE, SHOW PROOF OF CONCEPT AND THEN WE CAN TAKE THAT OUT OF ARPA-H TO BE FULLY DEVELOPED. AND THEN REALLY BRINGING BETTER HEALTH OUTCOMES TO EVERYONE, OUR GOAL ACROSS THE STATES AND THE WORLD SORL WE WILL USE THINGS LIKE COOPERATIVE TREATMENTS AND CONTRACTS AND OTHER FORMS THAT NIH USES AS WELL BUT WE WILL USE EXCLUSIVELY IN OUR APPROACH TO SCIENCE. ALSO UNIQUE, THERE ARE OTHER FUNDERS OUT THERE THAT USE SOME FLAVOR OF THIS, WHAT WE ARE CALLING OUR PATIO OFFICE. IT IS REALLY HERE TO HELP PROGRAM MANAGERS AND THEIR PROGRAMS LEVEL UP FROM THE BEGINNING BUT THEN ALSO GET OUT OF THE AGENCY. SO VERY EARLY ON, A PROGRAM MANAGER MAY COME TO ARPA-H, MAYBE THEY HAVE MINUTES STATEMENTIVE EXPERIENCE, MAYBE THEY ONLY HAVE GOVERNMENT EXPERIENCE SO NOT EVERYONE WILL BE ABLE TO DO A MARKET ASSESSMENT AND ENTREPRENEURS UNDERSTAND WHAT A METRIC IS. SO WE WILL DEVELOP PROGRAMS, THINK ABOUT WHAT ARE THE COST BARRIERS TO A PROGRAM LIKE THIS. THEN WE WILL HAVE THE BROAD AGENCY ANNOUNCEMENT, WHO ARE THE PERFORMERS, WHAT PEOPLE MIGHT WANT TO BE IN THIS SPACE SO A LOT OF NETWORKING AND GUESS WORK AND WE EXPECT PROGRAM MANAGERS BUT ALSO WANT TO CREATE ALTERNATIVE SOLUTIONS, PRIVATE SECTOR HAS SO MANY TOOLS AT THEIR DISPOSAL WE DON'T WANT TO MISS AND THEN WE HAVE NEGOTIATION WHO THINK ABOUT VENTURE CAPITAL WHERE WE WANT TO LOOK AT OUR PROJECT AND DO THE TECHNICAL DUE DILIGENCE UPFRONT SO WE CAN START TO GET A FEEL FOR WHO IS INTERESTED IN THIS, JUST TO GET THE PROGRAM THINKING IN THAT WAY THAT THEY DO SURVIVE. WE WILL CONTINUE DURING THE COURSE OF THE PROGRAM, UNDERSTANDING OUR RISKS FOR INVESTORS WHETHER THE TOWN STREAM FUNDER IS GOVERNMENT OR PRIVATE SECTOR AND DE-RISK WHAT THEY ARE WORRIED ABOUT AND THEN DESIGN MINIMAL PRODUCTS OR PROGRAMS TO ITERATE AND MOVE TOWARDS ADOPTION. AND THEN AS PROJECTS MATURE, MAKING SURE WE ARE PROTECTING IP AND HELPING COMPANIES AND TEAMS TO BE ABLE TO DO THAT IS A REALLY CRITICAL PIECE OF IT. I HAVE BEEN HERE EIGHT WEEKS SO A QUICK STATUS UPDATE. ARPA-H BY THE NUMBERS, WE LAUNCHED OUR WEBSITE JUST THREE WEEKS AGO. THE CONTENT I JUST SHARED IS ALL THERE ON THE WEBSITE. TAKE A LOOK AT OUR LANDING PAGE AND SEE HOW EASY IT IS TO APPLY. ALSO WE HAVE A PAGE WHERE PEOPLE CAN SEND THEIR IDEAS AS A PLACE TO START TOO. WE HAVE LAUNCHERRED ARPA-H AT HOWARD, SEVERAL PEOPLE HERE IN THE ROOM WERE THERE AND THAT WAS SPECIAL TO BE THERE WITH THE SECRETARY OF HOWARD UNIVERSITY TO HELP LAUNCH ARPA-H. AND A TEAM THAT IS REALLY EXCITED ABOUT IT. UNIVERSITIES WANT TO WORK WITH US SO WE HAVE BEEN WORKING WITH ADMINISTRATORS AND EDPS OF RESEARCH TO SPREAD THE WORD AND RECRUIT IS THE TOP LINE. WE HAVE SOME THAT HAD INITIAL OUTREACH TO US AND NOW PROACTIVELY WE ARE REACHING OUT TO THEM AGAIN FOR PRERECRUITMENT BUT ALSO THAT THEY KNOW HOW TO LAUNCH PROGRAMS WE ACTUALLY CARE ABOUT. SO I SHARED THESE SLIDES EARLIER IN THE WEEK AT A NATIONAL CANCER EVENT SO A LITTLE MYTH BUSTING HERE. THE PRESIDENT ANNOUNCED CANCER MOONSHOT TOGETHER WITH REINVIGORATING MOONSHOT BUT ALSO SHARING THE COMMITMENT TO ARPA-H IN AN AGENCY THAT WILL NOT ONLY WORK TOWARDS CANCER GOALS BUT ALSO AS A NUMBER OF DISEASES. YOU MAY KNOW THE MOONSHOT FOR CANCER IS A WHITE HOUSE INITIATIVE AND REPRESENTS MANY PLAYERS, EVERYONE FROM NASA, DOD, NIH, CDC, SO IT IS A REALLY BIG CANCER CABINET COMMUNITY WORKING TOWARDS THE MOONSHOT FOOLS. SO THE CONTEXT OF ARPA-H IS WHEN PRESIDENT BIDEN REINVIGORATED MOONSHOT, ALSO ANNOUNCING THIS AGENCY, SO WE ARE A PART OF THIS BUT NOT LEADING MOONSHOT. A LITTLE MYTH BUSTING THERE. I HAD A GREAT CONVERSATION WITH MONICA, DIRECTOR AT NCI WHERE WE CAN LEAN ON NCI AND BUILD THE TOOLS AND PLATFORMS AND TECHNOLOGIES THAT CAN BE APPLICABLE AND OF COURSE YOU KNOW THE CANCER MOONSHOT PRIORITIES SO EVERYTHING FROM ADDRESSING ENVIRONMENTAL EXPOSURE, BRINGING CUTTING EDGE RESEARCH FORWARD AND WE THINK IN THOSE FOUR AREAS ARPA-H CAN HELP ADDRESS THESE. SO WOULD WHAT HE WILL DO IS APPOINT A CHAMPION FOR MOONSHOT, A SINGLE POINT OF CONTACTED THAT CAN BE CONTRIBUTING AND ADVANCING THE STATE-OF-THE-ART. AND WE CAN ALSO ENGAGE STAKEHOLDERS ON BEHALF OF THE GOVERNMENT BUT THIS IS REALLY OUR WAY TO COLLABORATE ACROSS AGENCY SO WE DON'T HAVE PROGRAMS YET SO THIS IS THE THINGS TO COME IN THE NEXT YEAR BUT THIS IS REALLY HOW WE'RE THINKING ABOUT IT AND CONTINUING TO MAXIMIZE OUR INVESTMENT AND MAINTAIN FLEXIBILITY TO WORK ON A BROAD NUMBER OF ISSUES. IT IS KNOWN THAT CURRENT HISTO PATHOLOGY PRACTICE ARE CUMBERSOME AND MANUAL. SO IMAGINE IF ARPA-H COULD DEVELOP NEW AS SAYS AND DEVELOP THE MACHINE LEARNING TOOLS TO HELP WITH AN AUTOMATED DIAGNOSTIC IN THAT TISSUE CONTRACT OCCASION AND THEN IMPORTANTLY INTEGRATE THAT DATA QUICKLY TO A HEALTHCARE PROVIDER TO IMPROVE PATIENT STANDARD OF CARE. VERY OBVIOUS HOW THAT MIGHT HELP SOMETHING LIKE TUMORS, OTHER TYPES OF CANCERS, THIS IS HOW WE THINK OF BRINGING THESE FORWARD SO THE PROGRAMS HAVE BEEN ALIGNED WITH MOONSHOT. AND THEN MY LAST SLIDE, A CALL TO ACTION. WE ARE HIRING PROGRAM MANAGERS AND WANT THE BEST AND THE BRIGHTEST SO IF YOU CAN THINK OF A COUPLE FOLKS IN YOUR NETWORKS WHO YOU THINK WOULD ALIGN TO DO THE GOALS SET FORTH HERE AND REALLY TO ADDRESS BIG CHALLENGES IN HEALTH, WE WOULD LOVE TO HEAR FROM YOU. HAPPY TO TAKE ANY QUESTIONS. >> THANKS SO MUCH, RENEE, EXCITING TO SEE THE PROGRESS YOU HAVE MADE IN OUTLINING YOUR VISION AND I THINK THAT LAST SLIDE IS PROBABLY THE MOST IMPORTANT ONE, REACH OUT IF YOU KNOW ANYONE OR IF YOU YOURSELF ARE INTERESTED IN BECOMING PROGRAM MANAGER, WE NEED REALLY GOOD PEOPLE. AND YOU HAVE YOUR HAND UP -- [ OFF MIC ] >> GOOD MORNING, I AM ONE OF THE NEW MEMBERS OF ARPA-H AND IT IS AN HONOR TO BE HERE ESPECIALLY IN PERSON AND WELCOME AS WELL. SO HAVING CONVERSATIONS WITH ADINA WHO WAS AT DARPA FOR A WHILE SO REALLY EXCITED TO SEE THE POINTS HERE. I THINK IT IS REALLY OPPORTUNITY WE'RE TALKING ABOUT. AS YOU KNOW, ARP A -H TRAINS SOME 22,000 POST-DOCS AND THEY ARE THE MOST FEARLESS. AND WHEN I THINK ABOUT PEOPLE WHO ARE THE MOST DRIVEN, EXTREMELY DRIVEN IN MY 30s, HAVE LESS ENERGY NOW AS THE EMERGING YOUNG SCIENTISTS IN THE COUNTRY AND WHEN I THINK ABOUT THE ADVANTAGE LONG-TERM AS SCIENCE IS BEING BUILT, HOW WE PULL THOSE YOUNG SCIENTISTS SINCE THEY ARE IN THE PROGRAM A SHORT AMOUNT OF TIME. SO WONDERING IF YOU HAVE THOUGHT ABOUT THAT? >> ABSOLUTELY. WE HAVE BEEN TALKING ABOUT WHAT ARE SOME OF THE FELLOWSHIPS YOU WANT TO START AT ARPA-H AND THIS HAS DEFINITELY COME UP. FOR EXAMPLE, DARPA HAS A YOUNG FACULTY AWARD SO SOMEONE WHO IS STARTING AS A POST-DOC, THEY WILL NOT GET ONE OF THE 50 MAIN ONES BUT DEFINITELY CONSIDERED NEXT YEAR, GETTING TO INTERACT WITH THE TEAMS IN AI AND HOW WE CAN TO BETTER TO ADD ON AND SO THE PROGRAM WILL BE LOCKED IN FROM DAY ONE. WE HAVE A LOT OF FLEXIBILITY TO UPDATE THAT SO HEARING THOSE IDEAS FROM EVERYBODY IN THE LAB IS IN MY EXPERIENCE WHAT KEEPS ENRICHING THAT PROJECT AND HOW IT MOVES FORWARD, IT IS A GREAT IDEA, THANK YOU. >> HOWARD? >> HOWARD SCHULMAN FROM HCD, THANK YOU FOR SHARING YOUR VISION ON ARPA-H. >> I HOPE YOU CAN TALK ABOUT HOW ARPA WILL WORK TOGETHER AS A TEAM, TO SHARE KNOWLEDGE OF NETWORK AND ALSO MENTORS AND THE METRICS FOR THEIR GROWTH OR PROGRESS WITH AN ARPA-H PERSON ON THE PORTFOLIO BECAUSE EVERYBODY IS TIME BOUND AND EVERYBODY WILL ESSENTIALLY BE ON THEIR WAY OUT, WHAT IS SORT OF THE BENCHMARKS AND ALSO IF THEY ARE EVALUATING THEIR PROGRESS? >> LOTS OF QUESTIONS IN THERE. LET ME SEE IF I CAN HIT THEM ALL. SO IN TERMS OF PROGRAM MANAGERS WORKING TOGETHER, WE HAVE BEEN THINKING ABOUT HOW DO WE DO THAT IN A POST COVID WORK ENVIRONMENT WHICH IS INTERESTING BECAUSE WE DON'T HAVE A HEADQUARTERS YET BUT WHEN WE DO, WE KNOW WE WILL BE TRAVELING QUITE A BIT BUT HAVE TO MAKE SURE WE HAVE GOOD FACE-TO-FACE TIME. IMPORTANTLY ONE OF THE EXPERIENCES I HAD ON DARPA, WE HAD ENGAGEMENT WITH OUR CUSTOMERS AND SPENDING A DAY AT AN AIR BASE AND LEARNING ABOUT RADIATION EXPOSURE FOR PILOTS OR ANOTHER DAY, YOU KNOW, WORKING IN FIELD TRAINING UNDERSTANDING HUMAN PERFORMANCE IN THAT CONTEXT, REALLY CHANGES. WAY YOU APPROACH YOUR PROGRAMS. AND ALSO IT SPARKS CONVERSATIONS FROM COLLEAGUES AT OTHER OFFICES, WOW IF YOU HAVE A WEARABLE SENSOR I CAN MAKE THE OTHER PIECE AND COLLABORATE TOGETHER. SO THE IMMERSIVE EXPERIENCES IN HEALTH ACROSS THE UNITED STATES WOULD BE ONE WAY TO ENGAGE BUT WE ALSO WANT TO SUPPORT PROGRAM MANAGERS WORKING ACROSS OFFICES. THIS IS SOMETHING THAT DARPA DIDN'T REALLY NEED TO DO. I DIDN'T HAVE TO WORK WITH THE TACTICAL TECHNOLOGY LIKE WEAPONS AND MISSILES SO YOU KNOW HOW DO WE ENCOURAGE THE CROSS COLLABORATION. SO WHAT IS GREAT ABOUT HAVING A YOUNG ORGANIZATION IS THERE IS NO WAY THAT IT HAS BEEN DONE BEFORE SO WE WANT TO EXPERIMENT WITH COPIS AND CAN WE GET COMANAGERS WORKING COLLABORATIVELY WORKING ON PROJECTS, LIKE THE HISTOLOGY COMPONENT I EXPLAINED. IS REALLY TO ENCOURAGE NOT COMPETITION BUT LIKE YOU KNOW YOU ALMOST HAVE FO M O FROM NOT BEING ABLE TO COLLABORATE SO HOW TO CREATE A CULTURE AND ENVIRONMENT THAT REALLY SUPPORTS THAT SO THAT IS PART OF MY JOB IN CREATING THAT THAT WILL ALLOW FOLKS TO COLLABORATE AND HOSPITAL IN HAVE FEAR OF COMPETITION FOR THEIR PERFORMANCE. DID I GET THEM AL? >> THAT WAS GREAT, THANK YOU SO MUCH. >> SO THIS IS SO EXCITING I AM ABOUT TO QUIT MY DAY JOB AND JOIN YOU BUT I WANTED TO DOUBLE TOWN ON THE TRAINING. THE ENERGY AND EXCITEMENT IS JUST SO PALPABLE THAT I WAS THINKING EARLIER ABOUT INTERESTS IN OTHER PROGRAMS. NOW I DON'T WANT TO BURDEN YOU WITH A LOT OF TRAINING THAT IS CLOSING DOWN BUT IT IS REALLY INTERESTING THESE COLLEGES ARE ALL GIVING BIOMEDICAL ENGINEER DEGREES AND BRINGING IN THAT. >> WE HAVE AGREED AS AN ORGANIZATION TO LIKE MAYBE YEAR TWO, EXCITED ABOUT ENGAGING IN PROGRAMS LIKE THE PRESIDENT'S SUMMERS, CONTRIBUTING OUR WEBSITE, LED BY A PRESERVATION FELLOW AND THEN IT WAS LIKE CAN THIS LOOK LIKE A GOVERNMENT WEBSITE AND THEN GO AND OF COURSE BRINGING THAT FORWARD. WHAT I WILL SAY IS WE'RE THINKING A LITTLE ABOUT CHALLENGES THAT WE APPLY AND ONE WAY TO GET THAT ENERGY AND IDEAS WOULD BE TO CREATE A CHALLENGE OR PRIZE AROUND IT SO IF YOU WANT TO THINK OF ONE, COME TO ARPA AND RUN THESE CHALLENGES AND WE WOULD BE CERTAINLY OPEN TO THAT. >> SO I GET TO KEEP MY DAY JOB, THAT IS EVEN BETTER. SECOND QUESTION IS WHAT ARE THE OPPORTUNITIES FOR COLLABORATION? IT DOES SEEM OTHER PARTS OF THE WORLD HAVE DIFFERENT WAYS OF DOING COST AND STRENGTHS AND SCALE AND IS THERE OPPORTUNITY THERE? >> ABSOLUTELY. OF COURSE WE WILL CONTRIBUTE DOMESTICKICLY BUT WE ARE OPEN TO INTERNATIONAL COLLABORATION AND AGAIN IT IS A LITTLE CHICKEN AND EGG BECAUSE WE NEED A PROGRAM MANAGER. SO SHARING THIS MESSAGE, WE'RE HIRING. IF YOU KNOW FOLKS WHO WANT TO SOLVE BIG WORLD PROBLEMS, SEND THEM OUR WAY. IT CAN BE AT THE PROGRAM LEVEL BUT WE HAVE ALSO STARTED TO ENGAGE INTERNATIONALLY, WE HAVE BEEN INTERACTIVE AND SO FOR FOLKS WHO HAVE REACHED OUT BUT THE PLAN TO BE VERY ACTIVE ENGAGEMENT, WHAT OTHER COUNTRIES ARE INTERESTED IN THE AREAS WE'RE INTERESTED IN AND START COLLABORATING THAT WAY. >> DINA AND THEN JUDITH. >> SO I HAVE A QUESTION ABOUT THE PROJECT EXPECTED TO BE THE DEPTH OF ARPA-H, THE HISTOLOGY IDEA PRESENTED, THERE ARE LIKE A FEW COMPANIES WHO ARE EVEN COOKING ON THAT AND OF COURSE IT WOULD BENEFIT BUT THERE MIGHT BE OTHER ADDRESS SO REALLY JUST AN IDEA, LIKE THE IDEAS ON THE SLIDES, WHAT IS THIS GROUP AND HOW MUCH MIGHT THIS BE POSSIBLE IF NEEDED BEFORE STARTING A PULLDOWN OR APPLYING FOR A PROGRAM? >> YES, THERE IS A FRAMEWORK BY WHICH WE TALK ABOUT TECHNOLOGY LEVELS -- [INDISCERNIBLE] SO I THINK PRIMARILY WE WOULD BE INTERESTED IN FUNDING THINGS THAT ARE ZERO 1 TO 5 SO THERE CAN BE A PROTOTYPE, MAYBE TO SCALE THE SOLUTION, MAYBE IT IS FURTHER LIKE HISTOLOGY WHERE THE MAJOR BARRIER THERE IS SHARING AND BEING ABLE TO GET IT QUICKLY TO PATIENTS AND DOCTORS COAST TO COAST CAN COMPARE HOW THEY ARE TREATING PATIENTS SO WE WILL LOOK AT THE FULL GAMUT. I WILL NOT ANTICIPATE THAT WE WILL BE LOOKING AT A LOT OF FILES UNLESS IT IS LATE STAGE PUT WE WILL CONSIDER INNOVATION THAT CAN'T BE DONE SOMEWHERE ELSE. REALLY IT WILL BE ACROSS THE SPECTRUM BUT KEEP IN MIND THAT WHATEVER WAY THE PROGRAM IS DESIGNED IS THE WAY IT WILL BE FUNDED. >> SO I LOVE THE PROGRAM AND THE ENERGY YOU ARE BRINGING TO IT SO I WANT TO COME BACK TO THE TRAINEE ISSUE BECAUSE I FEEL LIKE THAT INNOVATION IS SO IMPORTANT AND THAT LITTLE MIND YOU HAVE AT NIH, RATHER THAN HAVING YOUR OWN TRAINING, COULD YOU WEU STILL WITHIN NIH OR EXPAND SOMEHOW TO BRING THAT CREATIVITY AND INNOVATION AND DRIVE INTO A TRAINING AT NIH, TO ME THAT WOULD BE A BETTER WAY OF GOING ABOUT IT THAN HAVING YOUR OWN PROGRAM BUT MAYBE I AM MISSING SOMETHING. >> YEAH, SO I LOVE THAT IDEA. SO FOR YOU WHO HAVE NOT BEEN A PROGRAM MANAGER, YOU COME TO ARPA-H AND GO THROUGH A BOOT CAMP, THIS IS HOW YOU NEED TO THINK ABOUT GOVERNMENT, HOW YOU TAKE RISKS, BE A PROGRAM MANAGER AND WE'RE TALKING ABOUT DOING THIS FOR PERFORMERS, TOO, SINCE IT IS SUCH A DIFFERENT MODEL. PROGRAM MANAGER ONE MONTH IN, THEY WERE LIKE WE WANT TO JOIN YOUR LAB MEETINGS AND I AM LIKE WHAT? SO FOR TRAINING FOLKS TO BE READY FOR THAT AND WE CAN DO A BETTER JOB IN ARPA'S SPHERE, SO IT IS NOT TO TRAIN THEM BUT BRING THE IDEA FORWARD AND PROOF OF CONCEPT FOR THEM AS A PERSON. SO YOU ARE COMING IN AT THE EARLY STAGE, LET'S GROUP YOU A BIT. SO I LOVE BRINGING THAT IDEA TOGETHER AND WE CAN DO ONE WITH NIH IF FOLKS ARE INTERESTED. >> I THINK IT IS REALLY IMPORTANT AND I HOPE YOU MANAGE THE -- HAVE A BANDWIDTH THAT WILL BE IF -- MAYBE YOU COULD HIRE SOMEONE AT NIH THAT WOULD BE SPECIFICALLY WORKING WITH NIH IN TRAINING. >> WHY IS, WE WILL THINK ABOUT THAT. THERE ARE A LOT OF EXISTING PRIORITIES WITH THE INFRASTRUCTURE WE HAVE AVAILABLE AND THE FUNDING -- >> BUT THE EXPLICIT MISSION OF BRINGING THAT INTO THE MISSION TO ME IS SUPER IMPORTANT. >> SHELLEY, BARBARA. >> I WANT TO FOLLOW UP ON THE FIRST POINT, I AM WONDERING BECAUSE MANY OF US ARE VERY MUCH FOCUSED ON MAINTAINING OUR PIPELINE OF POST DOC IS, GETTING THEM REALLY EXCITED ABOUT STAYING IN INNOVATIVE RESEARCH, SO I AM WONDERING IF YOU CAN THINK ABOUT EARLY STAGE INVESTIGATORS, EVEN POST-DOCS. THE TRAINING TAKES SO MUCH LONGER NOW THAT MANY OF THEM ARE IN THEIR 30s AND EARLY 40ES BY THE TIME THEY GET THE POSITION SO I WONDER IF YOU HAVE THOUGHT ABOUT EXPANDING THAT TALENT POOL AND CAN FIND THAT TALENT IN THE POOL THAT ALREADY HAVE SOPHISTICATED IDEAS AND ARE READY TO GO. YOU SPOKE TO EARLY INVESTIGATOR AWARDS SO I AM ENCOURAGING TO GO EVEN EARLIER. >> SO FOR PROGRAM MANAGERS, I CALLED OUT THE ROOKIE AS ONE OF THE TYPES AND THERE IS NO RESTRICTION THAT POST-DOCS CAN'T APPLY. WHAT I WILL SAY IS NOT TO SAY IT WON'T WORK BUT THESE PROGRAMS CAN BE 150 TO $200 MILLION, THEY ARE MANAGING BIG PIS, BIG PERSONALITYS, BIG TEAMS AND VERY AGGRESSIVE SCHEDULES. SO THERE ARE ABSOLUTELY CHANCES THEY WILL BE SUCCESSFUL BUT FOR FOLKS I HAVE MANAGED TEAMS BEFORE, MORE THAN A COUPLE OF UNDER GRADUATES WILL BE BETTER SITUATED TO DO THAT GOING FORWARD. >> IN MY LAB, I HAVE TEAMS THAT ARE ORGANIZED AND THE HEAD OF THOSE TEAMS IS A POST-DOC WHO IS SUPER INNOVATIVE, DRIVING THE RESEARCH, SO I WOULD ARGUE WE HAVE PEOPLE LIKE THAT IN THE NIH ECOSYSTEM -- [OVERLAPPING SPEAKERS] >> YEAH, I MEAN AGAIN, IT IS THE PERSON PLUS THE IDEA SO IF YOU POINT THEM TOWARDS OUR WEBSITE, AND I HAVE A BUNCH HERE I CAN HAND OUT BUT THE IDEA IS WE ARE MAKING IT EASY SO IT IS NOT THIS BIG LONG APPLICATION FOR YOU TO PRESENT YOUR IDEAS AND WE WILL TAKE REFERENCES BUT MAKE IT CLEAR THERE IS NO OBJECTION TO HAVING POST-DOCS. BARBARA? [ OFF MIC ] >> YEAH, OKAY, SORRY. EARLY SIGN IS GREAT BUT YOU ARE BUILDING THE WHOLE TEAM AND ONE OF THE CONCERNS SOME OF US HAVE HAD IS BUILDING FAST OUT OF THE GATE, THE SCALING ISSUE FOR PROGRAM OFFICERS IS SO PIVOTAL IN HOW MANY YOU CAN TAKE ON AND BUILD YOUR CULTURE? SO HOW DOES THE RAMP INUP LOOK LIKE IN TERMS OF BUILDING YOUR OFFICERS AND YEAR 1 OR 2, IS IT LINEAR OR -- >> LIKE HOCKEY STICK, YEAH. >> I THOUGHT IT MIGHT BE HOCKEY STICK SO GETTING THE FIRST GROUP OPERATING WELL IS A CHALLENGE. >> SO WE HAVE A COUPLE OF MANAGERS AND I CAN'T SAY WHO THEY ARE BUT WE HAVE A PRETTY DIVERSE GROUP OF PEOPLE GOING THROUGH THE PROCESS AND DROPPING THE TIMELINES SO WE DO HAVE DETAILS FROM DARPA AND THERE'S NIH-ERS THAT USED TO BE AT DARPA AND AVAILABLE TO US NOW WHO ARE HELPING US SHAPE THOSE TIMELINES. IN GENERAL THE PROCESS IS SOMEBODY COMES TO US WAN IDEA THAT IS GREAT BUT WE NEED TO LEVEL IT UP TO BE OUTSTANDING SO THOSE FOLKS WILL NOT BE ABLE TO GET FUNDING ANYWHERE ELSE AND THEN COME IN SO BEGINNING TO BRING FOLKS IN TO GET THEM TO THE NEXT STAGE. IT WE DO HAVE FOCUS WHO ARE DARPA MANAGERS SO THE RAMP UP WILL BE QUICK. AND SIMILARLY, WE HAVE MISSION DIRECTORS SO WE TALK ABOUT THE DEVELOPMENT, A GREAT STARTING PLACE TO BRING IN LEADERS WHO CAN EXECUTE THE MODEL WHO ARE A LITTLE MORE SENIOR AND WORK WITH STAFF THAT HAVEN'T DONE IT BEFORE. AND THERE ARE QUITE A FEW OF US IN-HOUSE THAT HAVE BEEN AT DARPA AND KNOW IT IS UNION SPEAK AND ARPA-H IS AN AUGMENTATION OF THAT MODEL BUT WE KNOW THE WORK AND BEST PRACTICES AND TRYING TO CREATE THAT INTERNALLY. ASK IT IS NOT JUST FOR PROGRAM MANAGERS, WE HAVE TOLD OUR STAFF, THEY ARE NOT ALLOWED TO SAY LIKE WELL THAT IS NOT HOW WE DO IT. [LAUGHTER] WE'RE A BRAND-NEW AGENCY SO THERE IS NO HOW WE DO IT, IT IS JUST TO DRIVE THE CULTURE TO GET THERE. >> THAT SOUNDS SUPER REASSURING -- . >> OH, SORRY, THE NUMBERS. I WOULD BE VERY HAPPY IF WE HIT 10 PROGRAM MANAGERS NEXT YEAR, I WOULD BE ECSTATIC IF WE HIP 20 BUT AGAIN IT IS NOT THE NUMBER BUT REALLY THE QUALITY OF THE IDEA AND PRESIDENT BIDEN HAS REQUESTED SIX AND A HALF BILLION IN THE PRESIDENT'S BUDGET FOR ARPA-H AND OF COURSE A LOT OF THAT DEPENDS ON CONGRESS AND WHERE IS -- IT IS GOING TO GO AND THEN THE HOCKEY STICK IS WHERE WE GET THE GROWTH. >> THE FIRST 15 OR 20 WILL BE REALLY TELLING SO THAT IS GREAT. AND ONE OTHER PIECE, VERY EXCITED ABOUT THE AREAS, GREAT JOB OF GIVING A FEW EXAMPLES. I LOVE THE AGO RHYTHMIC TISSUE AND CELL ENGINEERING IDEA PERSONALLY BUT I WILL SAY WHEN YOU GET THE ONE THAT RESONATES VERY QUITELY, THINK ABOUT A CUSTOMIZE L CANCER VACCINE FOR THE COST OF A CUP OF COFFEE. BUT TALKING ABOUT HOW THINGS GET THROUGH FDA, HOW THEY GO OUT IN THE COMMUNITY AND THERE IS A DIFFERENCE FROM A VACCINE THAT TAKES MORE THAN A COUPLE OF CUPS OF COFFEE TO MAKE AND THEN DOLING IT OUT AT THE COST OF A CUP OF COFFEE AND WOULD CAUTION THE DIFFERENCE BETWEEN THOSE TWO. >> A COUPLE MORE BECAUSE OUR NEXT GUESTS ARE ARRIVING SHORTLY. >> I APPRECIATE THE CHALLENGE OF BANDWIDTH AND ONE OF THE THINGS I DID AS A POST-DOC IS TO UNDERSTAND THE ISSUE AND I THINK WE CAN CREATE MORE BANDWIDTH WITH THE WORK YOU ARE DOING IN THE EARLY PHASES. I DO THINK THIS ISSUE IN FIGURING OUT HOW TO GET YOUNG PEOPLE INVOLVED IS QUITE POIGNANT. OUR NEXT SPEAKER IS AN EXAMPLE THAT A 20-YEAR-OLD CAN LEAD A TEAM AND TOTAL WE RE FORM ALLY SEARCH SPACE. SO I WONDER BEYOND THINKING ABOUT THE PROGRAM OFFICER, IS THERE A WAY WE CAN HAVE THOSE YOUNG MINDS IN THE COUNTRY BE ABLE TO LEAD THEMSELVES. >> GREAT POINT AND GLAD YOU BROUGHT IT OUT AGAIN. WHEN A PROGRAM MANAGER JOINS, IT IS NOT ONLY JOINING A BUSINESS TEAM WE HAVE BUT YOU CAN THINK OF A PROGRAM MANAGER AS A PI WITH A LOT OF TECHNICAL SUPPORT. SO MOST OF THE STAFF AT ARPA-H WILL BE CONTRACTORS. I STARTED MY CAREER AT DARPA AS A CONTRACTOR AND FOR FIVE YEARS, I ADVISED PROGRAM MANAGERS. I WAS NOT READY TO LEAD IN THOSE AREAS BUT I WAS ON EVERY SINGLE DARPA BIOPROJECT WHICH IT LAUNCHED AND THAT EXPERTISE AND ENERGY I BROUGHT FORWARD TO MY DIRECTORS, ONE WAS A MATHMETICIAN AND THAT IS A GREAT EXAMPLE. THEY ARE CALLED SETAS, SCIENTIFIC ENGINEERING AND TECHNICAL ASSISTANTS SO WE WILL HAVE HUNDREDS OF THEM AFTER WE'RE FULL CAPACITY OF PROGRAM MANAGERS. SO AT MY PEAK, I HAD $250 MILLION AND 15SETAS SO THAT IS A WAY TO THINK OF THOSE FOLKS AND WE NEED TO BE THOUGHTFUL OF BRINGING THEM IN AND USING THEM AS CONTRACTORS. IF I HAVE A CRAZY PROGRAM ON BIOLOGY AND THE NEXT ONE IS SOMETHING TOTALLY DIFFERENT, THEN I CAN SWAP THOSE OUT WITH A WHOLE NEW TEAM HAVING THAT EXPERTISE SO WE MAY BE ABLE TO CREATE SOLUTIONS THERE AND SOMEONE OUT OF A POST-DOC CAN BE REALLY USEFUL BECAUSE THEY KNOW WHAT A BUDGET IS AND FISCAL YEAR AND TEND TO BE ABLE TO HIT THE GROUND RUNNING. >> BUT ALSO SPECIFICALLY THINKING ABOUT PERFORMERS IN THIS CASE, RIGHT? >> OH, ABSOLUTELY. >> WE ARE POOLING THAT POPULATION INTO THE FROM PERFORMANCE -- [ OFF MIC ] >> I NEED TO UNMUTE FOR A SECOND. SO I WAS VERY EXCITED TO SEE THAT YOU LAUNCHED THIS INITIATIVE AT HOWARD UNIVERSITY. AND I WAS CURIOUS WHAT YOUR THOUGHTS ARE ABOUT WHERE YOU ARE GOING TO HAVE THIS HEADQUARTERS BECAUSE THE SITE IS GOING TO BE REALLY IMPORTANT AND WHAT ARE YOUR THOUGHTS? >> YEAH, THIS HAS BEEN COUNTERED A LITTLE BIT IN THAT AT THE END OF THE DAY IT IS NOT REALLY THAT IMPORTANT AS THE BEST DESCRIPTION I HEARD OF DARPA IS A HUNDRED SCIENTISTS BEING DIRECTED BY A TRAVEL AGENT. SO THEY ARE GOING TO UNIVERSITIES AND INDUSTRY AND WILL BE ALL OVER. WE'RE NOT REQUIRING OUR PROGRAM MANAGERS TO MOVE. IT IS A 3-YEAR APPOINTMENT SO A LOT OF TIMES THAT INVOLVES PICKING UP A FAMILY. THERE WILL BE TIMES WHEN WE HAVE TO GET TOGETHER BUT I AM VERY STRONG ON THAT IT DOESN'T MATTER. >> I THINK THE SITE COULD BE IMPORTANT. SO IF FOR EXAMPLE IT WAS A BUILDING ON THE HOWARD UNIVERSITY CAMPUS AND YOU HAD SOMEHOW -- GIVING A MESSAGE TO THE PUBLIC THAT INTEGRATING, I THINK YOU COULD USE THE SITE IN A IMPORTANT WAY FOR ARPA. >> I THINK WE DO FOR ALL OF OUR PROGRAMS AND FOR EXAMPLE, WE NEED TO DO THINGS VERY PUBLICLY TO SHOW WE'RE DOING THIS, I JUST DON'T THINK THERE NEEDS TO BE A HEADQUARTERS. WHEN PROGRAM MANAGERS LAUNCH PROGRAMS, WHAT THEY USUALLY WILL DO IS HAVE AN EVENT WHERE THEY INTRODUCE THE GROUPS AND WE SHOULD BE DOING THAT AT THE DIFFERENT SITES. WE HAVE TO MOVE ON. >> YES, MORE TO COME AND I AM SURE WE WILL HEAR FROM YOU AS TIME GOES ON SO THAT'S GREAT. WE WILL MOVE ON TO THE NEXT PRESENTATION AND HAVE A COUPLE OF GUESTS THAT RECENTLY JOINED US SO I WILL TURN IT OVER TO LARRY TO INTRODUCE THEM. >> THANKS, VERY BRIEFLY. ACTUALLY OUR GUEST DOESN'T NEED ANY INTRODUCTION. LET'S JUST SAY HE GOT HIS START AT MICROSOFT, OKAY? WE WANT TO THANK MR. GATES FOR BEING HERE TODAY. HE IS HERE FOR WHAT I BELIEVE IS THE 9TH GATES FOUNDATION NIH MEETING OF COLLABORATIVE EFFORTS NOW UP TO 4 DIFFERENT PROJECTS AND TONY GRACIOUSLY JUST STEPPED IN TO CHAIR THAT MEETING SINCE I AM HERE WITH YOU AT THE ACD MEETING. WE'RE DELIGHTED TO HAVE THE OPPORTUNITY FOR MR. GATES TO SPEAK TO PART OF THE ACD WHO IS HERE IN PERSON AND THE REST VIRTUALLY AND SO WITH THAT LET ME TURN IT OVER TO YOU. >> OUR PARTNERSHIP WITH EMA WILL HOPEFULLY STIMULATE SOME QUESTIONS SO I KNOW WHICH AREA TO DIVE INTO. THANKS, TONY. I MET HIM WHEN I FIRST SHOWED UP IN HIS BUILTING IN 2001 AND SAID TO HIM HEY, IF WE GET ASSISTANCE, IT CAN BE EASY TO HAVE A HIV VACCINE IN NINE YEARS AND HE TOLD ME THAT WAS A NAIVE POINT OF VIEW EVEN THOUGH HE WAS ENCOURAGING WE SHOULD DO OUR BEST AND TRY TO SOLVE THE MYSTERIES THAT EVEN TODAY, SITTING AND TALKING ABOUT THE LATEST TRIALS, APPROPRIATELY THERE IS SOME CONCERN ABOUT HOW LONG IT WILL TAKE. THE GATES FOUNDATION IS DIFFERENT THAN NIH, WE HAVE OVERLAPPING INTERESTS BUT SLIGHTLY DIFFERENT FOCUSES. SO GATES FOUNDATION IS LOOKING AT GLOBAL HEALTH, WHAT PEOPLE BUY UP OR WHAT CAUSES OUR LIFE TO BE UNHEALTHY IN POOR COUNTRIES SO WE'RE ALWAYS LOOKING AT OKAY WHAT ARE WE GOING TO DO AND IT'S MALNUTRITION, PRETTY GIGANTIC BUT ALSO HIV, HPV, MALARIA, VERY SPECIFIC AND OUR APPROACH IS ARE WE DOING THINGS TO REDUCE THOSE DEATHS. AND THIS ALL STARTED IN THE YEAR 2000 AND LUCKY ENOUGH IT HAS BEEN GROWING. IN TOTAL THE ORGANIZATION HAS BEEN GIVING ABOUT SIX BILLION IN GRANTS AND OVER THE NEXT FIVE YEARS WILL BE GETTING UP TO FIVE BILLION IN GRANTS AND THAT IS A MIX OF UPSTREAM WORK WHERE NIH, PARTICULARLY NAID IS OUR POST IMPORTANT PARTNER AND DOWNSTREAM THE DELIVERY OF THESE THINGS GOING INTO COUNTRIES AND TRYING TO HELP THEIR PRIMARY HEALTHCARE SYSTEM. TWO OF THE PRIMARY THINGS WE HAVE DONE IN THE FOUNDATION IN OUR FIRST TWO YEARS WHERE WE WERE CREATORS OF THE GLOBAL WIDE VACCINE AND WE WERE ONE OF THE FOUNDING PARTNERS OF THE CREATION OF THE GLOBAL FUNDS WHICH IS OF COURSE THE MULTILATERAL EQUIVALENT OF THE BILATERAL UNITED PETFAR AND THEY TAKE THE MEDICINES, THEY ARE NOT INVOLVED IN RESEARCH TO CREATE THE MEDICINES BUT THEY TAKE IN THE LATEST MALARIA DRUGS, WHATEVER WE COME UP WITH OR THE FIELD COMES UP WITH AND TRIES TO GET THOSE OUT TO EVERYBODY WHO NEEDS THEM. GLOBAL FUND, THE THREE DEVICES, TB, MALARIA AND HIV AND THEN GAVI HAS BEEN MOSTLY VACCINES, HPV ALTHOUGH WE'RE GETTING INTO SLIGHTLY OLDER AGES. ONE OF OUR BIGGEST PROGRAMS WE WILL NOT BE AS SUCCESSFUL BUT REMAIN OPTIMISTIC IS POLIO ERADICATION AND THAT IS ABOUT A BILLION A YEAR. SADLY WE HAD TO DO A LITTLE INNOVATION IN THAT CASE AS WELL BECAUSE THE INACTIVATED VACCINE ACTUALLY DOES REVERT AND CAUSE DISEASE AND INCLUDING CIRCULATING DISEASE AND WE DON'T SAY IT TOO LOUDLY SINCE IT WOULD CONFUSE PEOPLE BUT ACTUALLY MORE CASES OF POLIO ARE CAUSED BY REVERSION THAN ARE CAUSED BY WILD TYPES. ANY WAY SO WE DID A NEW VACCINE WHICH WAS GENETICALLY REENGINEERED TO MAKE THE REVERSION HOPEFULLY HUNDREDS OF THOUSANDS OF TIMES LESS LIKELY AND SO FAR THAT HAS BEEN BORNE OUT SINCE THE MODIFIED TYPE 2 VACCINE DOESN'T REVERT AND NOW WE'RE DOING THE SAME THING WITH TYPE 1 AND TYPE 3. IT WAS KIND OF AMAZING SINCE IT WAS THE FIRST VACCINE TO GET EMERGENCY USE AUTHORIZATION ABOUT FIVE MONTHS BEFORE THE FIRST COVID VACCINE. SO ANY WAY WE'RE IN UPSTREAM, WE'RE -- AND DOWNSTREAM. ONE OF OUR PRIMARY METHODS IS HOW MANY CHILDREN DIE UNDER THE AGE OF FIVE AND THE YEAR WE GOT STARTED, THAT WAS A BIT OVER 10 MILLION AND NOW THAT NUMBER IS A BIT UNDER 5 MILLION AND THE LARGEST SINGLE REASON FOR THAT IS THE WORK THAT GABI IS GETTING, THINGS LIKE PNEUMOCOCCAL. [ COUGHING DAB. [INDISCERNIBLE] WE HAVE NEW VACCINES COMING AND HOPE TO HAVE A TB VACCINE. WE'RE ABOUT TO INVEST OVERALL $800 MILLION IN THAT. ONE OF THE THINGS WE WERE JUST TALKING ABOUT THIS MORNING WHICH IS AN AMAZING PROGRAM IS THE TB DRUG DISCOVERY WORK THAT WE DO. AND CLIFFTON BARRY IS A PRETTY IMPORTANT PARTICIPANT IN THAT. BUT WE HAVE A INCREDIBLE LINE OF TB DRUGS SO BETWEEN ADVANCEMENTS AND DIAGNOSTICS OF DRUGS AND VACCINE TRIALS WHICH UNFORTUNATELY WILL TAKE A PRETTY LONG TIME, IT IS A PRETTY PROMISING PICTURE. WE TRY NOT TO DO RESEARCH BUT THERE ARE CASES WHERE WE END UP DOING RESEARCH. A LOT OF THE MICROBIOME RESEARCH HAS BEEN FUNDED BY US. WE WISH SOMEONE ELSE WOULD FUND IT AND WE JUST BENEFIT FROM IT BUT IN TERMS OF UNDERSTANDING WHY KIDS GET MALNOURISHED AND WHY YOU HAVE WASTING AND STUMPING, THERE ARE SOME PRETTY EXCITING THINGS WE HAVE LEARNED ABOUT MALNUTRITION. IN AFRICA, ABOUT ONE-THIRD OF ALL KIDS NEVER DEVELOP MENTALLY OR PHYSICALLY SO THAT IS IN A SENSE WORSE THAN JUST THE DEATH BURDEN. WE STILL HAVE 20 PERCENT OF KIDS WHO DIE UNDER THE AGE OF 5 DUE TO HEALTH INCLUDING NORTHERN NIGERIA WHERE YOU HAVE A LOT OF BIRTHS SO THE INEQUITIES ARE PRETTY DRAMATIC BUT DOWN MASSIVELY FROM THE YEAR 2000. SO MAYBE WITH THAT, WE CAN DELVE INTO ANY PARTICULAR TOPICS. >> GREAT, SO QUESTIONS FROM THE ACD MEMBERS BOTH ON ZOOM OR HERE? OH, ROBERTA, PLEASE. >> THANK YOU SO MUCH FOR ALL THE WORK THAT YOU ARE DOING AROUND THE GLOBE. I AM QUITE INTERESTED. I KNOW THE GATES FOUNDATION HAS A COMMITMENT TO ENABLING AND PROMOTE LOCAL LEADERS, LOCAL DIRECTORS, LOCAL DELIVERY, I AM WONDERING WHETHER THERE ARE OPPORTUNITIES WHERE YOU SEE THIS AS A LEARNING OPPORTUNITY FOR AMERICANS TO DEVELOP, YOU KNOW, THE SKILL SET OF WORKING IN AN INTERNATIONAL PROGRAM, INTERNATIONAL RESEARCH AS WELL AS DELIVERY, AND LEARNING CULTURES. >> YEAH, YOU KNOW WE HAVE OUR PRIMARY GOAL THAT WE OPTIMIZE FOR IS TO HELP OUTCOME. YOU KNOW WE END UP BUILDING CAPACITY IN PARTICULAR. WE DO A LOT OF WORK IN INDIA AND DON'T TALK ABOUT IT AS MUCH BECAUSE IT HAS BEEN SUPER SUCCESSFUL WITH VACCINATION RATES, GETTING THEM TO ADOPT VACCINES AND THEY HAVE CUT CHILD DEATHS IN HALF. THE LOCAL CAPACITY THERE, THE PARTNERS IN INDIA IS REALLY FANTASTIC AND IN AFRICA, AT THE TIME REALLY ONLY SOUTH AFRICA WHERE WE HAVE THAT KIND OF DEEP SCIENTIFIC PARTNERSHIP. AND BECAUSE WE'RE DOING THESE EXPENSIVE TRIALS LARGE LEAP IN AFRICA, HAVING THAT CAPACITY AND USING THAT AS THE BASE TO BUILD TALENT IS IMPORTANT. WE HAVE DONE SOME FELLOWSHIP PROGRAMS AND IT IS VERY IMPORTANT THE LOCAL SCIENTISTS ARE VERY CREDIBLE. TAKE THE ISSUE OF KILLING NOS SKEET TOES WITH THE GENETIC CONSTRUCT CALLED TEAM DRIVE. IN YOU LEFT IT TO THE GLOBE WHO DOESN'T CARE MUCH ABOUT MALARIA THEY WOULD BAN THIS TECHNIQUE BECAUSE IT IS GENETIC AND SCARY. SO IT IS REALLY THE TESTIMONY OF THE AFRICAN COUNTRIES WITH THE STRONG AFRICAN SCIENTISTS SAYING WAIT A MINUTE, MALARIA DOES REALLY MATTER AND YOU CAN KILL TRILLIONS OF MOSQUITOS THIS WAY AND HAVE GONE THROUGH THE RISKS THAT IS WORTHWHILE. EVEN IN CULTURAL WORK, WE HAVE EUROPEANS TELLING AFRICANS THEY SHOULDN'T USE GM O SEEDS TO GET MORE PRODUCTIVITY AND GET BETTER NUTRITION AND ONLY HAVING STRONG AFRICAN LEADERS WHO SPOKE TO THE PEOPLE THAT WE ARE STARTING TO TAKE THESE FANTASTIC SEEDS TO GET THOSE OUT IN PRODUCTION. WE HAVE SOME EXCITING FELLOW SHIPS IN AFRICA. I WOULD SAY FRANCIS HAS BEEN A GOOD CHAMPION PUSHING US FOR BUILDING THAT LOCAL SCIENTIFIC CAPACITY. MORE AND MORE, WE TRY TO TO DIRECT GRANTS. IF YOU GO TO THE EARLIER -- ALMOST ALL OF OUR GRANTS WE GAVE TO U.S. INSTITUTIONS THEN WOULD DO THE WORK IN AFRICA. I WOULD SAY NOW AT LEAST HALF OF THOSE ARE DIRECT GRANTS WITH AFRICAN ORGANIZATIONS WHICH, YOU KNOW, ALLOWS THEM TO TAKE CHARGE AND SOMETIMES ACTUALLY SOMEWHAT MORE EFFICIENT. >> I GUESS I SHOULD HAVE BEEN MORE CLEAR. MY SORT OF INTEREST IS IN HOW CAN WE LEARN FROM THIS GATES EXPERIENCE, RIGHT, IN THE SENSE OF BEING ON THE GROUND WITH YOUR TEAMS AND WITH THE, YOU KNOW, FOLKS IN THE LOCAL ECOSYSTEM. SO IT WASN'T ABOUT AMERICANS TAKING CHARGE, IT IS ABOUT THIS IS A GRAND GLOBAL OPPORTUNITY FOR LEARNING. >> I THINK THE LOCAL COLLABORATIONS ARE PRETTY AMAZING BEING ON THE GROUND WHERE THE TRIALS GET DONE. I SAY THAT IS STRONGEST WHERE WE HAVE THESE HUGE PARTNERSHIPS IN SOUTH AFRICA WHICH TRAGICALLY HAS BEEN TB AND HIV BURDENS SO WE SPEND MUCH OF THE TIME THERE AND THERE IS SOME MIXING WHERE PEOPLE GO OVER AND SPEND A LOT OF TIME. CLIFF TALKING ABOUT HE HAS A MILLION FREE MILES ON AIRLINES INVOLVED IN THE TB IN BOTH CHINA AND SOUTH AFRICA. >> THANK YOU. >> HOWARD, YOU ARE NEXT, PLEASE. >> MR. GATES, THIS IS HOWARD CHANGE, AC MEMBER AND THANK YOU FOR SPENDING TIME WITH US AND APPRECIATE THE WORK YOU ARE DOING. YOU ARE FORCED TO MAKE INVESTMENTS IN EARLY RESEARCH. CAN YOU TELL US BASED ON YOUR EXPERIENCE IF YOU SEE THE LONG-TERM STRATEGY IMPACT YOU HAVE BY INVESTING IN EARLY RESEARCH AND THEN THE SECOND ASPECT OF THE QUESTION IS THERE ANY LEARNING ABOUT WHY THE TOPICS ARE NOT PICK *UD UP BY NIH OR ANY OTHER SORT OF INTERESTING BASIC DISCOVERIES. >> I DON'T KNOW, TO SOME EXTENT THE MRNA VACCINE, YOU KNOW, THE MRNA VACCINES WORK IN TERMS OF GETTING INTO A PRODUCT. THAT IS LARGELY FUNDED BY DARPA AND GATES FOUNDATION. YOU KNOW WENT OUT, TRIED TO INTEREST ALL THE PHARMA COMPANIES AND ENDED UP GETTING THREE ORGANIZATIONS. CUREVAC WAS ACTUALLY THE FIRST. IN 2003, THEY GOT DARPA AND GATES FUNDING. THEN IN 2007, MODERNA AND BIOTECH IN 2011 AND THAT IS WHERE THE MRNA VACCINES COME FROM. NIH DID JUMP IN TO HELP DO THE SPIKE PROTEIN WORK BUT IN TERMS OF THAT LAST ONE, IT WAS DONE IS SOME UNUSUAL PLACES WHICH IS AN INDICTMENT OF PHARMA TO SOME DEGREE. WE ALMOST HAD THK INVOLVED IN THAT BUT DIDN'T SUCCEED. THERE ARE SOME VERY FUNDAMENTAL THINGS ABOUT MAKING VACCINES THAT ARE BLOCKING, LONG DURATION AND A HUGE BREADTH AVAILABLE TODAY. OUR COVID VACCINES FAIL IN ALL THREE OF THOSE AREAS. WE HAVE A COLLABORATION WITH STANFORD ON LOOKING AT BASIC VACCINES SIGNS TO TRY TO UNDERSTAND THOSE THINGS. A SHORT DURATION VACCINE IS NOT VERY INTERESTING FOR HIV OR TB OR MALARIA. MALARIA AS AN EXAMPLE WHERE WE FUNDED OVER JFK OVER A DECADE A VACCINE CALLED TRF THAT IS ACTUALLY NOT WORTH DEPLOYING BECAUSE ITS HALF LIFE IS SO LOW THAT YOU ARE BETTER TO SPEND YOUR MONEY ON BED NESTS THAN THE VACCINE. SO THE IDEA THAT OKAY WE WILL BE ABLE TO TAKE THAT AND EVENTUALLY TURN THAT INTO A REAL VACCINE, IT IS NOT A COMPLETE WASTE BUT IT IS AMAZING TO ME HOW LITTLE WE KNOW ABOUT THESE VACCINES' KEY CHARACTERISTICS. PROBABLY OUR HIGHEST PAYBACK IS OUR WORK THAT IS UPSTREAM-TYPE WORK BUT I GUESS ONE DOWNSTREAM EXAMPLE WHICH IS KIND OF AMAZING IS THE HPV VACCINE IS A VERY POWERFUL VACCINE AND, YOU KNOW, PHARMA IS NOT INSENTED TO PROVE YOU ONLY NEED ONE DOSE. WHY WOULD THEY PROVE TO PEOPLE THEY SHOULD HAVE HALF AS MUCH REVENUE? SAME WITH PNEUMOCOCCAL. IT IS ALMOST PROVEABLE THAT TWO ARE 20 SO GATES FOUNDATION DID THIS TO SHOW YOU ONLY NEED TWO. WITH HPV WE DID THESE INCREDIBLE STUDIES TO SHOW YOU ONLY NEED ONE SO ALL THE MONEY ON HPV VACCINES WILL GO DEVICE AS FAR. -- TWICE AS FAR. SO IF WE HAD 92,000 DOSES WE WOULD HAVE FAILED AND INSTEAD OF GETTING AS MANY PEOPLE TO HAVE ONE DOSE, THEY SAY WE WILL HAVE TWO THAT IS BASICALLY ONLY GIVING YOU 5 PERCENT PROTECTION. THANK GOODNESS THE ONE DOSE IS SO GOOD IT IS INDISTINGUISHABLE BETWEEN TWO-DOSE IN TERMS OF THE OUTCOME. SO WE CAN TAKE -- AND DELIVERY IS SUPER HARD, THE COST OF GETTING IT IN THE FIELD BUT OUR COVERAGE WOULD HAVE BEEN SUPER LOW. SO SOME OF THE IN-THE-FIELD STUFF IS PRETTY INCREDIBLE AS WELL. WE HAVE DONE A LOT ON REFRIGERATION TO MAKE THAT EUROPE EASY TO DO. BUT YEAH THE UPSTREAM RESEARCH IS WHERE THE MOST DRAMATIC THING IS. ALTHOUGH I HAVE GIVE ONE MORE EXAMPLE. WHEN THE GATES FOUNDATION STARTED, ROTAVAC WAS GIVEN TO RICH CHILDREN. ALL THE ROTA VIRUS DEATHS ARE IN POOR CHILDREN AND THEY HAVE ZERO VACCINES AND SO JUST GETTING THE WORLD TO TAKE THE R OT ROTAVAC VACCINE, GIVING IT TO INFANTS BUT THAT WAS GETTING THE COSTS DOWN, VOLUME UP, GOING FROM COUNTRY TO COUNTRY. IN INDIA WE HAVE A LOCAL MANUFACTURER AND NOW THAT IS A HUGE SUCCESS STORY BUT THAT WAS NONSCIENTIFIC INSTITUTIONARE AH THINGS AND PHNEUMOCOCCUS IS A LITTLE BIT OF SAME STORY ALTHOUGH WE DID HAVE TO CHANGE THE -- THERE WAS A SLIGHT RERUM CHANGE TYPE SO JUST DOING THE WORK THERE. NOW WE'RE JUST TRYING TO GET IT TO BE BELOW A DOLLAR A DOSE AND THAT HAS BEEN VERY PROMISING. >> ADD ADD MY THANKS TO YOU FOR THE GLOBAL VIEW OF INTERACTION SEEN DEVELOPMENT AND MORE. I WAS WONDERING, MAYBE YOU HAVE ALREADY SPOKEN TO IT A BIT BUT DO YOU THINK THE RNA VACCINE AS THE CORONA VIRUS VACCINE WILL IMPACT VACCINE DEVELOPMENT WORLDWIDE AND HOW YOU THINK THE SEED OF DEVELOPMENT WILL IMPACT? WILL IT IMPACT SOME OF THE AREAS YOU HAVE ALREADY SPOKEN TO? >> YEAH, SO THE BUSINESS CASE OF, YOU KNOW, BIOTECH AND MODERNA IS LARGELY BASED ON MRNA VACCINES IN ONCOLOGY. AND YOU KNOW THERE ARE PEOPLE WHO THINK THAT IS ABSOLUTELY GOING TO FAIL AND THERE ARE PEOPLE WHO THINK THAT IS GOING TO BE ABSOLUTELY PHENOMENAL. SO IT IS A GREAT QUESTION BUT THEY ARE GETTING SO MUCH PRIVATE CAPITAL, YOU KNOW, WE WILL HAVE AN ANSWER. BUT YOU HAVE A GOOD -- THE COUPLE THAT ARE FOUNDERS OF THE BY BIOTECH ACTUALLY CARE ABOUT INFECTIOUS DISEASE SO THEY ARE DOING MORE FOR INFECTIOUS DISEASE THAN A PURE BUSINESS-ORIENTED VIEW WOULD CAUSE THEM TO. I WOULD SAY THERE IS EVEN A DANGER THAT MRNA BECOMES -- WE OVERFOCUS ON THAT. THERE ARE OTHER VACCINES THAT MAY SOLVE THESE DURATION-TYPE ISSUES SO WE DON'T WANT TO BECOME OVERLY FOCUSED. THE THING ABOUT MRNA IS THE FLEXIBILITY, THAT YOU ARE JUST ESSENTIALLY CHANGING THE NUMBERS, THE MRNA-T SO WE CAN HAVE. >> Genny: NUCLEAR -- HAVE GENERIC VACCINES FACTORIES. THERE IS A LOT OF RESEARCH ON HOW LIPIDS TARGET DIFFERENT THINGS SO WE MAY HAVE TO CHANGE THIS BUT YOU CAN HAVE A MRNA FACTORY THAT CAN MAKE BILLIONS OF VACCINES IN MONTHS AND THE COST OF MAKING THE MRNA VACCINES ONCE YOU GET INTO THESE TYPE OF VOLUMES IS SUPER, SUPER LOW. SO THERE IS THIS DEBATE IN THE VACCINE WORLD SHOULD WE HAVE VACCINE FACTORIES IN ERR -- EVERY COUNTRY, WHICH IS INSANE. OR SHOULD WE HAVE SO MUCH CAPACITY OF VACCINE THAT THE IDEA OF DID YOU HAND IT OUT IN THE RIGHT ORDER WOULD ESSENTIALLY MAKE IT A MOOT QUESTION BECAUSE YOU GOT IT OUT SO QUICKLY THAT YOU ARE MORE BOTTLE NECKED WITH DISTRIBUTION PROBLEMS. AND PARTICULARLY IF CHINA WANTS ITS CAPACITY, EUROPE WANTS IT, U.S. WANTS IT, YOU COULD GET UP TO SIX BILLION COURSES PRETTY QUICKLY. SO NO, MRNA IS, YOU KNOW, FANTASTIC FOR LOTS OF THINGS INCLUDING NOT JUST VACCINOLOGY. AND THE LEVEL OF INTEREST IN IT NOW, ALMOST ALL OF THESE DEVELOPING COUNTRY VACCINE MANUFACTURERS ARE ALL DEVELOPING THE CAPACITY TO DO MRNA SO SERUM IN TWO OR THREE YEARS -- [INDISCERNIBLE] PFIZER IS THE HIGHEST REVENUE VACCINE MANUFACTURER BUT THERE IS A DIFFERENCE WHEN YOU SELL FOR $80 VERSUS TWO DOLLARS IN REVENUE VERSUS UNIT COST BUT WE WILL HAVE THOSE CAPACITIES PRETTY QUICKLY. SO I HOPE WE CAN SOLVE THE DURATION PROBLEM WITH SOME ADJUVANT OR SOMETHING. >> THANK YOU SO MUCH FOR BEING HERE. I AM GOING TO ASK YOU TWO QUESTIONS THAT ARE TWO PARTS OF MY IDENTITY. FIRST OF ALL I AM A PSYCHIATRIST AND A NEUROSCIENTIST AND I AM WONDERING, ONE OF THE THINGS I REGULARLY OBSERVED IN MY TRAINING IS NO MATTER NOW GOOD THE ANTIVIRALS WERE, THEY HAVE DIDN'T WORK IF MY PATIENTS DIDN'T TAKE THEM. SO I AM WONDERING HOW YOU ARE THINKING ABOUT MENTAL ILLNESS AND HOW YOU ARE THINKING ABOUT THAT AS YOU DEVELOP TREATMENT FOR VARIOUS DISEASES, AS YOU THINK ABOUT THAT WORLDWIDE. AND THEN THE SECOND PART IS MY FAMILY IS FROM GHANA IN WEST AFRICA AND WHEN I VISIT, I OBSERVE DISPARITIES FROM WHAT I OBSERVE IN THE UNITED STATES BUT ALSO SERVE IN PREDATOR AND THE DISPARITIES BLOCK TO BLOCK ARE GREATER THAN WHEN I TRAVEL TO MY FAMILY COMMUNITY IN GHANA. SO WONDERING IF YOU ARE THINKING ABOUT WAYS TO FIGURE OUT BEST PRACTICE IN AFRICA OR HERE AND VICE VERSA AND HOW YOU DO THAT. AND I WANT TO SAY A PERSONAL THANKS TO Dr. FAUCI, AS A YOUNG SCIENTIST, THE ROLE YOU PLAYED TO BRING SCIENCE AND MEDICINE TOGETHER TO HAVE A TRANSFORMATIVE EFFECT. >> YEAH, I MEAN THERE'S SOMETHING THAT I HOPE EVERYBODY PLAYS WITH ON A REGULAR BASIS WHICH IS THIS LONE BURDEN OF DISEASE DATABASE FROM IHME. YOU CAN LOOK AT COFACTORS, TRENDS, LOOK AT IT BY RACE, GEOGRAPHY OTHER TIME, DO FORECASTS NOW, YOU CAN LOOK AT DO PLAQUE PATIENTS SEEK HEALTH DIFFERENTLY THAN OTHER PATIENTS. THE DATABASE IS LARGELY FUNDED BY THE FOUNDATION, THE RESISTANCE IS SOMETHING FROM THE PAST. THERE IS THE TAKE WHERE THOUSANDS OF CHILDREN CAN DIE AND WE BASICALLY DO AUTOPSIES -- THIS IS ONLY IN DEVELOPING COUNTRIES WHERE THE OPAQUENESS OF CAUSE OF DEATH WAS SO HIGH AND THAT HAS BEEN A HUGE SET OF FACTORS INFORMING THE IHME TO ATTRIBUTE, OKAY, WHAT ARE THESE KIDS DYING OF, PARTICULARLY THINGS LIKE IF YOU DIE IN THE FIRST 30 DAYS, THEY BASICALLY FAIL WITH SEPSIS OR -- BUT THEY DON'T KNOW THE PATH AND GOING BACK AND FIGURING OUT HOW YOU WOULD HAVE SAVED THAT LIFE. WE DON'T DO MUCH ON MENTAL ILLNESS. THERE ARE DISEASES THAT ARE NOT MUCH IN THE RICH WORLD LIKE MALARIA BUT THEN YOU HAVE HIV THAT DOES EXIST IN THE RICH WORLD BECAUSE THERE IS A HUGE PROFIT MOTIVATION TO WORK ON THOSE THINGS. SO IT IS NOT THAT WE'RE NOT ABOUT INFECTIOUS DISEASE, WE'RE ABOUT ANYTHING WHERE WE CAN SAFE A LIFE FOR LIFE'S SAKE, BUT SOME DISEASE MEDICINES ARE AT THE POINT, SOME OF THAT HEART DISEASE WORK BEING DONE CALLED RESOLVE BUT WE'RE INTERESTED. AS THE RICH WORLD MAKES PROGRESS AND BRINGS THINGS TO BE CHEAP, WE WILL BE READY TO GO. SOME THINGS WE'RE SO IMPATIENT ABOUT, WE ARE -- WE GET INTO THE CAUSATION CHANGE THERE. SO THIS COLLABORATION ON GENE THERAPY WHICH TONY AND FRANCIS CHAMPIONED AND IS OFF TO A GOOD START, LIKE A DECADE-LONG THING, BUT THAT'S TO DO GENE THERAPY AT SOMETHING LIKE $1000 PER TREATMENT TO CURE PATIENTS OF SICKLE-CELL AND HIV. BECAUSE EVEN THOUGH THE U.S. CAN AFFORD -- WELL, MAYBE NOT, A MILLION DOLLARS PER SICKLE-CELL PATIENT, THE U.S. HAS ONLY 80,000, YOU KNOW AFRICA HAS MILLIONS AND CAN'T POSSIBLY AFFORD AN EXTENSIVE TREATMENT. AND THEN OF COURSE WITH HIV, UNLESS IT IS VERY EXPENSIVE, LIFE LONG TREATMENT IS MORE ATTRACT I HAVE THIS THAN LIKE BONE MARROW TRANSPLANTS. SO WE WILL TRY TO DRIVE THE COSTS TOWN. WE WILL END UP SAVING THE U.S. GOVERNMENT TENS OF MILLIONS OF DOLLARS BUT THAT IS AN ACCIDENTAL SIDE-STEP OF THE PROGRAM. >> JUDITH? >> YES, I WILL JUST SAY INSPIRING, THANK YOU AND LET'S MOVE ON. >> THANK YOU. >> SO I AM GOING TO ECHO SOMETHING THAT C.T.A. SAID THAT THE HEALTH DISPARITIES IN THE U.S. ARE ALSO EXTREME AND I GUESS THE QUESTION IS WHETHER OR NOT THE INFORMATION YOU ARE GLEANING FROM YOUR GLOBAL ANALYSIS OF MALNEWT TRICKS AND MICROBIOMES CAN TELL US ABOUT THOSE SAME THINGS IN THE *ULS AND ARE YOU COMPARING? THE MICROBIOMES, I WOULD GUESS THEY ARE SOMEWHAT DIFFERENT FROM MISSOURI MISSISSIPPI AND GHANA BUT I DON'T KNOW, IS THAT SOMETHING ON YOUR RADAR OR DO YOU CONSIDER THE U.S. AS PART OF THE GLOBE? >> DURING THE PANDEMIC BECAUSE WE HAD A LOT OF VACCINE EXPERTISE OUTSIDE THE NIH AND PRIVATE SECTOR, SIGNIFICANT AMOUNT OF VACCINE EXPERTISE THERE WAS WITH PEOPLE AT THE FOUNDATION, SUPER INVOLVED DURING THAT TIME PERIOD AND, YOU KNOW, YOU HAVE GOT TO LOOK AT THIS IHME DATA. SO LIKE TAKE THE FACT THAT BLACKS HAVE HIGHER MATERNAL MORTALITY, IT HAS NO GEOGRAPHIC -- IT IS EQUAL ACROSS THE ENTIRE UNITED STATES, EVEN IN VERY POOR TREATMENT SYSTEMS. BUT HIV, THAT IS EXTREMELY GRAPHIC. TAKE FLORIDA AND GEORGIA. THESE DATA SETS, THE FACT SO LITTLE ACTION IS TAKEN ON THESE DATA SETS IS MIND BLOWING. THEY ARE THERE, JUST CALLING OUT. IT IS NOT A FOUNDATION THING. WE ARE NOT THE -- I HAPPEN TO DO RICH WORLD WORK ON ALZHEIMER'S AND WORKED WITH NIA AND FUNDING DIAGNOSTIC TYPE STUFF BUT THAT IS NOT A FOUNDATION THING. SO WE'RE NOT, YOU KNOW, THAT FOCUSED ALTHOUGH I HAVE TO SAY WE DO DO U.S. EDUCATION. IF WE DECIDE THE MEDICAL SAVES INNER CITY KIDS IN TERMS OF STRESS, INFLAMMATION, STUFF LIKE THAT THAT CAN HELP THEM STUDY BETTER. WE HAVE FOUND STARTING SCHOOL LATER HELPS THEM SLEEP MORE AND THE TEST RESULTS OF THAT ARE FAIRLY SIGNIFICANT BUT THAT IS A SEMI RELATED THING. BUT NO, IT IS NOT A FOCUS OF OURS EVEN THOUGH THE PRIMARY DATA SETS THAT YOU WOULD START WITH, THE IHME DATA SETS, WE FUNDED THEM TO DO DEVELOPING COUNTRIES BUT THEN THEY CHOSE TO DO THE ENTIRE WORLD. AND YOU KNOW IT IS THE KIND OF THING YOU WOULD HAVE THOUGHT CDC WOULD HAVE DONE BUT THEY DIDN'T. >> I KNOW BEFORE GATES AND TONY HAVE HARD STOPS BUT LET'S LET THIS BE THE LAST QUESTION. >> THANK YOU SO MUCH. SO I WANTED TO TAKE THAT PIVOT JUST TO CELEBRATE THE MOMENT AROUND THE MALARIA VACCINE AND GET YOUR OUTLOOK ON WHAT YOU THINK WILL HAPPEN WITH THE DISEASE AND HOW THAT MIGHT PIVOT AS YOU THINK ABOUT THE APPROACH TO IT BECAUSE FROM A WORLD LIFE STANDPOINT, CONGRATULATIONS TO THE COMMUNITY THAT WORKED ON THAT VACCINE AND THANKS FOR ALL THE OTHER ONES. >> YOU WANT TO TALK ABOUT THE MALARIA ONE? [ OFF MIC ] >> WE STILL HAVE AN ISSUE WITH THE MALARIA VACCINE BECAUSE IT IS NOT OPTIMAL AND WHAT WE'RE TRYING TO DO RIGHT NOW IS TO TRY AND INCORPORATE SOME OF THE KNOWLEDGE THAT WE WILL GET FROM MONOCLONAL ANTIBODIES THAT HAVE A PRO PROFOUND INFECTION ON SUBTYPES. AND THE QUESTION IS WHEN WE GET THAT WILL WE MODIFY THE CURRENT MALARIA VACCINE WHICH BILL MENTIONED BUT NOS THE NOT THE END GAME AT ALL? BECAUSE BILL MENTIONED FOR THE AMOUNT OF MONEY IT WOULD TAKE TO GET THAT OUT THERE, AS BILL SAYS, AND I DON'T THINK HE WAS TRYING TO BE MORE FACEIOUS, YOU COULD DO BETTER JUST TO GET MORE BEDS OUT THERE. BUT WE'RE CAUTIOUSLY OPTIMISTIC BECAUSE THE DATA THAT BILL AND I SAW TODAY ON A MONOCLONAL ANTIBODY WHICH WAS AGAINST ADDITIONAL ECTOSPO REG E WAS REALLY GOOD. THE QUESTION IS HOW DO YOU PRODUCE A ANTIBODY THAT WILL LAST MORE THAN THE SIX MONTHS OF A MONOCLONAL ANTIBODY. >> THE SITUATION IS A BIT CONFUSING BECAUSE WE HAVE THE FOUR YEAR DATA AND IT IS PRETTY LOW, LIKE 30 PERCENT PROTECTION LEVELS BECAUSE OF THE HALF LIFE. WE ONLY HAVE ONE-YEAR DATA BUT THE ONE-YEAR DATA IS NO BETTER THAN THE RTSS ONE-YEAR DATA AND WE CAN SEE IT CHICANE. EVEN THOUGH WE WILL DO A FEW THINGS BETTER AND WE WILL PROBABLY BUILD ON R-21, EASIER TO MANUFACTURE. GSK REALLY EXITED THIS AREA WHERE THE INSTITUTE IS ACTIVELY ENGAGED. SO THERE ARE SOME THINGS LIKE THE DOSING SCHEDULE, SOME WORK WHERE IF WE HAVE CONTINUOUS EXPOSURE, WE MIGHT OVERCOME THESE RACIAL PROBLEMS. SO IT IS INTRIGUING AND SOME PEOPLE THOUGHT WE WOULD NEVER HAVE A VACCINE AGAINST THIS TYPE OF PATHOGEN. SO YOU KNOW WE'RE MAKING PROGRESS. THE BED ISSUE IS INTERESTING. THE SPECIES THAT CAUSES THE MOST DEATH, THEY ARE INDOOR BY THERS BUT YOU CAN'T JUST FOCUS ON THAT BECAUSE HALF OF THEM ARE OUTDOOR BITERS. SO THE DREAM IS THAT WE CAN GO TO THE WORLD AND SAY OKAY, WE HAVE THE TOOLS TO DO AN ERADICATION BUT TELLING THE WORLD THAT, AS WE HAVE SEEN IN THE POLIO CASE, IT IS SO HARD AND YOU END UP IN THE TOUGHEST PLACES. WITH MALARIA, THAT MEANS CENTRAL AFRICA, NORTHERN NIGERIA WHERE YOU HAVE MANY CHALLENGES OF GETTING ANYTHING TO BE DOWN SERUM ALTHOUGH WE DID IT WITH POLIO BUT ONLY WITH INCREDIBLE INTERVENTION AND WEIGHT AND IT TOOK WAY WAY LONGER THAN WE EXPECTED. SO YOU KNOW ALL THOSE TOOLS. AS TONY SAID THE ANTIBODIES, THAT THERAPY IS ABSOLUTELY AMAZING. >> WE'RE A LITTLE OVER TIME BUT THANK YOU VERY MUCH FOR BEING WITH US, REAL REALLY APPRECIATE IT AND CERTAINLY LOOK FORWARD TO SUCCESS OF COLLABORATION BETWEEN THE FOUNDATION AND NIH SO THANK YOU. >> THANK YOU AND WITH NEW PEOPLE COMING IN, WE HOPE TO MAINTAIN THE COVERAGE AND TONY HAS BEEN PHENOMENAL TO WORK WITH SO HE WILL BE MISSED. >> THANK YOU. >> THANK YOU. SO LET'S BE BACK IF WE CAN AT 1:00 FOR TONY'S PRESENTATION. LIKES WE HAVE NEVER SEEN IN OVER 100 YEARS WITH CLOSE TO 700 MILLION CASES IN CLOSE TO 7 MILLION DEATHS. THOSE NUMBERS ARE ALMOST CERTAINLY AND UNDERCOUNT AND IT IS ESTIMATED THAT DEATHS ARE PROBABLY TWO OR THREE FOLD MORE THAN THAT BECAUSE OF THE REPORTING ISSUES IN SEVERAL DEVELOPING NATIONS IN SOUTHERN AFRICA. SO WHAT ARE SOME OF THE LESSONS WE HAVE LEARNED FROM OUR EXPERIENCE I HAVE DIVIDED INTO SEVEN. BUT THESE ARE THE ONES THAT ARE THE MOST RELEVANT BUT JUST A COUPLE OF QUICK POINTS ON EACH BECAUSE YOU DON'T HAVE TIME TO DELVE INTO EACH OF THOSE BUT LET'S START OFF WITH THE IMPORTANCE OF GLOBAL INFORMATION SHARING AND COLLABORATION IS PROBABLY ONE OF THE MOST IMPORTANT THING WE NEED TO KNOW NOT ONLY OPEN INFORMATION FROM THE GIVEN COUNTRY THIS HAVE BEEN IMPORTANT IF YOU HAVE A MORE ACTIVE OR TRANSPARENT AVAILABILITY OF DATA WITH THE OUTBREAK OF CHINA BUT IT GOES BEYOND THAT AND SURVEILLANCE DATA AND GENOMIC DATA THAT IS IMPORTANT WITH REGARD TO THE EMERGENCE OF THE VARIANCE AND REAL-WORLD CLINICAL DATA. THE COLLABORATION AND IMMEDIATE TRANSPARENCY IS A VERY GOOD EXAMPLE SOUTH AFRICA HAS BEEN GOOD COLLEAGUES AND COLLABORATORS BUT IMMEDIATELY WITH THE EMERGENCE OF OMICRON IN SOUTH AFRICA THE DATA WAS MADE AVAILABLE TO US ON A ZOOM CALL IN THE MIDDLE OF THE MEETING ON SUNDAY NIGHT AS WE ARE TALKING ABOUT IMMEDIATE AVAILABILITY OF INFORMATION IN A TRANSPARENT WAY. TO CONTRAST WHAT WE EXPERIENCED EARLY ON IN CHINA WAS A BAD EXAMPLE EXISTING CLINICAL TRIAL STRUCTURE WHAT WE MEAN BY THAT IS TO TAKE THE RESOURCES YOU ALREADY HAVE EVEN FOR ANOTHER DISEASE AND REPLICATED IN THE EFFORT YOU HAVE TO THE CURRENT CHALLENGE PRACTICALLY SPEAKING WHAT DOES THAT MEAN FOR US? WE HAVE SPENT LITERALLY DECADES BUILDING AN INTERNATIONAL CLINICAL TRIAL NETWORK FOR HIV. WHAT WE DID IN THE BEGINNING OF THE OUTBREAK WITH THE LEADING CLINICAL TRIALS FOR VACCINES AND THERAPEUTICS INTO THE COVID PREVENTION NETWORK BY MERGING WITH THE CLINICAL TRIAL AND WITH THAT PREVENTION NETWORK BROADER DEFECT INFECTIOUS DISEASES CONSORTIUM AND A LARGE A CALL CHILD YOUR LINKING TO THE COVID-19 PREVENTION NETWORK VERY IMPORTANT SUCCESS STORY CAP NEXT HAVE A SUCCESS STORY WE NEED TO MAKE SURE WE DON'T SIDE OF IS THE SCIENTIFIC IT AND ENABLE THE RAPID VACCINE DEVELOPMENT IF THERE IS ONE THING WE DON'T WANT TO GET LOST SOME OF THE CHALLENGING IF NOT DISAPPOINTING ISSUES IS WHY IT WAS SO IMPORTANT TO MAINTAIN A SUSTAINED INVESTMENT OF BIOMEDICAL RESEARCH? I WROTE ABOUT THIS IN APRIL 2021 ISSUE OF SCIENCE WHEN I SAID THE SPEED AND EFFICIENCY WITH WHICH IS HIGHLY EFFICACIOUS VACCINES WORD DEVELOP THE POTENTIAL FOR SAVING MILLIONS OF LIVES WITH EXTRAORDINARY MULTIDISCIPLINARY EFFORT INVOLVING BASIC PRECLINICAL AND CLINICAL SCIENCE BEEN OUT OF THE SPOTLIGHT FOR DECADES BEFORE THE UNFOLDING OF THE COVID-19 PANDEMIC. FROM PLATFORM TECHNOLOGIES FOR VACCINES ALTER THE STRUCTURE -BASED DESIGN THAT IS NOW THE IMMUNOGEN USED FOR ALL OF THE VACCINES THIS IS SO IMPORTANT THAT SCIENCE MAGAZINE DEEMED THAT EFFORT THE SCIENTIFIC BREAKTHROUGH OF THE YEAR FOR 2020 RESULTING AS SHOWN HERE INTO A NUMBER OF VACCINES USING MULTIPLE DIFFERENT PLATFORMS MULTIPLE DIFFERENT DEVELOPERS SEVERAL OF WHOM HAVE ALREADY BEEN FULLY APPROVED AND OTHERS ARE STILL ON EMERGENCY USE AUTHORIZATION. NEXT, THIS IS VERY IMPORTANT THIS IS THE DIRECTION NIH HAS BEEN GOING THE PAST COUPLE OF YEARS. BOTH THE PROTOTYPE AND PRIORITY PATHOGEN APPROACH , WHAT DO WE MEAN BY THAT? THE PRIORITY PATHOGEN APPROACH YOU SELECT THE PATHOGEN ITSELF YOU FEEL HAS A GOOD CHANCE OF THE EMERGING INTO AN EPIDEMIC FORM THE BLUEPRINT HAS PICKED OUT A NUMBER OF PRIORITY DISEASES THAT HAVE THE POTENTIAL AT ANY TIME TO BECOME PANDEMIC AND WE ALREADY KNOW ABOUT THE CORONAVIRUS SINCE WE ARE LIVING THROUGH THAT AS WELL AS ISSUES LIKE EBOLA. BUT WHAT WE FEEL IS EVEN MORE IMPORTANT IS THE PROTOTYPE PATHOGEN APPROACH WHICH MEANS WHAT YOU DO IS SELECT FAMILIES OF VIRUSES IT CAN BE ANY PATHOGEN BUT FOR THE SAKE OF CLARITY IT IS VIRUSES IN WHICH YOU DO A NUMBER OF BASIC STUDIES IN EACH OF THE FAMILIES AND BUILD ON PRIOR EXPERIENCE WITHIN THAT PARTICULAR FAMILY. THERE ARE 20 FAMILIES OF VIRUSES THAT HAVE THE POSSIBILITY OF CONDEMNING OUTBREAK. OF THOSE, SEVEN OR EIGHT ARE OF THE HIGHER RISK AND SHOWN ON THE SLIDE. WITH THAT PROTOTYPE PATHOGEN APPROACH IS THE STUDY INDIVIDUAL VIRUSES IN THE FAMILY LOOKING FOR COMMONALITIES FOR YOU TO MOVE VERY QUICKLY SHED A PARTICULAR MEMBER OF THAT FAMILY EMERGE TO BE A PANDEMIC WE SAW THAT WITH THE CORONAVIRUS AND WHAT WE LEARNED FROM THE WORK IN 2002 SARS COVE E1 AND THAT ALLOWED US TO THE GROUND RUNNING THE UNPRECEDENTED SPEED TO DEVELOP THE VACCINE OF COVID-19 SO WHAT DID WE LEARN? THE FUNDAMENTAL TESTING THE DEVELOPMENT THE OPTIMAL PLATFORMS POTENTIAL IMMUNE CORRELATES DIFFERENT FROM MANUFACTURING STRATEGIES. NEXT THE IMPORTANCE WE HAVE LEARNED THIS VERY CLEARLY CONTINUED SURVEILLANCE IS CRITICAL MY COLLEAGUE AND I WROTE A COMMENTARY IN SEPTEMBER 2020 IN WHICH WE STRESS THE IMPORTANCE OF THE FACT THAT IN A HUMAN DOMINATED WORLD OUR AGGRESSIVE AND UNBALANCED INTERACTION WITH NATURE MAY ENCROACH AND WORD PROVOKE NEW DISEASE EMERGENCIES. AND WHERE WE STUDY THE CONTEXT OF THAT CONNECTION BETWEEN ANIMAL PATHOGENS AND 75 PERCENT OF THE NEW PATHOGENS THAT ARE EMERGING IN HUMANS ARE ORIGINALLY ZOONOTIC MEETING ORIGINATED FROM AN ANIMAL RESERVOIR. LOOKING AT WHAT WE ARE DEALING WITH NOW SOME VERY IMPORTANT PAPERS AND EVERYONE KEEPS AN OPEN MIND AS TO THE ORIGIN WITH A NATURAL OCCURRENCE. AND WITH THAT REVOLUTIONARY VIOLENCE VIROLOGIST AND PUBLISHED THE MOST LIKELY ORIGIN IS WHAT WE ARE REFERRING TO AS A NATURAL OCCURRENCE FROM AN ANIMAL RESERVOIR TO A HUMAN AND THEN ADAPTING ITSELF TO TRANSMISSION AMONG HUMANS NEVERTHELESS LONG-STANDING SYSTEMIC INEQUITIES DRIVE PANDEMIC DISPARITIES. SOME OF OUR OWN I WITH THOSE DISPARITIES ARE OBSERVED AMOUNT AND WHEN WE DO HAVE DATA VERY LIKELY PACIFIC ISLANDERS. THOSE THAT DRIVE DISPARITIES LIMITED HEALTHCARE ACCESS OCCUPATIONS DISPROPORTIONATELY INVOLVED IN ESSENTIAL WORK OF THE MINORITY POPULATIONS WHICH DOES NOT ALLOW THEM TO WORK REMOTELY THERE IS THAT INCOME AND WEALTH GAPS WITH THINGS SUCH AS HOUSING SOME PEOPLE WHO LIVE IN CROWDED CONDITIONS IT'S VERY HARD WITH PREVENTION STRATEGIES. MISINFORMATION IS THE TRUE ENEMY OF A PANDEMIC. THESE ARE A COUPLE OF SELECTIVE INDICATIONS AND EXAMPLES THE ALMOST LUDICROUS MISINFORMATION WITH BILL GATES AND I AT THE MEETING A COUPLE OF HOURS AGO WE ALWAYS JOKE ABOUT THE FACT THE MISINFORMATION LYING OUT THERE CONTINUES TO HAVE BILL AND I PUTTING CHIPS INTO VACCINES SO WE CAN CONTROL PEOPLE'S THOUGHTS THAT IS A PRETTY GOOD DISINCENTIVE FOR PEOPLE WHO BELIEVE THAT TO BE VACCINATED BUT AS JUST ONE EXAMPLE OF MISINFORMATION AND DISINFORMATION SO BEYOND 2022 WHERE WE GOING WITH THIS AND WHAT CAN WE EXPECT? CAN WE ERADICATE I WOULD BE ASTOUNDED IF WE ELIMINATED SARS/COV2 AND IMPORTANTLY EITHER VACCINE OR INFECTION IS MEASURED IN DECADES AND SOMETIMES FOR A LIFETIME. THAT ALLOWED US TO ERADICATE. THE NEXT QUESTION IS CAN YOU ELIMINATE? AGAIN I DOUBT AND WE HAVE ELIMINATED TO VIRUSES OF IMPORTANCE EVER OWN SOCIETY POLIO AND MEASLES BUT THOSE ARE PHENOTYPICALLY STABLE WE DON'T HAVE FIVE OR SIX VARIANCE LIKE WE DO WITH SARS/COV2 BUT INFECTION AND VACCINE -INDUCED IMMUNITY IS MEASURED IN DECADES AND OVER A LIFETIME SO WITH SARS/COV2 WE HAVE A PROBLEM AND EVOLUTIONARY DIVERSE VARIANT FIVE OR SIX OF THE HOME BUT ALSO THE WAITING VACCINE AND INFECTION INDUCED IMMUNITY WHY WE KEEP TALKING ABOUT THE IMPORTANCE OF STAYING UPDATED ON YOUR BOOSTER SHOTS BECAUSE IF WE DO THAT WE CAN GAIN A LEVEL OF CONTROL THAT THE INFECTION IN THE COMMUNITY IS LOW ENOUGH IT DOES NOT DISTURB THE SOCIAL ORDER. AND WHAT DO WE MEAN BY CONTROL? SOUND SEE THAT AS A RETURN TO NORMALCY AND IT DOESN'T DISRUPT SOCIETY. SO IT CAN BE DONE THAT SHOWN ON THE LEFT-HAND PART OF THE SLIDE WE HAVE TO IMPLEMENT COMMON SENSE VOLUNTARY MASKING WHERE APPROPRIATE AND THAT REQUIREMENT FOR INTIMATE VACCINATION WHICH IS THE MOST IMPORTANT AS WELL AS THE USE OR THE PRUDENT USE OF INTERVENTION SUCH AS MONOCLONAL ANTIBODIES SO I WILL CLOSE UP THE LAST SLIDE PAPER THAT MY COLLEAGUES AND I WROTE ABOUT 14 YEARS AGO THIS PAST MONTH. WE ENTITLED THE EMERGING INFECTIONS IN THE MESSAGE AND BOTTOM LINE OF THAT PAPER IS THAT WE HAVE ALWAYS BEEN CHALLENGED BY EMERGING INFECTIONS WE ARE CHALLENGED BY THEM NOW AND WE CERTAINLY WILL BE CHALLENGED IN THE FUTURE THAT'S WHY WE ENTITLED THAT A PERPETUAL CHALLENGE AND THE ONLY WAY TO MEET A PERPETUAL CHALLENGE IS TO BE PERPETUALLY PREPARED AND THAT IS THE ONE UNDERLYING MESSAGE OF THE LESSONS THAT WE LEARN WE MUST BE PERPETUALLY PREPARED. THANK YOU. >> I WILL TURN IT TO THE MEMBERS TO SEE IF THERE ANY QUESTIONS OR COMMENTS. >> AND THIS DEEPEST GRATITUDE FOR ALL YOU HAVE DONE FOR ALL OF US AND CONTINUE TO DO. COMING BACK TO THE PATHOGEN OF MISINFORMATION AND WITH THE THAT ON MANY LEVELS HOW DO YOU THINK IT'S POSSIBLE TO ADDRESS THAT AND PREEMPT THAT? >> ONE THING THAT IS VERY CLEAR THAT PROCESS OF SCIENCE AND PEOPLE ARE NOT USE TO THAT DATA INTERPRETATION AND INTO CLINICAL DECISION-MAKING AND LEARNING AS YOU GO IS AN OPPORTUNITY TO EDUCATE THE PUBLIC AND THE MEDIA? >> YOU MAKE A COUPLE OF REALLY GOOD POINTS MISINFORMATION AND DISINFORMATION SOMERSET FRANK MALICIOUS EVEN THOSE WHO KNOW BETTER -- IS THE FACT THAT ONE OF THE THINGS WE CAN DO IS BE VERY ENERGETIC TO COUNTER THE MISINFORMATION BY FLOODING THE SYSTEM WITH CORRECT INFORMATION IF THERE IS ANYTHING IS WHAT YOU ARE ALLUDING TO SO WHAT HAPPENS IN JANUARY 2020 THE VIRUS WAS A BIT DIFFERENT FROM JULY FROM THE VIRUS WE ARE DEALING WITH RIGHT NOW. GOING FROM A POORLY TRANSMITTED VIRUS TO A WELL TRANSMITTED VIRUS TRENDS TIRED FROM THOSE WHO DON'T HAVE SYMPTOMS THAT GREATLY INFLUENCES YOUR GUIDELINES AND ADVICE AND RECOMMENDATIONS THAT YOU MAKE. THAT SCIENCE FROM THE OUTBREAK IS A DYNAMIC PROCESS IT ISN'T STATIC I GIVE A SPECIFIC EXAMPLE TO SAY THE JANUARY 2022 PLUS 2 EQUALS FOUR BUT DECEMBER 2222 PLUS 2 STILL EQUALS FOUR HOWEVER THE VIRUS IN 2020 IS VERY DIFFERENT FROM THE VIRUS NOW. SO YOU CANNOT HOLD STRICT MATHEMATICAL PRINCIPLES REVOLUTION DEALING WITH BIOLOGY. WE HAVE TO DO A BETTER JOB TO COMMUNICATE THAT. >> SPEAKING OF MISINFORMATION IT IS CLEAR THERE ARE MANY PEOPLE THAT DON'T BELIEVE THAT VACCINES ARE EFFECTIVE BUT THAT THEY ARE HARMFUL. SO COULD YOU GIVE ME A CITATION OF A PAPER THAT COULD COUNTER THAT? SO WHAT IS THE BEST EVIDENCE IN YOUR MIND AND A SIMPLE STRAIGHTFORWARD WAY WHAT IS THE EFFICACY OF THE MRNA VACCINE? >> WE WILL GET THEM TO YOU. PLEASE REMIND US WITH THE SUMMARY DATA WITH MOTOR NOT ONE -- THERE IS A STUDY ON THE CDC WEBSITE THEY SHALL BE VACCINATED VERSUS VACCINATED AND LISTED IN THE HOSPITALIZATIONS AND DEAF YOU DON'T NEED A STATISTICIAN TO FIGURE IT OUT IS FOR EVERYBODY TO SEE. CDC.GOV. >> BUT THOSE WHO ARE CONCERNED ABOUT THIS? >> I THINK IF YOU TELL THEM TO GO THEY DON'T BELIEVE IT. THAT IS THE PROBLEM BUT MISINFORMATION IS NOT ALWAYS CURED ESPECIALLY WHEN A PERSON RECEIVES THE INFORMATION WHO DOESN'T WANT TO CHANGE THEIR MIND WE CANNOT GET DISCOURAGED BECAUSE IT'S SO EASY WHEN YOU ARE DEALING WITH PEOPLE WHO DON'T WANT TO TAKE THE DATA WHEN IT'S OVERWHELMINGLY CONVINCING. >> I PUT THE LINK IN THE CHAT. >> THANK YOU. >> I AM FASCINATED BY THE OPPORTUNITY TO USE BREAKING SCIENCE LIKE THE MEDIA USES BREAKING NEWS AND IT GIVES PEOPLE THE OPPORTUNITY TO REALIZE THE CONDITIONS ARE CHANGING HERE IS AN UPDATE AND I'M SURE YOU HAVE GIVEN THIS FAR MORE THOUGHT THAT HOW WE ENGAGE THE MEDIA TO BE A RELIABLE SPOKESPERSON FOR THESE CRITICAL CONDITIONS. >> THERE IS MEDIA THAT DO THAT. THE STANDARD NETWORKS DO THAT QUITE WELL THEN FOX NEWS MORE PEOPLE WATCH THAT THEN NBC AND ABC. THAT IS BIZARRE BUT IT IS TRUE. SORRY. [LAUGHTER] >> WE WILL LEAVE COMMENTS UNTIL LATER. [LAUGHTER] >> I THOUGHT I WOULD ASK DOING A SPECTACULAR JOB ON EVERYTHING AND SUMMARIZING TODAY, BUT AS WE GO FORWARD DO YOU THINK OR IS THERE ANYTHING WE CAN DO TO ELEVATE THE WILL TO KEEP GOING ON PANDEMIC PREPAREDNESS AND THE THINGS TO DO FOR THE NEXGEN VACCINES SOME ARE ENTIRELY BEHIND IT BUT WE THINK WE CAN LOSE OUR WILL BEFORE IT IS PROPERLY DONE. >> ONE OF THE PROBLEMS WE ARE FACING IS THE LACK OF INTEREST IN CONTINUAL FUNDING. IT IS CONFUSING BECAUSE IT'S NOT AS IF WE ARE NOT GRATEFUL FOR THE ENORMOUS AMOUNT OF FUNDING THE CONGRESS HAS GIVEN US TO THE TUNE OF BILLIONS OF DOLLARS. BUT THEN THEY JUST STOPPED. WE HAVE A PLAN FOR PANDEMIC PREPAREDNESS FOR NEXT-GENERATION VACCINES READY TO GO. BUT ESSENTIALLY WE HAVE RUN OUT OF MONEY. IT IS TRUE WE DON'T HAVE THE CAPABILITY FOR A RESOURCE STANDPOINT TO IMPLEMENT THAT PATHOGEN PROTOTYPE APPROACH. IF THERE'S ANYTHING YOU CAN DO PLEASE BE ADVOCATES FOR CONGRESSIONAL FUNDING OF SCIENCE IN PUBLIC HEALTH MEASURES WE KNOW THAT WORK WE'VE ALREADY PROVEN SO IT'S A DIFFERENT SITUATION SO WE ARE IN A BIG STUMBLING BLOCK WHEN IT COMES TO FUNDING. >> SEE YOU HAVE ENORMOUS ADVOCATES BUT YET I NOTICED AWARENESS OUTSIDE OF SUCH GROUPS AND THE LEAST OUTSIDE IS REALLY THE ONLY THING THAT YOU HAVE TO INVEST NOW IS HARD TO COME BY. THAT'S A MESSAGE YOU DO WHAT YOU CAN BUT IT SEEMS VERY DIFFICULT. WE WILL CONTINUE TO TRY. >> THANK YOU. >> WE ARE AT TIMES YOU HAVE TWO MORE MINUTES QUICK. >> PLEASE MAKE YOUR QUESTION PRECISE AND QUICK. >> THANK YOU SO MUCH FOR YOUR SERVICE OVER THE DECADES. YOU MENTIONED THE IMPORTANCE OF INVESTMENT AND BACKGROUND AND FOR EXAMPLE FOR THE VACCINE CAN YOU SAY MORE AT THE MR AND A VACCINE THE FIRST ONE TO CAUSE THE FINISH LINE THE FIRST TIME THAT PLATFORM WAS DEPLOYED SO WHAT DOES THAT TELL US HOW WE INVEST OR DEPLOY OUR PORTFOLIO? >> IT IS PROOF POSITIVE EVEN THOUGH SOME THOUGHT IT WAS RISKY BIT AS WITH ALL RESEARCH IT IS RISKY BUT THE MORE DATA WE ACCUMULATED THE MORE I BECAME CONFIDENT THAT MRNA APPROACH WOULD WORK BUT IS JUST AN EXAMPLE OF PUTTING YOUR FAITH IN THE DATA FROM THE INVESTMENT OF SCIENCE AND I THINK WE CAN DO THAT. AS BILL GATES MENTIONED THIS MORNING, IT IS A PHENOMENAL PLATFORM BUT NOT THE ONLY ONE WE CANNOT STOP AND SAY WE HAVE DONE THAT WITH MRNA NOW THERE ARE THOSE THAT ARE EXCITING TO TACK ON MULTIPLE DIFFERENT ANTIGENS AND THAT'S ONE OF THE MOST IMPORTANT WAYS TO GET UNIVERSAL VACCINES BY THE NANO PARTICLE APPROACH. >> LAST QUESTION. >> ONE OF THE MORE POWERFUL TOOLS COMBATING MISINFORMATION WAS A PRE- FACULTY MEMBER FROM NIH AT THE TIME SO WITH THAT PANDEMIC PREPAREDNESS IN THE FUTURE HOW DO YOU THINK ABOUT TRAINING THOSE IN PUBLIC ENGAGEMENT AND COMMUNICATION FOR WHAT IS LIKELY TO EMERGE? >> THAT'S REALLY IMPORTANT ONE OF THE THINGS I TO DO IN MY POST NIH LIFE IS SET AN EXAMPLE FOR PEOPLE TO STEP UP TO THE PLATE AND DO THAT BECAUSE YOU ARE ABSOLUTELY RIGHT WE NEED YOUNGER GENERATION PARTICULARLY SHOWING DIVERSITY. THIS IS A PERFECT EXAMPLE OF PEOPLE TO LISTEN WELL BEFORE THEY LISTEN TO ME WITH THAT FUNDAMENTAL TRUST FOR SOMEONE THAT LOOKS AND SPEAKS LIKE YOU. YOU ARE ABSOLUTELY CORRECT. WE HAVE TO DO THAT. >> INC. YOU SO MUCH WE APPRECIATE YOU SPEAKING WITH US TWICE TODAY AND FOR THE EXTRA TIME. WE WILL TRANSITION TO THE NEXT SPEAKER HOPEFULLY WE'LL SEE HER FACE IN A SECOND THE DIRECTOR OF CSR WILL BE TALKING TO US ABOUT SOMETHING YOU HEARD IN NOVEMBER WHICH IS PROPOSE CHANGES OF THE PEER-REVIEWED CRITERIA WITH A HIGH LEVEL PROPOSAL AND TODAY IS REVIEWING THOSE SUGGESTED CHANGES AS WELL AS THOSE TO THE PROCESS TO HAVE AN ENGAGING DISCUSSION ON THE TOPIC. >> THANK YOU VERY MUCH I WAS HOPING TO JOIN YOU THERE BUT I AM RECOVERING FROM BRONCHITIS I AM HERE A COUPLE MILES NORTH IN THE CSR BUILDING SO I WILL JUMP RIGHT IN YOU HAVE HEARD ABOUT THIS IN NOVEMBER HOPEFULLY YOU CAN HAVE A LITTLE LONGER TO DISCUSS THE PROPOSED CHANGES FOR THEIR RESEARCH PROJECT GRANTS AS WELL AS THE FELLOWSHIP SPACE SO JUST A LITTLE THAT OF BACKGROUND ON THE CSR TO OVERSEE THE REVIEW OF THREE QUARTERS OF NIH APPLICATIONS EVERY YEAR AND THE VAST MAJORITY APPLICATIONS. EARLIER THIS YEAR WE RELEASE THE FIVE-YEAR STRATEGIC PLAN AND ONE OF THE MAJOR OVERARCHING GOALS IS TO IMPLEMENT CHANGES FROM THE PEER-REVIEWED PROCESS TO MAKE IT MORE EFFECTIVE. THE PROPOSED CHANGES I WILL PRESENT WERE ENGAGEMENT THE BROADER SCIENTIFIC COMMUNITY AND ADVISORY COUNCIL AS WELL AS INPUT FROM NIH AND LEADERSHIP. >> WE HAVE TO CLOSE THAT BOTH ARE EQUALLY PROVIDED. FIRST IS TO REFOCUS THE FIRST LEVEL OF NIH PERIOD REVIEW ON HIS MAJOR ROLE OF PROVIDING EXPERT ADVICE TO THE GRANT APPLICATIONS UNDER REVIEW. AND RELIEVING THE ADMINISTRATIVE COMPLAINT AND WE HAVE HEARD THIS IS BURDEN AND A DISINCENTIVE TO PARTICIPATION ALSO TO MITIGATE THE BIAS TO THE PEDIGREES AND WHO YOU ARE CONNECTED WITH AND AND THEN TO MITIGATE THAT WITH THE PROCESS AND THAT COMES DOWN TO REFOCUSING THE EVALUATION OF THE INVESTIGATOR TO BE WITHIN THE CONTEXT OF THE PROPOSED SCIENTIFIC PROJECT TO FACILITATE THE BROADER GOAL TO IDENTIFY THE STRONGEST RESEARCH WITHOUT OTHER IN DO INFLUENCE SO THE SCOPE FOR THE WORKING GROUP WE FORMED WITH OVERLAPPING MEMBERSHIP FROM NON- CLINICAL TRIALS WHICH IS 90 PERCENT SO THE OTHER GROUP WAS FORMED TO LOOK AT THOSE CLINICAL TRIALS SO THE SCOPE WAS RPG THAT IS WHAT CSR DOES ON THE OFFICE OF GENERAL COUNSEL AND PROVIDED SOME REGULATORY GUIDANCE TO THE WORKING GROUP SO THE FIVE REVIEW CRITERIA FOR THE INNOVATION APPROACH AND ENVIRONMENT ARE DEFINED BY THE CODE OF FEDERAL FEDERAL REGULATIONS HOWEVER WE HAVE THE DISCRETION AT NIH HOW TO GROUP THE CRITERIA TOGETHER AND WHAT IS RELATED TO SCORING. THE GROUP FORMED BEFORE THE PANDEMIC STARTING JANUARY 2020 WE HAD BLOCK POST WITH COMMENTS THROUGH THE REVIEW MATTERS AND THE OFFICE OF RESEARCH HAS A BROAD AUDIENCE AS WELL WE GOT THE COMMENTS BACK AND WE HEARD FROM SOCIETY AND PROVIDED A CONTENT ANALYSIS TO THE WORKING GROUP AND TOOK THAT SERIOUSLY THERE 11 VIRTUAL MEETINGS TO THE HEIGHT OF THE PANDEMIC TO DEVELOP THE FRAMEWORK AND THE RECOMMENDATIONS. MARCH 2020 WONDERFUL ADVISORY COUNCIL DISCUSSED IN IMPROVE THE RECOMMENDATIONS WE PUBLISH THE WORKING GROUP REPORT ON THE WEBSITE. FOLLOWING THAT PROCESS WE HAVE SIGNIFICANT INPUT FROM NIH HIGH LEVEL EVALUATION ALL THE RECOMMENDATIONS BE MADE SOME MODIFICATIONS AND THEN HAVE FINAL PROPOSAL FROM CENTERED LEADERSHIP FROM SEPTEMBER THIS YEAR. IN NOVEMBER I PRESENTED A HEADS UP AND TOLD YOU WE WOULD BE ISSUING THE ARE AFTER I THAT IS NOT POSTED THAT I HOPE YOU CAN SHARE THAT WITH YOUR NETWORKS. I JUST WANT TO ACKNOWLEDGE OUR WORKING GROUP THAT WAS SHARED WITH SEATTLE CHILDREN'S AND THE DEPUTY DIRECTOR AND HAD A NUMBER MEMBERS OF THE ADVISORY COUNCIL THAT REPRESENTED DIFFERENT TYPES OF RESEARCH AND INSTITUTIONS I'M VERY GRATEFUL TO THEM FOR ALL THE HARD WORK AND THE THOUGHT THEY PUT INTO DEVELOP THE RECOMMENDATIONS. HERE IS THE OVERVIEW OF THE PROPOSED RVG FRAMEWORK THE OVERALL IMPACT SCORE WHICH IS WHAT DEFINES EVERY APPLICATION WILL RECEIVE AND EXPLORE AND THAT DOES NOT CHANGE THE CRITERIA HAS BEEN REORGANIZED INTO THREE FACTORS AMONG THE THEMES OF SHOULD IT BE DONE CAN IT BE DONE AND WILL IT BE DONE? SHOULD IT BE DONE IS A FACTOR NUMBER ONE OF THE CRITERIA THAT WE MUST HAVE. THIS WILL BE SCORED AND AFFECT THE OVERALL IMPACT. THE SECOND FACTOR IS FEASIBILITY THIS WILL ALSO BE SCORED AND AFFECT THE OVERALL EFFECT THE THIRD FACTOR IS EXPERTISE AND RESOURCES THIS WILL NOT BE SCORED BUT WILL AFFECT THE OVERALL IMPACT SCORE WE WILL TALK ABOUT THE DETAILS OF THAT COMING UP. IN ADDITION CURRENTLY WE HAVE ADDITIONAL REVIEW CRITERIA THAT ARE CRITERIA THAT DO AFFECT OVERALL IMPACT SCORE AND ANIMALS ET CETERA THESE WILL REMAIN UNCHANGED FOR THE MOST PART THAT WILL TIGHTEN UP THE LANGUAGE WE HAVE ADDITIONAL REVIEW CONSIDERATIONS THESE ARE ADDITIONAL ITEMS NIH HAS ASKED VIEWERS TO COMMENT THAT NO BEARING ON THE OVERALL IMPACT SO THE PROPOSAL IS TO REMOVE MOST OF THESE FROM THE FIRST LEVEL OF PEER-REVIEWED. NOW GOING INTO A LITTLE MORE DEPTH, HERE YOU SEE ON THE LEFT THE CURRENT SCORING SYSTEM WHERE WE HAVE THE CRITERIA THAT ARE SCORED AND EACH OF THOSE REVIEWERS ARE ASKED TO WRITE STRENGTHS AND WEAKNESSES FOR EVERY CRITERIA AND SCORE THEM BUT THE PROPOSAL WOULD BE THREE FACTORS TO SCORED ONE OF THEM NOT SCORED BUT THE ONE THAT IS NOT THE ITEM THAT IS APPROPRIATE WITH THE EXPERTISE AND RESOURCES THAT ARE PRESENT OR YOU COULD IDENTIFY GAPS NOT SCORED THAT CAN AFFECT THE OVERALL EFFECT. THESE ARE THE ADDITIONAL REVIEW CRITERIA THAT ARE CHANGE FROM HUMAN SUBJECTS AND INCLUSIONS AND THEN RE- SUBMISSIONS AND THEN THEY WILL REMAIN UNCHANGED. AND THESE ARE ADDITIONAL REVIEW CONSIDERATIONS AND IT HAS NO EFFECT ON THE OVERALL SCORE BUT PROPOSING WE MAINTAIN TWO OF THESE BUT WITH THE BIOLOGICAL AND CHEMICAL RESOURCE PLAN SO THAT SUPPORT THEY ARE REQUIRED TO DO. >> I WILL NOT GO INTO DETAIL BUT I WILL FOCUS ON THE MAIN REVIEW SO HERE IS THE PROPOSED FACTOR BUT SIGNIFICANCE IS IF EVERYTHING WORKS DOES IT MATTER? AND ONE THAT CREATES A EXTEND WE HEARD THAT DOES THAT MATTER SOMETHING IS REALLY SIGNIFICANT SO THEY DON'T KNOW HOW THAT YET THEY HAVE TO GET THAT CRITERION SCORE THEY ARE GROUPED TOGETHER AND THE REASON IS IT ALLOWS THE REVIEWER TO WAIT WHAT IS NECESSARY SO THERE MAY BE SOMETHING THAT IS INHERENTLY INNOVATIVE AND THAT COULD GET A GOOD SCORE. AND THEN REVIEWERS WOULD PROVIDE A NARRATIVE OF THE STRENGTHS AND WEAKNESSES. >> SO THIS IS AN APPROACH AND MOSTLY TO HIGHLIGHT THE IMPORTANCE OF RIGOR THERE IS A NUMBER OF QUESTIONS HERE DEPENDING ON THE TYPE OF APPLICATION THAT IT IS A SAMPLE SIZE AND THE ANALYTIC PLANS THE SUBJECTS CONVERTED ANIMALS BUT THEY ARE HIGHLIGHTED HERE AND THEN FEASIBILITY WHETHER THE APPROACH IS FEASIBLE SO THIS WOULD BE SCORED 129 AND THEN REVIEWERS WOULD SHOW MAJOR STRENGTHS AND WEAKNESSES SO THIS IS WHERE WE AT THE NIH TO WHAT IS PROPOSED BY A WORKING GROUP AND ADVISORY COUNCIL. SO IN THIS CASE WITH THE INVESTIGATOR AND REQUIREMENT DATA BUT HOWEVER IT HAS BEEN REWORDED IN A WAY TO PREVENT REPUTATION ALL BIAS FOR THE INVESTIGATOR AND THEN TO FOCUS ON THE SCIENCE AND THE PROJECT. DOES INVESTIGATOR HAVE THE BACKGROUND AND EXPERTISE? IF YES, THERE'S NO NEED TO WRITE A HALF A PARAGRAPH NO WRITE UP AS NEEDED. FULLY CAPABLE. IF THERE IS A NEED FOR MORE EXPERTISE A CAPABILITY THEN WE ASK THE REVIEWERS TO GET SPECIFIC WE WORD SEE WEAKER SCORES OR DEAF BY A THOUSAND CUTS WITH NO REAL WEAKNESS IT JUST DEPENDS ON THE INSTITUTION ENVIRONMENT SIMILARLY THE RESOURCES ARE THERE TO CONDUCT THE PROJECT SUCCESSFULLY COMPLETE THE PROJECT IF THERE IS NO ISSUE AND NO WRITE UP IS NEEDED OR IDENTIFY THE NEED FOR ADDITIONAL RESOURCES IF THERE ARE GAPS WE WANT TO HEAR ABOUT IT WITH THE OVERALL IMPACT SCORE WITH THOSE WELL-TRAINED INVESTIGATORS THAT THEY DON'T ALL EXIST IN CERTAIN AREAS OR INSTITUTIONS. THIS WOULD NOT RECEIVE AN INDIVIDUAL SCORE IF THERE IS A GAP IN EITHER CRITERIA. SO THE CURRENT STATUS CHANGES IS CURRENTLY LOOKING AT HOW WE CAN INCORPORATE INTO THE FRAMEWORK BECAUSE CLINICAL TRIALS ARE VERY DIVERSE AT NIH THE DEFINITION IS DIVERSE AND GETTING THEM TO FIT UNDER THIS WITH THE INCLUSIONS THAT YOU CONSIDER CAREFULLY RIGHT NOW. IT IS ANOTHER MONTH OR TWO AND WHAT THE BRAIN INITIATIVE WAS USING THE BIG PROPOSAL OF THE MAJOR CHANGES THAT CRITERIA ARE OUT. LOOKING FOR PUBLIC COMMENT THROUGH MARCH 10, 2023 GETTING OUT TO YOUR NETWORKS AND SOCIETIES. WE HAVE ESTABLISHED AN E-MAIL BOX. AND THEN A WEBPAGE WITH THE DETAILS WE COULD NOT PROVIDE TODAY. SO I CAN EITHER STOP. BECAUSE THOSE ARE PRETTY SIGNIFICANT I GAVE YOU A HEADS UP THIS WAS COMING DOWN THE PIKE BECAUSE NIH WAS DECIDING WHAT THE WORKING GROUPS HAD PROPOSED AND TO BE ENTHUSIASTIC OF THOSE PROPOSALS SO I AM SHOWING THIS TO YOU NOW SINCE THERE IS NO INTERNAL DELIBERATION PROCESS THERE IS A LOT OF SUPPORT FOR THE ADVISORY COUNCIL. >> SO WE HEARD THESE ARE NOT NEW CONCERNS THAT THE FELLOWSHIP PROCESS AND IT DISADVANTAGES SOME APPLICANTS WHO ARE HIGHLY QUALIFIED AND PROMISING SIMPLY BECAUSE OF WHICH LAB THEY ARE IN OR HOW WELL-FUNDED THEIR SPONSORS ARE. IN SEPTEMBER 2021 WE CONVENED A WORKING GROUP SO WE DO WORK FROM THE INPUT THROUGH THE SCIENTIFIC COMMUNITY AND WE CHARGE THE WORKING GROUP FROM THE FELLOWSHIP PROCESS AND TO RECOMMEND CHANGES AND THEN TO IDENTIFY THOSE OF WHERE THEY HAPPEN TO BE. AGAIN I'M VERY GRATEFUL FOR THE WORKING GROUP INCLUDING MEMBERS OF THE ADVISORY COUNCIL AND WITH THE BIOMEDICAL RESOURCE DEVELOPMENT AND VARIOUS TYPES OF INSTITUTIONS THAT HAVE BEEN SPONSORS AND APPLICANTS AND FELLOWSHIPS AS WELL. GRATEFUL TO THEM FOR ALL OF THEIR HARD WORK. STARTING IN SEPTEMBER 2021 LOOKING AT THE END RSA FELLOWSHIPS IN THE INPUT GATHERING WITH OPEN MIC AND THIS GROUP WAS VERY INTERESTED IN GETTING A LOT OF DATA I WANT TO THANK OUR DATA ANALYTICS TEAM FOR CONSTANTLY PRODUCING THE DATA WE ALSO DID THE CONTENT ANALYSIS AND THEY HELD 12 VIRTUAL MEETINGS OVER THE 11th MONTH PERIOD WITH THE FRAMEWORK AND THE RECOMMENDATIONS BECAUSE IN SEPTEMBER 2022 IMPROVING THE RECOMMENDATIONS WITH ENTHUSIASM AND IN NOVEMBER 2022 THE LEADERSHIP APPROVE THE SAME RECOMMENDATIONS WITH ENTHUSIASM SO HERE WE ARE TODAY. SO I WILL START WITH THE DATA -- IS BASED ON ONE YEAR OF 2021. THESE ARE THE DATA THE WORKING GROUP REQUESTED. THEY WANT TO KNOW WHAT IS THE DISTRIBUTION OF APPLICANTS AND HERE IS THE BREAKDOWN FOR WOMEN AND MEN MORE WOMEN THAN MEN ARE APPLICANTS. IF YOU LOOK AT SPONSORS AND GENDER DISTRIBUTION MORE SPONSORS OR MAIL SEE YOU HAVE EITHER A SINGLE SPONSOR OR TWO OR MORE FOR SINGLE SPONSOR FELLOWSHIPS 31 PERCENT IS MALE 15 PERCENT FEMALE THEN MULTIPLE SPONSORS AGAIN ARE ALL MAIL EXCEED ALL FEMALE. THE BREAKDOWN AGAIN FOR APPLICANTS AND UNDERREPRESENTED MINORITIES IS NOT A FINAL DISTRIBUTION 50 PERCENT OF THE APPLICANTS IN 2021 WERE UNDERREPRESENTED SO SPONSORS IN THE SAME GROUP 3 PERCENT WERE UNDERREPRESENTED MINORITIES THE REST OF THEM BREAKDOWN LIKE THIS. THERE WAS ALMOST NINE MAYBE ZERO THAT MANY TEAMS AND THEN LOOK AT SENIORITY MOST OF THOSE SINGLE SPONSORS OUR SENIOR. SO THIS IS REFLECTING THE COMMUNITY CONCERNS CELL ASSISTANT PROFESSORS MAKE UP A VERY SMALL PROPORTION OF SINGLE SPONSORS. LOOKING AT REVIEW OUTCOMES AND HOW THOSE TRACK WITH THE BANK 225 APPLICATIONS INCLUDE AN ASSISTANT PROFESSOR SPONSOR , 55 PERCENT OF THOSE WERE NOT DISCUSSED. A FULL PROFESSOR AND THOSE THAT WERE NOT DISCUSSED AND THEY CAN DO BETTER THAN THOSE THAT DO BETTER THAN FULL PROFESSOR THAT IS LIKE 18 OR ANOTHER TITLE OR CHAIR OR SOMETHING LIKE THAT. SO THE REVIEW OUTCOMES IMPROVED AS THE ACADEMIC RANK THE SPONSOR IMPROVES WE WENT TO LOOK AT WHO IS SUBMITTING THE APPLICATIONS AND THOSE TYPES OF SUFFICIENT. THE NUMBER OF INSTITUTIONS AND APPLICATIONS SO IN THE LAST YEAR WITH THE THREE ROUNDS OF DATA LAST YEAR 106 INSTITUTIONS SUBMITTED TO THE NIH 15 SENATE OVER 100 APPLICATION THAT IS VERY SCREWED THAT INTEREST OUR WORKING GROUP INCLUDES THREE OF THESE INSTITUTIONS REPRESENTED COMING UP WITH THOSE RECOMMENDATIONS THOSE ARE FACTORIES ARE PRODUCING FELLOWSHIP AND NOT UNEXPECTEDLY BASED ON THOSE THAT ARE SUBMITTED THOSE THAT SUBMIT BETWEEN ONE TO 25 APPLICATIONS THE LAST CALENDAR YEAR 53 PERCENT WERE NOT SUPPORTED THOSE THAT SUBMITTED 100 PLUS APPLICATIONS WERE NOT SCORED WITH THE HIGH IMPACTS NOT UNEXPECTED SO THE COMMUNITY FEEDBACK IT IS SUPPORTED BY THE DATA AND THE SOLICITED FEEDBACK SO IT IS PRETTY RESOUNDING. SO JUST A SMALL NUMBER OF APPLICATIONS SO THE KNOWLEDGE AND THE RESOURCES AND THE ABILITY TO WRITE A REALLY STRONG APPLICATION IS AN EVENLY DISTRIBUTED THOSE THAT ARE COMING FROM HIGH THE RESOURCE SCHOOLS IS A HAVE SENIOR SCIENTISTS ARE A BETTER AND THEN THE BOTTOM LINE CONCERN IS LEAVING OUT PROMISING YOUNG SCIENTIST BECAUSE HE EVER PROCESS FOR SENIOR SPONSORS AS AN OVERLY NARROW FOCUS WITH TRADITIONAL MARKERS OF SUCCESS AND SO THE WORKING GROUP WITH THAT CAREFUL PROCESS COMES UP WITH RECOMMENDATIONS THE TWO MAJOR RECOMMENDATIONS WHICH IS MODIFY THE REVIEW CRITERIA AND THEN THE INFORMATION THE REVIEWERS HAVE ACCESS TO AND ME WILL TALK ABOUT THAT MORE IN DETAIL WITH ADDITIONAL RECOMMENDATIONS WITH OUTREACH AND TRAINING AND PROCESS AS WELL AS NIH WITH HONORABLE MENTIONS WHO MISSED THE CUT OFF. AND WHAT TYPES OF CAREER GOALS I WILL NOT GET INTO THESE ADDITIONAL RECOMMENDATIONS SO BEFORE WE GET THERE THE THREE MAIN GOALS TO MODIFY THE REVIEW CRITERIA ABOUT ONE IS BETTER FOCUS ON THE THINGS THAT MATTER FOR A STRONG FELLOWSHIP APPLICANT THE POTENTIAL OF THE STUDENT, THE STRENGTH OF THE SCIENCE IN THE QUALITY AND THEY MEAN THESE THREE MAIN CRITERIA ALSO TO DEFINE CRITERIA IN A WAY THAT ALLOWS MORE NONTRADITIONAL APPLICANTS TO BE STRONG SMART AND HAVE A CHANCE IN SUCCEEDING WITHOUT DISADVANTAGING THOSE THAT ARE ALREADY ON A TRAJECTORY IN THAT WOULD INCLUDE EVALUATING THE ACCOMPLISHMENTS OF EACH INDIVIDUAL AND THEIR OPPORTUNITIES AND OTHER PERSONAL CHARACTERISTICS THAT CORRELATE TO SUCCESS OR PERSISTENCE AND TENACITY. OF COURSE TO REDUCE THE BIAS OF RPG BY NOT HAVING SPONSOR AN INSTITUTIONAL REPUTATION PLAYED AN APPROPRIATE ROLE OF THE ASSESSMENT IT IS CRITICAL TO A STRONG TRADING PLAN BUT NOT NECESSARILY JUST BECAUSE OF THE REPUTATION SO TO EVALUATE THE SPONSOR WITH RESPECT TO THE QUALITY OF THE SCIENCE HERE IS THE CURRENT REVIEW THERE IS APPLICANT IN A CRITERION FOR RESEARCH TRADING PLAN AND THE INSTITUTIONAL ENVIRONMENT. THE WORKING GROUP RECOMMENDED THOSE THAT CONTRIBUTE TO REPUTATION ALL BIAS OF A STRONG SPONSOR AND INSTITUTION AND INCORPORATE THEM SO IT IS STILL IMPORTANT IN THE CONTEXT OF WHAT TYPES OF TRADING PLANS ARE AVAILABLE. SO THIS IS WHERE THE APPLICATION COMES IN SO THEN TO CHANGE THE APPLICATION TO ASSESS THOSE APPLICATIONS. SO FIRST IN THE MOST OVERWHELMING RESOUNDING FEEDBACK WE HEARD FROM THE COMMUNITY ACROSS THE BOARD WAS TO ELIMINATE BUT INSTEAD OF THOSE FORCES THE STUDENT HAS TAKEN THIS WAS SUPPORTED ACROSS THE BOARD FROM THE ADVISORY COUNCIL FROM THE COMMUNITY AND AGAIN THIS IS BECAUSE SO GRADES ARE NOT NECESSARILY AN INDICATOR OF SUCCESS AS A SCIENTIST SOMEONE THOSE MEETINGS SO THIS IS IN LINE WITH THAT. THE SECOND RECOMMENDATION THIS IS THE SECTION THE APPLICANT FILLS OUT AND THEY SUGGESTED REVISING THE WITH THE PROPOSED CRITERIA TO ALLOW THE APPLICANT A CHANCE TO PRESENT THEIR SCIENTIFIC THINKING AND THEIR GOALS FOR THE FELLOWSHIP. THERE IS A LOT OF REPEATED INFORMATION THESE ARE SHORTER BUT STRUCTURED AND FOCUSED AND THEN TO DO A SELF-ASSESSMENT ABOUT THE GOALS TO DESCRIBE THE ACTIVITIES UNDER THE AWARD PROPOSAL. SO THIS IS IMPORTANT THE CURRENT RESEARCH TRAINING PLAN THE STRATEGY AND CONTRIBUTIONS AND THAT IS IN THE FELLOWSHIP APPLICATIONS THE OTHER TO REVISE THE SPONSOR SECTION TO ALIGN WITH THE NEW REVIEW CRITERIA WHICH MEANS INSTEAD OF WHAT WOULD BE INCLUDED BUT REALLY A GREATER EMPHASIS ON HOW THE SPONSOR WILL TRAIN THE STUDENT REALLY IS MUCH MORE ABOUT THE APPROACH AND THE TARGETED PLAN FOR THE STUDENT AND ASKING A NUMBER OF DIFFERENT QUESTIONS THEY SUGGESTED REVISING THE LETTERS OF SUPPORT THIS IS WHAT SPECIFICALLY SHOULD BE TARGETED TO THE STUDENT OR TO THE APPLICANT IT'S MUCH MORE ON SPECIFIC QUESTIONS BECAUSE LETTERS OF SUPPORT ONLY HAVE ONE LANGUAGE THAT DOESN'T HELP DIFFERENTIATE AND THEN THE LAST RECOMMENDATION IS TO ALLOW AN OPTIONAL STATEMENT SPECIAL CIRCUMSTANCES BECAUSE WE HAVE HEARD SITUATIONS WHERE THERE HAVE BEEN HARASSMENT AND THEN THE PANDEMIC AND OTHER CIRCUMSTANCES THERE IS A LOT OF DISCUSSION RELATED TO THIS TO MAKE SURE IT DOES NOT BECOME REQUIRED BUT I'M INTERESTED TO HEAR YOUR THOUGHTS. THE CURRENT STATUS IS WE WILL HAVE A DISCUSSION HERE TODAY IN THE FEBRUARY MARCH TIMEFRAME IF YOU WANT MORE INFORMATION THERE IS A REPORT PUBLISHED ON THE CSR WEBSITE WHICH IS AN HOUR AND 15 MINUTES LONG WITH THE DETAILS AT THE COUNCIL MEETING I CAN TAKE QUESTIONS. >> I MISS THIS POINT BUT THE BIAS IN THE OFF PUT THAT PRODUCES ARE WE MISSING THE MARK FROM THAT PARTICULAR ASPECT TO APPROPRIATELY ADDRESS DIVERSITY? >> I'M SORRY I MISSED PART OF IT SO WHAT YOU ARE SAYING IS WE SHOULD ADDRESS DIVERSITY QUICK. >> OF THE REVIEW COMMITTEES. >> THANK YOU FOR THAT QUESTION. THIS IS ONE SMALLER PART TO CHANGE THE PROCESS TO PREVENT TOBIAS FROM COMING IN CSR HAS A NUMBER OF MULTIPRONGED EFFORTS I HOPE YOU HAD A CHANCE TO TAKE THE BIAS AWARENESS TRAINING WE HAVE DIVERSIFIED THE PANELS SIGNIFICANTLY WE ARE CONTINUING TO DIVERSIFY THE PANEL TO CREATE A DATABASE THAT ALLOW IT WITH THE REPORTING BIAS AND INTO WE REVIEW THE APPLICATION TO LOOK BACK AT THE REVIEWER TO MAKE SURE THEY UNDERSTAND THAT IS A BIAS STATEMENT AND IF NECESSARY LITTLE FROM THE COMMITTEE TAKING STEPS THIS IS JUST A PART THAT FOCUSES ON THE REVIEW CRITERIA. >> I JUST HAVE A QUESTION ON FACTOR THREE WITH THE OVERALL IMPACT TAKING AND IMPORTANT STEP OF HOW THE FIRST PART IS FACTORED. NOT THE END OF THE DAY YOU GO BACK TO THIS NUMBER THAT REPRESENTS THE FULL PROPOSAL SO ONE QUESTION IS MEANT BY NOT IMPACTING? DID SOMEBODY SAY SOMETHING NEGATIVE FOR CANADA POSITIVELY IMPACT AS WELL AND HOW DO YOU THINK ABOUT THAT STEP WHEN YOU TAKE THAT SECOND STEP BACK. >> THAT'S AN EXCELLENT QUESTION AND I WILL GIVE YOU MY TAKE ON IT. WE ARE TRYING TO REMOVE THE SCORES MOVING TO THE BETTER JUST BECAUSE OF RECOGNITION OR REPUTATION. BUT IF THERE IS A CONCERN WITH NO RESOURCES TO DO THE WORK OR IF THE REVIEWERS FEEL THEY ARE NOT QUALIFIED FOR SOME REASON ALL WE WANT IS A SPECIFIC STATEMENT OF WHAT THAT GAP IS AND THAT SHOULD HAVE MET THE OVERALL SCORE IF THE RESOURCES ARE NOT AVAILABLE IT SHOULD AFFECT THE OVERALL SCORE BUT IT WOULD BRING IT DOWN. I THINK THAT HAS TO COME OUT AND TRAINING THAT YOU BUMP UP THE SCORE FOR FACTOR THREE JUST BECAUSE OF THE FAMOUS PERSON OR APPROPRIATE DOES NOT MEAN THE PERSON GETS IT. WE NEED TO MAKE SURE THERE IS AN OVERALL SCORE IF THERE IS A GAP. >> I HAVE THE SAME QUESTION BUT I FEEL THAT YOU DID NOT ANSWER IT. SO SUPPOSE A FELLOWSHIP APPLICATION COMES IN AND IT IS FANTASTIC AND SIGNIFICANT AND IMPORTANT AND CREATIVE YOU CONSIDER THE FACT IT IS RIGOROUS TICKETS TO, NUMBER NINE THE APPLICATIONS FABULOUS THAN THE THIRD FACTOR IS INAPPROPRIATE SO THEN THIS IS ALL MATH BUT YET IT IS WISHY-WASHY STATEMENT IMPACT ON CURIOUS HOW YOU START TO IMPACT THE SCORE. IF IT IS INAPPROPRIATE RESOURCES IS NOT FUNDED? I DON'T UNDERSTAND THAT THIRD FACTOR. >> THEY TALKED ABOUT TWO DIFFERENT THINGS TODAY THE ONE FACTOR BEING EXPERTISE AND RESOURCES THAT IS FOR THE RPG BEFORE THE FELLOWSHIP IT'S NOT THE FACTOR OR SCORING THE FACTORS ALTHOUGH THERE WERE THREE CRITERIA. LET'S ASSUME YOU ARE TALKING ABOUT THE APPLICATION THAT COMES IN INSTEAD OF FELLOWSHIP THE RESOURCES ARE ABSENT WHERE THERE IS SOME KEY PIECE THAT IS MISSING OR THE INVESTIGATOR HAS NOT BEEN TRAINED IN THE APPROACHES PROPOSED, THAT SHOULD NEGATIVELY IMPACT THE OVERALL IMPACT SCORE. >> HOW? IF YOU HAVE A FANTASTIC APPLICATION WE BE HAS WRITTEN A FABULOUS APPLICATION BUT YET YOU SAY THAT ALL HAVE THE EXPERTISE MAYBE THIS PERSON IS A SMART MAYBE THEY CAN GET ON THEIR OWN BUT I AM REALLY CURIOUS HOW YOU USE THAT FACTOR NUMBER THREE TO CHANGE THE SCORE WHEN YOU SAY IT IS NOT SCOREABLE. >> EVEN NOW WITH THE FIVE CRITERIA REVIEWERS HAVE TO EXPLAIN WHAT CAUSED THEM TO GET THE OVERALL IMPACT SCORE THEY HAVE TO DO THAT WITH THE FACTOR -BASED SYSTEM WITH THE GAP THE RESOURCES. IT'S NOT A MATHEMATICAL FORMULA IT IS NOT NOW IT WILL NOT BE THAT BUT THE IMPORTANT TWO FACTORS IS THE DASHES CLEARED THE THIRD FACTOR YOU WANT THE EXPERTISE AND RESOURCES TO BE THERE FOR MOST PEOPLE IT WILL BRING IT DOWN THOSE TO JUSTIFY TO THE REST OF THE COMMITTEE. >> YOU DON'T FEEL LIKE YOU ARE ANSWERING MY QUESTION BUT LET'S MOVE ON. APPARENTLY IN JANUARY IT WILL BE A DATA SHARING PLAN AND WHERE WILL THAT COME? THAT FACTOR NUMBER TWO THERE IS THAT PART OF ADDITIONAL INFORMATION? THAT WAS NOT LISTED IN YOUR ADDITIONAL INFORMATION. >> IT IS NOT THAT DATA SHARING IS SIMPLY LOOKING AT THE BUDGET IF IT IS THAT APPROPRIATE THAT THE REVIEW WILL NOT EVALUATE THE DATA SHARING PLAN. >> CAN WE GO BACK TO THE QUESTION HE FELT WAS NOT ADDRESSED? IN OTHER WORDS YOU HAVE THE FIRST TWO ELEMENTS WHICH ARE STORED EVERYBODY KNOWS WHAT NINE AND EIGHT BUT THAT THIRD ELEMENT IS NOT SCORED BUT COMMENTED. IS IT FAIR TO SAY, IF I PUT IN AN APPLICATION AND I WENT TO SOLVE THE STRUCTURE OF A MOLECULE AND NOWHERE IS THERE AT THE GOVERNOR ANY EVIDENCE TO USE CRYO- TO SOLVE THE STRUCTURE. WOULD IT BE SAFE TO SAY SOMEBODY WITH COMMENT HE IS OKAY WHAT A BEAUTIFUL PROPOSAL BUT HE'S NEVER DONE THE THINGS HE SAYS HE CAN DO THE COLLABORATORS DON'T SEEM TO EITHER SO WHEN THE FINAL SCORE IS ARRIVED AT IS THAT CONSIDERED AS PART OF THE OVERALL SCORE OR BOTH WHEN THE PROGRAM STAFF REVIEW THE SUMMARY STATEMENT I PRESUME THEY WILL BE FOR WHATEVER THAT SPECIFIC COMMENT IS CORRECT AS OPPOSED TO WHAT HAPPENS NOW WITH THE SCORE BUT YOU DON'T KNOW WHY MAKING THE NUMBERS THAT SAID ABOUT ONCE I GOT A SET BECAUSE THERE IS NO STRUCTURAL STUDY IS THAT WAS THE ESSENCE OF THIS IS? >> EXACTLY THE GOAL IS TO MAKE IT GET VERY SPECIFIC TO THE CRITERIA RIGHT NOW THERE IS THAT CAN BE PUT IN A SCORE TO THE INVESTIGATOR THAT HERE WE FORCE THE REVIEWERS TO ASSESS BASED ON VERY SPECIFIC CRITERIA OUTLINED VERY SPECIFIC CONCERNS BUT IT SHOULD INFORM THE OVERALL SCORE. IF IT WERE UP TO ME WE WOULD GET VERY SPECIFIC. >> DOES THAT HELP QUICK. >> NOT MUCH BECAUSE THE DATA POINT OF THE OVERALL SCORE AND THAT IS NINE IF YOU GET TO NUMBER NINES EDITS A NUMBER FOUR IF YOU GET TO NINES BUT THIS PERSON CANNOT DO IT? >> I DON'T THINK THAT'S THE CASE. >> THAT'S WHAT IT SOUNDS LIKE. >> AT LEAST FOR NOW THE BIG ADVANCES THEREFORE THERE WAS VAGUENESS LIGHT ENVIRONMENT WAS NOT GOT TO BE APPROPRIATE FOR A PERSON'S BACKGROUND IS NOT THOUGHT TO BE APPROPRIATE BECAUSE SADLY IN MANY INSTANCES BECAUSE THEY WERE NOT IN A TOP TEN SCHOOL. THIS IS SOMETHING I'VE WITHOUT FOR 25 YEARS BECAUSE I LIVED IT. SO NOW AT LEAST WITH SPECIFICITY THIS GUY SAYS HE WILL DO XYZ SO YOUR POINT MAYBE HE CAN FIGURE IT OUT, BECAUSE I DID IT IS APPROPRIATE AND IS UP TO THE REVIEWERS AND IT'S UP TO PROGRAM STAFF STATES NUMBER TWO TO SAY WAY TO TAKE GOD AT NINE AND NINE AND THIS COMMENT XYZ AND I THINK THE PROGRAMS THAT YOU USE THEIR INSIGHT IF THAT MAKES SENSE NOT TO SUPPORT THE APPLICATION GOING FORWARD. >> BUT THAT FACTOR NUMBER TWO IS FEASIBILITY AND THEN CAN ADDRESS IF IT IS FEASIBLE THE APPLICANTS VIEW THE POWER TO SAY IT IS FEASIBLE EVEN THOUGH I DON'T HOW THAT EXPERTISE BECAUSE. >> THAT IS THE CASE NOW. ABSOLUTELY. >> I THANK YOU ARE RIGHT FOR A GOOD PROPOSAL THAT ADDRESS THAT HEAD ON THE OF IT'S NOT A GOOD PROPOSAL AND I HEADED AND WILL NOT GET THE NUMBER NINE? IM UNCOMFORTABLE WITH THE WISHY-WASHY OF NUMBER THREE. >> IT IS MORE WISHY-WASHY NOW. >> I THINK THIS REVEALS AS IT GOES OUT INTO THE COMMUNITY WHETHER OR NOT THIS COMES OUT IN THE REQUEST FOR INFORMATION OR NOT, I DON'T KNOW BUT IF PEOPLE IT CLOSELY WHEN YOU PUT INTO MOTION A LOT OF THIS WILL GIVE GUARDRAILS MORE THAN ANYTHING ELSE BECAUSE REALLY THE JUDGMENT IS BE ALREADY AND YOU ARE TRYING TO REMOVE THE POSITIVE BIAS SO IT CAN'T HELP YOU NOW THAT IT CAN DO YOU AND WHAT IS DISTURBING TO SOME OF US BY HOW MUCH? IS THAT WILL CONSIDER IT OR NOT. >> RIGHT NOW THE APPROACH IS SIGNIFICANT BY FAR THAT'S WHAT YOU HAVE THE CORRELATION ARE YOU ON THE CALL? >> THAT'S AN IMPORTANT POINT TO MAKE IT'S NOT BASED ON ALGEBRA IT IS A SEPARATE OVERALL THOUGHT OF WHAT IT SHOULD BE. WE HAVE DONE SOME EMPIRICAL ANALYSIS FOR WHAT IS IT STRONGLY CORRELATES WITH THE IMPACT SCORE AND FAR AND AWAY IT IS THE APPROACH WITH THE INVESTIGATOR AND ENVIRONMENT TO BE UNCORRELATED. IF YOU HAVE A NUMBER ONE APPROACHING THE SIGNIFICANCE A NUMBER TWO WITH INVESTIGATOR THEN IT'S NOT ONE PLUS ONE PLUS TWO DIVIDED BY THREE IT DOES NOT WORK THAT WAY. IT IS AN OVERALL IMPRESSION BASED ON A GENERAL CONSENT. >> JUST TO CLOSE THE LOOP ON THIS THOUGHT IF IT IS MORE OFTEN THE CASE NOW THAT THERE IS SOME COMMENT MADE ABOUT ENVIRONMENT THAT WITHOUT ANY SPECIFICITY SO NOBODY REALLY KNOWS WHAT THE ISSUE IS THAT WITH THIS NEW APPROACH IT IS MUCH MORE SPECIFIC AND FINALLY WE HAVE INSIGHT TO THE CONCERN IS THAT ACCURATE? >> YES. THAT IS PARTLY ACCURATE THE OTHER PART IS SCORES ARE GIVEN RIGHT NOW THAT ARE NOT JUSTIFIED BY WHAT IS WRITTEN AND ARE CLEARLY BASED ON BIAS SO WE ARE TRYING TO GET MORE SPECIFIC AND OFTEN ANY THIS ANSWERS YOUR QUESTION, JUDITH. >> I'M NOT SURE IF IT DOES. [LAUGHTER] >> WE NEED A DIFFERENT QUESTION. [LAUGHTER] >> I WILL MOVE ON SO IF YOU WANT TO TALK ABOUT THE POLICY. >> IF YOU CANNOT SEE THE CHAT IT'S IN RELATION TO A POLICY RELATIVE TO OPPORTUNITY. >> WANTED TO MAKE SURE I DIDN'T MISS ANYTHING SO A NINE IS VERY GOOD AND ONE IS VERY BAD SO HOW DO WE HANDLE THAT CATEGORY? IF THE GRADE GOES IN AND SOMEBODY GETS TO NUMBER ONE'S THAT THEN THE INVESTIGATOR SAYS IN MY RESOURCES IT'S LISTED AT THE SQUARE GOES DOWN DOES THAT GO BACK TO THE BEST A GATOR OR CAN THEY CALL THE PROGRAM OFFICER AND SAY I HAVE IT ISSUED IN THE PROGRAM ARE COLLECTED CORRECTED? >> IT IS THE LATTER BECAUSE THE FACT WE ARE GETTING SPECIFIC NOW HELPS THAT CONVERSATION AND POST REVIEW WHEN WE DO THE TRADING AND ROLL THIS OUT WE WILL MAKE SURE WE VIEWERS ARE PAYING ATTENTION TO MAJOR ISSUES AND NOT MINOR ISSUES BUT WE HAVE 19000 REVIEWERS WILL PAY ATTENTION THAT WILL BE RESOLVED. >> BENEFITS CONCRETE THERE IS A PROBLEM WITH THE BUILDING CAN THE INVESTIGATOR IMMEDIATELY COME BACK QUICK. >> THEY CAN TO PROGRAM AND THE PROGRAM CAN DECIDE RIGHT NOW THE ISSUE IS THERE ARE ARBITRARY COMMENTS NOT EVEN A COMMENT BUT IT'S A SCORE OF FOUR YOU FIND OUT FROM THE HBCU AND YOU LOOK AT BIAS TRADING YOU SEE THE TESTIMONY OF BEGINNING THAT TALKS ABOUT THAT. >> THANK YOU FOR THIS DISCUSSION AND PRESENTATION AND WENT TO ACKNOWLEDGE IT SEEMS THAT YOU ARE FAVORING A PROJECT -BASED EVALUATION. SO THE ORGANIZATION THAT HAS THE OPPOSITE PHILOSOPHY SO THAT IS ON PEOPLE FIGURING OUT THE PROBLEMS AS THEY GO ALONG IS THAT THE POINT YOU ARE TRYING TO DO BECAUSE THE CURRENT EVALUATION PUTS LIP SERVICE THAT THIS PERSON HAS AN AMAZING TRAJECTORY SO THE SECOND POINT IS YOU SHOWED THIS DATA ABOUT THE APPLICATION FOR TRAINING GRANTS I WOULD GUESS IT WOULD BE THE SAME BUT THE APPLICATION OF SCIENCE ITSELF I'M NOT SURE THAT'S A PROBLEM BECAUSE IT IS A REFLECTION OF EXPERIENCE SO YOU KNOW WHAT TO LOOK AT AND ALL THOSE KINDS OF THINGS. SO I AM JUST WONDERING. >> THE DATA SHOWED WAS RELATED TO FELLOWSHIP APPLICATIONS THAT THE EARLIER QUESTION THAT YOU ASKED I THINK THE DATA WAS ABOUT THAT IT DIDN'T CORRELATE WHAT YOU SAID BEFORE BUT ABSOLUTELY EVEN AT THE NIH THAT MANY INSTITUTES ARE USING THAT IN THAT SPACE OF THE ENTERPRISE THERE IS ROOM FOR RESEARCH PROJECT ANSWERS ARE IMPORTANT AND THERE IS ROOM TO HAVE THOSE AWARDS IT IS A COMPLETELY DIFFERENT SET OF CRITERIA WE ARE TRYING TO STOP THE REPUTATION TO REDUCE THE EFFECT OF REPUTATION ON WHETHER THE PROJECT IS GOOD WHETHER IT CAN BE DONE SO THAT'S WHERE IT COMES FROM WITH THE RPG THOSE FELLOWSHIPS ARE BASED. >> BUT THEN YOU ARE REMOVING THE INVESTIGATOR AS SOMEBODY THAT YOU ARE NOT. >> IT IS SIGNIFICANT AND INTERESTING AT THE TRADING PLAN IS GOOD IF IT'S NOT THE EXPLICIT CRITERIA ANYMORE? >> FOR FELLOWSHIPS THE FELLOWSHIP APPLICANT AND HIS OR HER EXPERIENCE AND HOW THAT ALLIANCE WITH FUTURE GOALS AND THE SCIENCE IS STILL THERE BECAUSE IT MATTERS BUT VERY MUCH BASED ON POTENTIAL FOR TRAINING A FELLOW TO BECOME A FUTURE BIOMEDICAL BEHAVIORAL RESEARCHER. NOT THE WHOLE GOAL OF THE ENTIRE EFFORT. >> THANK YOU VERY MUCH FOR THE PRESENTATIONS WHEN YOU REVIEW THE FACTORS WITH THE QUALITY OF THOSE SIGNIFICANTLY THE FACTOR I AND FACTOR TO AND EVEN FACTOR THREE. AND SO YOU ARE COMING BACK INTO THE ISSUE TO SAY WHY THEY SAY THIS PERSON IS NOT QUALIFIED AND WHY THEY ARE NEGATIVELY EVALUATING THE INVESTIGATOR. >> AND THAT PROCESS TO ME AND THEN YOU JUST FORCE THEM AND PUT THAT INFORMATION IN THE BOX AND THEN IT WITH THAT SPECIFIC INFORMATION AND THEN TO GET THAT EVALUATION ABOUT THIS NEGATIVITY IF IT IS MINUS ONE OR MINUS TWO OR MINUS TEN BECAUSE THE CONCERN IS SOMEBODY HAS TO DECIDE SHOULD I STILL DO WITH IT OR NOT? THE MOST LIKELY THEY WILL SAY NO. BUT THEY ARE NOT THE BEST EXPERT IN THE SUBJECT MATTER. AND NOT HAVE ENOUGH TIME OR EXPERTISE SOMEBODY HAS TO MAKE A DECISION. SO YOU CAN GET WHAT YOU WANT BUT AT THE SAME TIME LEAVE SOME SPACE FOR THE PERSON TO SAY. >> LET ME MAKE SURE THAT I COMMUNICATE THIS AVAST MAJORITY WITH THE WELL-QUALIFIED AND MOST OF THEM ARE APPROPRIATE AND WILL MOVE ON. THE FACT THAT IT'S NOT SCORED COMPARED TO THE FIRST TWO FACTORS. THERE IS A CONCERN I'M NOT THINKING THERE MANY MORE NEGATIVE COMMENTS. AND THEN TO SCORE THE FACTOR THAT DOES NOT MAKE SENSE WITH CRITERIA. >> AND THEY ARE FORCED TO CHOOSE ONLY NEGATIVE POINTS , FACTOR OF ONE TO TEN IT IT'S MUCH INTO THEIR OWN INTERPRETATION SO THAT PROCESS PERIOD REVIEW WITH INDIVIDUAL REVIEWERS ASSESSMENT. THE HOPE IS THE REVIEWER'S RIGHT IN A VERY EXPLICIT WAY WHAT THEIR CONCERNS ARE AFTER. REVIEW. I'M NOT SURE ADDING A SCORE THE MANY PET NUMBERS IN FRONT OF PEOPLE IT WOULD MAKE IT MORE CONFUSING THAT IT'S PRETTY SIMPLE PROCESS IS APPROPRIATE IT'S A CONCERN YOU LIST THE CONCERN WE HAVE POST REVIEW EVALUATIONS AND THIS IS ONE OF THOSE. >> I GUESS IT IS THE NIH DECISION SO I REALLY DON'T SEE WHY THEY CANNOT EXPLAIN TO BE VERY EXPLICIT TO JUSTIFY IT AND THAT WOULD GIVE ENOUGH INFORMATION. >> THEY WILL HAVE A LOT OF INFORMATION AND THAT ASPECT IMPACTS IT'S DIFFERENT FOR EVERY REVIEWER AS IT IS NOW. >> ONE MORE THAN ME WILL BE AT TIME FOR BREAK. >> I WANT TO MAKE TWO POINTS I WANT TO COMMENT ON THE DISCUSSION ABOUT THE SCORING. I JUST WONDER IF YOU THROW OUT THE BABY WITH THE BATHWATER THAT THERE IS VALUE IN SCORING I DO THINK THERE IS VALUE IN SOME OBJECTIVE SCORE TO ASSESS THE INVESTIGATOR I DON'T THINK INVESTIGATORS ARE IRRELEVANT I THINK HOWARD WAS TRYING TO MAKE THAT POINT AND I DO THINK THERE IS VALUE SO IM PUSHING BACK ON ELIMINATING THAT I'M JUST NOT SURE FOR A NUMBER OF THE REASONS BROUGHT UP WITHOUT A SCORE IT'S HARD TO EVALUATE HOW THAT CRITERIA COMES INTO THE FINAL OVERALL SCORE. I DON'T KNOW. I JUST WONDER IF THERE SHOULD BE MORE DISCUSSION AT THIS POINT BEFORE A FINAL DECISION IS MADE ABOUT WHAT TO DO ABOUT THE INVESTIGATOR SCORE I THINK IT'S BETWEEN OUR 35 AND NO IMPACT. >> ABSOLUTELY. THE INVESTIGATOR IS QUITE IMPORTANT FOR A RESEARCH PROJECT GRANT BUT THAT'S NOT WHAT WE ARE SAYING. THE INVESTIGATOR SHOULD AFFECT THE OVERALL SCORE. THAT STILL AFFECTS THE OVERALL SCORE WHICH IT DEFINES THAT OVERALL IMPACT SCORE BUT ALWAYS SAY SO IN THE CONTEXT OF THE PROPOSED WORK. >> I UNDERSTAND. BUT THERE ARE ELEMENTS OF THE INVESTIGATOR THAT COME TO BEAR ON WHETHER PROPOSED WORK IS GOING TO BE ABLE TO BE CARRIED OUT AND GO BEYOND THE CENTRIFUGE ANYWAY. THAT IS ONE POINT I WANT TO MAKE. THE OTHER POINT IS ABOUT IF YOU HAVE DISCUSSED WHAT HAS BEEN ON MY MIND IF THERE SHOULD BE A REQUIREMENT FOR SERVICE ON REVIEW. RIGHT NOW I DON'T BELIEVE THERE IS AND I FEEL THAT EVERYONE SHOULD BE CONTRIBUTING TO THE REVIEW PROCESS. I THINK IT IS SKEWED BY NOT HAVING A REQUIREMENT FOR SERVICE ON REVIEW. AND ONCE I AM OFF A CD I WILL OFFER TO REVIEW AT LEAST ONCE A YEAR AND MORE ESTABLISHED PEOPLE SHOULD. RIGHT NOW I THINK IT'S NOT REPRESENTATIVE OF THE COMMUNITY THAT IS FUNDED. AND I THINK IT SHOULD BE. DID YOU DISCUSS THIS ASPECT? ANY THOUGHTS ON THAT QUICK. >> THIS IS THE BEST WORKING GROUP BUT WITH CSR AND THOSE EFFORTS WE ARE MAKING ME LOOK CAREFULLY AT OUR RECRUITMENT. I THINK LEGALLY WE CANNOT REQUIRE PEOPLE GETTING FUNDED TO SERVE. I WILL DEFER TO THE LEGAL MINDS HERE BUT I DON'T THINK THAT LOOKING CAREFULLY AT RECRUITMENT WE ARE TRYING TO MOVE IN THE OTHER DIRECTION TO MAKE SURE WE HAVE A MUCH BROADER POOL OF REVIEWERS NOT JUST THE PEOPLE WHO ARE FUNDED BECAUSE THAT DOES CREATE A CYCLE WE WANT A GOOD PROPORTION OF THOSE WHO ARE FUNDED TO SERVE BUT WE ALSO WANT THE STAFF TO INVITE PEOPLE WERE FUNDED BY OTHER AGENCIES SO WE ARE CREATING DATABASES TO INCORPORATE FUNDED INVESTIGATORS TO ALLOW STAFF. >> THAT MAKES GOOD SENSE BUT THAT IS A GOOD IDEA BUT THE OTHER POINT THAT INVESTIGATORS WHO HAVE COME TO THE SYSTEM AND FUNDED BY THE SYSTEM SHOULD HAVE AN OBLIGATION TO PROVIDE EVALUATION FOR GRANTS GOING FORWARD IT WOULD BE THE CHANGE IN THE STATUTES. >> WE CAN INCENTIVIZE THE REVIEW. YOU CAN HELP US WITH THOSE DEVICE WE COMMUNITIES AND WORKING ON SOME STRATEGIES. >> UNFORTUNATELY THERE ARE A SUBSET THAN THAT -- INDIVIDUALS AND I'M SAD TO SAY THAT. >> I UNDERSTAND THAT THERE ARE WAYS TO ELIMINATE THE GROUP WITHOUT HAVING A REQUIREMENT FOR A BROADER SWATH. >> IT IS A BALANCE BUT HAVE A CHANGE IN STATUTE TO REQUIRE THAT. IS THAT ACCURATE I KNOW WE ARE OVER TIME. >> YES. THAT IS CORRECT. >> WE HAVE FOUR HANDS UP I PROPOSE WE GO OVER BUT MAYBE IF WE CAN LIMIT TO FIVE MINUTES IF YOU CAN BE VERY QUICK IMPRECISE THAT WOULD BE HELPFUL TO MAKE SURE WE GET A LITTLE BIT OF A BREAK BEFORE THE NEXT SESSION. >> JUST A QUICK COMMENT AND THEN A QUESTION WITH REGARDS TO THE COMMENT I ENJOY INVESTIGATOR SCORES BUT IT'S LARGELY BECAUSE I'M GOOD AT POSTDOC. I CAN TAKE AWAY THE CHANGE CAN THIS BE DONE OR CAN IT NOT BE DONE IN THAT CASE? SWEATS COMING OUT IS FROM THE YOUNGER POPULATION BUT I DO HAVE A QUESTION WITH REGARDS TO PROCESS SO IS THE SCORE THE FIRST TWO CATEGORIES IS ASSIGNED TO WHEN I GET THE GRANT AND REVIEW TO SEND DAD IN DOES THE LAST CATEGORY IS THERE A-MODIFYING NUMBER? SO WHEN DOES THAT ADJUSTMENT COME IN QUICK. >> IT IS NOT THAT GRANULAR BUT IF YOU ARE A REVIEWER YOU WILL SUBMIT A CRITIQUE OF FACTOR ONE OR FACTOR TO AND YOU WILL DROP DOWN TO MAKE AN ASSESSMENT. THERE IS A GAP AND YOU SUBMIT THE CRITIQUE WITH AN OVERALL SCORE IT IS NOT A MATHEMATICAL AVERAGE THAT OVERALL SCORE IS THE ONLY THING WE LOOK AT. >> PEOPLE ARE DROPPING OFF AND MOVING AROUND. >> THIS SEEMS VERY HIGH STAKES WITH THAT UNINTENDED CONSEQUENCES YOU DON'T GET THE KINKS OUT OF IT BUT IF THERE IS AN OPPORTUNITY TO FIELD TEST THIS IN PARALLEL? BECAUSE IF YOU HAVE A GRAND IN FRONT OF YOU, YOU MIGHT BE ABLE TO DESIGN OR TAKE SOME GRANTS PREVIOUSLY DONE AND PULLED TOGETHER AND SIX MONTHS LATER WHEN THEY WERE FORGOTTEN , I THINK SOUND TESTING IN THE FIELD MIGHT NOT BE HELPFUL TO ENSURE PEOPLE ARE FINDING OTHER WAYS TO PUT THE SYSTEM DOWN. >> THANK YOU. >> ARE YOU APPLYING THE SAID CRITERIA TO THE POSTDOCTORAL TRAINING GRANTS OR HAVE YOU THOUGHT ABOUT HOW YOU WILL REVIEW THOSE? THAT CAN BE A YES OR NO. >> THE POST DOC TRADING GRANTS IS WHAT I TALKED ABOUT IN THE SECOND HALF OF MY PRESENTATION. THAT IS WHAT WE ARE PROPOSING HAS CHANGED WE WILL PUT THAT OUT. >> THAT WAS ALSO TRAINING GRANTS YOU MEAN T30 TO THE GRANT? KNOW. IT DOES NOT APPLY. >> THANK YOU SO MUCH WE APPRECIATE THE DISCUSSION. >> THE GROUP DESERVES A BREAK. IF WE CAN BE BACK BY 3:00 O'CLOCK WE WILL GO TO THE NOVEL AND ALTERNATIVE METHODS DISCUSSION. >> IT LOOKS LIKE WE HAVE MOST PEOPLE BACK ON. >> DO WE HAVE A QUORUM? >> WE SHOULD BE GOOD. >> SO NOW WE WILL KICK THINGS OFF A WORKING GROUP YOU HEARD A LITTLE BIT ABOUT IN NOVEMBER ABOUT ALTERNATIVE METHODS AND WILL DETAIL OUT THIS TOPIC FURTHER FOLLOWING THE NOVEMBER DISCUSSION WHAT THEY STARTED TO DO CONSIDERING GOING FORWARD. >> IAM DELIGHTED TO BE HERE IN PERSON WITH YOU WE DISCUSSED THIS BRIEFLY BUT THIS TIME IT WILL BE MORE ENGAGING AND ROBUST CONVERSATION BECAUSE WE ARE JOINED BY THE COCHAIR HOWARD CHANG I WILL TURN IT OVER TO YOU TO START THE CONVERSATION. >> THANK YOU AND GOOD AFTERNOON EVERYBODY AND GLAD YOU JOINED ME VIRTUALLY AND THE PHYSICIAN SCIENTIST AND WE ARE EXCITED TO TALK TO ABOUT A NEW WORKING GROUP PROPOSED FOR ALTERNATIVE METHODS. WE ARE EXCITED TO BE LOOKING AT A TIME THE MEETING TECHNOLOGY CREATING FROM SIGNIFICANT OPPORTUNITIES. I WILL START WITH TWO EXAMPLES THE LAST FROM MY FIELD THE CHALLENGE IS TO UNDERSTAND THE GENETIC BASIS OF DISEASE THERE ARE DOZENS OF HUNDREDS VARIANCE THAT CONTRIBUTE TO DISEASE AND THEY HAVE A SEA OF MANY OTHER DIFFERENCES THAT TO OUR KNOWLEDGE ARE NOT FUNCTIONAL SO WITH THOSE MULTIPLE ADVANCES IN TECHNOLOGY TO MAKE IT POSSIBLE TO CONTROL WHERE GENES TURN ON AND OFF WITH THE ONE MILLIONFOLD INCREASE AND THEN TO DIRECTLY STUDY HUMAN TISSUES DOWN TO THE SINGLE CELL LEVEL. THE SECOND CHALLENGE THEY WORK TOGETHER IN COMBINATION AND THERE IS A HUGE ASTRONOMICAL NUMBER OF POSSIBILITIES SO IN THE PAST THEY TEST THEM ONE AT A TIME BUT IT WASN'T FEASIBLE BECAUSE THOSE COMBINATIONS THAT WE WILL NOT GET THERE SO HERE ADVANCES IN COMPUTATION OF MACHINE LEARNING MADE POSSIBLE TO SORT TO THE POSSIBILITIES AND IDENTIFY THE CAUSAL CHANGES IN GENETIC DIFFERENCES. ON THE RIGHT IS THE EXAMPLE LOOKING TO MAKE IT POSSIBLE TO STUDY INTERACTIONS BETWEEN THE DIFFERENT CELL TYPES WITH A MUCH GREATER LEVEL. SO NOW I WILL HAND IT BACK TO LYRIC TO SUMMARIZE. >> AND WE WANT TO TALK ABOUT WHAT WE MET BY ALTERNATIVES IN THIS CASE SEVERAL OTHER STAKEHOLDERS IN THE GOVERNMENT ARE PROMPTED TO USE THE TERM ALTERNATIVE METHODS AND HAVE CHOSEN TO USE THIS TERM FOR SHORTHAND WHILE LIKE KNOWLEDGE EATING THE CONVERSATION THINKING OF SOME OF THOSE NUANCED NUANCES BUT THE FACT THEY RELY ON A COMBINATION OF TECHNOLOGIES SO THE USE OF ANY GIVEN APPROACH IS THAT APPROPRIATENESS SO FOR THE PURPOSES OF OUR CONVERSATION TODAY WE ARE LOOKING AT THOSE APPROACHES THAT ARE COMPLEMENTARY TO TRADITIONAL ANIMAL MODELS THAT TAKE ADVANTAGE OF NEW TECHNOLOGIES AND CAPABILITIES OF RAPIDLY ADVANCING RESEARCH LANDSCAPE WHAT WE ARE TALKING ABOUT TODAY. DISCUSSING BRIEFLY FROM LAST TIME THEY ARE IN THREE BROAD CATEGORIES THOSE THAT ARE EXPERIMENTS LIKE DNA OR PROTEINS OR TEST TUBES OR IN VITRO METHODS AND THOSE COMPUTATIONAL MODELS TO STIMULATE HOW THESE SYSTEMS WORK AND PREDICT OUTCOMES TO REFINE HYPOTHESIS THIS IS THE BUCKETS AND IT'S IMPORTANT FOR THAT TYPE OF CONTEXT SO FOR THE FOUNDATION TO THE PRESENT DAY I HAD A STRONG INTEREST OF SUPPORTING THE DEVELOPMENT AND USE OF ALTERNATIVE METHODS SO I AM SHARING THE TRAJECTORIES NOTE THIS DOES NOT INCLUDE CLINICAL RESEARCH THIS IS REALLY THE INTERSECTION OF THE TECHNOLOGICAL LANDSCAPE'S YOU CAN SEE WE HAD A HUGE SLOPE INCREASE OVER THE LAST DECADE THESE ALTERNATIVE METHODS ARE BOTH DEVELOPED HERE AND APPLIED IN A WIDE RANGE OF AREAS TO SURFACE COMPLEMENTARY APPROACHES WE HAVE SEEN THE SAYS NEW EXPERIMENTAL APPROACHES REGARDING 3D PRINTING AND SIGNAL TRANSDUCTION BUT ALSO SERVING AS ADDITIONAL COMPLEMENTARY CONDITIONS OF THOSE HOLISTIC PICTURES OF INFECTIOUS DISEASE SO IN THIS MODEL YOU SEE THIS INTERNAL ANALYSIS WE CONDUCTED THE LARGER CIRCLES REPRESENT A HIGHER NUMBER OF PROJECTS AND THE THICKNESS OF THE LINE IS THE CONNECTIVITY THIS IS JUST A ROUGH ANALYSIS TO UNDERSTAND WHERE THE POTENTIAL WAS. >> BEFORE WE GET MUCH FURTHER DOWN WE WENT TO EMPHASIZE THE DEVELOPMENT OF ALTERNATIVE METHODS MAY INCREASE THE TOOLS AND REDUCED AND REFINED THE FUTURE USE OF SOME RESEARCH AREAS THIS IS THE CONVERSATION WE HAVE TODAY WITH THERE IS PROMISE AND POTENTIAL AND FOR THE FORESEEABLE FUTURE OUR POSITION ALL APPROACHES WILL BE NECESSARY INCLUDING TRADITIONAL ANIMAL MODELS TO ESTABLISH THE RIGOROUS EVIDENCE NEEDED FOR BASIC DISCOVERY THIS EXPLORATION IS NOT AN OPPOSITION TO ANY OTHER APPROACH THAT IS INTENDED TO SPUR COMPLEMENTARY APPROACHES TO ADVANCE SCIENCE. HOWARD I WILL TURN IT BACK OVER TO YOU. >> TO HAVE THE BEST TOOLS FOR THE JOB AT HAND THAT PROGRESS AND SCIENCE DEPENDS ON THE TECHNIQUES AND NEW DISCOVERIES AND CONCEPTS AND IN THAT ORDER WE HOPE THAT IS TRUE SO IF WE LOOK AT THE LANDSCAPE THERE ARE OPPORTUNITIES AND CHALLENGES SO IN SOME CASES THE IDEA OF ALTERNATIVE METHODS SHOULD BE SOME TOXICOLOGY OF WHAT'S GOING ON WITH THOSE COMPOUNDS INTERACT BECAUSE THERE IS HISTORICAL DATA BUT IN OTHER CASES ESPECIALLY COMPLEX INTERACTION AND FURTHER THE ISSUE OF TRANSLATE ABILITY THIS WAS TO THE AUTHENTICATION AND IMPORTANCE IS FOR STANDARDIZATION AND VALIDATION THESE ARE NECESSARY TO BENCHMARK AND NECESSARY STRATEGIES BUT ALSO TO GET COMMUNITY BUY-IN WE CAN SOLVE THE PROBLEM FOR BETTER QUALITY SOLUTION ALSO FOR REGULATORY CONSIDERATIONS TO WITH THAT THERAPEUTIC DEVELOPMENT IS THERE A PUBLIC TRUST IN THOSE NEEDS TO DISCUSS STAKEHOLDERS WORKING ON THE REGULATORY SIDE. AND ITS LOCAL COMPLEMENTARY SOLUTIONS ARE NEEDED TO GET TO A TRUE ANSWER AND HERE IS ANOTHER EXAMPLE REGARDING STUDIES THESE ARE DNA MUTATIONS BUT THE WAY THE ADVANCES WERE MADE FROM A GENETIC ANALYSIS VERIFYING THOSE ACTIONS OF HUMAN BRAIN TISSUES BUT ALSO IN TACT ANIMALS AND ALSO WITH THE CHEMICAL SCREENINGS ALL OF THE METHODS TOGETHER PROVIDE MUCH MORE ROBUST INFORMATION ON THOSE ISSUES OF INTEREST. AND WE HAVE ALREADY SEEN AGAIN AND AGAIN THERE IS A RAPID UPTAKE IT SHOWS THE DATA ON APPLICATIONS AND THAT PATENTS WITH GENE EDITING AND THIS HAS ALWAYS BEEN AN INTEREST WITH THE PUBLICATION OF THE WAY MORE SIMPLER WAY TO DO GENOME EDITING THERE IS A RAPID UPTAKE OF THESE TECHNOLOGIES AND APPLICATIONS IN THE LABORATORIES IS ALSO A STRONG INCREASE ON THE WHY AXIS SCALE. >> WE ARE REALLY EXCITED THE OPPORTUNITY TO ADVANCE SCIENCE BUT ALSO FINALIZE NEW TECHNOLOGIES BUT THIS CONCEPT WAS HIGH HIGHLIGHTED FROM PRIOR WORK FROM THE ACD FROM THE RIGOR AND TRANSPARENCY I FEEL SLIGHTLY AWKWARD TALKING MORE ABOUT IT WHEN THEIR OTHER COCHAIRS IN THE ROOM BUT THE KEY ITEM IN THE REPORT WAS THINKING HOW TO FORM AND INITIATIVE FOR THOSE ALTERNATIVE APPROACHES AND THAT MECHANISTIC INVESTIGATION THAT MAY BE VALUABLE TO ANSWER THAT QUESTION SO TO RECOGNIZE THE REPORT ALSO ACKNOWLEDGED THOSE IN TERMS OF ENSURING RIGOR THAT COULD COME AT THEIR OWN CHALLENGE THAT THEY FAILED TO UNDERSTAND THOSE APPROACHES SO FOLLOWING UP ON THOSE RECOMMENDATIONS THIS IS A BURGEONING AREA OF INVESTMENT WE JUST RECENTLY MET WITH THE ADMINISTRATION WE ARE LOOKING FORWARD TO PARTNERING TO CAPITALIZE ON THOSE ADVANCES OF OTHERS SO THAT THE END OF THE DAY FOR INTERESTED HAVING AN HONEST ASSESSMENT OF THE SCIENTIFIC OPPORTUNITY TO ENHANCE THE RIGOR OF ANIMAL STUDIES AND ALSO AN HONEST ASSESSMENT OF WHERE ALTERNATIVES COULD HAVE THE BIGGEST SCIENTIFIC IMPACT WE CANNOT STATE THIS ENOUGH THERE IS A LOT OF HYPERBOLIC LANGUAGE IN THE NARRATIVE WHERE THESE CAN CHANGE SCIENCE ARE MORE OR LESS IMPACTFUL IS KEY TO UNDERSTAND WHERE THEY WILL BE OF VALUE THAT OUR HOPE IS TO USE THIS INFORMATION TO BE STRATEGIC IN OUR INVESTMENTS AT NIH SO UNDERSTAND THE SCIENTIFIC DISCOVERIES BUT ALSO THAT IS THE CATALYST THAT WE SAW WITH THE GENE EDITING TECHNOLOGIES THAT WITH THE INVESTMENT CHANGED HOW WE DO SCIENCE THESE ARE THE TWO AREAS WE ARE PARTICULARLY INTERESTED IN SO THIS BRINGS US TO THE CHARGE OF THE WORKING GROUP WE HAVE EXPANDED BASED ON FEEDBACK OF THIS GROUP SO THE FIRST ASPECT IS TO GET A LANDSCAPE ASSESSMENT AND ASSESS THE GENERAL STRENGTH AND WEAKNESSES STUDYING HUMAN BIOLOGY AND THE DISEASE STATES WE HAVE SHOWN PRIOR ANALYSIS AND THEN TO HAVE THAT TOTALITY. ALSO WE ARE ASKING FOR A CHARACTERIZATION FOR WHICH ALTERNATIVE MODELS AND ARTICULATING HIGH PRIORITY AREAS FOR NOVEL METHODS WITH HUMAN APPLICABILITY THAT'S A DISCUSSION WE HAD LAST TIME TO UNDERSTAND PROGRESS BUT ALSO HOW DO WE AUGMENT THE CAPABILITIES IN TERMS TO CAPITALIZE NEW SCIENTIFIC INQUIRY? WE ARE PLEASED TO ANNOUNCE THE WORKING GROUP TODAY AND HOWARD HAS AGREED TO BE A COCHAIR SEEING REPRESENTATIVES FROM BOTH ACADEMIA AND THE PRIVATE SECTOR AND GOVERNMENT PARTNERS TO BE SYNERGISTIC WITH THOSE EFFORTS AND THOSE WORKING WITH ANIMAL MODELS AND TOXICOLOGY STUDIES IN THOSE UNDERSTAND THE LIMITATIONS ACROSS DIFFERENT SPECIES. WE ARE DELIGHTED YOU HAVE THIS GROUP HERE AND YOU WILL SEE ONE OF YOUR OWN ON THE CALL TODAY. THANK YOU AND BARBARA HAS AGREED TO SERVE AS AN EXPERT AND BE A PARTNER WHEN CALLED UPON. THANK YOU FOR YOUR HELP. IN TERMS OF THE CHARGE WE INTEND TO DO THE LANDSCAPE ASSESSMENT INCLUDING PERSPECTIVES OF THOSE RELEVANT FIELDS AND HOLD WORKSHOPS ON SPECIFIC TOPICS AS NEEDED AS MENTIONED WE PLAN TO GET MOVING QUICKLY AND HOW OUR GOALS ARE CHARGED WORKING VERY HARD IN THE SPRING OF NEXT YEAR IMPORTANT LANDSCAPE ASSESSMENT AND PRESENT THE PRELIMINARY FINDINGS AND START TO ENGAGE IN ROBUST STAKEHOLDER ENGAGEMENT OUR GOAL IS TO DELIVER THE FINAL REPORT WITH FINAL RECOMMENDATIONS DECEMBER OF NEXT YEAR SO WITH THAT IS COMPLETION WOULD YOU LIKE TO SAY ANY REMARKS BEFORE WE OPEN THE FLOOR QUICK. >> NOTHING FURTHER THAT WAS A GREAT SUMMARY. >> NOW WE WILL OPEN FOR QUESTIONS I WILL SEE IF YOU WANTED TO ADD ANYTHING TO THE CONVERSATION BEFORE YOU HAVE TO LEAVE? >> I HAVE NOTHING TO ADD. >> I DON'T HAVE MUCH TO ADD I DO HAVE A QUESTION SO WHAT I HEAR YOU SAYING IS THAT AT THE END OF THIS ASSESSMENT THERE WILL BE RECOMMENDATIONS FOR TECHNOLOGICAL AREAS TO PURSUE FOR THOSE STRATEGIES TO DEVELOP ALTERNATIVE MODELS. >> IT IS TWOFOLD TO UNDERSTAND WHAT IS VALUABLE WHAT TYPES OF AREAS ARE THEY SO THERE ARE CERTAIN AREAS OF SCIENCE WHERE THE ALTERNATIVES VERY CATALYTIC IN OTHER AREAS WHERE THEY DON'T PROVIDE THE RIGOROUS STUDIES FOR THE QUESTIONS BEING ASKED. SO TRYING TO FIGURE OUT WHERE THESE WILL BE MOST BENEFICIAL IS THE KEY. >> SO NOW WHAT I HEAR YOU SAY THIS IS NOT A STRATEGY FOR A BLUEPRINT TO ADVANCE TO FORWARD IN DEVELOPMENT OF THESE ALTERNATIVES BUT TO ASSESS WHERE THEY ARE APPROPRIATE FOR THAT SCIENTIFIC QUEST? >> I THINK IT IS BOTH. >> I AGREE. >> YES. >> OBVIOUSLY WANT AN ASSESSMENT OF THE CURRENT STATUS AND VALUE ADDED. THE INSTITUTE FOR CENTERS WILL USE THAT INFORMATION TO MOVE THAT FIELD FORWARD BECAUSE AS YOU SAW FROM THE VARIOUS SLIDES PRESENTED THOSE MULTIPLE DIFFERENT SYSTEMS AND SOME MAY BE FURTHER ALONG THAN OTHERS. >> SO IS THERE OVERLAP IN THIS REGARD QUICK. >> WE LIKE TO PLAY NICE. WE WILL SHARE. AGAIN AS ALLUDED TO THIS MORNING THERE IS A CERTAIN EXPERTISE OR INFORMATION THEY CAN PULL UPON FOR THE ORGANIZATION AND THIS IS JUST AN EXAMPLE AND HOPEFULLY THEY BENEFIT. >> I THINK TRYING TO CHANNEL MY INNER RENƒE IS THAT SHE WOULD SAY THIS AREA COULD POTENTIALLY MEET THAT DEFINITION OF WHAT THEY WILL FOCUS ON A PLATFORMS TECHNOLOGIES AND CAPABILITIES IF THEY HAVE THE RIGHT PROGRAM MANAGER AND THE RIGHT PROGRAM. >> THAT WAS INTERESTING. THANK YOU. I FELT A LITTLE BIT LOOKING AT THE LIST OF THE THREE CATEGORIES THAT MOST OF THEM IF NOT ALL HAVE BEEN USED. SO I'M JUST WONDERING IF YOU COULD EXPLAIN MORE OF HOW WILL YOU MAKE RECOMMENDATIONS HOW TO UTILIZE THE VARIOUS APPROACH AND ORGANIZED WAYS AND MANY OF THE APPROACHES LISTED WITH WIDESPREAD USE JUST A LITTLE BIT CURIOUS WHAT EXACTLY THE FORM OF THE RECOMMENDATIONS WOULD BE QUICK. >> SO DEFINITELY WE HIGHLIGHT THE NOVEL ALTERNATIVE METHODS BUT STILL DOES HAVE RECENT ADVANCES BECAUSE OF THE COMPLEXITIES SO THERE ARE AREAS SO THE INITIAL GOAL IS TO UNDERSTAND THE LANDSCAPE WE ARE NOT EXCLUDED BUT WHAT IS THE MOST CATALYTIC THING THAT CAN BE DONE SO WITH THAT APPLICATION AREA THAT MAKES SENSE FOR NIH TO HIGHLIGHT AS PART OF THE PREVIOUS WORKING GROUP THAT LINDA TALKED ABOUT AND THAT IS THE BIGGEST IMPACT OF REAL MEDICAL APPLICATIONS AND MANY OF THE THINGS THAT WE MENTIONED FOR THAT KIND OF APPROACH TO GET AROUND THE USE OF ANIMALS CAN YOU TALK ABOUT THAT? I'M INTERESTED IN THAT AND IT IS DIFFICULT TO DO AND I'M WONDERING IF THAT IS A MAJOR IMPETUS QUICK. >> UNDER IT IS JOIN THE TEAM AND IS AMAZING TO WORK WITH THEIR HUGE, THERE IS LANGUAGE BUT IT IS A PANACEA BUT IT'S NOT THE CASE SO UNDERSTAND THOSE IS KEY AND THEN ALSO TALKING ABOUT THE LEVEL OF INTEREST SO WITH THE FDA THE SCIENTIFIC OPPORTUNITY IN THE REGULATORY PROCESS TO HAVE THAT PIPELINE. >> . >> FIRST BRAVO YOU ARE OFF TO A GREAT START SOME OF THESE ARE A HAPPY FLASHBACK OR JUST A FLASHBACK TO THE EARLIER COMMITTEE. [LAUGHTER] AND LESS HAPPY PART IS YOU CANNOT BOIL THE OCEAN OF COURSE WE ALL WENT TO PROMOTE ALL KINDS OF THINGS THAT ALLOW YOU TO WORK ON A HUMAN PROBLEM THAT IS A DREAM THAT GETTING CLOSER IS A KEEPING BUT THIS PIECE WORKING ON A CHAPTER THE FEW PIECES MAYBE WHERE THESE AREAS ARE STILL PLAGUING WHERE THEY HAVEN'T MATURED TO THE POINT AS A STANDARD COMPLEMENT THE SWEET SPOT AND LOOKS LIKE YOU ARE FOCUSED BY SHINING THE LIGHT ON THIS AND WORKING WITH THE FDA I THINK IT DOES A LOT FOR THE ENTIRE ENTERPRISE WORKING SCIENTIST THOSE IN THE ANIMAL FEEL TO BE MORE AWARE AND ALSO FOR SIMPLY PUBLIC AWARENESS THAT NIH HAS BEFORE AND WILL IN THE FUTURE EVEN MORE INVESTED GOING IN THIS DIRECTION AND IT IS CLEAR TO ME ALTHOUGH OF THE OCCASIONAL EXCITING ARTICLES OF SCIENCE TIMES THAT HAS BROUGHT VERY LITTLE AWARENESS OF THIS. >> IS THE GENERAL AWARENESS OF HOW TO MAN TO USE THESE TECHNOLOGIES WITH NIH FUNDING AND ACADEMIES STUDY WITH PRIMATES AND ALTERNATIVES HOW DO YOU MAKE THE CONNECTIONS TO MAKE THAT AN EFFECTIVE IN TERMS OF TRANSLATION? AND THEN TO DEMOCRATIZE TO UNDERSTAND THEIR VALUE MORE EFFICIENTLY. >> THIS SEEMS VERY EXCITING TO ME WHAT I'M HEARING IS YOU LOOK AT TECHNOLOGIES THAT ARE CURRENTLY DEVELOPING THOSE THAT ARE MOST APPLICABLE TO HUMAN BIOLOGY? >> LOOKING AT TECHNOLOGIES AND GETTING VERY CLOSE TO FRUITION WHICH OF THOSE WOULD BE MOST APPLICABLE TO HUMAN BIOLOGY. >> SO THAT IS PART OF IT BUT THE MANDATE OF THE WORKING GROUP GOES BEYOND AND THIS CAN HELP NIH TO ANSWER THE QUESTIONS THEY WANT TO ADDRESS MORE EFFICIENTLY AND NOW IT'S AT THE COST TO MAKE THAT LEAP THAT YES ONE OF THE GOALS IS TO APPROACH MORE CLOSELY TO HUMAN HEALTH CONDITION WHICH WE ARE ALL HERE FOR. >> TALK ABOUT DEVELOPING METHODS THOSE EFFORTS HAVE NOT BEEN SUPPORTED IN HOPING IT WOULD BE MORE EMPHASIS ON THOSE METHODS IF IT HAS ANYTHING TO DO WITH HUMANS BUT IT COULD EASILY. AND THOSE THAT HAVE ALLIED OF IMPORTANCE IT WOULD THE NICE IF YOU'RE WORKING GROUP COULD REINFORCE THE DEVELOPMENT OF TECHNOLOGY. >> ABSOLUTELY THAT'S WHY WE WANTED VERY TANGIBLE OPTIONS SO THE VALUE OF WORKING TO IMPROVE HUMAN HEALTH THAT IS A TOOL SO MY PRIOR WORK WAS ON THE BRAIN INITIATIVE ON THE INTERSECTION OF ENGINEERING SO WE CAN CATALYZE NEW TYPES OF RESEARCH AND THAT IS WHAT WE ARE TO. >> THANK YOU DIDN'T SEE ANY OTHER QUESTIONS IN THE CHAT. ANYTHING ELSE? WE HAVE GONE THROUGH THIS SESSION VERY EFFICIENTLY WITH THE EARLY BREAK IN AND MEETING A FEW MINUTES EARLY AFTER THE SESSION. IS ANYTHING ELSE? >> THAT WAS A BURST OF OPTIMISM. >> EVERYDAY APPRECIATES THEY ARE INTENSELY INTERESTED IN FOR DIFFERENT REASONS AT LARGE AND SO WHATEVER WE DO WE HAVE TO MAKE SURE WE ARE AS PRECISE AS POSSIBLE AND I DO THINK IT IS AN OPPORTUNITY TO HAVE DISCOVERY AT NIH AND OTHER PLACES THAT IT WILL BE INTENSELY SCRUTINIZED WITH ANIMAL RESEARCH IN RESEARCH FOR BOTH POSITIVE AND NOT POSITIVE REASON SO ALL THE COMMITTEE MEMBERS ARE AWARE OF THAT AND HOPEFULLY WE GET THAT INTERIM CHECK-IN AND THEN MAYBE WITH A FINAL REPORT. BUT IT IS VERY MUCH AN OFFSHOOT AND THANK YOU FOR GIVING US SOME CONTINUITY SWELLING FORWARD TO HEARING ABOUT THIS THANK YOU FOR TAKING THIS ON AND TAKING ONE FOR THE TEAM. SO LET'S TAKE A BREAK. >> WE WILL COME BACK AT 350 AND GET STARTED ON THE NEXT SESSION A COUPLE MINUTES EARLY. BABY WE CAN GET OUT OF HERE. >> THAT'S A PROBLEM WHY WE ARE NOT JUST LAUNCHING RIGHT INTO IT. THE NEXT TOPIC PEOPLE WILL BE AS INTERESTED IF NOT MORE SO. >> SO THE NEXT SESSION STARTS AT 4:15 P.M. SO WE WILL TAKE A LITTLE BREAK AND STAY ON SCHEDULE AND WE WILL COME BACK THEN. WE WILL RECONVENE AT 4:15 P.M. AND THEN TO SEE THE SCIENCE TITLED THE CASE OF DISAPPEARING PERIOD. THAT IT WAS BECOMING SOMETHING THAT WAS STARTING TO APPEAR AND THEN JANUARY 2017 THE IMPACT OF THE POSTDOCTORAL TRAINING AND THEN MORE RECENTLY HERE IN THE 2022 THERE IS A LARGE NUMBER OF REPORTS AND OPINION PIECES WITH THE QUESTION OF RECRUITING THE POSTOP AND CHANGE AND SCIENCE TITLE AT THE TOP. THE IMPACT ON RESEARCH AND SCIENCE ADVANCES AND THEN QUESTIONS ABOUT THE LABOR FORCE AND THEN EVEN THIS MONTH ANOTHER PAPER SO THE CONSTANT DRUMBEAT MAYBE IT'S TIME FOR NIH AND AS WE STARTED TO GET THIS GOING WE HAVE HEARD FROM VARIOUS ORGANIZATIONS THAT MANY ARE LOOKING INTO THIS IT'S ONLY NIH THAT NEEDS TO WRESTLE WITH THE PROBLEM AND TO THINK ABOUT IT. >> WITH THE WAY OF THE LAND THE NEXT SEVERAL MINUTES THE INFORMATION WILL PROVIDE THAT LAST MONTH WHEN WE MET THERE ARE MULTIPLE FORCES AFFECTING THIS DECLINE AND WHAT WE ARE SEEING IS LOWER NUMBERS OVERALL, LOWER NUMBERS OF THE GRAD STUDENTS WHICH HAS SOME IMPACT ON THE LINE. AND THEN FEWER APPLICATIONS AND AWARDS. THIS IS DESPITE THE FACT THAT STIPENDS HAVE INCREASED BUT NOT KEEPING PACE WITH THOSE IN INDUSTRY AND THE NUMBER OF GRAD STUDENT HAS CONTINUED TO RISE WITH THOSE TAKING THOSE POSITIONS HAS BEEN ON A DOWNWARD TREND RECENTLY AND INTERESTINGLY GRAD STUDENTS AND POSTDOCS REPORT DECLINES IN OVERALL QUALITY OF LIFE AND IT'S WORSE FOR INTERNATIONAL TRAININGS SO THESE ANECDOTAL DISCUSSIONS THEY SUGGEST THEY ARE WORKING WORSENING SINCE 2020 WITH THE ADDED STRESSORS THAT HAS ARISEN FROM THE PANDEMIC AND THOSE ECONOMIC CHALLENGES THAT HAVE RESULTED SO WE ARE HEARING ALL OF THIS STUFF DOES THE DATA BEAR THIS OUT? SUGGEST STARTING TO GET THE DATA WHAT WE WILL PRESENT TODAY WAS JUST SCRATCHING THE SURFACE BUT IT IS HELPFUL BACKGROUND FOR CONTEXT AND AS WE KNOW PREVIOUSLY AND ASSESS COLLECTS DATA ON GRADUATE STUDENTS SCIENCE AND ENGINEERING AND THEY DO THIS ANNUAL CENSUS OF ALL ACADEMIC INSTITUTIONS THAT GRANT RESEARCH-BASED MASTER'S OR DOCTORATE'S. IN SCIENCE AND ENGINEERING NIH COSPONSORS THE WORK SO WHAT IS OUTLINED HERE WHICH IS THE MOST RECENT DATA THOSE THAT ARE REPRESENTED BY THE GREENLINE HAS STEADILY INCREASED SINCE 1980 BUT THAT HAS PLATEAUED AND HAS REMAINED FLAT FOR THE LAST TEN YEARS COLLECTING DATA AND IMPORTANTLY IT HAS NEWER UPDATED DATA AND WILL GIVE US A LITTLE BIT OF A GLIMPSE INTO THE PANDEMIC ON THE WORKFORCE BUT WE HAVE BEEN IN CONVERSATION WITH NSF AND THEY WILL BRIEF THE WORKING GROUP. SO WHEN WE LOOK AT WHO MAKES UP THE COHORT OF THE POSTOP SO THOSE THAT SHOW IN THE GREEN TEAL COLOR VERSUS THE LIGHTER BLUE LINE SHOWS PERMANENT RESIDENCE THAT IN THE NINETIES WHEN THE TEMPORARY VISA HOLDERS SURPASSED THE US CITIZENS OF PERMANENT RESIDENTS IN TERMS OF ABSOLUTE NUMBER OF POSTOP. SO IN 2020 ONLY 46 PERCENT WERE US CITIZENS OR PERMANENT RESIDENTS. THIS IS AN IMPORTANT POINT TO ILLUSTRATE THE POOL OF THE POSTDOCS COMING TO THE US TO THE LESSER FOR THE BIOMEDICAL ENTERPRISE. SO THIS MAKES US DOWN FURTHER AND THEN IT SHOWS SOME SIMILAR DATA AFTER DECADES OF GROWTH AND HAS BEGUN TO DECLINE OR PLATEAU. TO BREAK THAT DOWN BY GENDER. SO THIS CORRELATES WITH THE CLIENTS WE ARE SEEING IN INTERNATIONAL GRADUATE SCHOOL ENROLLMENT WITH THE DATA ON THE LEFT STARTING IN 2007 MAYBE NOT UNEXPECTEDLY THERE IS A SHARP DECLINE IN ALL CATEGORIES STARTING IN 2020 WE CAN IMAGINE WHAT WOULD BE THE CAUSE OF THAT. A NUMBER OF INTERNATIONAL STUDENTS DROPPED BY 15 PERCENT OBVIOUSLY THIS PRIMARILY WAS DUE TO THE PANDEMIC BUT IT'S IMPORTANT TO NOTE ONE THING. ELEVEN PEOPLE SAY THAT PANDEMIC IS THE ONLY CAUSE OF THE DECLINE BECAUSE IT MAKES IT CLEANER BUT UNFORTUNATELY IF YOU LOOK AT ENROLLMENT TRENDS DOWN IN THE BOTTOM RIGHT THESE ARE NOT LIMITED TO COVID-19 BECAUSE BOTH NEW AND CONTINUING ENROLLMENT GOES BACK TO THE 2018 ACADEMIC YEAR. THAT IS BEFORE THE PANDEMIC SO CLEARLY WHILE THERE WAS A MAJOR IMPACT AND EXACERBATE THE PROBLEM AND THEN TO KNOW WHO IS FINANCIALLY SUPPORTING THE WORKFORCE. AND THROUGH FEDERAL RESEARCH SUPPORT THROUGH FELLOWSHIPS THROUGH THE F 30 CHOOSE THAT NONFEDERAL SUPPORT HAS BEEN GROWING ACCOUNTING FOR 40 PERCENT AND FOR THOSE POSTDOCTORAL WORKFORCE AND LOOK AT WITH THOSE OF WORDS SPECIFICALLY RELATED TO THE F 32 APPLICATIONS THAT ARE SUBMITTED INDEPENDENTLY YOU CAN SEE THAT AND THAT AFTER THE TWO FELLOWSHIP HAS DECREASED OVER TIME. BUT WHAT IS EVEN MORE TELLING THE DARK BLUE BAR THE NUMBER OF APPLICATIONS WE ARE RECEIVING ALSO HAS DECREASED OVER THE LAST SEVERAL YEARS. EVEN THOUGH WE HAVE SUCCESS RATES THAT ARE FAIRLY HIGH. CONSISTENT SINCE THE EARLY 2000'S IS JUST UNDER 30 PERCENT BUT THESE TRENDS EXTEND BEYOND THAT THE DATA SHOWS NOT ONLY ARE THE NUMBERS OF POSTOP DECLINING BUT SOME OF THOSE ON TRAINING GRANTS? SO WHAT WE SEE THE NIH POOL OF POSTOP REGARDLESS OF A FUNDING MECHANISM IS DWINDLING AND WHAT WE ARE SHOWING HERE ARE ABSOLUTE NUMBERS NOT PERCENTAGE THE ACTUAL NUMBERS WE ARE SUPPORTING. AND IF YOU LOOK AT WHERE PEOPLE ARE GOING RIGHT OUT OF GRADUATE SCHOOL, WHAT WE SEE HERE IS THE PERCENTAGE OF PHD WITH POSTGRADUATE PLANS THERE IS A SLIGHTLY INCREASING PERCENTAGE OF NEW PHD'S WHO ARE GETTING A JOB AND THEY ARE SKIPPING POSTDOCTORAL TRAINING SO IN 2021 OVER 40 PERCENT BUT IF YOU GO BACK TO 1985 TO BEGINNING OF THE CHART THIS PERCENTAGE IS CLOSER TO 35 PERCENT IT IS A HUGE CHANGE BUT IT IS A CLEAR SEEING. THAT IF WE BREAK THIS DOWN FURTHER TO KNOW WHERE THEY ARE GOING AFTER NOT DOING PERIOD WHERE ARE THEY GOING? SO WHAT WE HAVE HERE THE DATA SHOWS AN INCREASING PERCENTAGE OF PHD'S GOING INTO INDUSTRY OR BUSINESS AND NOW THE LARGER SHARE THOSE THAT HAVE DEFINITE COMMITMENTS SO IN 202157 PERCENT WENT INTO INDUSTRY AND ONLY 26 PERCENT WENT INTO ACADEMIA NOT ALL INDIVIDUALS COULD BE DOING POSTDOCS BUT IT IS IMPORTANT TO HIGHLIGHT THE GROWING TREND I WANT TO EMPHASIZE SOMETHING I EMPHASIZED LAST TIME A DISTRIBUTION OF SCIENCE AND ENGINEERING GOING INTO A RANGE FEEL THAT IS A GOOD THING I WENT TO MAKE SURE THAT IS THE TAKE-HOME MESSAGE ON THIS SLIDE IT IS POSITIVE BUT IT'S HELPFUL TO UNDERSTAND THE POSTDOCTORAL TRAINING AND WHERE PEOPLE ARE GOING TO HELP US FIGURE OUT WHY AND HOW WE RESPOND TO THAT. PART OF THIS REASON I HAVE HEARD NUMEROUS TIMES AND SHELLEY HAS OCCURRED ECHOED SIMILAR SENTIMENTS IS PEOPLE HAVE TO BE ABLE TO PAY THEIR BILLS AND LIVE IN A SHELLEY WILL BREAK DOWN DATA BUT COST-OF-LIVING IS A MAJOR FACTOR IN THIS EQUATION IF YOU LOOK AT THE STIPENDS THOSE HAVE STEADILY BEEN GROWING OVER THE LAST TEN YEARS NOW IT IS ABOUT $55000 SOMEBODY JUST STARTING OUT. SO THOSE WHO ARE IN THEIR MOST EXPERIENCED POSTDOCTORAL YEARS THEY ARE MAKING CLOSER TO 66000 AND IT'S GREAT PROCEEDING THE GROWTH THAT WE HAVE TO THINK ABOUT THIS IN THE CONTEXT OF THE WHOLE ENVIRONMENT AND IF WE LOOK AT HOW THAT COMPARES TO INDUSTRY THE NATIONAL AVERAGE IS BETWEEN 73 AND 84000 ACCORDING TO THE JOB SEARCH SITES THAT'S A CONSIDERABLE JUMP ABOVE FIGHT $55000 ABOVE THE STIPEND AND VERY RECENTLY IN RESPONSE TO DIFFICULTIES OF HIRING POSTDOC AND GROWING CONCERN BOTH MIT AND SAINT JUDE HAVE RAISED THEIR SALARIES TO 65 AND 70000 RESPECTIVELY. AND THE NSF SURVEY THE DATA HIGHLIGHTS THE SALARY GAP EVEN FURTHER SO THEY SUGGEST HIGHER DISCREPANCY BETWEEN SECTORS BASED ON THE WAGES OF THOSE SURVEYED WHEN GRAD STUDENTS ARE CONTEMPLATING THE NEXT STEP MAY BE A POSTDOC OR MAYBE NOT THEY HEAR THAT THEY CAN GO TO SIX FIGURES GOING INTO INDUSTRY IF YOU THINK OF THAT COMPARED TO 55 THAT IS A BIG DIFFERENCE ESPECIALLY FOR THOSE STARTING FAMILIES OR WITH OTHER RESPONSIBILITIES. WE CAN RECOGNIZE ALL THE FACTORS INFLUENCING HOW WE MIGHT IMPROVE THE PATHWAY AND THE ECOSYSTEM SO NOW SHELLEY WILL ELABORATE FURTHER ON THE RECENT DATA. >> SO THIS IS CLEARLY A MULTI- EFFECT REAL CHALLENGE THERE ARE MANY ELEMENTS COMING INTO PLAY THAT ARE AFFECTING RELATING TO THIS ISSUE OF WHAT GRADUATE STUDENTS ARE PLANNING ESPECIALLY IN THE BIOMEDICAL FIELD. ONE IS THE LOW SALARY DURING THIS LINK THE STUDENT LIFE OF POSTDOC AND THAT PERIOD OF TIME HAS BEEN GROWING SO THAT TRAINEES HAVE BEEN FACING THESE LOW SALARIES FOR MUCH LONGER TIME THAN IN PREVIOUS GENERATIONS. I THINK THE BIOTECH AND PHARMA INDUSTRY HAS BEEN BURGEONING THE LAST FIVE OR TEN YEARS AND SO THAT HAS LED TO THE DIRECT RECRUITMENT GRADUATE STUDENTS INTO INDUSTRY SO THE NUMBERS AT SEPARATE THOSE FROM BIOMEDICAL THAT WOULD BE INTERESTING FOR US TO TAKE A LOOK AT. CREDIT HAS AMPLIFIED THE TREND TREMENDOUSLY AND TALKING TO HER OWN STUDENTS WITH THE DRAMATIC EFFECT OF THAT AND WE WILL GET TO THOSE NUMBERS SO IMMIGRATION HAS BEEN LOWERED FOR MANY REASONS NOT ONLY COVID THAT IMMIGRATION POLICIES AND RESEARCH AND BRIDE HAS BEEN IMPROVING THINK THAT HAS ACCELERATED THE TREND AND ENOUGH WE CAN DO ANYTHING ABOUT THIS BUT THE TIME TO PUBLISH HAS BEEN EXPANDING. I KNOW THE JOURNALS ARE TRYING TO ADDRESS THIS BUT IT IS NOT AN EASY FIX I THINK THE STUDENTS AND POSTDOC SEE THAT AS AN ISSUE THAT TOP HEAVY ACADEMIA THEY SEE THE ENTRY INTO FACULTY POSITIONS ARE DIFFICULT AS A CAREER PATH. SO THE NATURE SURVEY 2020 THIS IS JUST THE BEGINNING OF COVID SO WHAT WE SEE HERE IN THESE NUMBERS ARE WORSE OF THIS SURVEY WOULD BE REPEATED SO WE CAN START AT THE TOP IT IS POSTDOC CAREER SATISFACTION IN 2020 AND THIS IS WORLDWIDE THE BOTTOM LINE POSTDOCS ARE EXPERIENCING DISTRESS ABOUT THEIR CAREER WORKLOAD AND CULTURE SEE YOU CAN SEE WORLDWIDE IN US DOLLARS THE ANNUAL SALARY 30000 TO 80000 PROBABLY BECAUSE INTERNATIONAL SALARIES ARE LOWER THAT CLUSTERING AROUND THERE. THEN IN THE BOTTOM LEFT THE PAST YEAR WITH YOUR LEVEL OF SATISFACTION IF YOU LOOK AT THE TOP TWO CATEGORIES THAT IS 50 PERCENT OF POSTDOC HAS REPORTED SIGNIFICANTLY WORSENED LEVEL OF SATISFACTION SO THAT IS PRETTY HIGH THE TOP RIGHT IN SPITE OF ALL OF THAT THERE IS A HOPE OVER 60 PERCENT HOPING TO PURSUE THAT IS THEIR CONFIDENCE THEY CAN PURSUE AND THOSE ARE REFLECTED HAD HE FEEL ABOUT YOUR JOB PROSPECTS EXTREMELY NEGATIVE AND SOMEWHAT NEGATIVE OVER 50 PERCENT SO THAT IS PRETTY EYE-OPENING AND THEN AT THE BOTTOM RIGHT MAYBE THERE WERE STATISTIC OF ALL CLOSE TO 80 PERCENT SAY THE JOB PROSPECTS ARE SOMEWHAT WORSE OR MUCH WORSE THAN PREVIOUS GENERATIONS. SO THAT SOUNDS PRETTY DISMAL. IS A GRADUATE STUDENTS WE REALLY NEED TO DO AGAIN BUT HERE WE ARE LOOKING AT GRADUATE STUDENTS SOME FINANCIAL PRESSURES THAT THEY FEEL IS FROM THE 2022 SURVEY IT'S HARD TO FOCUS ON WRITING PAPERS WHEN YOU DON'T KNOW IF YOU HAVE ENOUGH MONEY FOR FOOD AND FINANCIAL DISTRESS IS IN A RIGHT OF PASSAGE IT CAN BE AN EXISTENTIAL THREAT. SO THAT DOES SOUND PRETTY DISMAL SO NOW MOVING TO THE GRADUATE STUDENT TRAINING SURVEY FROM THE CAREER FEATURE FROM ANOTHER SURVEY PHD AND MASTER STUDENTS STRUGGLE WITH WORK LIFE BALANCE COST-OF-LIVING AND MENTAL HEALTH SO AT THE TOP LEFT WHAT ARE YOUR CONCERNS AND YOU STARTED A GRADUATE WORK TO MAINTAIN A WORKLIFE BALANCE? UNCERTAINTY ABOUT FUTURE EMPLOYMENT 65 PERCENT AND AS A RESULT OF UNDERTAKING A GRADUATE DEGREE 57 PERCENT INABILITY TO FINISH STUDIES IN THE TIME PERIOD I SET OUT 51 PERCENT. HOW SATISFIED ARE YOU WITH YOUR EXPERIENCE IN SPITE OF ALL THAT GOOD NEWS HOW SATISFIED WITH THE EXPERIENCE HOW MANY HOURS DO YOU WORK SOMEWHERE BETWEEN 40 AND 60 HOURS WHAT IS THE MOST DIFFICULT FOR A GRADUATE STUDENT IN THE COUNTRY YOU ARE STUDYING? AND 57 REPORT COST OF LIVING AND WITH THE WORKLIFE BALANCE AND LACK OF AFFORDABLE HOUSING AND THEN BOTTOM RIGHT GETTING INTO MENTAL HEALTH ISSUES HOW MANY RECEIVED HELP FOR ANXIETY OR DEPRESSION THAT HAVE NOT YET GOTTEN IT 40 PERCENT AT MASTERS LEVEL AND 50 PERCENT FOR A PHD THAT'S PRETTY HIGH. SO FOR INTERNATIONAL GRADUATE STUDENTS WHAT ARE THEY EXPERIENCING? THEY REPORT FINANCIAL STRUGGLES SO THE SURVEY STARTED WITH ARE YOU STUDYING IN THE COUNTRY YOU GREW UP IN? AND OVERALL IT IS YES 71 PERCENT AND THEN YOU CAN SEE THE BREAKDOWN UNDERNEATH THAT. SO WHAT PROMPTED YOU TO STUDY OUTSIDE YOUR COUNTRY OF UPBRINGING MORE JOB OPPORTUNITIES SO HAVE YOU EXPERIENCED DISCRIMINATION OR HARASSMENT THESE NUMBERS ARE HIGH INTERNATIONAL 26 PERCENT DOMESTIC STUDENT 17 PERCENT. IF YOU EXPERIENCED DISCRIMINATION OR HARASSMENT AND GENDER DISCRIMINATION IS BEHIND THAT. SO IN SPITE OF ALL OF THIS THE MAJORITY OF STUDENTS REPORTED SATISFACTION WITH THEIR EXPERIENCE THIS IS OVERALL INTERNATIONAL NUMBERS REPORTED INTERNATIONAL STUDENTS AND DOMESTIC NECESSITY 5 PERCENT OF INTERNATIONAL STUDENTS AND DOMESTICALLY 61 PERCENT SATISFIED THAT IS GREAT. SO THE CHARGE TO THE WORKING GROUP TO EVALUATE THE EVIDENCE OF THE PERCEIVED SHORTAGE I THINK WE REALLY NEED TO EVALUATE THE EVIDENCE WE CAN SEE THERE IS POSITIVE AND SOME NEGATIVE EVIDENCE THAT THERE IS A TREND TOWARD A SHORTAGE AND WITH THE PERSISTENCE OF THE ISSUE TO REVIEW AND COMPARE OTHER APPROACHES SO HERE WE ARE TALKING ABOUT CONSIDERING THE STRUCTURAL CHANGES THE WAY POSTDOC TRAINING IS SET UP WITH ANOTHER TIER OF TRAINING FOR POSTDOC IN CONSIDER WAYS TO SUPPORT THE WORKLIFE BALANCE TO INCREASE RETENTION AND WE WANT TO ENGAGE IN INTERNAL AND EXTERNAL STAKEHOLDERS THERE IS A LOT OF PEOPLE INTERESTED IN THIS ISSUE NATIONWIDE AND WORLDWIDE. SO PROPOSED ACTIVITIES EARLY 2023 WE WILL GATHER COMMUNITY FEEDBACK WITH A LISTENING SESSIONS AND CONSULT EXPERTS AND ECONOMISTS AND WHAT HAPPENS IF WE ALTER THE SALARIES AND HOW DO WE TACKLE THIS ISSUE? YOU WANT TO TALK TO HAD TO GRADUATE STUDENTS AND I HAVE DONE QUITE A BIT OF THAT AND IT IS VERY CLEAR FOR GRADUATE STUDENTS THERE IS A BIG SHIFT AT UNIVERSITY OF PENNSYLVANIA AND REPORTING AND WITH THOSE STUDENT ORGANIZATIONS AND THEN REVIEWABLE DATA AS MENTIONED THIS UPDATE TO JOIN THE SURVEYS IS EXPECTED IN DECEMBER 2022 MANY ARE CONDUCTING POLLS WITH THOSE PUBLISHED STUDIES FROM THE NATURE WE HAVE BEEN LOOKING AT. >> SO SHE AND HER TEAM HAVE BEEN GATHERING THE DATA HELPING TO SET UP THE WORKING GROUP. >> WE HAD BEEN INCREDIBLY FORTUNATE TO HAVE A TREMENDOUS AMOUNT IN THIS GROUP WE ARE LUCKY TO HAVE STRONGER MEMBERS OF VARIOUS BACKGROUNDS THAT HAVE AGREED TO PARTICIPATE AND YOU CAN SEE ALL OF THEM HERE. THE WORKING GROUP INCLUDES A VARIETY OF DIFFERENT PEOPLE AND DIFFERENT PERSPECTIVE WE HAVE MEMBERS WHO ARE GRAD STUDENTS AND POSTDOC EARLY CAREER AND ECONOMIST WITH THE POSTDOC ASSOCIATION AS WELL AS MEMBERS OF VARIOUS ORGANIZATIONS INCLUDING AAU AND WE HAVE A REPRESENTATIVE FROM INDUSTRY AND NIH. WE ARE EXCITED TO HAVE TO MEMBERS WHO AGREED TO JOIN THOSE E-MAILED ME IN NOVEMBER EVEN BEFORE WE FINISHED THE PRESENTATION AND SAID WE ARE INTERESTED AND THEY ARE JOINING US FOR THIS EFFORT. WE ALSO HEARD FROM ALL OF YOU FOR THOSE INDIVIDUALS TO LOOK AT THAT PERSPECTIVE WITH MEMBERS OF THE GROUP WHO CAN BRING THAT PERSPECTIVE WE DID REACH OUT TO ONE ORGANIZATION SPECIFICALLY AND ARE STILL WORKING TO GET A REPRESENTATIVE. BUT AS SHELLEY MENTIONED WE DO INTEND TO HAVE EXPERTS COME TALK TO THE GROUP ON THE AD HOC BASIS SO THEY CAN CONSULT TO PROVIDE ADDITIONAL INSIGHT AND OF COURSE WE WILL GET A LOT OF FEEDBACK TO THE LISTENING SESSIONS AND OTHER MECHANISMS. SEVERE OFF TO A REALLY GREAT START PRESENTING THIS CONCEPT LAST MONTH AND INVITED THE WORKING GROUP MEMBERS OF THE LAST FEW WEEKS COMMITTED AND ON BOARD AND THEN ONCE WE HAVE THE MEANING KICKING OFF THE GROUP THAT ALLOWS US TO GO FORTH THEN THE HARD WORK WILL BEGIN. WE WENT TO ENSURE WE HAVE HEARD FROM VOICES THAT WILL BE IMPACTED BY THE CURRENT SITUATION THAT'S REFLECTED IN ANY DRAFT RECOMMENDATIONS SO TRYING TO ENGAGE WITH THE COMMUNITY BETWEEN DECEMBER AND THE NEXT ACD MEETING IN JUNE AND AT THAT POINT WE HOPE TO HAVE SOME DRAFT RECOMMENDATIONS AND GET YOUR REACTION AND WORK THROUGH THEM TO PUT TOGETHER A FINAL RECOMMENDATION BY THIS TIME NEXT YEAR. SPENT THANK YOU FOR ENGAGING IN THIS CONVERSATION FROM OTHERS IN THE COMMUNITY AND WE REALLY WELCOME THE FEEDBACK. >> I JUST WANT TO SAY PART OF THE INSPIRATION FROM THE EARLY STAGE INVESTIGATOR INITIATIVE WHICH I THINK IS A GREAT EXAMPLE OF HOW A HUGE IMPACT CAN BE MADE TO THAT EFFORT I'M OPTIMISTIC THAT WE NEED CREATIVE IDEAS I'M EXCITED ABOUT THE RANGE VOICES ON THE WORKING GROUP TO BRING IDEAS. >> WE WILL DO OUR BEST WITH THE PREVIOUS DISCUSSION AND TRY TO GET SPECIFIC. >> AND ALSO REACHING OUT TO THE NATIONAL ACADEMY AT THEIR RECENT MEETING THIS WAS A HOT TOPIC AND ACROSS THE NATION REFLECTIVE OF THIS DISTRESS WITH UNIONIZATION ATTEMPTS SO CLEARLY WE NEED TO BE THINKING ABOUT MAKING THIS BETTER JOB FOR PEOPLE. >> WITH RESPECT TO THE ACADEMIES WE TALKED ABOUT THIS COUPLE OF TIMES EVEN AS RECENTLY AS LAST NIGHT. BECAUSE AS YOU SAID THEY HAVE A GROUP. >> . >> SO I HEARD ABOUT THIS MEETING IN THE WORKING GROUP AND THOUGHT THIS IS RIGHT UP MY ALLEY I WAS ON THE NEXT GENERATION. SO WE HAVE ACTUALLY THOUGHT ABOUT THIS ISSUE AND IN ADDITION HOW IT INTERFACES WITH THE GRADUATE STUDENTS AND ESI. IT IS GOOD WE ARE FOCUSING ON POSTDOC BUT I WONDER WHETHER OR NOT WE BROUGHT IN THAT WHAT ARE THE DIFFERENT CAREER OPTIONS FOR GRADUATE STUDENTS WHEN THEY LEAVE PHD? STAFF SCIENTIST IS ANOTHER POSSIBILITY THERE BE DIFFERENT TRACKS IF YOU GO TO POSTDOC FOR TWO YEARS IN PREPARATION SO THINGS WE HAVE NOT THOUGHT ABOUT AND ARE NOT ARTICULATED IN A WAY THAT GRADUATE STUDENTS CAN HEAR THEM AND IF WE CAN ARTICULATE DIFFERENT TRACKS IT MAY HELP THEM SEE THIS IS A PATH THEY CAN FOLLOW RATHER THAN POSTDOC OPEN ENDED WHO KNOWS WHAT I WILL HAND ON -- END UP. I'M HOPING WE CAN BE THINKING BROADLY ABOUT DIFFERENT TRACKS THE GRADUATE STUDENTS CAN GO WIN. SO HOPEFULLY IN GRADUATE SCHOOL THAT PASSION IS NURTURED AND WILL CONTINUE FOLLOWING IT AND FOLLOW IT IN A NUMBER OF DIFFERENT WAYS BUT STILL FOLLOW THAT PASSION AND WHERE IT WILL BE? IT'S AN EXCITING TIME TO THINK ABOUT THE DIFFERENT PATH FOR THE CLASSIC POSTDOC RULE PATH IS BROKEN RIGHT NOW. WE COULD REPLACE IT THAT'S CALLED POSTDOC BUT HAS MORE STRUCTURE AND THAT MIGHT BE A WAY TO HELP THE WHOLE ENTERPRISE. >> I TOTALLY AGREE WITH THAT WE NEED TO LOOK AT THOSE CHANGES IN THE WAY NIH IS FEELING POSTDOC TRAINING AND AND THAT IS THE UMBRELLA TERM A LOT OF THE READING I HAVE DONE JUST TO DEFINE WHAT THE POSTDOC IS IS A CHALLENGE. SO WE HAVE TO START WITH THAT AND THINK ABOUT HOW TO DEFINE THE POSTDOC. IT DOES ENCOMPASS THE CATEGORY BUT THE QUESTION IS CAN WE FIND A WAY TO THINK OF A FUNDING CATEGORY AFTER THE TRADITIONAL POSTDOC AS WE THINK OF IT NOW TO FIND A WAY TO MAYBE APPROACH OR TO DEFINE OR FIND A WAY TO EXTEND A FUNDING MECHANISM FOR IT. AND MORE STATUS IN THE ACADEMIC COMMUNITY THESE ARE THE CONSIDERATIONS WE NEED TO LOOK AT. >> I THINK YOU COVERED IT WELL GOING TO A COUPLE OF DIFFERENT LENSES HOW WE CAN SUPPLEMENT AND SUPPLANT AND DO THE MENTAL PART EXERCISE AND WHAT THAT WOULD MEAN AND THEN CONSIDERING THE COUPLE OF PATH THAT WE HAVE WITHIN THE CONTEXT OF NIH WHAT CAN NIH DO FROM POLICIES OR PROCESS OR ACTION AND WHAT CAN IT DO BECAUSE OBVIOUSLY WE DO NOT CONTROL THE WHOLE SECTOR THAT WE CAN HAVE A LARGE INFLUENCE ON THE ECOSYSTEM. >> THIS IS A TIMELY TOPIC I'M GLAD FOR TAKING THIS ON THE UNIVERSITY OF CALIFORNIA ALL TEN CAMPUSES THE POSTDOC STUDENTS ARE ON STRIKE OVER THESE EXACT ISSUES SO THIS BRINGS UP SEVERAL POINTS. FIRST I THAT THE COMMITTEE WITH THE SYSTEMIC IMPACT BECAUSE IF THE GRANTS STAY THE SAME SIZE AND POSTDOC SALARIES GO UP AND THERE ARE FEWER AVAILABLE THAN THAT OF THAT'S A NET POSITIVE OR NOT IF IT DOESN'T KEEP UP WITH THAT AND HAS TO GO DOWN SO THEN THE PAY LINES ARE AFFECTED THE SECOND COMMENT RELATES IF IT GOES TO POSTDOC EQUALLY OR WITH EXPERIENCE THOSE WITH A CERTAIN SKILL SET THERE IS INTENSE INDUSTRY DEMAND IF ANYBODY WALKS AROUND WITH THAT EXPERTISE WITH THAT STANFORD MONIKER THEY CAN GET COACHED AND HAVING FLEXIBILITY OF DIFFERENT PAY SCALES. >> WE HAVE TALKED ABOUT THAT A LOT. SO WHEN YOU MAKE CHANGES THAT MEANS THERE ARE CONSEQUENCES. SO ONE OF THE THINGS WE HAVE TO CONSIDER IS WHAT ARE THE OTHER INCENTIVES -- INCENTIVES THAT IS MORE THAN JUST A SALARY INCREASE TO HAVE A BIG IMPACT AS WELL? SO WORKING AT THIS THERE ARE A LOT OF ANGLES. >> I'M HOPING FOR SOME CREATIVE IDEAS HOW TO BRING ADDITIONAL MONEY INTO PLAY MY PERSONAL BIAS I'M NOT SPEAKING FOR NIH. WE ARE THE TRAINING GROUND FOR INDUSTRY FOR NIH FUNDED LABS WE PROVIDE A STRONG TRAINING FOR GRADUATE STUDENTS. WE NEED TO BE ABLE TO MAINTAIN THAT. AND INDUSTRY IF WE APPROACH IT THE RIGHT WAY IN ACCORDANCE WITH ALL THE LEGISLATION AND THE MANDATE THAT NIH AND APPEAL TO THE IDEA WE CAN ENHANCE TRAINING FURTHER BY KEEPING STUDENTS IN POSTDOC LONGER AND NOT SELECTING FOR EVERYONE WITH THE BIOMEDICAL HEALTH AND INNOVATION SO I WOULD LIKE TO TRY TO THINK OF SOME CLEVER AND CREATIVE WAYS WITH THE FINANCIAL ASPECTS OF THE PROBLEM WHICH I THINK ARE A MAJOR SOURCE OF ANXIETY FOR GRADUATE STUDENTS AND POSTDOC. >> AND NOW YOUR SECOND QUESTION ON THE DEFERENTIAL PAY SCALE. SO FIRST I DON'T KNOW THE DEGREES OF FREEDOM ARE BUT I THINK THERE ARE SOME PRACTICAL IMPLICATIONS BUT THEN I WANT TO MAKE SURE TO EMPHASIZE YOU HAVE THOSE DISCUSSIONS IN THE CONTEXT OF ENSURING EQUITY CONSIDERED SO BY TRYING TO SOLVE ONE EQUITY ISSUE WE CREATE ANOTHER. IS JUST ONE THING I WENT TO EMPHASIZE. >> STARTING OFF WITH A SMALL DEFINITION FOR PEOPLE WHO ARE CLEARLY POSTDOCTORAL FELLOWS, EVERYBODY CALLS THEM POSTDOC. THE INSTITUTIONAL DIVERSITY WHETHER OR NOT WHICH IS VERY COMMON WHETHER IF THEY ARE INSTITUTIONALLY PERMITTED OR EVEN IF THEY WISH TO. AND THEN TO BE MOVED TO ANOTHER STATUS WILL BE REQUIRED. I'M GUESSING MY INSTITUTION IS NOT THE ONLY ONE SO THAT WILL MESS WITH THE NUMBERS SO HOPEFULLY WE CAN UNWRAP AND THINKING OF COMPENSATION AND ACHIEVING SCIENTIFIC EXCITEMENT AND COMPASSION THERE IS A CULTURAL ELEMENT TO THE STAFF SCIENTIST TRACK IF YOU ARE. THERE BY A REQUIRED INSTITUTION OR BY CHOICE. SO OF THE QUESTIONS THAT WERE ASKED IF THEY ARE GRANULAR ENOUGH THAT IT WOULD BE NICE TO UNDERSTAND HOW THOSE PEOPLE OF THE CURRENT GENERATION VIEW A STAFF SCIENTIST OR ACADEMIA THAT IF YOUR PAID ACTS THEN SOMETHING THAT THE CULTURE SO THAT OTHER PIECE FLOATING IN THE BACKGROUND WHAT ELSE WHAT HAPPENED IS AN INTERESTING PLACE. >> A TOTALLY AGREE. I FEEL THAT WE HAVE TO ADVERTISE ALL OF THE ADVANTAGES OF WHAT WE DO. IT ISN'T DISCUSSED ENOUGH WERE TALKING ABOUT IT ON AND OFF A GREAT MANY REWARDS FOR DOING IT. AND TO FIND A WAY TO CREATE ANOTHER CATEGORY THAT IS VALUED AND FEELS VALUED AND THAT IS WHAT YOU ARE GETTING AT. >> YES. A RECOGNITION IN EVERY OTHER WAY OPERATING IN THAT MODE. >> SOMEHOW I FEEL LIKE THE EARLY-STAGE INVESTIGATOR SOLUTIONS THAT WE COULD FIND A WAY TO EMPOWER THAT LEVEL WITH THE LATER STAGE THAT HAS TO BE PRESTIGE SO SOMETIMES WE HAVE TO FIND A WAY TO DO THAT WE WILL DISCUSS HOW TO CONSIDER THAT. I COME FROM COMPUTER SCIENCE. AND THEN WITH THE POSTDOC FOR ONE DAY AND THEN THEIR MAIN REASON COMPUTER SCIENTISTS CAN FIND A JOB VERY EASILY AND WITH THE PHD AND IT'S HARD TO COMPETE AGAINST MARKET FORCES. WE CAN ALWAYS ATTRACT EVERYTHING THAT IS IN PRESTIGE BUT PEOPLE TO BE INTERESTED IN A REASONABLE LIFE HAVING FAMILY THAT THERE WILL BE A SMALL NUMBER OF PEOPLE TO ATTRACT USING OTHER MECHANISMS. SO OBVIOUSLY COMPUTER SCIENCE WITHOUT A LARGE NUMBER OF POSTDOC AND HOW THINGS WORK IN OTHER FIELDS AND THEN LOOK AT THIS AS A POSITIVE THING AND THEN TO BE EFFECTIVE AND THEN TO BE A PART OF THE WORKFORCE. >> SO IT IS QUITE DIFFERENT WITH BENCH RESEARCH. AND THEN TO CONDUCT RESEARCH IS GREATER I HAVE SAMPLED MANY COLLEAGUES WHAT PART OF TRAINING HAS HAD THE MOST IMPACT ON THE WAY YOU CONDUCT RESEARCH YOURSELF? AND ALMOST EVERYONE WILL SAY IN RESEARCH THROUGH BENCH RESEARCH IS POSTDOC WE CAN SAMPLE TO SEE IF THAT'S THE CASE. SO IT TAKES A BIGGER GROUP TO CARRY OUT THE RESEARCH AND THAT IS STRATIFIED BY SOPHISTICATION AND KNOWLEDGE. IT TAKES LONGER TO ACCUMULATE. SO IS IT POSSIBLE SHOULD WE CONSIDER WE ARE AT THE INFLECTION POINT THAT IS SOMETHING WE CAN DISCUSS? >> I THINK WE SHOULD. BECAUSE THE DATA WHETHER ANECDOTAL OR MORE QUALITATIVE OR QUANTITATIVE DATA SHOWS THAT IF WE ARE NOT AT AN INFLECTION POINT WE ARE GETTING THERE SO THEN THAT IS THE IMPORTANCE OF THESE DISCUSSIONS. >> I REALLY LIKE WHAT YOU HAD TO SAY AND I WISH THAT WERE TRUE IN OUR FIELDS AS WELL. I THINK IT USED TO BE TRUE AND ONE OF THE DIFFERENCES IS MANY UNIVERSITIES DO NOT WANT TO HIRE SOMEONE WHO IS FACULTY UNLESS THEY HAVE PRELIMINARY RESULTS TO PULL IN TO ONE -- TWO OF THE OUR ZERO ONE I HAVE A LOT OF POSTDOCS GO OUT TO JOB INTERVIEW AND THEY HAVE BEEN ASKED ABOUT OUR ZERO ONE AND THE PRELIMINARY RESULTS. THAT IS PART OF THE JOB PROCESS WHICH TO ME IS BAD IN A LOT OF WAYS. AND PERHAPS THAT IS THE MOST CREATIVE TIME AND THEY SHOULD BE OFF IN THEIR OWN LABS. SECOND, IT MEANS THEY ARE TETHERED TO THE SCIENCE IN POSTDOC BUT THEY CANNOT GO OUT AND EXPAND BEYOND THAT. TO FIND OUT WHAT KIND OF PROBLEMS THEY WANT TO START. SO THAT IS A HUGE ISSUE AND ONE THAT WE NEED TO FIGURE OUT HOW TO ADDRESS. IT IS A SYSTEMIC ISSUE NOT JUST FOR POSTDOC BUT FOR THE SYSTEM. AND WHAT ARE THE KEY ISSUES AND THE MOST CREATIVE AND GROUNDBREAKING SCIENCE THAT YOU SPEND THE WHOLE POSTDOC WITH PRELIMINARY RESULTS AND SPEND YOUR WHOLE ASSISTANT PROFESSORSHIP FOLLOWING THOSE UP. THAT IS STAGNANT. THE SYSTEM WE HAVE NOW IS NOT THE BEST FOR SCIENCE. >> I WILL TURN IT OVER TO LARRY FOR THE FINAL WORD THEN YOU CAN CLOSE. >> TAKE YOU FOR A VERY RICH DISCUSSION I APOLOGIZE MISSING A PORTION IN THE BEGINNING. SO TO YOUR LAST POINT WE DO HAVE AN AWARD WE ARE NOT ALLOWED TO SUBMIT PRELIMINARY DATA FOR THAT PRECISE REASON SO THAT YOU ARE NOT TETHERED TO YOUR MENTORS EFFORTS. BECAUSE IT IS A ZERO-SUM GAME THE SCALE OF RESOURCES THAT YOU NEED FROM SOME OTHER SOURCE OF INDUSTRY OR FOUNDATION THAT IS SIGNIFICANT LOOKING AT THE BACK OF THE ENVELOPE CALCULATIONS SUSPENDING OUR WAY OUT OF THIS SO WE HAVE THIS CONTRACT WITH ACADEMIC HEALTH CENTERS AND FUNDAMENTALLY THAT IS PART OF THE STRUCTURAL PROBLEM. THE CONTRACT SAYS ONE GRAND ISN'T ENOUGH ANYMORE WE CONTINUE TO TRAIN PEOPLE IN OUR IMAGE AND THOSE WHO HAVE GONE ON TO INCREDIBLY IMPORTANT SCIENTIFIC CAREERS THAT ARE NOT AT THE BENCH OR THE BEDSIDE BUT INTO POLICY HAD TO FORGE THEIR OWN WAY THEY HAD TO FIGHT AND CLAW AND FIGURE OUT FOR THEMSELVES WITHOUT TOO MUCH HELP FROM ACADEMIA IN FACT I HOPE IT HAS CHANGED NOW BUT FOR A LONG TIME WAS LOOKED THAT YOU ARE NOT REALLY A SCIENTIST. AND PEOPLE WHO HAVE MADE THEIR CAREERS IN SCIENCE ADMINISTRATION AND POLICY HAVE ENORMOUS RESPONSIBILITY FOR BIOMEDICAL RESEARCH. WE HAVE TO RETHINK THAT. I NOW UNDERSTAND WHY I HAVE HAD SO MANY PROBLEMS BECAUSE OF NEVER BEEN POSTDOC IT'S INTERESTING TO LEARN THAT'S WHY. [LAUGHTER] I AM ALWAYS LEARNING STUFF ABOUT MYSELF. BUT I THINK THE RICHNESS OF THE CONVERSATION UNDERSCORES THE COMPLEXITY OF THIS WE HAVE TO PUT THIS INTO TANGIBLE VERY SPECIFIC THINGS IF IT WAS EASY IT WOULD HAVE BEEN FIGURED OUT ALREADY. THE OUTFIT THAT YOU WILL SEEK AND SOUND WILL BE GREAT SOME WILL BE NOT SO GREAT BUT YOU HAVE TO LISTEN TO IT ALL BECAUSE IT'S VERY IMPORTANT THAT WE LAYOUT THE POTENTIAL OPTIONS. THE CURRENT SYSTEM FOR ALL THE REASONS PEOPLE ALLUDED TO IS NO LONGER SUSTAINABLE AND THEN IF YOU SPRINKLE IN THOSE CHALLENGES THEN WE ALL COLLECTIVELY WORRY I'M LOOKING FORWARD TO HEARING THE INTERIM DISCUSSION IN JUNE AND THEN WHEN THE GROUP COMES UP WITH THE FINAL DELIBERATIONS I HAVE NO DOUBT IF AND WHEN THE TRANSITION TO A PERMANENT DIRECTOR TO BE VERY INTERESTED IN THIS TOPIC SO WE EMBRACE THIS AS A GREAT SERVICE. WE ARE PAST TIME. THANK YOU FOR HANGING OUT WITH US WE HAVE MORE TOMORROW I HAVE A GREAT EVENING I CERTAINLY LOOK FORWARD TO TOMORROW'S SESSION.