>> GOOD MORNING, EVERYONE. GLAD TO HAVE YOU HERE THIS MORNING FOR WHAT WILL BE A VERY INTERESTING HALF DAY. AND APPRECIATED EVERYBODY'S ATTENDANCE AT THE DINNER LAST NIGHT WHICH WAS WONDERFUL OPPORTUNITY FOR MORE INFORMAL CONVERSATIONS, CERTAINLY ENJOYED THAT THOROUGHLY, HOPE YOU DID AS WELL. THE FIRST ITEM IS OUR USUAL REVIEW OF OUTSIDE AWARDS THAT NEED ACD APPROVAL AND LARRY, YOU WILL WALK US THROUGH THIS. BY THE WAY I SHOULD SAY WE LOST A COUPLE OF MEMBERS, MIKE WELSH FELT ILL BY THE END OF YESTERDAY AND ENDED UP GETTING ON A PLANE AND GOING HOME. AND CHRIS WILSON TOLD US IN ADVANCE HE WOULD NEED TO GO AND HELEN HAD TO JUMP ON A PLANE LAST EVENING. WE STILL HAVE A QUORUM, WE WILL PROCEED. I THINK CHRIS MAY CALL IN LATER. ERIC ARE YOU ON THE PHONE? >> YES, I AM. >> WELCOME BACK. >> GOOD MORNING. >> GOOD MORNING. >> THANK YOU. >> SO WE ARE GOING TO HAVE THERE DISCUSSION ABOUT AWARDS THEN WE'LL HAVE A WONDERFUL OPPORTUNITY TO HEAR ABOUT SOME SCIENCE FROM PAUL SIEVING, DIRECTOR OF NATIONAL EYE INSTITUTE, SOMETHING WE HAVE DONE OFTEN AT THE CD IS ASK AN SITE DIRECTOR TA TALK WHAT'S PIETENING THEIR PARTICULAR AREA. THEN WE WILL HAVE A PRESENTATION BY BOB EISINGER ON THE PRIORITIES WE ARE CURRENTLY WORKING WITH HIV AIDS AND HOW WE'RE IMPLEMENTING THAT PLAN. THEN FINISH THE MORNING WITH THE RECORD ON THE BIG DATA TO KNOWLEDGE PROGRAM FROM BILL BOURNE. NOTICING WE HAVE NOT SCHEDULED ANY BREAKS IN HERE BUT OBVIOUSLY IF YOU FEEL THE IRRESISTIBLE URGE YOU WILL TAKE ONE AND THAT WILL BE OKAY. LARRY, WHY DON'T YOU GO AHEAD WITH THE AWARDS. >> I THOUGHT BY SCHEDULING THOUGH BREAKS YESTERDAY YOU WOULDN'T NEED ANY TODAY. >> SAVED UP. >> SO THE HIGHLIGHT OF A MEETING AT LEAST FOR ME, DIRECTING YOUR ATTENTION TO TAB 14, THIS LISTS THE AWARDS FOR THE CD REVIEW AND APPROVAL AND JUST TO SERVE AS REMINDER THAT FEDERAL LAW PROHIBITS FEDERAL EMPLOYEES FROM RECEIVING ADDITIONAL MONEY DURING THE PERFORMANCE OF THEIR JOB. THAT'S WHY WE NEED TO SCRUTINIZE THESE T. LISTS OF AWARDS WERE PRE-SCREENED BY DR. AKILL AND WILSON AND DEEMED ELIGIBLE BY THE NIH ETHICS OFFICE. HUDA, I DON'T KNOW IF YOU WANT TO COMMENT ABOUT THIS. >> I MEAN, IT'S A VERY GOOD PROCESS, I THINK AND WHEN ONE OF THESE THINGS COME I TRY AND ACQUAINT MYSELF WITH THE RULES BECAUSE THEY ARE MANY AND I'M NOT AWARE OF A LOT OF THE NUANCES H. VERY RESPONSIVE IN GIVING ME BACK THE INFORMATION IN EACH CASE. WHENEVER I HAVE A QUESTION ABOUT INTENT OR WHETHER IT WAS DIRECTED TO THE PERSON OR THEIR LAB OR WHATEVER, I GOT ALL THAT INFORMATION PROMPTLY AND THE ONES THAT ARE APPROVED LIKE THEY WOULD BE JUST FINE AND NICE. >> THANK YOU. I APPRECIATE THE FEEDBACK BECAUSE THE OFFICE IS WORKING HARD AND USER FRIENDLY. WITH THAT, COULD WE HAVE A MOTION PLEASE? >> SO MOVED. >> SECOND? ALL IN FAVOR? I THINK WE'RE COMPLETE. THANK YOU VERY MUCH. ALL RIGHT. TERRIFIC. THAT WAS VERY EFFICIENT. SO WE CAN NOW MOVE ON TO DIRECTOR'S REPORT, THE DIRECTOR OF THE NATIONAL EYE INSTITUTE, FOR A NUMBER OF YEARS BUT IT'S BEEN A DECADE. PAUL HAS INTERESTING BACKGROUND AS M.D. Ph.D. WHO WAS PREVIOUSLY MARY SUE AT THE UNIVERSITY OF MICHIGANER, HE WAS THERE WHEN I WAS THERE, I REMEMBER SPENDING TIME A IN DAVE GINSBERG'S LAB TALKING WITH PAUL AND RESEARCH IDEAS, MY HOW THINGS HAVE COME ALONG SINCE THAT TIME. PAUL IS NOT ONLY LOADING THE EYE INSTITUTE AS A INSTITUTE DIRECTOR ALSO HAS A VIGOROUS RESEARCH PROGRAM OF HIS OWN AND I ASSUME WE MIGHT HEAR A MIC OF THOSE THINGS IN THE PRESENTATION TODAY WHICH YOU'LL SEE. PAUL IS ALSO FRESH BACK FROM KOREA, IF HE STARTS BABBLING SOMEBODY THROW COFFEE AT HIM OR SOMETHING. ARE THESE POWERPOINT UP WHERE ERIC GUSBY CAN SEE THEM? WE'LL SEND THEM TO YOU NOW, ERIC. >> WHILE WE'RE GETTING SET UP, FRANS IS ON THE AWARDS IT WOULD BE NICE KNOW WHAT THEY MEAN, FOR EXAMPLE, THE FREEZE AWARD, $60,000, THAT'S A MONETARY VALUE SUBSTANTIVE STICK ANYTIME THERE. >> WE CAN PROVIDE THAT TO YOU. >> GREAT. >> SO I HEARD THE PHONE BLEEP. WHO JOINED? >> HI, FRANCIS, IT'S ME. I USUALLY CAN SEE THE POWERPOINT, YESTERDAY, BUT AT THIS TIME'S ME. >> OKAY. >> WE CAN'T SEE IT EITHER. RIGHT NOW IT'S NOT (INAUDIBLE) >> ALL RIGHT. WE HAVE LIVE IMAGES. >> GOOD MORNING, THANK YOU TO THE ACD AND FRANCIS FOR THE OPPORTUNITY TO DESCRIBE SOME OF WHAT'S HAPPENING IN THE VISION RESEARCH, OBVIOUSLY THIS IS QUICK AND LIMITED TOUR. ANY FIELD HAS A BREADTH AND DEPTH TO IT THAT CANNOT BE SUMMARIZED IN 40 MINUTES. I WANT TO SPEND TIME IN TWO AREAS, FIRST ON ANY ADO SHUTS GOALS INITIATIVE AND THEN TURN TO SOME OF THE INTERESTING VENTURES AND BREAK THROUGHS THAT COME OUT OF GENETICS OF EYE DISEASE. SO LET ME START WITH THE AUDACIOUS GOALS INITIATIVE. THIS IN VERY BRIEF SUMMARY IS A 12 TO 15 YEAR EFFORT TO CATALYZE INNOVATION AND VISION RESEARCH. THE GOAL, THE GOAL IS TO REGENERATE NEURONS AFT ARE AND NEURAL CONNECTS IN EYE VISUAL SYSTEM AND PAYING PARTICULAR ATTENTION TO PHOTO RECEPTORS AT THE OTHER END OF A THIN NEURAL RETINAL TISSUE RETINAL GANG -- GANGLION CELLS AND OPTIVE NERVE. LET'S CONSIDER WHAT HAVE WOULD BE AUDACIOUS? IT HAS TO BE BIG AND BOLD. IT OUGHT TO INSPIRING AND WHEN IT'S DONE IT SHOULD HAVE BEEN WORTH THE EFFORT. IT SHOULD FUNDAMENTALLY ADVANCE IN OUR CASE VISION RESEARCH AND ULTIMATELY VISION CARE. SOME THING ARE SOMEWHAT OBVIOUS, NEEDS TO BE ON THE EDGE OF AND EVEN BEYOND CURRENT TECHNOLOGIES, WE HAVE TO PUSH BOUNDARIES WITH THIS AND IT NEEDS TO HAVE MAJOR IMPLICATIONS WHEN IT COMES TO FRUITION AND IN SHORT, IT NEEDS TO BE MORE THAN AN RO-1. I BROACHED THIS TOPIC TO THE NATIONAL ADVISORY EYE COUNCIL SEVERAL YEARS AGO WITH A SLIDE SIMILAR TO THIS. IT SEEMED TO ME AT THAT POINT AND STILL THAT THE TIME IS RIGHT. WE HAVE HAD A REMARKABLE DECADE OF BIOLOGY LEVERAGING PUBLICATION OF HUMAN GENE COMPLIMENT FOR VISION WE HAVE HAD HUMAN OCULAR GENE THERAPY, WORKING WITH STEM CELL BIOLOGY INCLUDING IN PATIENTS. WE KNOW PATHOBIOLOGY AND WHEN I WAS A RESIDENT 30 SOMETHING YEARS AGO COULD BE ONLY DREAMED ABOUT. AND IN FACT HERE, WE NOW IN 2011 HAVE SELF-ORGANIZING NEURAL TISSUE, THREE DIMENSIONAL TISSUE CULTURES. SO WITH THAT, AS A STARTING POINT THE ADVISORY EYE COUNCIL BOUGHT INTO THIS ENTHUSIASTICALLY. AT THAT TIME THE AMERICA COMPETES RE-AUTHORIZATION ACT WAS FRESH AND THE IDEA OF DOING CHALLENGE PRIZES WAS IN THE WIND SO WE INCORPORATED THAT. THE VENTURE WAS NOT TO HAVE ANY EYE TELL THE VISION COMMUNITY WHAT TO DO BUT HAVE THE VISION COMMUNITY TELL ITSELF WHAT TO DO. WE CREATED TEN PRIZES WITH THE ENORMOUS AMOUNT OF $3,000. ENORMOUS BECAUSE THAT CATCHES THE ATTENTION OF A GRADUATE STUDENT OR POST DOC. AND EVEN AFTER TAXES YOU CAN BUY YOUR FRIENDS A BIG LUNCH. SO WE PUT A CHALLENGE PRIZE OUT, THAT NETTED 550, 548 SUBMISSIONS. NUMBER FROM OVERSEAS AND TO OUR GRATITUDE A NUMBER OF THESE HAD NO PREVIOUS NIH GRANTING EXPERIENCE. THESE WERE DULY DEIDENTIFIED AND JUDGED BY 81 REVIEWERS ORDERED AND ULTIMATELY TEN IDEAS SURFACED IN SIX TOPIC AREAS. WE THEN TOOK THIS THREE YEARS AGO IN FEBRUARY 2013, TO A MEETING OF 200 INVITED ATTENDEES. YOU MAY RECOGNIZE A FEW OF THESE PEOPLE. JOSH SANE IN THE FRONT ROW, HAS BEEN INSTRUMENTAL CENTRAL L IN THE BRAIN INITIATIVE, CONNIE SETGO, CALVIN PANG FROM HONG KONG, A GENETICIST FROM WORKING WITH CHINESE GENES. IF THERE ARE SUMP THINGS. -- SUCH THINGS. AND TONYA REX IN THE FRONT, YOU DON'T KNOW HER BUT SHE'S AN ASSISTANT PROFESSOR AT VANDERBILT AND ONE OF THE TEN PRIZE WINNERS WITH THE IDEA OF LET'S FIX THE OPTIC NERVE AFTER OPTIC NERVE INJURY SUCH AS, FOR INSTANCE, GLAUCOMA. SO WITH THESE IDEAS IN MIND WE PROCEEDED FOR TWO AND A HALF DAY OF DISCUSSION. FRANCIS JOINED US ON THE THE OPENING SESSION ON A SUNDAY NIGHT, THANK YOU, FRANCIS, FOR GENEROUSLY TAKING THE TIME. AND I USE THIS QUOTE AS A MESSAGE TO THE VISION COMMUNITY BUT I THINK IT'S GENERALLY TRUE, IT'S OFTEN, SAYS FRANCIS, SEEMS TO ME THAT VISION RESEARCH IS A CAN COUPLE OF STEPS HAPPENING IN BIOMEDICAL RESEARCH, CLEAR VISION RESEARCH PLAYED A LARGE SHARE IN SCIENTIFIC BREAK THROUGHS, I CAN THINK OF THINGS IN THIS CASE THINGS SUCH AS THE FIRST CRYSTAL STRUCTURE OF A G PROTEIN COUPLED RECEPTOR. RHODOPSIN, A LOT HAS BEEN DONE WITH THAT WONDERFUL MOLECULE. OVER THE PAST DECADE, THE FIRST IN CLASS ADVANCES IN HUMAN GENE THERAPY, FOR AN EYE DISEASE AND FIRST HUMAN IPS CELL AND ES CELL APPLICATIONS. THE EYE AUDACIOUS GOAL, REGENERATE NEURONS AND CONNECT THEM, MAKE NEURAL CONNECTIONS IN THE EYE AND VISUAL SYSTEM, THIS WOULD ADDRESS THE PATHOPHYSIOLOGY OF A NUMBER OF SERIOUS EYE DISEASES. LARGE SCALE EYE DISEASES, AGE RELATED MACULAR DEGENERATION ARCMD. GLAUCOMA. A GENETIC FORM OF OPTIC NEUROPATHY AFFECTING THE MITOCHONDRIA IN THE OPTIC NERVE. A BROAD CRASS OF RETINAL DEGENERATIONS. BEYOND VISION, CERTAINLY THIS WOULD HAVE IMPLICATIONS FOR REGENERATIVE THERAPY IN OTHER NEURAL TISSUES, CNS AND SPINAL CORD. PLASTICITY, THE VISUAL SYSTEM IS A WONDERFUL PLACE TO STUDY PLASTICITY AND THIS WOULD ADDRESS CONDITIONS OF (INDISCERNIBLE) AND CENTRAL VISUAL PROCESSING DEFICITS. SO HOW DID WE APPROACH THIS? MY IDEA WAS TO ACCELERATE THE TRAJECTORY OF SCIENCE. WE WANT TO GO TO AN END LOCATION. WE DIDN'T KNOW THOUSAND GET THERE YET. WE NEED TO BE ADAPTABLE AND AGILE AS ADVANCES WERE MADE, TO MAKE ADJUSTMENTS TOWARD THAT END GOAL. I VALUE ALL RESEARCH. BUT IN THIS CONTEXT I VALUE RESEARCH THAT WILL GET US TO NEURAL REGENERATION. TO THAT END WE SET UP INDEPENDENT SCIENTIFIC LEADERSHIP COMMITTEE FROM OUTSIDE NEI ROTATING BASIS. WE INVOKED MULTI-DISCIPLINARY, IT'S A BIG WORD BUT MEANS A LOT OF PEOPLE KNOWING A LOT OF THINGS. I WANTED THIS TO BE ANCHORED IN THE ADVISORY EYE COUNCIL, THEY ARE I TOLD THEM RESPONSIBLE FOR MAKING THIS WORK. THE STEERING COMMITTEE, SOME OF THESE NAMES YOU WILL RECOGNIZE. MARK BLOOMENCRANS HAPPENED TO BE A BIOLOGICALLY GROUNDED OPHTHALMOLOGIST, CHAIR AT STANFORD UNTIL JUST RECENTLY. TRANSLATIONAL. THIS STEERING COMMITTEE IS A WORKING GROUP OF COUNCIL AND REPORTS BACK TO COUNCIL. IT NEEDS TO HELP CONCEIVE THE TRAJECTORY OF THIS. AND AS THE TRAJECTORY CHANGES WE WILL HAVE NEW PEOPLE TO SUIT THE TASK. OBVIOUSLY WE NEED TO KNOW WHERE TO GO AND WHAT THE GAPS ARE. AND WE NEED TO MONITOR THE PROGRESS. I WANT SOME OF THAT MONITORING TO HAPPEN FROM THE OUTSIDE. AT THE SAME TIME THIS WAS A BIG VENTURE, IS A BIG VENTURE, IT'S ONGOING. AND I WOULD PARTICULARLY APPLAUD FOR PROGRAM DIRECTORS DON TOM GREENWELL SHERRY WAKE AND MIKE STEINMETZ INSTRUMENTAL MAKING THINGS HAPPEN ALONG WITH A NEW HIRE STEVE BURKE WHO HAS BEEN ABSOLUTELY STELLAR. THIS GROUP CONSIDERS AND INTEGRATES RECOMMENDATION OF THE STEERING COMMITTEE HAVE TO MONITOR PROGRESS MAKE RECOMMENDATIONS TO THE EYE COUNCIL AND TO ME. AND PROVIDES LOGISTICAL SUPPORT NOT THE LEAST OF WHICH IS TO DRAFT THE FUNDING ANNOUNCEMENTS. THE FIRST PUBLIC VENTURE ON THIS WAS A YEAR AGO AT SOCIETY OF NEUROSCIENCE ON THE TOPIC OF RESTORING VISION AND REGENERATING THE OPTIC NERVE. 30 LEADING RESEARCHERS, IT WAS A CLOSED MEETING. AN IDEA GENERAL RIOTING MEETING TO -- I ASKED PEOPLE TO CHAIR THE MEETING JEFF GOLDBERG. AT UCSD WORKING AMOCK THE BEST CURRENT WORK IN RETINAL CELL GANGRENION OPTIC NEXT AND BILL GUIDEO LOOKING IN LOWER SPECIES IN THE ORGANIZATION OF THE VISUAL PROCESSING CENTRAL PROCESSING. AND THE TOPICS THAT CAME UP WERE QUITE SIMPLE, GOLDFISH CAN REGENERATE NERVES. AND RETINAS. WHY CAN'T HUMANS DO THAT? HOW DO WITH WE REGENERATE THE RETINAL AXONS? INSUFFICIENT ASSAYS, LARRY BENOWITZ AT MET HAS A VIGOROUS PROGRAM IN OPTIC NERVE REGENERATION, THAT'S AFTER OPTIC NERVE CRUSH. IT WAS THOUGHT, BELIEVED DEEMED AT THIS MEETING THAT WE NEEDED TO QUICKLY MOVE TO A -- SEVERING THE OPTIC NERVE AND LOOKING FOR RECONNECTIONS ACROSS THE AIR SPACE BETWEEN THE SEVERED ENDS. THAT MIGHT HAVE TAKEN LARRY SOME TIME TO DO ON HIS OWN BUT THE COMMUNITY PUSHED TO DO THIS IS VERY VIGOROUS. AND NOTE THAT THE FIRST OF THOSE MEETINGS WAS AT THE SOCIETY FOR NEUROSCIENCE, I'LL RETURN TO THAT IDEA IN A MOMENT. SIX MONTHS LATER CONVENIENTLY SIX MONTHS LATER THE ASSOCIATION FOR RESEARCH AND VISION AND OPHTHALMOLOGY LARGE MEETING 20, 25,000 VISUAL SCIENTISTS, MEETS IN THE SPRING EVERY YEAR. AND THIS YEAR IT MAY 2015, DAVID GAMBLE AND RACHEL WONING CONVENED ALSO A CLOSED MEETING AN IDEA GENERATING MEETING ON PHOTO RECEPTOR REGENERATION. DAVID GAN IS THE CURRENTLY LEADING PERSON IN THE COUNTRY GENERATING HUMAN ROD PHOTO RECEPTORS FROM IPS CELLS. AND RACHEL WONING IS THINKING ABOUT HOW THE CIRCUITRY IN THE RETINA IS ESTABLISHED AND OBVIOUSLY IF YOU TRANSPLANT PHOTO TOE RECEPTORS YOU NEED TO GET THEM CONNECTED SO THAT'S AN INTERESTING MATCH. AND DAVID RACHEL DIDN'T REALLY KNOW EACH OTHER BUT FOR THIS. SO THERE IN IS ONE OF THE OUTCOMES OF ADVENTURE LIKE THE AUDACIOUS GOALS INITIATIVE. EXPERTS ASSEMBLE TO LOOK AT THE OPPORTUNITIES AROUND PHOTO TOE RECEPTOR REPLACEMENT. THE WHITE PAPER ON THIS IS PUBLISHED AND IS RELEASED ON THE NEI WEBSITE, P YOU CARE TO LOOK, AMONG TOPICS OF WHAT ENDOGENOUS AND ENDOGENOUS SOURCES FOR PHOTO RECEPTORS TO BE TRANSPLANTED. RODS AND CONES, VERY DIFFERENT CELLS. NEURAL INTEGRATION. THE END COAL IS TO GET TO HUMANS SO WE'RE GOING TO NEED TO HAVE OUTCOMES ASSESSMENT WAYS TO KNOW MRS. SMITH MT. CHAIR BENEFIT FROM THIS. THAT MEANS WE NEED TO WORK OUR WAY THROUGH ANIMAL MODELS AND IDENTIFY TARGET PATIENT POPULATIONS. AND THEN TWO MONTHS AGO AGAIN RETURNING TO THE SOCIETY FOR NEUROSCIENCE IN OCTOBER 2015 IN CHICAGO, RECONNECTING NEURONS NOW WE MADE THIS AN OPEN FORUM. IT WAS A SATELLITE EVENT, AN OFFICIAL SATELLITE EVENT OF THE SOCIETY FOR NEUROSCIENCE WHICH IS SOMETHING QUITE NEW FOR THE NATIONAL EYE INSTITUTE. MIKE PRAYER AN CAROL MASON CHAIRED THIS, CAROL SOME OF YOU MAY KNOW IS THETY MEDIATE PAST PRESIDENT FOR SOCIETY FOR NEUROSCIENCE, LOOKING FOR TARGET ENGAGEMENT, WE WANTED TO MAKE THIS OPEN, WHICH IT WAS SO WE CAN ATTRACT THE INPUT FROM THE 30,000 VISION -- EXCUSE ME, 30,000 NEUROSCIENTISTS WHO WERE ASSEMBLED IN CHICAGO. AND NOW LOOKING AHEAD TO THE SPRING UPCOMING IN MAY 2016, NOW WE'RE GOING TO HAVE A TOWN HALL MEETING AT THE VISION RESEARCH MEETING. ON THE TOPIC OF OCULAR DISEASE. WE HAVE OUR HANDLE -- HANDS AROUND THE CONCEPTS OF BADE SICK BIOLOGY BUT IF WE ENGAGE HUMAN POPULATIONS,'S NEVER TOO EARLY TO THINK ABOUT THE DISEASES AND HOW ONE DOES THAT AND THAT MEANS ENGAGING CLINICIANS. I WOULD EXPECT THAT THIS IS GOING TO BE A SEVERAL-YEAR PROCESS FOR CLINICIANS TO REALLY THINK ABOUT WHAT IS APPROPRIATE TO DO AND FIRST THING TO DO. NOW, WITH ALL THOSE IDEAS IN HAND, WE ARE ABLE TO GET MONEY ON THE STREET. AND THE FIRST OF THE AUDACIOUS GOALS INITIATIVE AGI AWARDS WERE PUT OUT IN MAY, THIS PAST MAY, 2015. ON FUNCTIONAL IMAGING. YOU WILL KNOW THAT OPHTHALMOLOGY OPHTHALMOLOGISTS ARE TAKING IMAGES OF THE HUMAN EYE REGULARLY IN THE EYE CLINIC. BUT THOSE ARE STRUCTURAL STATIC IMAGES AND WE WANT TO MOVE THIS TO FUNCTIONAL IMAGING. THAT GETS TO SOME PRETTY BIG WORDS SUCH AS INTERFERON METRIC OPTO PHYSIOLOGY WHICH MEANS THAT WHEN THE RETINAL GANG GLEION CELLS GANGLION CELLS RECEIVES INPUT FROM THE NEURAL TISSUE RETINA, WHEN THE GANGLION CELL FIRES, A SIGNAL DOWN THE OPTIC NERVE THE CELL BODY TWITCHES. AND THROUGH PHASE CONTRAST INTERFERONOMETRY, ONE CAN LOOK AT THAT TWITCHING GANGLION CELL IN MRS. SMITH AND THE CHAIR, AT LEAST THAT'S WHERE IT'S HEADED. WE CAN DO IT IN ANIMALS, NOW WE IMMEDIATE TO MOVE THIS TO PEOPLE, THAT'S THE FIRST OF THOSE US A TIN (INDISCERNIBLE) AND YOU CAN SEE THAT THE OTHER FOUR ALSO HAVE THE THEME OF FUNCTIONAL IMAGING, SOME INTERESTING NAMES, CONNIE SETGO IS THERE, BOTO ROSCA WHO HAS A MAJOR ADDRESS AT THE SOCIETY FOR NEUROSCIENCE LAST YEAR. SOME -- VERY GOOD PEOPLE SO THE THEME NOW ON THE LEFT SIDE OF THIS SLIDE ON THE BOTTOM FOUR BOXES, FOAs ISSUED, APPLICATIONS RECEIVED, REVIEWED, AND PAYMENT PLANS ANNOUNCED, THAT STANDARD NIH BUSINESS. WHAT HAVE WE HAVE ADDED THAT IS NEW AT LEAST FOR THE EYE INSTITUTE, IS THE TOP ON THE LEFT, THE TOP THREE BOXES, VIGOROUS COPIOUS INPUT FROM THE BROAD SCIENCE COMMUNITY. ON THE RIGHT SIDE, WE ARE LOOKING TO CHANGE THE SOCIOLOGY HOW THINGS ARE DONE. WE ARE ASKING POLITELY BUT ACTUALLY REQUIRING STRONGLY THERE BE COLLABORATION COOPERATION WITHIN THE GROUP SO THAT GROUP OF FIVE AWARDS ON FUNCTIONAL IMAGING HAS AN OVERSIGHT COMMITTEE EXTERNAL OVERSIGHT COMMITTEE BUILT INTO IT, AT ANNUAL MEETING TO GET THE PEOPLE TO SIT AND TALK AND WORK TOGETHER. OBVIOUSLY THIS IS GOING TO TAKE BROAD EXPERTISE FROM MANY DISCIPLINES, NEUROSCIENCE, YES. MOLECULAR GENETICS, I HAPPEN TO LIKE THAT. DEVELOPMENTAL BIOLOGY, STEM CELL BIOLOGY, BIOINFORMATIC, THERE'S SOMETHING HERE FOR EVERYONE. BUT IT MEANS NO SINGLE LABORATORY HAS THE WHERE WITH ALL TO PUT ALL THIS TOGETHER. TO START WITH FUNDAMENTAL BIOLOGY AND HAVE INSIGHTS, AND BREAK THROUGHS, FOR INSTANCE, RECONNECTING NEURONS WOULD BE A BREAK THROUGH, A BASIC BIOLOGY BREAK THROUGH. AND THAT IS GOING TO BE ESSENTIAL IN ORDER TO MOVE DOWN THE PATHWAY TO INTEGRATING INFORMATION AND ULTIMATELY CONDUCTING CLINICAL THERAPY TRIALS. SO THIS IS NOT IN ONE SENSE A TRANSLATIONAL SCHEME, THIS TAKES BASIC DISCOVERY ONGOING AND THEN INTEGRATING THAT INTO A GOAL. WE WANT TO GET SOMEWHERE. THE SPECIFICS SOMEWHERE. TIME LINE, WELL WE'RE ACTIVELY MANAGING THIS, I WOULD THANK STEVE BECKER FOR HELPING THE PROGRAM DIRECTORS TO HELPING TO ACTIVELY MANAGE THIS, WE HAVE MONEY ON THE CRETE THAT ON THE BOTTOM, THE BLUE BOX, WITH WE HAVE A ROUND CIRCLE DEADLINE IN JANUARY 16 FOR ANOTHER RFA, WE ARE PUTTING MONEY ON THE STREET. OBVIOUSLY MONEY ATTRACTS INTEREST IN THE VISION COMMUNITY. SO THAT'S THE AUDACIOUS GOALS INITIATIVE. NOW, A WORD FROM OUR SPONSOR. WORD FROM OUR SPONSOR. NATIONAL EYE INSTITUTE, JUST A FEW SLIDES. BUT WE HAVE A MISSION STATEMENT, THE SECOND LINE SAID -- SAYS WITH RESPECT TO BLINDING EYE DISEASES, VISUAL DISORDERS MECHANISMS, WE WANT TO ADVANCE KNOWLEDGE OF THE VISUAL SYSTEM, WANT TO HELP PREVENT AND TREAT EYE DISEASE, IMPROVE QUALITY OF LIFE FOR PEEP. PARTICULARLY VISION QUALITY OF LIFE. TO DO THAT THE AMERICAN TAXPAYER COMMITTED THIS PAST YEAR APPROXIMATELY 670, $670 MILLION. WE HAVE 257 FTEs, THESE NUMBERS ARE IMPORTANT BECAUSE THESE ARE THE PEOPLE WHO DO THE WORK. THAT GET AGI TO HAPPEN. WE HAVE DOUBLE THE CONTRACTORS FOR A STAFF APPROACHING 600 PEOPLE, MONEY IS DISTRIBUTED IN A WAY INSTITUTES DISTRIBUTE THE MONEY, 82% GOES TO EXTRAMURAL RESEARCH PROGRAM. WE DO HAVE AN INTRAMURAL AND WE HAVE ADMINISTRATIVE COST AND TAPS. LOOKING AT THAT BIG CHUNK OF MONEY, THE EXTRAMURAL FUNDING, NEI RECEIVES 850 TO 900 ROI APPLICATIONS A YEAR, THE MAJORITY GOES TO FUNDS RO-1 APPLICATIONS, WHICH MEANS THAT WE -- THE EYE INSTITUTE FUNDS SOMEWHAT MORE RO1s RELATIVE TO BASE THAN DO MANY OTHER INSTITUTES WE FUND CURRENT YEAR 18 TO 20% OF THE APPLICATIONS THAT COME IN. BUT THIS IS A VERY ACTIVE PORTFOLIO, NEW PROJECTS MU IDEAS, A THIRD OF THOSE APPLICATIONS ARE FOR NEW IDEAS AND NEW PROJECTS. AND ONE-THIRD OF THOSE APPLICATIONS ARE COMING FROM NEW INVESTIGATORS. WE TAKE PARTICULAR CARE FOR NEW INVESTIGATORS AND NEW INVESTIGATOR SUCCESS RATE HIGHER FOR ESTABLISHED INVESTIGATORS SUBMITTING NEW APPLICATIONS. WE ACTIVELY MANAGE THE PORTFOLIO, BOTTOM TWO POINTS PERHAPS ESOTERIC FOR MANY ACD MEMBERS BUT NOT FOR NIH PROCESS. ONE OF SEVEN GRANTS IS PAID OUT OF ORDER FOR PROGRAMMATIC RELEVANCE. A NUMBER ARE SELECT PAY, AGAIN TO FUND NEW INVESTIGATORS. AND A NEW CONCEPT THAT IS EVOLVING, YOU CAN ASK JIM ANDERSON ABOUT THIS LATER IF YOU WISH. OVERLAP FUNDING CO-EFFICIENT AT NEI IS THE HIGHEST AT NIH. THE INTRAMURAL PROGRAM, WE COMMIT ABOUT $50 MILLION A YEAR, STAFF A LITTLE OVER 300 PEOPLE, 25 LABORATORY SECTIONS ORGANIZED IN FIVE THEME LABORATORIES. SCIENTIFIC CORES BUT I PARTICULARLY HERE POINT TO THE CLINICAL ACTIVITY THAT WE DO, THE OFFICE OF CLINICAL DIRECTOR, WE HAVE AN ACTIVE OUTPATIENT CLINIC. QUESTION SEE A GOODLY NUMBER OF INDIVIDUALS EVERY YEAR, 8500 IN 50 ACTIVE CLINICAL PROTOCOLS. VIGOROUS CONSULT SERVICE TO PEOPLE THAT PROVIDE 3,000 CLINICAL CONSULTS A YEAR, THIS IS SERVICE TO THE NIH CLINICAL CENTER INTO THE OTHER ICs. LAST, IF YOU THINK EVERYTHING IS LOOKING INWARD TO VISION ALONE, WE ARE EXTREMELY PLEASED TO PARTICIPATE WITH THE BRAIN INITIATIVE. OTHER 15 MEMBERS ON THE INITIAL BRAIN WORKING GROUP, FOUR WERE VISION BASED INCLUDING BILL KNEWSOME FROM STANFORD WHO CO-CHAIRED THAT GROUP. AND PETER MCLEISH, DICK NORMAN, JOSH SINGS. THE FIRST AWARD WERE PUT OUT IN 2014, VISION RESEARCH I'M PLEASE PLEASED TO SAY DID FINE. THANK YOU. WE VISION RECEIVED 41% OF THE AWARDS AND 47% OF THE FUNDS BECAUSE OF THE ORGANIZED THE NEURAL STRUCTURE ANOTHER RETINA. GREAT DISCOVERY HOW NEURAL SYSTEMS ARE ORGANIZED. THE SECOND TRANCHE 2015 AWARDS, 20% WENT TO VISION. LET ME RETURN THEN TO SOME IDEAS OF ADVANCES THAT ARE HAPPENING IN EYE AND VISION. AND THE EYE OBVIOUSLY I FIND IT A FASCINATING TISSUE WHEN I SEE PATIENTS AND LOOK AT IDEAS THAT ARE FLOWING PAST MY DESK. AT THE FRONT OF THE EYE WE HAVE A VERY NOVEL TISSUE, THE ONLY OPTICALLY CLEAR TISSUE IN THE BODY. THERE'S IN WAY TO LOOK AT THE KIDNEY THROUGH THE SKIN BUT YOU CAN LOOK AT THE NEURAL RETINAS FROM -- THROUGH THAT CLEAR TISSUE. THAT FOCUSES LIGHT ON THE BACK OF THE EYE. THE NEURAL RETINA AT THE BACK OF THE EYE NICELY ORGANIZED IN LAYERS THAT ARE BY KITLY CONNECTED AND SERVE TO PROCESS SIGNALS FROM THE PHOTO TOE RECEPTORS, THE RODS HERE IN BLACK, THIN BLACK RODS AND RED GREEN AND BLUE CONES. SO LEST YOU THINK THAT EVERYTHING IS FOCUSED ON THE RETINA, IN FACT WE HAVE VIGOROUS ACTIVITY AT THE FRONT OF THE EYE, THE CORNEA LENS ALSO. THIS IS A DIFFERENT WAY TO LOOK AT WHAT I'M GOING TO BE PRESENTING. THESE ARE VISION DISEASES THAT HAVE A GENETIC BASIS. THE LENS, CATARACT. YOUNG CHILD LOOKING AT YOU CROSS EYED WITH STRABISMUS. GENES DRIVE THAT. IRIS COLABOMA A DEHIZENS OF THE EYE AT INSERTION HERE. MACULA, MACKLOPOTHY, STAR GART, ABCA 4 TRANSPORTER MACK HOPTHY. AGE RELATED MACULAR DEGENERATION WITH THE -- IMAGINE WHAT YOUR RETINA LOOK LIKE IF YOU HAVE BLOOD, YOU LOSE VISION IN AGING FROM MACULAR DEGENERATION. OPTIC NERVE AXON LOSS ENLARGES THE CUP IN GLAUCOMA. IT'S BEEN A REMARKABLE DECADE FOR THESE GENETIC BASE VISION DISEASES, I WOULD ANCHOR THIS BACK HA A STRONG PIVOT POINT IN 2001 WITH HUMAN GENE COMPLIMENT BEING PUBLISHED. SO VIGOROUS IS THE ACTIVITY IN THE GENETIC BASIS OF UNDERSTANDING OUR SYSTEMS THAT WE CAN NOW MAP OUT SYSTEMS BIOLOGY PHOTO TRANSDUCTION GENES THAT INVOLVE TRANSDUCTIONS IN THE GENES, ABCA 4 I MENTIONED FOR STAR GART A VITAMIN A TRANSPORTER FROM PHOTO RECEPTOR THE TO PIGMENT DISEASE. MACULAR DEGENERATION. TO DOES A GREEN PHOTO RECEPTOR, THEY DON'T MAKE THEM GREEN BUT IN THE ILLUSTRATION IT'S GREEN. AT THE TOP THE BLUE RETINAL PIGMENT EPITHELIUM CELL VISION CYCLE RETINOID PROCESS GENES THAT CAUSE DISEASE, NUMBER LISTED HERE, DISEASE INCLUDING RHODOPSIN IDENTIFIED IN 1989 OR 1990. ONE IS A GENE CALLED RS 1 X LINKED RETINA SKSIS. I WENT TO FRANCIS IN HIS LAB AND SAID HOW DO I DO THIS GENETIC STUFF? AND HE SAID HE SAID FIRST YOU HAVE TO FIND THE GENE. SO THE GENE WAS LAB HERE AT NIH, ONE DIRECTOR MAINTAINS A LABORATORY, I HAVE BEEN PUSHED THE RETINA PROTEIN AROUND, WE HAVE NICE CRYO-EM IMAGES OF THIS MOLECULE THIS SUMMER AT FOUR ANGSTROM RESOLUTION, INTERESTING TO GO FROM A DISEASE CONCEPT TO A MOLECULE. NOW WE HAVE THIS IN CLINIC, INTERESTING TO MY SIDE TO WORK THROUGH THE PROCESS OF FILING AN IND WITH THE FDA. I LEARNED A LOT. IN THAT PROCESS. THAT WILL BE HELP MISDEMEANOR THE NEXT TRANCHE, THAT'S NOT ALL, IT'S GLAUCOMA. HERE ARE GENES COMMON ADULT ONSET OPEN ANGLE PRIMARY OPEN ANGLE GLAUCOMA POAG. GENES, MANY GENES NOW THAT HAVE SMALL, RISK FACTORS. OR GENES THAT HAVE LARGE EFFECT APPROACHING MENDELIAN TRAITS FOR NORMAL TENSION GLAUCOMA, ONTY NEURON. LARGE EFFECT GENES SMALL EFFECT GENES RARE DISORDERS, COMMON DISORDERS. THE GLAUCOMA STORY IS STARTING TO BE PUT TOGETHER. THIS IS BEING LED BY JANIE WIGS AND IT IS A NETWORK THAT NEI ESTABLISHED OF NEIGHBOR AND NEIGHBORHOOD NETWORK. OF ABOUT 10 OR 12 INSTITUTIONS AN INVESTIGATORS. HERE THE CHILD IS LOOKING AT YOU WITH CROSSED EYES MISALIGNED EYES. ELIZABETH ENGLE IS A LEADING PERSON IN THIS. THIS CHILD IS NOT SLOPEY, AT THE BOTTOM TRYING TO LOOK AT YOU AND LOOKING JUST THROUGH -- CHILD CAN'T OPEN THE LIDS. OFTEN WITH OCULAR ALIGNMENT GOES LID PROBLEMS. ELIZABETH HAS FAMILIES SHE'S ACCUMULATED, ACQUIRED ACTIVELY SOUGHT OUT AND GWAS IS GOING ON BUT AT THE SAME TIME WE HAVE IN THE PAST DESAID SINCE 2001 ANOMALY COME TO UNDERSTAND THE DEVELOPMENTAL -- GENES THAT CONTROL DEVELOPMENTAL REGULATION FROM THE NUCLEI TO CONTROL THE EYE POSITION IN THE EXTRAOCULAR MUSCLES. THESE GENES WHICH ARE DEVELOPMENTALLY IMPORTANT IN MOUSE, ET CETERA, MUTATIONS CAUSE HUMAN DISEASES. DWAYNE SYNDROME, NOBODY IN THIS ROOM KNOWS DWAYNE SYNDROME. BUT IF YOU'RE RESIDENT IN OPHTHALMOLOGY YOU LEARN ABOUT THAT BECAUSE IT'S A OCULAR STRIBISMIC PROBLEM AND IT IS A MISINNERVATION OF EXTRAOCULAR MUSCLES, THE NEURAL PATHWAY HERE IS DEVELOPMENTALLY DEVIATES FROM THE PROPER LOCATION, SO THIS IS COMING ON VERY NICELY. MEANWHILE THE VISION COMMUNITY HAS BEEN THOUGHTFUL AND ACTIVE IN DOING SOMETHING ABOUT THIS. HUMAN GENE THERAPY, OCULAR GENE THERAPY, RP-65 REPLACEMENT RESTORES VISION. LET ME TELL YOU THIS STORY QUICKLY, CONGENITAL AMOROSIS THESE ARE PATIENTS I SAW AS A RESIDENT, I LEARNED LCA BLIND KITS, PIPELINE KITS IN 1969 WHEN DR. THEODORE LABOR DESCRIBED A FEW. USUALLY IT'S E RECESSIVE SO NO FAMILY HISTORY, THE EYES ARE BOBBING AROUND SWINGING, THEY HAVE NYSTAGMUS, ELECTRICAL FUNCTION OF THE RETINA, NONE EXIST SO THIS WAS A SIMPLE IDEA. NOW, THERE ARE 19 GENES ASSOCIATED WITH LCA, AT LEAST AS OF RECENT DATE. ONE OF THOSE RP 65 FUNCTIONENING THE RPE, HERE IS A PHOTO RECEPTOR IN THE RPE, IT'S VITAMIN A CYCLE GENE, IT IS THE RETINOID ISOMERASE IN THEMENT EPITHELIUM THAT ASSISTS MOLECULE IN VITAMIN A CYCLE CRITICAL FOR VISION. WITHOUT H THAT THE PHOTO ACCEPTTOR STRUCTURE CAN BE DO THERE BUT IT THE DOESN'T FUNCTION. YOU CAN HAVE A CAR WITH THE PERFECT MOTOR BUT NO GAS, IT DOESN'T RUN. THIS IS THE ENZYME THAT CONVERTS CARROTS VITAMIN A, TO THE MOLECULAR FORM THAT'S USEFUL FOR VISION. THE STORY STARTS HERE AT NIH IN 1993 MIKE REDMOND IN THE EYE INSTITUTE IDENTIFY AD COPIOUS GENE COPIOUSLY EXPRESSED IN THE RETINA. FUNCTION UNKNOWN, ABUNDANT PROTEIN, RP 65. HE MAKE A KNOCK OUT MOUSE AND FOUND THE MOUSE WAS BLIND AND A RETINOID PROCESSING PROBLEM. A YEAR LATER, IN SWEDEN A DOG WAS IDENTIFIED WITH AN RP-65 MUTATION ACTUALLY FOUR BASE PAIR DELETION FOUND HUMAN, AND WITHIN TEN YEARS CONVERTED TO HUMAN GENE THERAPY. SHOWN HERE MACGUIRE JEAN BENNETT NOW MACGUIRE PIONEERED THIS. THIS IS CORRY, IF YOU LOOK UP CORRY IN RP-65 ON THE WEB YOU FIND NICE CLIPS OF PUBLIC TV. GOOD ADVERTISINGS FOR NIH. BUT I WOULD SAY THAT IT'S NOT JUST GENE -- SIMULTANEOUSLY THERE'S THREE INDEPENDENT GROUPS WHO PUBLISHED THIS FINDING. OF SUCCESS IN HUMAN OCULAR GENE THERAPY FOR RP-65, VIGOROUS DEEP VISION RESEARCH COMMUNITY. DIFFERENT VECTORS. DIFFERENT PROMOTERS. AND SUCCESS ALL AROUND. NOW IN 2015, WE HAVE THE FOLLOWING CLINICAL TRIALS AT THE TOP, RP-65, NCI MERTK IS BEING TRIED IN A SAUDI POPULATION, THIS IS COMING OUT OF ENGLAND. SOME IN DIRECT WAYS OF MODERATING AMELIORATING AMD. NOT NECESSARILY SUCCESSFUL BUT BEING TRIED STAR GART, VERY BIG GENE, ONE OF THE BIGGEST KNOWN, IT'S HARD TO FIT INTO AAB SO IT'S PUT INTO A LENTIVIRUS, WHICH TARGETS THE RPE BUT THE GENE IS FUNCTIONING IN THE PHOTO TOE RECEPTOR, NOT SURE THAT IS GOING TO WORK. USHER IS DEAFNESS AND BLINDNESS, MULTI-SENSORY. RETINA SKESIS, I STARTED THIS TRIAL IN NIH IN FEBRUARY, WE HAVE DOSED NINE PEOPLE AND ARE ON OUR WAY TO SEEING WHAT HAPPENS. ACHROME TOP SEEIA STARTED BY (INDISCERNIBLE) FOUR WEEKS AGO IN GERMANY AND I ADDED THIS, THIS WILL BE AN NIH VENTURE, DR. WU AT THE EYE INSTITUTE HAS THE PRE-CLINICAL WORK WELL UNDERWAY. IT'S BEEN A REMARKABLE DECADE FOR US. THOSE ARE MONOGENIC DISEASE. WHAT ABOUT THE COMMON COMPLEX DISEASES? TO MY AMAZEMENT 2005 COMMON FACTOR H, FIRST USE OF THE INTERNATIONAL HAT MAP THANK YOU TO THE GENETICS LEADERSHIP INCLUDING HERE AT NIH. COMMON REFRACTORY FOR AMD, AMD THE SCOURGE OF VISION LOSS AS ONE GETS OLDER IN 2 MILLION AMERICANS, 8 MILLION AT RISK. WE'RE ALL GETTING OLDER, WATCH OUT. HERE IS A HEMORRHAGE, YOU CAN'T LOOK THROUGH THAT HEMORRHAGE, AWFUL THING FOR THE DOCTOR TO SEE, WORSE FOR PATIENT. THE NEURAL TISSUES BECOME ATROPIC, THE CELLS DIE. PREMONITIONS OF AMD YOU CAN SEE CLINICALLY, DON'T KNOW HOW TO HANDLE IT YET. WE DON'T KNOW THE PATHWAYS. WE DON'T KNOW MECHANISMS. COMPARED TO A NORMAL EYE. SO THE FINDS OF COMPLIMENT FACTOR H, ACTUALLY IT WAS FIVE GROUPS SIMULTANEOUSLY, AGAIN, THE DEPTH OF WORK OR MAYBE IT'S THE FOCUS OF WORK, IN THE VISION COMMUNITY, RATHER ASTONISHING I THINK, FIVE GROUPS SOME PUBLISHING IN THE SAME ISSUE OF SCIENCE, I HIGHLIGHT THIS BECAUSE EMILY WHICH YOU IS HERE AT NATIONAL EYE INSTITUTE, JOHN PAUL SANGIAVANNI AND RICK FAIRS, THIS STUDY WAS DONE ON BASIS OF AGE RELATED EYE DISEASE PATIENTS WHO WERE SEEN HERE AT THE NIH CLINICAL CENTER. SO COMPLIMENT PATHWAY GENE. THEN A YEAR LATER IN 2006 TWO MORE COMPLIMENT FACTORS, FACTOR B AND C 2, THOSE THREE GENES HAVE A REMARKABLE CUMULATIVE RISK. FOR ARCMD. THE PACE OF GENE DISCOVERY GOES ON NOW IT IS UP TO 34 LOCI WITH 52 INDEPENDENT GENETIC EFFECTS HOW DO WE PUT THAT STORY TOGETHER, THAT IS NATURE GENETICS, EMINENTLY. THIS IS A AMD NETWORK THE NEI FORMED AND IT IS NOW TAKEN ON INDEPENDENT LIFE, ACCUMULATING SOMETHING LIKE 35,000 AMD CASES AND CONTROLS, THAT GIVES THE DEPTH OF PATIENT PATHOLOGY TO NET 52 INDEPENDENT GENES. SO WHERE ARE THESE GENE? THEY'RE IN THE COMPLIMENT CASCADE, AT LEAST THE INITIAL TRANCHE. OTHERS ARE INVOLVING LIPID METABOLISM. OTHERS INFLAMMATORY FACTORS. COMPLIMENT FACTOR H SITTING RIGHT AT A CONTROLLING POINT, FOR ALL THREE PATHWAYS C-2 AND FACTOR B WERE THE SECOND GENES SET OF GENES FOUND THOSE THREE ACCOUNT FOR HIGH CUMULATIVE RISK FOR DEVELOPING AMD. FACTOR D IS INTERESTING, IT'S ALSO IMPLICATED AND ONE OF THE CLINICAL TRIALS CURRENTLY GOING ON IS ANTI-FACTOR D COMPOUND THAT LOOKS LIKE IT MIGHT HAVE LIFE TO IT. (OFF MIC) >> THAT'S -- THANK YOU, THAT'S AN INTERESTING QUESTION, IT'S DRY OR WET. THESE CAME OUT OF WET. AND THE QUESTION IS, THE RELATIONSHIP OF DRY TO WET. ATROPIC TO HEMORRHAGIC. NOT FULLY UNDERUNDERSTAND WHAT THAT -- UNDERSTOOD WHAT THAT RELATIONSHIP IS. I SAID ANTI-FACTOR D LOOKS HOPEFUL BUT MEAN CHILD WHILE 43 TRIALS ARE UNDERWAY MAJORITY WHICH ARE TARGETING FACTORS IN THE COMPLIMENT CASCADE AND THE OVERWHELMING MAJORITY OF WHICH ARE PROVING NOT SUCCESSFUL SO WE NEED TO GO BACK AND UNDERSTAND THE BASIC BIOLOGY. MEANWHILE, WE'RE NOT DOING JUST GENETICS BUT TREATING PATIENTS, HERE IS A CLINICAL PROTOCOL T FOR DIABETIC MACULAR ADEE MA HEAD TO HEAD COMPARISON. THIS IS THE FIRST ADVANCE IN THE LAST 40 YEARS. THIS CAME OUT THIS YEAR, IT IS GOING TO CHANGE THE COURSE OF MEDICINE. STEM CELL THERAPY, ACT HAS THE FIRST HUMAN ES THERAPY, THESE ARE CELLS PUT INTO THE SUBRETINAL SPACE, LITTLE CELLS ON CLINICAL IMAGING, CELLS PUT INTO SUBRETINAL SPACE OF PATIENTS WITH AMD. IPS CELLS, NOW THIS IS BEING WORKED ON HERE AT THE EYE INSTITUTE, ONE OF OUR INVESTIGATORS AUTOLOGOUS CELL BASED THERAPY FOR AMD USING IPD DERIVED RPE CELLS, BLOOD REPROGRAMMED TO NET HUMAN RPE CELLS, THIS PROCESS HAS BEEN VETTED THROUGH THE FDA AND THEY'RE MORE THAN PLEASED WITH IT. SO WE ARE ON TRACK TO FILE THE FIRST IN THE THIS COUNTRY IPS BASED IND IN THIS CASE FOR AMD, A LOT OF CODE WORDS. WE STARRED WITH CENTER FOREIGN GENRETIVE MEDICINE FRANCIS SET UP, WE OBTAINED SEED FUNDING AND NOW SUCCESSFUL IN THERAPEUTIC CHALLENGE WORK BY NIH MATCHING THOSE FUNDS OFF AND RUNNING HAVING PICKED UP DOD MONEY IN ADDITION TO DO THIS, THEY'RE INTERESTED IN 3-D OCULAR TISSUES AND PARTNERING, A LOT OF PARTNERING. N CATS, CELLULAR DYNAMICS MADISON CLINICAL CENTER. THAT PARTNERING IS IMPORTANT, IT'S SOMETHING THE EYE INSTITUTE IS CONTRIBUTING TO THE CLINICAL CENTER. WE SET UP A RELATIONSHIP WITH CDI IN MADISON, WISCONSIN. THEY HAVE GLP AND GMP MANUFACTURING PROCESSES, THEY TOOK OUR PROTOCOLS, HAVE PUT THEM THROUGH THEIR MODIFIED PROCESSES, DELIVERED THEM TO US AND THESE WILL GO INTO HUMAN PATIENTS, IN THE CLINICAL CENTER, MEANWHILE THIS IS BEING TRANSFERRED TO THE CLINICAL CENTER FOR USE BY ANYONE HERE AT NIH. IN A PIG MODEL YOU CAN SEE A SINGLE LINE HERE BUT A DOUBLE LINE, THE DOUBLE LINE IS THE TRANSPLANT IN THE SUBRETINAL SPACE OF A PIG, RPE TRANSPLANT. THAT GREEN EYE BALL NATURE 2001 MAKING EYES FROM ES CELLS,. THAT CERTAINLY HOLDS PROMISE. I WOULD THINK IF ALL GOES WELL, 40 YEARS FROM NOW WE WON'T FIX THE TISSUE, WE CERTAINLY WON'T CAT RISE IT WITH LASER, WE'RE GOING TO RE-- QUAD RISE IT WITH LASER. WE'LL REPLAICE IT. WE HAVE SOME ACTIVITY GOING ON THERE, COURTESY OF HOUSE APPROPRIATIONS REPORT WHICH DIRECTED THE COMMITTEE DIRECTS NEI TO A CHALLENGE PROGRAM, THAT'S THE SPEED OF BASIC RESEARCH TO CURE DISEASE SO WE ARE DEVELOPING CHALLENGE EXETITION TO DEVELOP AND USE 3-D RETINAL ORGANOIDS, OBVIOUSLY GOOD TO GIVE DISEASE INCITE RETINAL DISEASE INSIGHT AND TEST THERAPIES. SO THEN SUMMARY SLIDE, DISCOVERIES OF THE LAST DECADE PRESENTED REMARKABLE OPPORTUNITIES FOR VISION RESEARCH. THE NEI SUPPORTS A FULL SPECTRUM OF RESEARCH FROM BASIC DISCOVERY TO TRANSLATIONAL. AND INTO CLINICAL TRIALS THAT AFFECT CLINICAL PRACTICE. THE OPPORTUNITIES, WE NEED TO BE ANCHORED IN MECHANISTIC BASED TREATMENTS AND THAT IS AN EFFORT BY AGI TO CONVERT BASIC DISCONSERVATIVE INTO A CLINICAL APPLICATION. BUT IT STARTS, IT'S GROUNDED IN BASIC DISCOVERY, NEIHI PUTS A SPOTLIGHT WHERE WE WANT TO GO, WHERE -- THE PLACE WE WANT TO REACH. AND IT WILL REQUIRE COLLECTIVE AND CONCERTED ACTION, MANY LABORATORIES, IN WAYS THAT I THINK IS CURRENTLY UNUSUAL. THIS PROCESS SO FAR IS EMBRACED BY SCIENTISTS IN MANY DISCIPLINES AND I THINK THE MOMENTUM THAT WE HAVE HOLDS PROMISE. COMING DOWN THE ROAD. SO THANK YOU FOR THE OPPORTUNITY TO SPEAK WITH YOU. AND IF ANYONE WANTS TO SIGN UP FOR STARTING A VISION RESEARCH LAB, LET ME KNOW. [APPLAUSE] >> THANK YOU PAUL, AMAZING ARRAY OF ADVANCES THAT HAVE HAPPENED IN THE COURSE OF JUST THE LAST FEW YEARS, YOUR AUDACIOUS GOALS WILL DRIVE IT HARDER AND FURTHER. ARE THERE QUESTIONS, COMMENTS THE GROUP WOULD LIKE TO PUT INTO THIS? YES. >> I AD TWO QUESTIONS. FIRST, YEAH, SPECTACULAR -- SPECTACULAR TO SEE THIS HAPPEN. ONE IS ON LC, WONDERING DO THESE KITS HAVE ALTERED CIRCADIAN RHYTHMS OR INCREASE INCIDENCE IN PSYCHIATRIC DISEASE? EXPOSURE THE LIGHT. THAT'S MY FIRST QUESTION. SECOND, I REMEMBER READING THE SUGGESTION, BASICALLY EPIDEMIOLOGICAL SUGGESTING THAT LACK OF EXPOSURE TO UV LIGHT LED TO EPIDEMIC OF MYOPIA. IS THERE ANY CREDENCE TO THAT? >> TWO RATHER DIFFERENT QUESTIONS, ON LCA CIRCADIAN RHYTHM. THERE'S A FULL SPECTRUM, 19 GENES IMPLICATED, THEY EACH HAVE THEIR OWN PECULIARITIES, SPECIAL PROPERTIES ON A CLINICAL SCALE. MOST OF THE INDIVIDUALS DO HAVE SOME RESIDUAL VISION PARTICULARLY AT VERY HIGHLIGHT LEVELS WHICH MEANS THEY KNOW WHEN THE SUN IS UP AND AS LONG AS YOU CAN DETECT THE DIFFERENCE BETWEEN LIGHT AND DARK CIRCADIAN RHYTHM REMAINS INTACT AND CYCLING PROPERLY. SO THAT IS GENERALLY NOT THE CASE FOR THE LCA CHILDREN, IT HAS BEEN DEMONSTRATED IN SOME OTHER FORMS OF COMPLETE BLINDNESS SUCH AS BILATERAL NO EYES, THEY DO HAVE DISTURBED SLEEP RHYTHMS OF. ON MYOPIA AND UV LIGHT. ONE OF THE DRIVERS OF MYOPIA SEEMS TO BE LIGHT GOING PHOTO RECEPTORS BIPOLAR CELLS, AMICINE DOPAMINE SECRETION WHICH FILTERS BACK AND ALTERS THE SHAPE OF THE EYE. HOW MUCH OF THAT IS DRIVEN SPECIFICALLY BY UV EYE DON'T KNOW. AND THERE IS ALSO A -- SOME KIND OF FOCUSING COMPONENT TO THIS DEPTH OF THE FOCUSING SO THE ASIAN CHILDREN NOT SPENDING AS MUCH TIME OUT OF DOORS DO CERTAINLY DEVELOP MYOPIA AT HIGHER RATES AND THE GENES SO FAR FOR MYOPIA HAVE BEEN CLONED OUT OF ASIAN SOCIETIES. >> THAT WAS REALLY COOL, FIRST I WANTED TO MENTION I TRIED, I DON'T KNOW IF I SUCCEEDED TO SEND Y'ALL ON THE COMMITTEE, FROM DAN GOLDMAN, ABOUT RETINAL REGENERATION, IT'S JUST A VERY COOL ANIMATION, HE'S NEI FUNDED INVESTIGATOR BUT I LIKE IT TO BE BECAUSE IT'S A COLLABORATION BETWEEN THE VISUAL ARTISTS, HIS BROTHER AND HIM AND IT SHOWS TRANSCRIPTIONAL REGULATION AND PROTEINS AND REGENERATION SO IT'S JUST A COOL VISUAL THING. SORT OF JUST A COUPLE OF COMMENTS, ONE IS THAT IT'S INTERESTING NEUROSCIENCE INSTITUTE EVERY YEAR WE TALK TO PEOPLE ABOUT THE PROGRESS. AND TO ME THE PEOPLE WHO HAVE BEEN DOING THE VISUAL STUFF ESPECIALLY RETINAL RELATED STUFF, FROM YEAR-TO-YEAR YOU SEE DRAMATIC PROGRESS THAT I SEE ACROSS DIFFERENT NEUROSCIENCE, IN OTHER AREAS YOU SEE LITTLE BREAK THROUGHS HERE AND THERE IN INCREMENTAL CHANGES THAT THE VISUAL STUFF IS JUST AMAZING TAKING -- IT'S JUST THE FIELD SEEMS RIPE FOR REALLY TRANSFORMATIVE STUFF, SO IT MUST BE REALLY EXCITING FOR YOU TO BE IN THAT -- AT THIS TIME IN THIS FIELD, IT'S ABSOLUTELY REMARKABLE. MICRORNA STEM CELL GENETICS, ANIMAL MODELS, ET CETERA, AMAZE. I KNOW YOU KNOW THAT, LOOKING AT IT AS SOMEBODY NODDING THE -- WATCHING PEOPLE, I JUST WANTED TO ECHO. WHAT YOU WERE SAYING. FINALLY, I HAVE THIS ODD INTERACTION WITH SOMEBODY WHO HAS BEEN IN SOLITARY CONFINEMENT FOR OVER 20 YEARS, IT WAS THE TRIPLE A MEETING ABOUT SOLITARY CONFINEMENT AND THEY WANTED A POINT OF VIEW OF A NEUROSCIENTIST AND WHEN I TALKED TO THE GUY THE MOST IMMEDIATE AND DISCONCERTING THING HE TALKED ABOUT IS THE VISUAL CHANGES, HE SAID WHEN YOU NEAR A TINY PLACE THE SIZE OF A KING SIZE BED, THE FIRST THING THAT YOU NOTICE YOUR VISION GOES. VERY DISORIENTING. HE COULD ARTICULATE THAT MUCH BETTER THAN ANY AFFECTIVE CHANGES OR DEPRESSION OR ANYTHING LIKE THAT AND EVEN THINKING BACK ON IT 20 YEARS BACK IT WAS LIKE EXTREMELY -- WHEN YOU SAID SOMETHING ABOUT DEPTH PERCEPTION, HE LOST HIS DEPTH PERCEPTION. THEN WHEN HE EVENTUALLY GOT -- THIS WAS A VERY BIG CHALLENGE FOR HIM AFTER -- SO IT'S KIND OF AN INTERESTING POPULATION KIND OF ENVIRONMENTAL UNUSUAL ENVIRONMENTAL CHALLENGE FOR OVER 20 YEARS, MY GOODNESS BUT EVEN FOR SHORTER PERIOD. SO RANDOM ASSOCIATION. >> THANK YOU, IF YOU WANT AN NEI GRANT PLEASE APPLY. >> FIRST THANK YOU FOR THE PRESENTATION, I JUST HAVE A COUPLE OF QUESTIONS, YOU TALKED ABOUT OVERLAMP CO-EFFICIENT ZONE NUMBER. WHAT WAS THAT CO-EFFICIENT YOU TALKED ABOUT EARLIER? >> WE HAD A LONG DISCUSSION WE COULD HAVE AT THE COFFEE BREAK. >> I PREFACE A COUPLE OF QUESTIONS. >> YOU SAW YESTERDAY WHEN I SHOWED THE DATA MIKE LOWERY HAS BEEN GENERATING OVERLAP BETWEEN FUND AND UNFUNDED GRANTS IN THAT AREA, THIS IS A MEASURE OF THE DEGREE OF OVERLAP BETWEEN DISTRIBUTIONS AND MIKE CAN TELL YOU MORE. >> YOUR -- WHAT IS YOUR CO-EFFICIENT THAT YOU EXPRESSED? >> IT'S >> THIS IS A MEASURE OF THE HISTOGRAM THAT LARRY SHOWED, YOU SEE DISTRIBUTION OF GRANTS AWARDED AND NOT AWARDED ACCORDING TO PERCENTILE SCORE AND THERE'S A TRIANGULAR AREA IN THE MIDDLE OF OVERLAP SO NEI IS ONE OF THE HIGHEST AMOUNTS OF OVERLAP FOR AMONG ALL THE INSTITUTES HERE. >> SO WHAT IS YOUR CO-EFFICIENT AND WHAT IS THE RANGE? >> .3. AND THE RANGE IS FROM.-- A LOW OF .11 TO A HIGH OF .3. >> ONE OTHER POINT -- ONE OF THE QUESTIONS I HAVE HAD, AND P WE TALKED A COUPLE OF TIMES, WITH TALK ABOUT THE FACT THAT THIS COULD ENCOURAGE NEW INVESTIGATORS OR LOOK AT DIFFERENT PROGRAMMATIC AREAS, MY QUESTION HAS BEEN TO WHAT EXTENT HAS THIS BEEN USED TO INCREASE OR IN SOME CASES DECREASE DIVERSITY OF THE RECIPIENT OF GRANTS. FOR YOU INSTITUTE WHAT'S THE AFFECT OF THAT OVERLAP ZONE IN TERMS OF RACIAL ETHNIC DIVERSITY OF THE RECIPIENT OF NEI GRANTS. >> THAT'S A VERY INTERESTING QUESTION, TWO COMMENTS, FIRST THE IDEA OF THIS OVERLAP ANALYSIS MIKE AND OTHERS, HAVE RECENTLY BEGUN TO DO THAT SO WE DON'T KNOW THE FULL PLAY-OUT EVEN AT THE MOMENT ACROSS ALL INSTITUTES. SECOND WOULD BE I THINK WE CAN LOOK AT THAT PROSPECTIVELY BUT WE DON'T HAVE DATA AT THIS POINT TO ADDRESS YOUR IMPORTANT QUESTION. >> I WANT TO EXPRESS A CONCERN WITH THAT THAT WE HAVE HAD COMMITTEE MEETINGS OVER THE YEARS TO TALK ABOUT HOW WE'RE INCREASING DIVERSITY, THERE WAS A DISCUSSION HAVING A CONTEXT IN TERMS OF BEING ABLE TO DO THAT. BUT WE HAVE CREATED POLICIES AN PROCEDURE AND PROGRAMS TO CREATE THESE OVERLAPS ZONES, ACROSS DIFFERENT INSTITUTES, WITHOUT LOOKING AT WHAT THE EFFECTS WERE, I HAVE SPOKEN ABOUT IT. >> JUST TO SO WE HAVE LOOKED AT IT NOT IN THE EXACT WAY PAUL DESCRIBED BECAUSE THIS IS A NEW APPROACH TO EXPLAIN THE DATA. IT'S RACE NEUTRAL. WE LOOKED. IT IS RACE NEUTRAL. NOW YOU CAN ARGUE WHY AREN'T YOU USING IT TO ENHANCE DIVERSITY AND INDEEDS SOME INSTITUTES HAVE REPORTED THEY ARE IN FACT DOING THAT BUT THAT IS ONLY ONE OF MANY CONSIDERATIONS THAT GO INTO THEIR FORMULA. SO OUR CONCLUSION LOOKING AT THE AGENCY AS A WHOLE IS THAT THE ISSUE OF SKIPS OR SELECT PAY IS RACE-NEUTRAL. >> I WOULD ARGUE IF THAT DOES MEAN -- IN THE WORLD OF RACE NEUTRAL, THAT MEANS ONE HAS AN OVERLAP ZONE WHERE ONE IS SKIPPING ONE AREA, NOT SKIPPING THE OTHER AREA, IN THAT ZONE THERE ARE HIGHLY MERITORIOUS APPLICATIONS, INDIVIDUALS WHO ARE RACIALLY ETHNICALLY DIVERSE, THAT THOSE INDIVIDUALS SHOULD NOT BE SKIPPED. IT MAYBE OVERALL RACE NEUTRAL IN TERMS OF BECAUSE YOU'RE SKIPPING AND THEN PEOPLE, LATINO OR ASIAN APPLICANT CAN BE FUNDED NON-MAYBE BUT I'M SAYING MY CONTENTION IS IF IT MEANS THERE ARE INDIVIDUALS THAT ARE SKIPPED OVER WITH MORE MERITORIOUS APPLICATION BY SCORE WHO ARE RACIAL ETHNICALLY DIVERSE, THOSE INDIVIDUALS SHOULD BE FUNDED. THAT'S THE POINT I MADE. >> AND AGAIN, CATO, WE HAVE DONE THE ANALYSIS, WE HAVEN'T PUT IT IN THE FORMAT THAT PAUL AND MIKE SPOKE TO. IT IS RACE NEUTRAL. LOOKING AT THE AGENCY AS A WHOLE. >> JUST SAYING I THINK THERE'S AN OPPORTUNITY HERE THOUGH THAT ONE IS INTERESTED IN PROMOTING AND INCREASING DIVERSITY THAT THE END POINT SHOULDN'T BE NEUTRAL, P ONE IS USING -- OBVIOUSLY THE OTHER AREAS, INCREASING THE NUMBER OF YOUNG INVESTIGATORS, IS NOT NEUTRAL, IT'S HAVING A PURPOSE, HAVING A ROLE AND BEING EFFECTIVE IN TERMS OF DOING THAT, AND IT SO WE SHOULD BE THINKING ABOUT THAT IN TERMS OF USING AS AN INSTRUMENT. >> I WANT TO DOUBLE DOWN ON SOMETHING HOUDA SAID. THE QUALITY OF RESEARCH AND ADVANCES THAT HAND AT THE NEI IS REALLY SPECTACULAR. I THINK THAT THAT'S PARTLY BECAUSE SMART PEOPLE LIKE TO BE WITH OTHER SMART PEOPLE AND THERE HAVE BEEN VERY SMART PEOPLE IN SPECIFICALLY IN VISUAL NEUROSCIENCE, LIKE REST OF NEUROSCIENCE LOOKED UP TO THEM AND (INAUDIBLE) BUT I THINK IT'S ALSO A SIGN OF THE LEADERSHIP OF THE NEI CONSISTENTLY AND SUPPORTIVE SCIENCE AND REAL PROTECTION AND PROMOTION OF RESEARCH, BEST RESEARCH AND PARTNER SHIP WITH RESEARCHERS. I THINK IT'S'S A VERY GOOD REPUTATION IN THE EXTRAMURAL COMMUNITY AS AN INSTITUTE THAT WORKS EXTREMELY WELL WITH SCIENTISTS. IT'S GREAT TO SEE THAT AT EVERY LEVEL FROM MOLECULAR TO CLINICAL. Q. I WAS GOING TO ASK YOU QUESTION CORRY JUST PROPOSED WITH WHICH IS WHAT DO YOU ATTRIBUTE THE SUCCESS, IS THERE A CULTURAL ISSUE WITHIN -- BEST PRACTICES THAT CAN BE DISSEMINATED. YOU'RE MAKING THIS PRESENTATION TO US AND BUT WHAT ARE THE PROBLEMS THAT YOU SEE? WHAT ARE THE CHALLENGES THAT IMPEDE THAT KIND OF PROGRESS GOING FORWARD TO MAKE IT BETTER? >> I CAN HINT OUT QUICKLY AT THE MOST OBVIOUS LACK OF FUNDING. WHEN I HAVE BEEN ASKED AT OUR CURRENT BUDGETS AND WHAT COULD WE USE INSTEAD OF ANSWERING THAT QUESTION, I ANSWER THE QUESTION OF ARE CURRENT SUPPORTED PI, NUMBER OF PIs VERSUS PEAK POPULATION 2008 AND WE ARE DOWN BY 16, 18%, MASSIVE THREAT. AT THE TIME THAT WE ARE MOVING IN TO TARGETED FOCUSED IN THE FUTURE AUDACIOUS GOAL, WE PUT TO PUT NEURONS IN THE DATA EXTRINSIC OR INTRINSIC AND GET THEM TO CONNECT AND SEE WHERE THAT LEADS US IN HEALTHCARE. AT THE SAME TIME THAT WE ARE DOING THAT, WE DON'T HAVE THE RESOURCES TO FUND THE FULL VIBRANCY OF OUR EXTRAMURAL APPLICATION POOL. TO MY WAY OF THINKING, THAT IS THE PRINCIPLE LIABILITY THAT WE HAVE >> THANK YOU SO MUCH FOR YOUR PRESENTATION, I'M TEACHENING THE SPRING AND TAKING NOTES, STUDENTS LOVE THE EYE FOR REASONS ELOQUENTLY EXPLAINING YOUR PRESENTATIONS, TWO QUESTIONS FOR YOU. ARE YOU DOING ANY WORK ON HEALTH DISPARITIES OR FUND PROGRESS APOLOGETICS RELATED TO HEALTH DISPARITIES AND VISION? AND ALSO I WAS CURIOUS, YOU DIDN'T TALK ABOUT THE ARTIFICIAL RETINA AND RETINAL IMPLANT OF ARE THERE ANY DISCOVERIES ON THAT FRONT? >> HEALTH DISPARITIES, ONE OF THE HEALTH DISPARITIES IS BIOLOGIC IN OUR ZONE. HISPANIC AND BLACK POPULATION VERSUS HIGHER INCIDENCE OF GLAUCOMA. THAT IS A LIABILITY FOR THAT POPULATION, CONVERSELY IT'S AN OPPORTUNITY FOR US, WE HAVE GENE DISCOVERY WORK GOING ON WITH IN AFRICAN COUNTRIES TO TRY TO IDENTIFY WHAT THAT FACTOR IS. WE HAVE OTHER HEALTH DISPARITY WORK GOING ON IN THIS COUNTRY PARTICULARLY IN GLAUCOMA. OTHER APPROACHES WE HAVE TAKEN HAVE BEEN ON THE YOUNGER GENERATION, EDUCATION TRAINING. WE HAVE SOMETHING CALLED DIVERSITY IN VISION RESEARCH. THAT IS QUITE SUCCESSFUL IN ATTRACTING OR AT LEAST ENROLLING MINORITY POPULATION STUDENTS IN OUR SUMMER INTERNSHIP PROGRAM, A NUMBER OF THEM STAY SPEND A YEAR AND MATRICULATE IN BRANCH RATE WAIT OR PROFESSIONAL PROGRAM AFTER THAT. SO WE ARE INTERESTED IN THAT. ON THE RETINA CHIP THAT'S WONDERFUL, IT'S THE FIRST VISION PROSTHESIS APPROVED REGISTER FOR SALE, THE ARGUS 2, IT GIVES SOMETHING TO VISION, IT GIVES PREACCEPT, IT DOES NOT RESTORE VISION. YOU AND I HAVE 100 MILLION ROD CONE PHOTO RECEPTORS IN THE EYE, DEVICE SAYS 30 ELECTRODES YOU CAN REPLICATE 100 MILLION BY 30. IT'S GENERATING SOME VERY IMPORTANT UNDERSTANDING OF THE PHYSIOLOGY OF HUMAN RECEPTION AT THE SURFACE. WE'RE GOOD AT PHOTO RECEPTORS, WE UNDERSTAND HOW THEY'RE ORGANIZED AND WHAT THE CIRCUITS ARE AND HOW TO STIMULATE, ET CETERA BUT AT THE SURFACE OF THE RETINA IT GETS MORE VAGUE. THIS IMPLANT GOES AT THE SURFACE OF THE RETINA. SO IT PROVIDES ENTRE TO STUDY THAT COME CAN PARTMENT OF VISION. I PERSONALLY LIKE BIOLOGY MORE THAN RETINA CHIPS. >> WHAT IS THE LATEST ON THE DURABILITY OF THE GENE THERAPY STRATEGIES FOR RPE 65, WHICH OBVIOUSLY SUBJECT OF ENORMOUS INTEREST AND IT WAS IMPRESSIVE AT FIRST TO SEE SUSTAINABILITY OF THE IMPROVEMENT IN VISION THAT HAPPENED WITH JUST ONE ADMINISTRATION BUT I GATHER IT DOESN'T LAST FOREVER. IT BEGINS TO WEAR OFF. WHAT TEASE GENERAL SENSE ABOUT WHAT THERE'S A WAY TO INCREASE THE SUSTAINABILITY OR CAN YOU KEEP READMINISTER SOMETHING >> YOU ASKED A VERY INTERESTING QUESTION THE SHORT ANSWER WILL TAKE AN HOUR, LET ME GIVE YOU THE SHORT ANSWER. IF YOU HOLD THE PERSONAL SHARES OF GENE THERAPY COMPANY STOCKS YOU MIGHT QUESTION YOUR ADVISOR'S WISDOM AT THE MOMENT. >> NOBODY HERE DOES, [LAUGHTER] >> SO WE'RE ALL SAFE, LARRY. >> I'M GOING TO NEED A BREAK RIGHT NOW. [LAUGHTER] >> SO HOW LONG DOES THAT RP-65 GAIN OF VISION SURVIVE? HOW DURABLE IS IT FOR THESE CHILDREN WITH LABOR CONGENITAL AMAUROSIS SEVERE VISION IMPAIRMENT FROM BIRTH? THE VISION GAINS ARE IMPRESSIVE AT LEAST BY NUMBER SCORES, LOG ORDERS OF IMPROVED SENSITIVITY, LIGHT SENSITIVITY. THAT IS PERSISTING IN THOSE CHILDREN BUT QUESTIONS WERE ASKED BY S TREATMENTLY ASTUTE SCIENTIST SAMUEL JACOBSON UNIVERSITY OF PENNSYLVANIA OVER THE PAST YEAR. AS TO WHETHER THE STRUCTURE IS ALSO BEING MAINTAINED, ARE THE PHOTO RECEPTORS THERE? THEY'RE WORK BUG ARE THERE AS MANY NOW AS FIVE YEARS AGO? THE ANSWER IS NO. CAN THAT BE IMPROVED IN? PROBABLY. WHAT IS THE APPROPRIATE DOSE OF PENICILLIN TO TAKE? IT'S NOT 10-MILLIGRAMS, IT'S HIGHER THAN THAT. AND THE GENE PERTY TRIALS WITH WERE ONE DOSE TRIALS WE NEED TO KNOW WHETHER INCREASING THE DOSE WILL INCREASE THE DURABILITY, WE NEED TO KNOW WHETHER INCREASING THE GEOGRAPHIC, THE REGION THAT'S TREATED, THEY TREATED A SMALL REGION, IF YOU INCREASE THAT, DOES THAT INCREASE SURVIVAL OVERALL OF THE ENTIRE PAST? THERE'S MANY QUESTIONS, ONE DOWN SIDES OF HUMAN GENE THERAPY IS IT TAKES FIVE OR MORE, TEN YEARS TO REALLY UNDERSTAND WHAT THE NEXT QUESTION IS GOING TO BE. SO WE NEED SOME WAY TO SPEED THIS UP. BUT PERSONALLY I'M STILL ROOTING STRONGLY FOR OPPORTUNITIES IN GENE THERAPY. HAS DOWN SIDES BUT IT'S ONE WAY TO HELP SOME PEOPLE AND LEARN GREAT BIOLOGY T. >> DO YOU SEE AN ALTERNATIVE TRYING TO UNDERSTAND WHAT WORKS MANY THOSE CREATURES THAT CAN REGENERATE AND TRY AND UNDERSTAND DIFFERENCES BETWEEN THOSE SPECIES AND US AND SEE IF WE CAN REPLICATE THAT AND MAKE IT MORE INTRINSIC MECHANISM AS OPPOSED TO GENE THERAPY? INHIBITORS THAT PREVENT US FROM REGENERATION? >> THANK YOU, I THINK YOU RECAPITULATED A CHUNK OF THE REPORT WE HAVE OUT -- THOSE ARE THE IDEAS, WE NEED TO START WHERE THERE IS SPECIES WHERE ONE CAN FIND THESE PHENOMENA, FIND DIFFERENCES THAT PREVENT THAT IN THE NEXT RANGE OF SPECIES TO LOOK FOR INHIBITOR FACTORS AND THE UNDERLYING PRINCIPLES, BUT THE PUSH HERE IS TO TAKE WHAT WE HAVE AND NOT STUDY IT DEEPER. WE HAVE GOT A LOT OF RO-1 GRANTS ON THE STREET WHICH THAT'S GOING TO CONTINUE TO BE AVAILABLE. BUT TO TAKE WHAT WE KNOW AND TO MOVE IT ALONG A PATHWAY TO SEE IF WE CAN GET THIS ACTIVE ULTIMATELY IN HUMAN. >> IT'S BEEN A WONDERFUL PRESENTATION AND GREAT DISCUSSION, MANY THANKS FOR BYING THE GREAT SCIENCE TO US. WE BENEFITED AND ENJOYED IT ENORMOUSLY. THANK YOU. [APPLAUSE] >> WE WILL NOW MOVE TO THE NEXT TOPIC, A DISCUSSION ABOUT HIV AIDS PRIORITIES. BOB EISINGER, ACTING DIRECTOR OF THE OFFICE OF AIDS RESEARCH, GOING TO WALK US THROUGH THIS, THE MATERIALS, SLIDES I HAVE GONE LIVE ON THE ACD SITE BECAUSE I KNOW THERE ARE PEOPLE WATCHING BY WEBINAR, LET ME CHECK TO SEER RICK GUSBY, ARE YOU STILL ON PHONE? >> STILL ON THE PHONE. >> I HEARD ANOTHER BLEEP. CHRIS WILSON, HAVE YOU JOINED US? >> YES. >> GREAT. SO ERIC AN CHRIS BOTH HERE THOUGH NOT IN THE ROOM. AND LET ME MAYBE JUST MAKE A COMMENT TO INTRODUCE THIS AND THEN TURN THIS OVER TO BOB. OBVIOUSLY WE HAVE COME A LONG WAY IN HIV AIDS SINCE THIS CONDITION WAS FIRST IDENTIFIED NOW 25 YEARS AGO. 35 YEARS AGO. EXCUSE ME, IT'S BEEN LONGER. AND OF COURSE PEOPLE IN THE ROOM LIKE TONY FAUCI IN THE BACK HAVE PLAY AD CRITICAL ROLE ONE HAS ACCESS TO ANTIRETROVIRALS IS COMPATIBLE WITH ALMOST NORMAL LIFE SPAN, THOUGH WE'LL TALK ABOUT NOT WITHOUT POTENTIAL COMORBIDITIES WE DON'T ENTIRELY UNDERSTAND. SO SOME MIGHT SAY WE CONQUERED THIS ILLNESS BUT AS SOON AS YOU LOOK CLOSELY YOU WILL SEE THAT'S NOT THE CASE. THERE ARE ROUGHLY 15,000 NEW CASES IN THE FIST EACH YEAR AND MY MORE WORLD WIDE. OUR THERAPY ARE SUCCESSFUL IF AVAILABLE. BUT NOT PERFECT. WE WANT TO MOVE IN THE DIRECTION ACHIEVING A COMPLETE ERADICATION OF THIS DISEASE AND AIDS FREE GENERATION. TO GET THERE THIS WOULD BE A VERY UNFORTUNATE TIME TO TAKE ONE'S FOOT OFF THE ACCELERATOR. WE ARE AT THE POINT OF HAVING OPPORTUNITIES IN AREAS SUCH AS VACCINE. AND MAYBE EVEN A CURE. THAT DESERVE THE MOST INTENSE ATTENTION. YOU CAN IMAGINE. LOOKING AT THE WAY WHICH OUR AIDS PRIORITIES HAD BEEN IMPLEMENTED, IT WAS CLEAR THAT WE HAD NOT TAKEN A HARD LOOK AT THIS ISSUE IN TERMS OF THE RAPID CHANGES IN SCIENCE IN A WHILE. WE HAVE HELP FROM OPHIDIA OFFICE OF AIDS RESEARCH ADVISORY COUNCIL AND A VARIETY OF OTHER INPUTS FROM EXPERTS IN THE FIELD. SOUGHT TO REIDENTIFY PRIORITIES AND THEN TO LOOK CLOSELY AT OUR PORTFOLIO TO SEE HOW THOSE PRIORITIES COULD BE IMPLEMENTED. IN A ON GOING WAY. THIS HAS BEEN A COMPLICATED PROCESS, AS YOU MIGHT IMAGINE. WE ARE DETERMINED THAT THIS IS A DISEASE THAT CAN ULTIMATELY BE CONQUERED. WE ARE ALSO DETERMINED THAT WE WOULD NOT STEP BACK IN TERMS OF THE DOLLARS THAT WILL BE INVESTED IN HIV AIDS IN FY 16 COMPARED TO 15. WE ARE NO LONGER ARGUING THIS NEEDS TO BE A FORMULA BASIS FOR THAT. YOU KNOW GOING BACK 20 YEARS THERE HAD BEEN THIS EXPECTATION THAT 10% OF THE NIH BUDGET WOULD BE DEVOTED TO RESERVE ON HIV AIDS. THAT WAS A CRITICALLY IMPORTANT STEP BACK MANY THE POINT WHERE WE WERE DESPERATE FOR NEW ANSWERS AND GREAT THINGS CAME OUT OF THAT, BUT WE DON'T HAVE THAT FORMULA FOR ANY OTHER DISEASE AND THE ARGUMENT TO MAINTAIN IT FOR HIV AIDS IS MOST OF US BELIEVE NOW REALLY NOT A DEFENSIBLE ONE, WE SHOULD BE LOOKING AT WHAT ARE THE MOST IMPORTANT SCIENTIFIC PRIORITIES AND HOW TO MAKE SURE THOSE ARE BEING SUPPORTED. SO ALL THAT IS BY WAY OF BACKGROUND FOR WHAT BOB IS GOING TO TELL YOU ABOUT, WHICH IS AN EFFORT UNPRECEDENTED ONE TO DEFINE PRIORITIESEN LOOK CLOSE AT THE PORTFOLIO SPECIFICALLY GRANTS TURNING OVER IN FY 16 TO SEE WHETHER WE MAKE ADJUSTMENTS TO MAKE SURE THE COLLAR DOLLARS WE HAVE GO TOWARD PRIORITIES NOW MOST PROMISING. ALL THIS OF COURSE CREATES SOME SENSE OF UNEASYNESS BECAUSE WE ARE TALKING ABOUT LOOKING AT THIS IN A VERY INTENTIONAL WAY BUT I BELIEVE THOSE WHO CONSIDERED THE OPPORTUNITIES HERE GENERALLY AGREED THAT THIS IS A GOOD TIME TO BE DOING THIS AND WE THOUGHT IT WOULD BE VERY APPROPRIATE AND IMPORTANT FOR THE ACD TO HEAR ABOUT IT. SO WITH THAT AS A PREAMBLE, BOB WHO HAS WORKED HARD GETTING US TO THIS POINT CAN TELL YOU ABOUT THE STATUS THAT HE AND HIS COLLEAGUES HAVE COME UP WITH FOR Y'ALL TO HEAR ABOUT AND DISCUSS. THANKS, BOB. >> THANK YOU. THANK YOU FOR THE OPPORTUNITY TO PRESENT TODAY TO THE ACD. THE NIH AIDS RESEARCH PROGRAM REPRESENTS A VERY COMPREHENSIVE PROGRAM OF BIOMEDICAL, BEHAVIORAL AND SOCIAL SCIENCE RESEARCH ON HIV, AND ASSOCIATED CO-INFECTIONS CO-MODERRED BITY AND OTHER COMPLYCATIONS. THE NIH RESEARCH PROGRAM REPRESENTS THE LARGEST PUBLIC INVESTMENT IN AIDS RESEARCH IN THE WORLD. SO AS DR. COLLINS INDICATED, IS CRUCIAL WE ENSURE THAT AIDS DOLLARS AND RESOURCES ARE ARE GOING TO THE HIGHEST OVERARCHING AIDS RESEARCH PRIORITIES, MY PRESENTATION TODAY WILL FOCUS ON THE NEW HIV AIDS RESEARCH PRIORITIES AND REPORT ON THE PORTFOLIO REVIEW THAT IS RECENTLY BEEN COMPLETED BY THE OFFICE OF AIDS RESEARCH. RECENT SCIENTIFIC ADVANCES IN AREA OF PATHOGENESIS IMMUNE DYSFUNCTION VIRAL RESERVOIRS HAVE RESULTED IN TRULY UNPRECEDENTED SCIENTIFIC OPPORTUNITIES TO ACHIEVE A SAFE EFFECTIVE AIDS VACCINE STRATEGIES TO CURE HIV AND AIDS, AS WELL AS TO END AIDS PANDEMIC AND ACHIEVE AN AIDS-FREE GENERATION. AS SUCH, IT IS INDEED CRUCIAL THAT WE LOOK CAREFULLY AT THE AIDS PORTFOLIO TO ENSURE THAT WE ARE INDEED MOVING IN THE RIGHT DIRECTION. ON AUGUST 12 DR. COLLINS ISSUED A STATEMENT THAT IDENTIFIED THE NEW OVERARCHING AIDS RESEARCH PRIORITIES FOR THE NIH FOR THE NEXT 3 TO 5 YEARS, THESE PRIORITIES ARE LISTED TON NEXT SLIDE. FIRST TO REDUCE HIV INCIDENCE AN THIS INCLUDES THE DEVELOPMENT AND TESTING OF A SAFE AND EFFECTIVE AIDS VACCINE CANDIDATE AS WELL AS POTENTIAL MICROBICIDES, PREP AND OTHER STRATEGIES. OVERARCHING PRIORITY IS DEVELOPMENT AND CLINICAL TESTING OF THE NEXT GENERATION OF HIV THERAPIES. THAT SHOW FEWER SIDE EFFECTS LOWER TOXICITIES, BETTER SAFETY, AND EASE OF USE. RESEARCH TOWARD A CURE IS ANOTHER OVERARCHING AIDS RESEARCH PRIORITY AS DEVELOPMENT TESTING OF STRATEGIES TO PREVENT HIV ASSOCIATED COMORBIDITIES AND CO-MORE IT WILLTIES. CROSS CUTTING ALL THESE AREAS IS A CONTINUED YEAR AFTER. ING PRIORITY ON BASIC RESTORAGE PROVIDE FOUNDATION AND TOOLS TO DEVELOP NEW AND BETTER STRATEGIES TO PREVENT AND TREAT HIV AND AIDS. RESEARCH IN HEALTH DISPARITIES IS ANOTHER OVERARCHING PRIORITY AS IS TRAINING FOR THE NEXT GENERATION OF AIDS RESEARCHERS. ON AUGUST 12th, THE NIH ISSUED A NOTICE OF THE NIH GUYED THAT HIGHLIGHTED THESE OVERARCHING PRIORITIES AND ALSO PROVIDED NEW GUIDELINES FOR DETERMINING THE USE OF AIDS FUNDING. IN AUGUST DR. COLLINS CHARGED OFFICE OF AIDS RESEARCH TO LOOK AT THE ENTIRE AIDS RESEARCH PROGRAM AS CURRENTLY EXISTS, AND CONDUCT A PORTFOLIO ANALYSIS TO ASSESS HOW WELL THE CURRENT PORTFOLIO IS ALIGNED WITH THESE NEW OVERARCHING PRIORITIES. THE APPROACH THAT WE USED INVOLVED LOOKING AT ALL GRANTS AND CONTRACTS THAT WERE SUPPORTED WITH AIDS DOLLARS IN FISCAL YEAR 2014, AND ELIGIBLE TO RECOMPETE IN FISCAL YEAR 2016. IN ADDITION WE LOOK AT INVESTIGATOR INITIATED INTRAMURAL PROJECTS. THAT WERE FUNDED WITH AIDS DOLLARS IN FY 14 REVIEWED BY THE INSTITUTE CENTERS BOARD OF SCIENTIFIC COUNSELORS AND FUNDING DECISIONS IN FY 16, THIS WAS UNIQUE TO THIS PORTFOLIO REVIEW INSOFAR AS WE DID LOOK AT ALL GRANTS, CONTRACTS AND INTRAMURAL PROJECTS THAT MET THE CRITERIA. THE PORTFOLIO REVIEW WAS CONDUCTED BETWEEN AUGUST AND THE END OF LAST MONTH AND THE RESULTS ARE BEING PRESENTED TODAY AT THE ACD MEETING. THE METHODOLOGY USED FOR THIS REVIEW INVOLVE NEW OVERARCHING PRIORITIES AN NEW GUIDELINES FOR THE USE OF AIDS FUNDS AND OAR ESTABLISHED PANELS OF NIH INTRAMURAL AND EXTRAMURAL SCIENTISTS ALONG WITH OAR SENIOR SCIENTIFIC STAFF WHO INDEPENDENTLY RATED EACH PROJECT, BASED ON ASSESSMENT OF EACH PROJECT INDIVIDUAL PROJECT AIM AND GOALS. RECENT PROGRESS REPORTS AS WE AS PUBLICATION AND OTHER DATA. EACH PROJECT WAS SIGNED EITHER A HIGH, MEDIUM OR LOW PRIORITY BASED ON NOTICE IN THE NIH GUIDE. EACH PROJECT WAS REVIEWED AND RATED INDEPENDENTLY BY THREE INDIVIDUALS, THREE SCIENTISTS FROM NIH. AND A FINAL RATING WAS DETERMINED BASED ON THE MAJORITY RATING. THE INSTITUTES AND CENTERS WERE PROARE VIEDED OF THEIR INITIAL LOW PRIORITY PROJECTS, PROVIDED AND THESE WERE DISCUSSED SO WE CAN TAKE INTO CONSIDERATION ANY ADDITIONAL DATA OR FINDINGS RECENTLY PUBLISHED. FINALLY DETERMINATION WERE MADE ON EACH PROJECT BY THE OAR AND LIST OF LOW PRIORITY PROJECTS WILL BE PROVIDED TO THE INSTITUTES AFTER THE ACD MEETING. IS PRIMARY OUTCOMES ANTICIPATED FROM THIS PORTFOLIO REVIEW WAS EACH PROJECT WILL BE ASSIGNED A HIGH, MEDIUM OR LOW PRIORITY. BY LOW PRIORITY WHAT WE ARE INDICATING IS THE PROJECT WAS INITIALLY NEEDING A PRIORITY WHEN IT WAS INITIALLY FUNDED. HOWEVER IT IS NO LONGER ALIGNED WITH THE OVERARCHING PRIORITIES. THAT WERE JUST RECENTLY ANNOUNCED BY DR. COLLINS. ONE MAJOR OUTCOME FROM THIS PORTFOLIO REVIEW WAS THAT WE WERE ABLE TO IDENTIFY A TOTAL AMOUNT OF FUNDS THAT COULD BE REDIRECTED FROM THESE LOW PRIORITY PROJECTS TO HIGHER PRIORITY AIDS RESEARCH PROGRAMS AND PROJECTS. THESE ARE PROJECTS ENDING IN FY 16 AND ELIGIBLE FOR RECOMPETITION. THOSE LOW PRIORITY PROJECT PROJECTS ASSUME THESE ARE RESUBMITTED TO THE NIH COMPETE WELL AN DEEMED HIGHLY MERITORIOUS COULD BE SUPPORTED WITH THE INSTITUTE OR CENTERS NON-AIDS DOLLAR BUT AS A RESULT OF THIS PORTFOLIO REVIEW, NO LONGER ELIGIBLE FOR SUPPORT WITH AIDS DOLLARS. (OFF MIC) >> TURN YOUR MIC ON. >> I'M NOT CLEARING THE METHOD FOR RIGHT. SAY TWO PEOPLE RATE ME HIGH AND ONE PERSON RATES LOW. WOULD YOU ESTABLISH A NUMERICAL MEAN AND PUT IN ONE OF THOSE THREE BIN? >> YES. THAT'S WHAT WE DID. IF THERE WAS A SIGNIFICANT LEVEL OF DISCORDANCE WHERE YOU MIGHT HAVE ONE LOW, ONE MEDIUM AND ONE HIGH, ULTIMATELY, IT WAS ADJUDICATED BY MYSELF AFTER LOOKING AT ALL THE DATA THAT WAS AVAILABLE AND AFTER DISCUSSIONS WITH THE ICs. SO THAT WE TRULY WERE MAKING A DECISION ON -- BASED ON RECENT INFORMATION THAT WAS AVAILABLE IN EACH PROJECT. >> >> I HAD ANOTHER QUESTION ABOUT METHODOLOGY, SO THE CRITERIA FOR RATING WHETHER OR NOT IT FIT WITH NEW PRIORITIES AND THAT WAS IT OR WHETHER THERE WAS OTHER SPECIFIC CRITERIA USED TO RATE EACH ASPECT OF THE PROJECT. >> WHAT WE DID IS WE LOOKED AT HOW THE PROJECT AIMS AND ALIGNED WITH THE OVERARCHING PRIORITIES, THEN WE USE THE NEW GUIDELINES FOR DETERMINING HIGH MEDIUM OR LOW PRIORITY AS DESCRIBED IN THE NIH GUIDE NOTICE. >> WE LOOK AT PROGRESS REPORTS. >> WE LOOK AT PROGRESS REPORTS AS WELL AS RECENT PUBLICATIONS ANNIE OTHER DATA AVAILABLE PROJECT BY PROJECT BASIS. >> LET ME CLARIFY BECAUSE THE TERMINOLOGY MAY THROW PEOPLE WHEN IT SAYS LOW PRIORITY THAT DOES NOT MEAN NECESSARILY THESE WERE LOW PRIORITY SCIENCE, IT MEANS THEY WERE LOW PRIORITY AS FAR AS THEIR FITTING WITH THE CURRENT AIDS RESEARCH PRIORITIES THAT BOB WENT THROUGH. SO THOSE PROJECTS MIGHT VERY WELL BE MERITORIOUS FOR RENEWAL BUT THEY NEED TO BE FUNDED OUT OF A DIFFERENT POT OF FUNDS. >> THAT'S MY QUESTION, JUST TO PUSH A LITTLE BIT MORE, IMAGINE THE AIMS MAY OR MAY NOT BE COMPATIBLE WITH NO NOTICE. AND THERE'S THE HERB SOMEHOW OF SCIENTIFIC QUALITY OF THE WORK. I'M WONDERING IF THAT LOW MEDIUM HIGH ONLY CONSIDERED THE AIMS. OR IF IT ALSO CONSIDERED QUALITY OF WORKING DONE SO YOU CAN IMAGINE HIGH PRIORITY ACTIVITY THAT WAS NOT BEING EXECUTED PARTICULARLY WELL. WHAT DID HA TURN INTO? >> WE DID NOT FOCUS SHOALLY ON THE AIMS AND THAT'S ONE REASON WE LOOKED AT THE -- MOST RECENT PROGRESS REPORTS SO WE CAN INDEED SEE WHETHER OR NOT THE SCIENCE WAS BEING -- IF THE PROJECT WAS MOVING THE SCIENCE FORWARD OR NOT. AND IF IT WAS MOVING IT FORWARD, WAS ANYTIME ARYANMENT WITH OVERARCHING PRIORITIES. >> THESE ARE PROJECTS DUE FOR RECOMPETITION SO A COMPETING RENEWAL, THERE WILL BE A PEER REVIEW PROCESS THAT WILL DELVE INTO THE QUALITY OF THE SCIENCE IF THIS PROJECT COMES BACK FOR RENEWAL SO IT'S SOMETHING CALLED HIGH PRIORITY, DOES IT NECESSARILY MEAN THAT WHEN IT COMES BACK FOR COMPETITION IT WILL GET FUNDED BECAUSE THE PEER REVIEWERS MAY SAY IT'S IN THE RIGHT SPACE SCIENTIFICALLY BUT NOT AS PRODUCTIVE AS WE LIKE. >> WE WERE LOOKING AS DR. COLLINS INDICATED PROJECTS THAT WERE ENDING FOR RECOMPETITION, WE DID NOT -- THE GOAL OF ALL THIS WAS NOT TO DEFUND ANY ONGOING PROJECTS. THE FUNDS THAT ARE IDENTIFIED FROM THESE LOW PRIORITY PROJECTS, WILL GO TO A COMMON HIGH AIDS RELEVANCE POOL. ALL THE ICs WILL BE ELIGIBLE TO SUBMIT PROPOSALS THAT ARE INDEED ALIGNED WITH THE OVERARCHING PRIORITY. THIS WOULD BE USED THEN TO SUPPORT HIGHLY MERITORIOUS GRANTS, CONTRACTS AS WELL AS COMPONENTS OF INTRAMURAL PROJECTS. BUT THESE HAVE TO BE ALIGNED WITH OVERARCHING PRIORITIES. SHIRLEY, SORRY. >> ARE THE INVESTIGATORS GIVING FEEDBACK ON THIS? THE PI NECESSARY -- PIs? Q. WE'LL PROVIDE THE INFORMATION TO THE INSTITUTES AND THEY IN TURN HAVE THE RESPONSIBILITY TO BE BACK IN CONTACT WITH THE PRINCIPAL INVESTIGATORS. >> HOUDA, IT'S ALSO TRUE, DO INVESTIGATORS KNOW THAT THEIR GRANT IS CATEGORIZED AS AIDS OR NON-AIDS? >> THE ONLY WAY THEY KNOW THIS WOULD BE IF THEY GO INTO THE CCDC AND DETERMINE WHETHER OR NOT THEIR PROJECTS LISTED BUT TO BE HONEST -- >> DON'T KNOW. >> THEY DO NOT KNOW THAT'S TRUE FOR THE EXTRAMURAL AS WELL AS FOR THE INTRAMURAL. >> AND NOTICE THAT WAS PUT OUT EARLIER IDENTIFYING THE PRIORITIES ALERTING EXTRAMURAL COMMUNITY TO WHAT IS NOW VIEWED AS HIGH PRIORITY RESEARCH FUNDED WITH THE SET OF FUNDS. >> I'M CONFUSED ABOUT THE 10% SET ASIDE OF AIDS FUNDS, WERE THOSE ALLOCATED TO INSTITUTES AN CENTERS OR WERE THEY ADDED ON TOP OF -- >> THE AIDS BUDGET IS DETERMINED NOT BASED ON A FORMULA. IT'S RATHER BASED ON THE INITIATIVES THAT EACH INSTITUTE PUTS FORWARD. THERE IS A COMMITMENT BASE THAT IS BUILT INTO THEIR AIDS BUDGET BUT THEY ARE REQUIRED TO SUBMIT TO THE OFFICE OF AIDS RESEARCH ANY NEW RECOMPETING OR EXPANDED INITIATIVES, THEN OAR DETERMINES BASED ON THE SCIENTIFIC PRIORITIES, WHICH ULTIMATELY SHOULD BE SUPPORTED WITH AIDS DOLLARS. >> WE OBVIOUSLY ARE DETERMINED NOW TO MAKE SURE THAT WITH THESE PRIORITIES ARTICULATED THAT GOING FORWARDS THEY'RE GOING TO BE IMPLEMENTED IN TERMS OF HOW DOLLARS ARE SPENT. IN THE PAST SOME OF THE DECISIONS ABOUT AIDS DOLLARS WERE MORE RETROSPECTIVE THAN PROSPECTIVE. GOING BACK 25 YEARS, THE DOLLAR WERE SIGNED A CERTAIN WAY AND AFTER PERIOD OF TIME DIFFERENT INSTITUTES WOULD HAVE DIFFERENT PROPOSALS ABOUT THINGS THAT THEY WANTED TO WORK ON THAT RELATED TO AIDS DOLLAR GET ASSIGNED. THERE IS OAR HAS RESPONSIBILITY TO LOOK ACROSS THE PORTFOLIO AND NOW IMPLEMENTING IN A MORE INTENTION AL WAY AND ASK WHETHER WE ARE PUTTING THOSE MONEY IN PLACE AND THERE'S AN AUTHORITY TO MOVE DOLLARS FROM INSTITUTE TO INSTITUTE UP TO 3% OF THE BUDGET IN A GIVEN YEAR BASED UPON WHERE THE SCIENCE NEEDS TO BE DONE. >> THAT'S THE PART THAT I DONE UNDERSTAND. THESE DOLLARS WERE NOT ACTUALLY -- THE DOLLARS WERE IN THE INSTITUTE, OAR CALLED THEM AIDS DOLLARS, NOW OTHER DECIDES THEY'RE NOT AIDS DOLLAR AN MOVE T THEM OUT OF THE INSTITUTE. >> YOU'RE ABOUT TO HEAR IT MOVES IT TO COMMON POOL THAT THE INSTITUTES CAN COMPETE FOR. NOW THAT THEY ARE CLEARLY ASSIGNED TO BE HIGH -- >> OAR DOES NOT GIVE BUT IT DOES TAKE AWAY. >> THE HIGH PRIORITY POOL WILL BE ASSIGNED SOMEWHERE. SO YOU WILL HEAR, WE'RE GOING TO FREE UP A SUBSTANTIAL AMOUNT. OF DOLLARS THAT'S COMPETE FORD BY ALL THE INSTITUTES BUT THEY HAVE TO PUT FORWARD HIGH PRIORITY PROJECTS TO BE ABLE -- ELIGIBLE TO MAKE THAT COMPETITION, IT WILL RESULT IN SHIFTING OF DOLLARS AROUND. WHICH WE THINK NEEDS TO HAPPEN. DID THAT MAKE SENSE? >> YOU STILL LOOK PUZZLED. >> FRANCIS, WOULD YOU CLARIFY -- HIGH PRIORITY INITIATIVES UNDER WHICH INDIVIDUAL PROJECTS WILL BE FUNDED THROUGH RFAs, PAs AND LIKE. >> IT COULD BE INDIVIDUAL PROJECTS, I MEAN INSTITUTES THAT HAVE RECEIVED A UNSOLICITED INVESTIGATOR INITIATED PROJECTS THAT COME THROUGH PEER REVIEW AND GET A GOOD PRIORITY SCORE AND BY THEIR SPECIFIC AIMS FIT OUR DEFINITION OF THOSE FOUR PRIORITIES AN INSTITUTE CAN PUT THAT FORWARD AND SAY WE THINK THAT SHOULD BE FUNDED WITH AIDS DOLLARS. WITHOUT HAVING A RESPONSE TO RFA. >> I'M TRYING TO -- LET ME USE A REALLY EXTREME EXAMPLE TO SEE IF I'M UNDERSTANDING THIS CORRECTLY. LET'S SAY THAT OTHER HAS DECIDED -- OAR DECIDES CANCER WAS AN INCREDIBLY IMPORTANT SIDE EFFECT OF AIDS AND DEFINED A BUNCH OF GRANTS IN THE P NCI WITH NCI DOLLARS, AS AIDS GRANT. NOW OAR DECIDES THAT'S NO LONGER CANCER GRANT, IT TRANSFERS ALL THAT NIH NCI MONEY INTO OAR. IS THAT WHAT I'M HEARING? >> I WOULD NOT SAY IT'S TRANSFERRED TO OAR, THOSE DOLLARS THIS FY 16, TALKING ABOUT THINGS TURNING OVER IN THIS YEAR. AND NOTHING IS GOING TO GET CHANGED THAT'S ALREADY IN THE MIDDLE OF A FUNDING CYCLE SO IF NCI HAS, THIS MAY BE THE CASE, GRANTS WHICH ARE TURNING OVER, NOW NOT JUDGED HIGH PRIORITY OR MEDIUM PRIORITY ZONE, THEN THE UNDERSTANDING IS THOSE DOLLARS NOW BECOME AVAILABLE NOT FOR OAR TO OWN BUT FOR THEM TO MANAGE AND ALL THE OTHER INSTITUTES CAN RAISE THEIR HAND AND SAY WE HAVE THINGS THAT REALLY DO NEED TO BE FUNDED THAT DO FIT THE PIE HIE PRIORITIES, WE WOULD LIKE AN OPPORTUNITY TO COMPETE FOR DOLLARS NOW FREED UP. >> THIS MECHANISM OF MOVING MONEY AROUND TO ADDRESS HIV RESEARCH IS IN THE NEW SO PEOPLE IN THE PAST HAVE DECIDED THAT HIV IS NO LONGER RELEVANT TO THE -- THEIR SPECIFIC INSTITUTE AND MONEY HAS BEEN MOVED AROUND. IT'S NOT A NEW PROCESS. IT IS NOW JUST REALLY RIGOROUSLY APPLIED BASED ON THESE RESEARCH PRIORITIES. >> AN IDEA ON THE SIZE OF THE MOVEMENT EXCLUDING ESPECIALLY DISEASE, WHAT ARE INSTITUTES PROPORTIONAL AIDS? >> I'M SORRY COULD YOU REPEAT? >> WHAT OTHER INSTITUTE OTHER THAN NIAID HAS HAS PROPORTION OF AIDS -- HIGHEST PROPORTION OF AIDS? >> ALL INSTITUTES AND CENTERS CURRENTLY RECEIVE AIDS DOLLARS, THEY'RE PROBABLY ABOUT FOR OR FIVE ICs INCLUDING BESIDES NIAID THERE'S THE CANCER INSTITUTE, NIDA, NATIONAL HEART LUNG AND BLOOD INSTITUTE, TO SOME DEGREE THE NATIONAL INSTITUTE OF MENTAL HEALTH, AIDS BUDGET, THOSE ARE TOP FOUR OR FIVE. >> THOSE WOULD HAVE MORE THAN 10%. >> THE THAT YOU UNDERSTAND ARE PROVIDED, THE AIDS DOLLARS PROVIDED TO THE INSTITUTE AGAIN ARE NOT DETERMINED BASED ON A FORMULA, BASED ON THE INITIATIVES THEY PUT FORWARD AND THIS IS PART OF THE NORMAL BUDGET DEVELOPMENT PROCESS THAT OAR LEGISLATIVELY MANDATED TO DO. >> IF YOU CAN GO ON TO EXPLAIN WHAT WE'RE ABLE TO IDENTIFY AS FAR AS FUNDS AVAILABLE FOR COMPETITION IN FY 16 AND THIS MAY MAKE IT MORE CLEAR TO CORRY'S QUESTION. WHAT EXACTLY IS INVOLVED HERE IN IMPLEMENTING THESE PRIORITIES? >> IN FISCAL YEAR 2014, THE NIH AIDS RESEARCH BUDGET TOTALED $2.98 BILLION THIS REPRESENTED SUPPORT FOR 5,243 UNIQUE EXTRAMURAL GRANTS, 435 INTRAMURAL PROJECTS AND 68 CONTRACTS. IN OUR PORTFOLIO REVIEW, WE DID A SUBSET WHICH WE WERE ONLY FOCUSING ON THOSE PROJECTS RECOMPETING IF FISCAL YEAR 2016 SO WE FOCUSED ON $435.65 MILLION WORTH OF PROJECTS, THIS INCLUDED 1207 EXTRAMURAL GRANTS TOTALLY $407 MILLION, SLIGHTLY ABOVE THAT AMOUNT. 56 INTRAMURAL PROJECTS TOTALING ABOVE $21 MILLION. 11 CONTRACTS WHICH TOTALED APPROXIMATELY $6.89 MILLION. THIS SCHEMATIC SHOWS WHAT HAPPENS ON -- AS A RESULT OF THIS PORTFOLIO REVIEW. AND EACH REVIEWER ASSESSED EACH PROJECT, AGAIN LOOKING AT THE SCIENTIFIC AIMS, RECENT PROGRESS REPORTS, PUBLICATIONS AND OTHER DATA AVAILABLE. EACH REVIEWER ASSIGNED A HIGH, A MEDIUM OR A LOW PRIORITY RATING TO THAT PROJECT AGAIN BASED ON HOW WELL THE OBJECT IS ALIGNED WITH THE OVERARCHING PRIORITIES AND THE NIH GUIDE NOTICE THAT DESCRIBED WHAT FIT INTO EACH OF THESE THREE CATEGORIES. MAJOR FOCUS WAS ON LOW PRIORITY PROJECTS FOR THESE ARE THE ONES THAT WERE ENDING UP FOR RECOMPETITION AND ASSESS LOW PRIORITY THOSE AIDS DOLLARS WOULD BE REDIRECTED TO HIGHER PRIORITY AIDS RESEARCH PROJECTS. WE ALSO CONDUCT AD PRO RATING PILOT STUDY, AS YOU MAY KNOW THERE ARE MANY TRANS-NIH PROGRAMS AND PROJECTS THAT MAY HAVE AN AIDS AND NON-AIDS COMPONENT. IN ORDER TO STANDARDIZE THE PRORATING PROCESS ACROSS THE INSTITUTES, WHAT WE DID WAS WE TOOK A SAMPLE OF ALL THE HIGH AN MEDIUM PRIORITY PROJECTS REVIEWED, WE ASKED THE PANEL REVIEWERS SO INDEPENDENTLY ASSESS EACH PROJECT AND NOW TO ASSIGN EITHER 0, 25, 50, 75 OR 100% TO EACH PROJECT, AGAIN TO TRY AND STANDARDIZE HOW MUCH SHOULD BE SUPPORTED WITH AIDS DOLLARS. THE FOLLOWING SERIES OF SLIDES WILL PRESENT THE RESULTS OF THE THIS PORTFOLIO REVIEW. I'LL START WITH THE EXTRAMURAL PORTFOLIO ASSESSMENT OF THE 1207 EXTRAMURAL PROJECTS IN THESE TOTALED APPROXIMATELY $407 MILLION, 832 PROJECTS OR 69% OF THE TOTAL RATED HIGH PRIORITY AND THESE TOTALED 3 -- SLIGHTLY OVER $300 MILLION. ADDITIONAL 133 PROJECTS OR 11% OF THE TOTAL PROJECTS THAT WERE REVIEWED, WERE RATED MEDIUM PRIORITY. THESE ARE TOTALING APPROXIMATELY 4 # $.5 MILLION. $41.5 MILLION. WE IDENTIFIED 242 PROJECTS OR 20% OF THE TOTAL OF THE EXTRAMURAL GRANTS REVIEWED WERE RATED AS LOW PRIORITY. AND THIS TOTALED T SLIGHTLY OVER $65 MILLION I WANT TO GIVE A FEW EXAMPLES OF WHAT WE IDENTIFY LOW PRIORITY PROJECTS. THIS INCLUDES STUDIES ON THE BASIC VIROOLOGY AND IMMUNOLOGY, GENOMICS, INFECTIOUS PATHOGENS, BUT OUTSIDE OF THE CONTEXT OF HIV, WE ALSO IDENTIFIED TRAINING PROGRAMS WHERE THERE WAS NO INDICATION OF AN AIDS COMPONENT. (OFF MIC) >> THIS IS BASIC RESEARCH ON NEISSERIA GONORRHEA THAT WAS NOT IN THE CONTEXT HOW DOES THAT STUDY DIRECTLY RELATE TO HIV DISEASE. NEXT ARE INTRAMULE PORTFOLIO ASSESSMENT. IN THIS CASE THERE WERE 56 INTRAMURAL PROJECTS TOTALING LITTLE BIT OVER $21 MILLION THAT WERE FUNDED WITH AIDS DOLLARS IN FY 14 REVIEWED BY THE IC BOARD OF SCIENTIFIC COUNSELORS IN FY 15 AND PENDING A FUNDING DECISION IN FY 16. OF THESE 56 INTRAMURAL PROJECTS, 18 PROJECT OR 32% OF THE TOTAL PROJECTS REVIEWED, WERE RATED HIGH PRIORITY. AND THIS TOTALED APPROXIMATELY $10 MILLION. IN ADDITIONAL 12 PROJECTS REPRESENTING 21% OF THE TOTAL, WERE RATED AS MEDIUM PRIORITY. AND THERE WERE 26 PROJECTS OR 47% OF THE TOTAL THAT WERE RATED AS LOW PRIORITY. THESE LOW PRIORITY PROJECTS TOTALED $6.6 MILLION. THE FOLLOWING REPRESENTS SOME OF THE EXAMPLES OF LOW PRIORITY PROJECTS, THIS INCLUDED BASIC RESEARCH ON PATHOGENESIS AND TREATMENT OF INFECTIOUS PATHOGENS, AGAIN, NOT IN THE CONTEXT OF HIV DISEASE, INCLUDING CHLAMYDIA, CRYPTOCOCCUS, NEISSERIA GONE REIA, HEPATITIS VIRUSES AND FUNGAL INFECTIONS. BASIC STUDIES ON TUMOR KNEWMOLOGY AND GENETICS. -- IMMUNOLOGY AN GENETICS. T-CELL GENETICS AUTO-IMMUNITY AN CANCER NOT IN THE CONTEXT OF HIV DISEASE, YOU'RE ALSO NUMBER OF STUDIES LOOKING AT BIOLOGICAL AND BEHAVIORAL EFFECTS OF DRUG DEPENDENCE AND TREATMENT WITH NO AIDS COMPONENTS. THE RESULTS OF THE CONTRACT PORTFOLIO ASSESSMENT WE LOOKED AT 11 CONTRACTS OR TASK ORDERS, TOTALING LIGHTLY UNDER $7 MILLION THAT WE'RE ELIGIBLE TO RECOMPETE IN FY 16 AND ONLY ONE OF 11 WAS RATED LOW PRIORITY TOTALING $1.26 MILLION. I WANT TO BRIEFLY MENTION RESULTS OF OUR PRO RATING PILOT STUDY. THE REVIEWERS QUITE HONESTLY HAD SOME DIFFICULTY WITH DOING THIS, THERE WAS A LARGE RANGE OF DISCORDANCE IN THE PERCENT OF AIDS DOLLARS THAT THE REVIEWERS FOUND SHOULD BEER SHOULD BE USED THE SUPPORT THESE PROJECTS. THESE ARE VERY BROAD PROGRAMS THAT HAVE BOTH AIDS AND NON-AIDS COMPONENT. THE PRO RATING WAS HIGHLY SUBJECTIVE AND SO WHAT THIS WILL REQUIRE IS OAR WILL WORK CLOSELY WITH THE ICs TO DEVELOP A SERIES OF GUIDELINES THAT WOULD INDEED BE APPROXIMATELY CABLE ACROSS INSTITUTES AND ACROSS AREAS OF SCIENCE. THE OVERALL CONCLUSIONS OF OUR PORTFOLIO REVIEW IS THIS PROCESS WE DEVELOP AND UTILIZED LOOKING AT THE FY 14 PROJECTS RECOMPETING MANY FY 16 COULD BE USED TO DIFFERENTIATE THE RELEVANCE OF AIDS PROJECTS AND IDENTIFY PROJECTS THAT ARE NO LONGER A PRIORITY FOR SUPPORT WITH AIDS DOLLARS. IT IS NOT SAYING THE LOW PRIORITY PROJECTS SHOULDN'T BE SUPPORTED BUT NOT WITH AIDS DOLLARS, THEY ARE ELIGIBLE FOR SUPPORT BY THE ICs WITH THEIR NON-AIDS DOLLARS. ANOTHER CONCLUSION FROM OUR PORTFOLIO REVIEW WAS THE PANELS THAT WE ESTABLISHED OF OAR SENIOR SCIENTIFIC STAFF AND IC SCIENCE -- SCIENTIFIC STAND COULD INDEPENDENTLY ASSESS A VERY EXTENSIVE COMPLEX PORTFOLIO OF AIDS PROJECTS WITH A HIGH LEVEL OF CONCORDANCE IN REGARDS TO THEIR PRIORITY RATING. THERE IS A LEVEL OF SUBJECTIVITY IN ASSESSING THESE PROJECTS BUT BY HAVING MULTIPLE REVIEWERS INDEPENDENTLY LOOK AT THAT, WE WERE ABLE TO OVERCOME THE SUBJECTIVITY WE WERE CONCERNED ABOUT. CERTAINLY IN REGARDS TO PRO OPERATATING THIS WILL REQUIRE A ON GOING DISCUSSION WITH ICs TO DEVELOP A ROW RATING SCHEME THAT COULD BE UTILIZED. AS A RESULT OF-PORTFOLIO REVIEW THE FOLLOWING ARE FOUR RECOMMENDATIONS THAT WE THOUGHT ARE VERY IMPORTANT. THE FIRST IS THAT WE NEED TO CONDUCT A SIMILAR ANNUAL PORTFOLIO REVIEW FOR THE NEXT THREE TO FOUR YEARS TO FURTHER FOCUS THE HIV AIDS RESEARCH PROGRAM TO ENSURE THAT IT IS INDEED TRULY ALIGNED WITH THE HIGHEST PRIORITIES AND THAT QUITE HONESTLY, THAT THESE FUNDS ARE INDEED AVAILABLE FOR THE OVERWAR -- OVER ARCHING PRIORITY PROJECTS. THE OAR WILL WORK CLOSELY WITH NIH RESEARCH BECAUSE REVIEWS REQUIRE A COMPREHENSIVE REVIEW OF THE INTRAMURAL PROGRAM AS WELL. THE SECOND RECOMMENDATION, WAS THAT WE NEED TO CONSIDER REVISING PRIORITIES IN FY 17 AND BEYOND TO REFLECT EMERGING SCIENTIFIC OPPORTUNITIES THE CHANGING LANDSCAPE OF EPIDEMIC AND RECENT ADVANCES AND FINDINGS. THIRD, RECOMMENDATION IS WE NEED NIH AND OFFICE OF AIDS RESEARCH NEEDS TO CLEARLY COMMUNICATE WHAT THESE OVERARCHING PRIORITIES ARE AND THE ROLE OF THE PORTFOLIO REVIEW PROCESS TO SCIENTIFIC COMMUNITY, RESEARCH ADVOCATES, AND OTHER STAKEHOLDERS. FINALLY, WE WILL NEED TO FURTHER REFINE OUR PRORATING GOODBYE GUIDELINES DOCUMENT ULTIMATELY BEGINNING IN FISCAL YEAR 2017 WILL BE ABLE TO MORE EASILY USE THIS PRO RATING SCHEME, ACROSS INSTITUTES AND ACROSS AREAS OF SCIENCE. FINALLY ALL THESE ACTIVITIES ARE TO ENSURE THAT AIDS DOLLARS ARE ARE AVAILABLE TO SUPPORT DEVELOPMENT SAFE EFFECTIVE VACCINE CANDIDATES TO ULTIMATELY IDENTIFY A STRATEGY OR STRATEGIES TO ACHIEVE A FUNCTIONAL CURE FOR HIV TO END THE AIDS PANDEMIC AND ULTIMATELY ACHIEVE AN AIDS-FREE GENERATION. THANK YOU. [APPLAUSE] >> IT MAY HELP IF YOU CAN GO BACK TO SLIDE 13, THE ONE ABOUT THE EXTRAMURAL PORTFOLIO AND IN TERMS OF WHAT YOU FOUND WHEN YOU WENT THROUGH THERE. THAT ONE. SO JUST TO CLARIFY HOW THIS NOW RESULTS IN WHAT WE'RE TRYING TO ACCOMPLISH. IN THE EXTRAMURAL PROGRAM YOU CAN SEE THAT THERE ARE 242 PROJECTS TOTALING $65.22 MILLION THAT WERE RATED AS LOW PRIORITY FOR HIV AIDS, NOT AGAIN TO SAY LOW PRIORITY IS NOT -- WE WOULD NOW SAY THOSE $65.22 MILLION ARE NOW AVAILABLE FOR COMPETITION BY INSTITUTES WHO HAVE IDEAS ABOUT EXCITING SCIENCE THAT WOULD FIT THE CURRENT PRIORITIES AND MIGHT OTHERWISE GO UNFUNDED. SO THIS IS AN OPPORTUNITY TO SHIFT OUR AREA OF ONLY FA SCHISMS TONY COME O THE TABLE BECAUSE IT WILL BE AN INTERESTING DISCUSSION ABOUT THE SCIENTIFIC OPPORTUNITIES, I'M QUITE COMPELLED BY THE DEVELOPMENTS THAT OCCURRED JUST IN THE LAST COUPLE OF YEARS WITH ABOUT AN UNDERSTANDABLE OF BROADLY NEUTRALIZING ANTIBODIES AN POTENTIAL FOR THERAPEUTICS BUT ALSO UNDERSTAND HOW YOU MIGHT DEVELOP A VACCINE THAT ACTUALLY WORKSES IN PRODUCE THOSE IN THE AVERAGE PERSON AND YET TO GO DOWN THAT ROAD IS QUITE CHALLENGING AND I THINK THIS IS A TIME YOU WANT TO PUSH HARD ON THAT. IF WE CONTINUE THE PROCESS WE HAVE BEEN FOLLOWING OVER THE YEARS MUCH MORE LA SHIRKSSSES FAIR I DON'T THINK WE HAVE WOULD HAVE HAD THE OPPORTUNITY TO SEE AND JUMP ON IT AND THAT'S PART OF THE MOTIVATION. BUT TONY, PLEASE JUMP IN AND SAY A WORD ABOUT SCIENCE. >> I WAS GOING TO JUMP TO THE TABLE WHEN I SAW CORRY'S PAIN IN YOUR FACE WHEN EXPLAINING IT. THERE'S THE POSSIBILITY OF CONFUSION. I WILL SAY THE SAME THING THAT BOB SAID WELL AND THAT FRANCIS AND CATHY SAID. MAYBE TO CLARIFY A LITTLE BIT MORE, WHEN YOU TALK ABOUT LOW MEDIUM AND HIGH PRIORITY WITH REGARD TO SCIENCE PLUS PRIORITY FOR ENING THE EPIDEMIC, LET'S JUST FOR THE SAKE OF ARGUMENT TO MAKE IT CLEAR, PUT ASIDE SCIENTIFIC QUALITY. LET'S ASSUME, LET ME EXPLAIN -- FINISH, AND I THINK IT WILL CLARIFY FOR YOU. IF YOU ASSUME THAT ALL OF THESE THINGS THAT HAVE GONE UNDER PEER REVIEW ARE GOOD SCIENCE, SOME BETTER SCIENCE THAN OTHER BUT LET'S ASSUME THEY'RE ALL GOOD SCIENCE, THE QUESTION YOU'RE ASKING NOW IF THE GOAL IS BECAUSE WE GET A LOT OF PRESSURE FROM CONGRESS, ABOUT MONEY FOR HIV, SHOULD WE DECREASE IT, WHERE IS THE END GAME AND WHAT FRANCIS AND I AND ALL THE OTHERS HAVE SAID, WE FEEL WE CAN BE ON THE PATH TO END THE AIDS EPIDEMIC SO WE WON'T DEMAND A CERTAIN PERCENTAGE OF MONEY BUT WE'LL GUARANTEE YOU THE HIGHEST PRIORITY RESEARCH. SO HISTORICALLY, THE ISSUE IS NOT IS VACCINE HIGH PRIORITIES IS DRUG HIGH PRIORITY, IS A CATEGORY WHICH WE WERE CALLING AIDS RELATED, WHICH WAS A BROAD CATEGORY IN WHICH YOU MAY HAVE REALLY GOOD SCIENCE THAT HAS AN AIDS COMPONENT TO IT OR THAT CAN BE DIRECTLY OR INDIRECTLY RELATED TO AIDS, THAT WE DEEM PAID FOR BY AIDS DOLLARS. IT IS LIKELY THAT TYPE OF RESEARCH IS IMPORTANT TO THE MISSION WHATEVER PARTICULAR INSTITUTE AND LIKELY WOULD HAVE GOTTEN FUNDED ANYWAY. BUT UNDER THE BROAD UMBRELLA OF AIDS RELATED MANY THINGS GOT FUNDED WITH AIDS MONEY, AIDS RELATED THAT WHEN YOU LOOK AT THE PRIORITY OF ENDING THE AIDS EPIDEMIC, WOULD YOU RATHER HAVE A DRUG THAT'S LONG ACTING THAT CAN BE PREVENTION EXPOSURE PROPHYLAXIS OR VACCINE OR WOULD YOU RATHER HAVE MONEY THAT IS INDIRECTLY RELATED TO AIDS IN THAT YOU'RE LOOKING AT BASIC RESEARCH OF A MICROBE THAT MAY OR MAY NOT BE INVOLVED SO AN EXAMPLE FROM EVERY, SO IT DOESN'T LOOK LIKE ME AND MY INSTITUTE OF INFECTIOUS DISEASE. SO LET'S SAY I'M SAYING LOOKING AT FUNDAMENTAL MOLECULAR MECHANISMS OF RESISTANCE TO 2009COCCUS, I SHOULD BE DOING THAT ANYWAY. EVEN IF THERE WASN'T AIDS. SHOULD WE TAKE MONEY THAT GOES FOR DRUG DEVELOPMENT FOR HIV FOR VACCINE DEVELOPMENT FOR THAT? NEXT. ANOTHER GYNOCOCCUS. ANOTHER INSTITUTE. CANCER. FUNDAMENTAL MECHANISMS OF DEVELOPMENT OF CANCER THAT MAY BE TOTALLY IMPORTANT EVEN IF THERE WERE NO AIDS, SHOULD AIDS DOLLARS BE PAYING FOR THAT AS OPPOSED TO A VACCINE? BEHAVIORAL RESEARCH, WHAT ARE THE PSYCHOSOCIAL GENETIC MAKE UPS THAT HAVE SOMEONE GO INTO INJECTION DRUG USE? YOU SHOULD BE DOING THAT ANYWAY, EVEN IF THERE WAS B AIDS SO THE REAL ISSUE HERE IS LET'S FOCUS ON PRIORITIES THAT GET US TO END AIDS EPIDEMIC AND FOCUS RESOURCES ON THAT. IS THAT WHAT WE'RE SAY SOMETHING >> WELL PUT. >> THIS IS WHAT I DON'T UNDERSTAND. WHAT I DON'T UNDERSTAND IS AIDS DOLLARS DON'T SEEM TO BE DOLLARS THAT WERE ALLOCATED BY CONGRESS FOR AIDS RESEARCH BUT RATHER DOLLARS THAT WAS IN THE NIH WERE SAID TO BE SPEND ON AIDS. >> INCORRECT. >> THAT'S >> ALLOCATED FOR AIDS. THAT'S WHY I SAW -- I WAS TO RAISE MY HAND, YOU DIDN'T -- >> THAT'S THE PART -- >> THERE IS AN AIDS BUDGET, SINCE 199 # OR '93, CONGRESS P IN THEIR APPROPRIATE RATIONS HAVE SAID YOU -- APPROPRIATIONS LAST YEAR FOR FIRST TIME THEY DIDN'T SAY THAT FREEING US UP TO BE ABLE TO MAKE THE RIGHT SCIENTIFIC DECISIONS, DON'T HAVE THIS KIND OF FORMULA APPROACH TO ANY OTHER DISEASE, THIS IS A CARRY OVER FROM ACRITICAL TIME WITH WE NEED TO PUSH HARD AND IT HAS A WONDERFUL CONSEQUENCE BUT THIS IS A DIFFERENT ERA WITH A DIFFERENT SET OF PRIORITIES. >> CORRY JUST AGAIN TO CLARIFY MORE, IS IT AIDS DOLLARS OR NOT AND WHAT DO YOU MEAN BY 10%? IF YOU LOOK HISTORICALLY AT THE AIDS BUDGETS INCREASED IN THE LATE MID TO LATE '80 ET CETERA, WITH WE STARTED OFF WITH .1% OF THE BUDGET AND THEN 1% THEN 2 THEN 4 THEN 7 THEN 9.8 THEN 10. IT LANDED AT TEN AND THERE WAS THIS UNDERSTANDING THAT IN FAIRNESS TO THE FACT THAT WE WERE STILL IN THE MID OF A VERY IMPORTANT EPIDEMIC, AS LONG AS AIDS -- THE NIH BUDGET GREW, AIDS SHOULD GROW AS MUCH AS THE REST OF THE NIH BUDGET. THAT DECISION WAS MADE INFORMALLY AT THE POINT THE AIDS BUDGET WAS 10 PEST OF THE NIH BUDGET. THERE WAS NOTHING WRITTEN DOWN BUT THAT WAS THE WAY THINGS WENT. SO THEN THE SITUATION SAID WELL, NOW THAT THE NIH IS GOING THROUGH SOME INTERESTING BUT GETTING EARMARKED MONEY FOR THIS AND WE'RE GETTING THAT, DOES THAT MEAN IT SHOULD BE ALWAYS 10%? WHAT WE'RE SAYING, WELL, THAT DOESN'T MEAN THE AIDS BUDGET WON'T GROW IF THE SCIENTIFIC OPPORTUNITY IS THERE, BUT SOMETHING ARTIFICIAL ABOUT A PRE-DETERMINED PERCENT. BUT THERE STILL IS MONEY THAT DESIGNATED FOR AIDS, WHETHER THAT'S 10% 8% OR 12%, IT'S STILL AIDS MONEY. >> EXCELLENT EXERCISE, EFFECTIVELY WILL NOT ONLY REFOCUS OR SHARPEN THE FOCUS ON AREAS THE SIGNS NOW TRANSFORMATIVE APPROACHES FOR HIV BUT ACTUALLY THE SAME IN ALL THE INSTITUTES WHERE THERE WAS SOME RELEVANT AIDS RELATED FUNDING AS WELL ASKING WHAT PERCENT, SAY THE NCI OVERALL BUDGET HAS 20% BUDGET COMING FROM THE AIDS OR 5%, WHATEVER IT IS. IT IS INTERESTING TO REALLOCATE THOSE BUDGETS THAT WERE UNDER THE AIDS UMBRELLA INTO THEIR OWN BUDGET. THEREFORE, PROBABLY WILL ALSO INCREASE FOCUS, A GREAT EXERCISE, KEY IS NOW COMMUNICATION TO THE COMMUNITY, WHAT IS THE CRITERIA USED? IF DIVERGENCE IN ASSESSMENT ARE SO HIGH, VERY IMPORTANT TO EXPLAIN. >> KEEP IN MIND THE DOLLARS WE'RE TALKINGN'T TO REALLOCATE TO HIGH PRIORITIES IN FY 16, THE 65.22 MILLION, HAS .2% >> OVER FOUR YEARS, >> GRANTS WILL TURN OVER ON ROUGHLY A FOUR YEAR CYCLE SO WE NEED TO KEEP THIS GOING AS SAID BY BOB OVER THE NEXT THREE TO FOUR YEARS. HOUDA. >> I AGREE, THIS SEEMS LIKE A GOOD PROCESS. I THINK THE ORIGINAL ALLOCATION THE WAY I REMEMBER IN AT LEAST THE NEUROSCIENCE RELATED INSTITUTES, SPAWN CERTAIN AREAS OF RESEARCH THAT WERE DERIVATIVE BECAUSE YOU HAVE MONEY FOR BRAIN AND AGE, YOUR BRAIN ON AIDS, SO THERE IS MONEY EARMARKED FOR, THAT IT HAS TO BE SPENT FOR THAT. SO PEOPLE RULED OUT IDEAS -- ROLLED OUT IDEAS SO THAT MONEY COULD BE USED AND THEY WERE NOT NECESSARILY OVER THE VERY BEST SCIENTISTS WHO HAD THEIR OWN PROGRAMMATIC RESEARCH, THEY -- THAT WAS KIND OF AN OPPORTUNITY TO DO SOMETHING. IN THE PROCESS, REALLY INTERESTING STUFF COMES OUT BECAUSE YOU'RE LOOKING AT NEUROIMMUNE MECHANISM AND BLOOD BRAIN BARRIER SO GOOD THINGS HAVE COME UP BUT IN MY VIEW SHOULD BE ABLE TO SURVIVE SCRUTINY OUTSIDE OF THAT AIDS CRITERIA. SO HAVING ALSO I LIKE -- I UNDERSTAND YOUR RATIONALE AND I THINK IT'S -- THE ONLY THING THAT WOULD WORRY ME IS IF -- INADVERTENTLY IN THIS PROCESS, AN INSTITUTE GETS REALLY HURT, SAY THE BIOBEHAVIORAL ASPECTS OF DRUG SEEKING, THAT LED PEOPLE TO DO DRUG AND AIDS BEHAVIOR AN RISK TAKING AT NIDA, IF THERE WAS ENOUGH OF THAT MONEY THAT WAS IN THAT 65 MILLION, HOW IS THAT GOING TO UNHINGE THE ENTIRE PORTFOLIO AND IS THERE ANY WAY TO EASE INTO IT? SO I UNIT'S NOT BIG MONEY BUT THAT WOULD BE MY MAIN HESITATION N THAT TRANSITION PERIOD, TO MAKE SURE NO MAJOR IMPORTANT PROGRAM HA THAT HAS GONE ALLOCATED THAT WAY, GETS -- >> YOU'RE ARTICULATING SOMETHING WE WANT TO BE CAREFUL ABOUT. IT IS MANY A WAY EASING INTO IT BECAUSE WE'RE ONLY LOOKING AT THE GRANTS THAT TURN OVER SO IT WILL GRADUALLY GET IMPLEMENTED OVER THE COURSE OF ABOUT FOUR YEARS. THIS TRANSITION THAT WE'RE TRYING TO MAKE. THAT DOES MEAN THAT THE ACTUAL TOTAL DOLLARS FOR ANY SINGLE INSTITUTE IS MODEST COMPARED TO TOTAL BUDGET. AGAIN, IT'S USEFUL BOB AND HIS TEAM HAVE HAD INTERACTIONINGS WITH EACH IC EVERYBODY COME TO AN AGREEMENT ABOUT WHAT NEEDS TO HAPPEN HERE, WE PRESENTED THIS TO THE INSTITUTE DIRECTORS IN OUR OWN MEETING A WEEK AGO. PEOPLE ARE ANXIOUS ABOUT CHANGE, THIS GENERAL ACCEPTANCE THIS IS THE RIGHT THING. WHEN WE MET WITH THE INSTITUTE, OFFICIALS TO GO OVER LOW PRIORITY PROJECT THE INITIAL RATINGS, IN MAJORITY OF CASES THERE WAS CONCURRENCE THEY AGREED ALSO IN VIEW OF THE NEW OVERARCHING PRIORITY AN NEW GUIDELINES THAT CONCURRED THOSE DID INDEED FALL INTO OR SHOULD BE RATE AS LOW PRIORITY. BASED ON THE SCIENCE TODAY. AND THE PRY YOURS. -- PRIORITIES. >> SINCE I CAN'T SEE THEM RAISING THEIR HANDS, ERIC AND CHRIS WILSON ON THE PHONE WITH CONSIDERABLE EXPERTISE IN THIS SPACE, WANT TO OPEN THE FLOOR TO EITHER OF YOU TO ASK A QUESTION OR MAKE COMMENTS. >> THIS IS CHRIS. I THINK THIS IS THE RIGHT THING TO DO. I THINK HOUDA POINTED OUT SOME OF THE I THINK SENSITIVITIES THAT NEED TO BE DEALT WITH HERE. I THINK WAY YOU DESCRIBE THE PROCESS AND TONY PROVIDED ADDITIONAL BACKGROUND, PROVIDES THE SOUND JUSTIFICATION AND ALSO INDICATE THAT THE PROCESS WAS A THOUGHTFUL ONE AN EFFORT HAS GONE INTO DOING THIS, THIS ROLLING APPROACH TO REPRIORITIZING THINGS IS SOMEWHAT EASE THE CLIFF PEOPLE MAY BE CONCERNED ABOUT BUT IT'S REALLY IMPORTANT AS WE TALK ABOUT YESTERDAY THAT WE BE GOOD STEWARDS OF THE MONEY THAT IS PROVIDED FOR US TO SPEND. THIS IS A REALLY FINE EXAMPLE OF RYING TO EXERCISE THAT STEWARDSHIP TO ASSURE WE PUT MONEY TO THINGS WITH THE HIGHEST PROBABILITY OF REAL ADVANCES HERE, CLEARLY WHAT WE DON'T WANT TO IS SAY WE'RE CAN YOUING OFF GREAT FUNDAMENTAL SCIENCE, THAT SHOULD BE FUNDED ANYWAY JUST AS I THINK TONY ARTICULATED. SO I'M QUITE SUPPORTIVE OF THIS SUPPRESS. >> THANKS, CHRIS. ERIC ARE YOU THERE? >> HI. THANKS, FRANCIS. I ALSO FEEL THAT THIS REFLECTS AN ATTEMPT TO INCREASE OUR RIGOR AT A ASSURING, ENSURING WE ARE INDEED TAKING THE EFFORT TO PRIORITIZE AND FUND THOSE INQUIRERIES HA HAVE THE BEST OR THE MOST LIKELIHOOD TO CREATE THE OUTCOMES HA HAVE THE IMPACT THAT THE NEW PRIORITIES ARTICULATED BY BOB AND FRANCIS IN THE AUGUST PUBLICATION HAVE PUT FORWARD. AND I THINK IT REFLECTS THE OTHERALL ROLE SINCE ITS INCEPTION, WHICH WAS TO DO WHAT I THINK WE WERE SEEING IN THE FIRST PRESENTATION THIS MORNING IN LOOKING AT ACCELERATION ATTEMPT MADE IN THE OPTHALAMOLOGIC INVESTIGATIONS. OAR WAS AN EARLY EXAMPLE IN MANY WAYS OF A CONCERTED ATTEMPT TO FOCUS A PRIORITIZATION PROCESS THAT RESULTED IN PRIORITIZATION OF ALLOCATION. I THINK REFLECTED IN THE RAPID ACCRUAL OF NATURAL HISTORY PATHOPHYSIOLOGY OI THERAPEUTIC CANCER-RELATED UNDERSTANDINGS AND ADVANCES THAT REALLY MOVED US DOWN THE ROAD RAPIDLY. I SEE THIS AS A CONTINUATION OF THE SAME COMMITMENT AND I THINK UNDERSTANDING HOW IT UNFOLDEDS, HOUDA'S CAUTION AROUND THE EVOLUTION BEING MEASURED AND OBSERVED SO WE SEE WE DON'T COULD L SOMETHING OUT THAT IS INDEED STILL A CONTRIBUTION TO THE GREATER GOOD. THAT WE NEED. AND WE GIVE OURSELVES ENOUGH LEEWAY MANY THE PROCESS TO ACKNOWLEDGE GOING DOWN THE WRONG WAY AND TUMBLING THE DOMINOES AWAY FROM THAT ACCELERATED OUTCOME IMPACT. TO THAT END HAVING SOME CONSIDERATION ON A PROCESS THAT I WOULD LIKE MAYBE BOB TO UNPACK A BIT, IF THERE IS CONCERN OR A QUESTION ONCE PI LEVEL DISCUSSION IS ENGAGED WITH THE INSTITUTE THROUGH AND UNDER INSTITUTE DIRECTION, HOW WILL THAT RESURFACE BACK TO A RECONSIDERATION OR IS IT A FINAL DECISION THAT IMPLEMENTED? I ALSO WANT TO EMPHASIZE THE FACT THAT IT KIND OF PUTTING THIS TOGETHER I THINK IT'S IMPORTANT TO ARTICULATE THE FACT A THE TOTAL AMOUNT FOR AIDS FUNDING APPEARS TO BE THE SAME BETWEEN 15 AND 16, IT'S NOT THAT IT IS DROPPED, IT IS A REPRIORITIZATION OF WHAT TURNS OUT TO BE THE LOW PRIORITIZE -- 65 MILLION ONLY. I WANTED THAT TO BE REEMPHASIZED A LITTLE BIT. >> LOW PRIORITY PROJECTS TOTAL $65.2 MILLION. ALL THE INSTITUTES WILL BE ELIGIBLE TO SUBMIT HIGH PRIORITY INITIATIVES PROJECTS TO SUPPORT WITH THIS. WE RECOGNIZE H THAT CERTAINLY WITH A PROJECT IS UP FOR RECOMPETITION THEY MAY INDEED COME IN WITH DIFFERENT AIMS THAT MAY BE NOW ALIGNED WITH THE OVERARCHING PRIORITY SINCE WE DID ADVERTISE IN THE NIH GUIDE NOTICE. WE CLEARLY STATED WHAT ARE THE OVERARCHING PRIORITIES, WHAT QUALIFIES FOR AIDS FUNDING. SO WE ENVISIONED THAT SOME OF THE PROJECTS THAT ARE CURRENTLY IN THIS LOW PRIORITY CATEGORY MAY INDEED COME IN AND BE REVIEW AND DEEMED HIGH LE MERITORIOUS AND BE ALIGNED WITH OVERARCHING PRIORITIES AN WORK WITH THE INSTITUTES ON A PROJECT BY PROJECT BASIS TO DETERMINE WHETHER OR NOT IT SHOULD INDEED BE SUPPORTIVE WITH AIDS DOLLARS. >> IT WILL BE VERY IMPORTANT. I THINK ERIC IS PARTLY REBLINDING US TO PAY ATTENTION TO TRACK AND SEE WHAT HAPPENS OVER THE COURSE OF THE NEXT YEAR WITH THIS IMPLEMENTATION. THEN LET'S LOOK AND SEE NOT JUST WHAT HAVE NOW IS FUNDED WITH AIDS DOLLARS BUT WHAT'S HAPPENED TO PORTFOLIOS THAT WERE PREVIOUSLY INCLUDED IN SOME WAY AND WHICH NOW THE INSTITUTES ARE ASKED TO PICK UP WHAT EXACTLY IS THE WAY IN WHICH SCIENCE WAS UTILIZED TO MAKE THOSE DECISIONS. WE CAN COLLECT THAT DATA WE CAN SEE WHAT IT LOOKS LIKE. I WANT THE TO SAY ONE OTHER THING THAT'S NOT ON THE SLIDES BUT IMPORTANT TO POINT OUT, GOING FORWARD, OBVIOUSLY INSTITUTES ARE ALWAYS INTERESTED IN PUTTING FORWARD REQUESTS FOR APPLICATIONS IN ALL KINDS OF AREAS OF SCIENCE SOME WHICH INCLUDES OF COURSE AIDS RESEARCH. IN THE PAST INSTITUTES HAVE DONE SO AND PRETTY MUCH MADE THE DECISION THEMSELVES ABOUT WHETHER THEY THOUGHT A PARTICULAR RFA WAS APPROPRIATE FOR AIDS FUNDING NOW THAT WE HAVE CLEAR DEFINITION WHAT THE PRIORITIES ARE FOR AIDS DOLLARS THEY ARE BEING ASKED TO CLEAR WITH THE OFFICE OF AIDS RESEARCH BEFORE SAYING THAT A PARTICULAR RFA IS ACTUALLY GOING TO BE FUNDED THAT WAY, WE WANT TO BE SURE WE HAVE GOT EVERYTHING IN SYNC SO WE DON'T HAVE A PROBLEM GOING FORWARD WITH A MISMATCH OF INSTITUTE EXPECTATIONS AND THE WAY WHICH WE NOW WANT THESE DOLLARS TO BE PRIORITIZED. IT'S NECESSARY, DIFFICULT BUT I'M SURE IT'S PAINFUL AND SOME OF THE DISCUSSION INDICATES THE PLEXTIES THAT -- IN COMMUNICATION OF ALL THIS TO OUR COMMUNITY. SO I THINK I WOULD BE VERY IMPORTANT AS YOU TALK ABOUT THIS YOU DESCRIBE THE HISTORY OF THE AIDS BUDGET SO IT'S CLEAR IT'S NOT A CLAW BACK OF SOMETHING THAT WAS PART OF WHAT EVERY INSTITUTE HAS TO ALLOCATE AND WHETHER THEY WANTED TO DO SO, WE HAD THE SAME PROBLEM WITH BEGINNING OF THE BIODEFENSE PROGRAM WHERE PEOPLE SAID ALL THIS MONEY IS COMING OUT OF OTHER THINGS THAT SHOULD BE ALLOCATED. SO HAVING LEARNED THAT LESSON, IF YOU'RE PROACTIVE WITH THE ACT VEST COMMUNITY AN SCIENTIFIC COMMUNITY IT WILL BE VERY HELPFUL. RUSS. >> I AGREE WITH THE COMMENTS PREVIOUSLY, IT LOOKS LIKE VERY REASONABLE PROCEDURE. MY QUESTIONS ARE ARE ABOUT THE PRO RATA ACTIVITY WHICH WAS LESS SUCCESSFUL. THERE IS A VERY LONG TAIL OF WORK THAT COULD BE ABSOLUTELY RANDOMLY CRITICAL FOR THE AIDS -- CRISPER WAS NOT FUNDED WITH AIDS DOLLARS, I'M GOING TO GUESS. BUT COULD BE A KEY PART OF -- SO MY QUESTION IS HOW IMPORTANT IS IT TO DO PRO RATA RATING FOR THE WAY THINGS WORK AND COULD THAT BE ABANDONED -- I'M A LITTLE WORRY ABOUT THAT PART OF THE ACTIVITY BUT MAYBE IT'S CRITICAL FOR SOME REASON. >> I THINK IT WAS COMPLICATED BY THE FACT THAT WE WERE LOOKING RETROSPECTIVELY AT PROJECTS THAT WERE FUNDED FOUR OR FIVE YEARS AGO. IF WE CAN COME WITH A SCHEMATIC USED FOR FUTURE FUNDING IT IS IMPORTANT BECAUSE IT IS A WAY OF ENSURING THAT DOLLARS, AIDS DOLLARS ARE SPREAD APPROPRIATELY F ONE WANTS TONE SURE IT H AS AIDS NON-AIDS COMPONENT THE FUNDING SHOULD BE DIVIDED WHETHER 50, 50 OR SOME OTHER PERCENT, IT'S IMPORTANT FOR US TO DO SO THAT YOU DON'T HAVE AIDS DOLLARS SUPPORTING A MAJOR ACTIVITY THAT ONLY HAS SAY 25% FOCUS ON HIV AND AIDS. >> SO IS IT YOUR SENSE BASED ON THE DIFFICULTY THAT WAS -- ENCOUNTERED WHEN YOU DO IT THE FIRST TIME THAT THERE IS A WAY TO DEFINE HOW TO DO THIS DIFFERENTLY THAN WHAT YOU ASK PEOPLE TO DO THE FIRST TIME? SOUNDS LIKE IT WAS REALLY HARD, HOW ARE YOU GOING TO MAKE IT MORE FEASIBLE. >> I THINK WE'LL BEGIN BY TALKING FURTHER WITH THE INSTITUTES AND CENTERS BECAUSE THEY ARE THE ONES WHO ACTUALLY FIRST SEE THE GRANT, THEY'RE THE ONES WHO CODE GRANTS. THEY HAVE THE BEST PERSPECTIVE TO WHAT PORTION OR PROPORTION OF THE PROJECTS SHOULD BE SUPPORTED WITH AIDS VERSUS NON-AIDS DOLLARS. >> SO I GUESS I WOULD ENCOURAGE PEOPLE TO THINK ABOUT THE FACT THAT YOU CAN DECLARE IT A WASH, YOU CAN SAY THE AIDS DOLLARS THAT ARE NOT IN A PRIMARILY AIDS YOU HAVE ADMINISTRATIVE CHALLENGE HOW DO WE GIVE A 25% RELEVANT TO AIDS PROJECT, 25% MONEY, YOU CAN ALSO SAY WE'RE GOING TO ASSUME THAT AIDS WORK IS GOING TO BENEFIT THROUGH OTHER INSTITUTES IN SOME RANDOM WAY THAT'S UNPREDICTABLE AND THOSE OTHER INSTITUTES WILL FUNDS WORK THAT WILL BENEFIT AIDS AND THEREFORE WE'LL DECLARE IT A WASH AND NOT GOING DOWN TO THAT LEVEL. I DON'T KNOW IF THAT'S FEASIBLE BUT IT SHOULD BE CONSIDERED BECAUSE IT MIGHT SAVE TIME IF YOU DECIDE -- IT'S A TRADE, WE'RE GOING TO CALL IT EVEN. >> PROBLEM WE ENCOUNTER IS THERE'S BEEN HETEROGENEITY OF THE WAY INSTITUTES HAVE BEEN DOING THIS ALREADY. AND THAT MEANS THAT THERE'S SOME DEGREE OF IRRATIONALITY 5-DOLLARS ARE BEING SPENT AND THAT HETEROGENEITY IS NOT THE ANSWER AND MAKE COME UP WITH A MORE UNIFORM SCORING METHOD, WE HAVEN'T FOUND THAT YET. I THINK WE CAN KEEP LOOKING. >> I THINK PART WAS ARTIFICIAL BECAUSE CERTAIN AMOUNT OF MONEY NEEDED TO BE SPENT. YOU HAD TO GO THROUGH SOME GYRATIONS TO JUSTIFY IT. SO I THINK THE RETROSPECTIVE MAKES IT COMPLICATED AND MAY NOT BE INFORMATIVE, I AGREE WITH YOU. BUT WHAT I AM -- WHAT I WOULD LIKE TO SUGGEST IS JUST A THRESHOLD METHOD WHICH IS INSTEAD OF RYING TO JUDGE EVERYTHING BETWEEN 0% AND 100%, SAY IT HAS TO BE AT LEAST 50% AIDS AND JUST ASK BOTH INVESTIGATOR MAYBE TO JUSTIFY WHETHER THIS IS 50% AIDS, AND MAYBE AND/OR THE STUDY SECTION OR PROGRAM OR WHATEVER LEVEL AND NOT TRY AND CUT IT TOO FINE, IT MIGHT BE KIND OF AN EXERCISE IN FUTILITY. >> THAT WOULD BE A MODEL. WE PROBABLY CAN'T SOLVE IT HERE THIS MORNING BUT I DO THINK THOSE KINDS OF THINGS ARE WHAT WE NEED TO NEXT PURSUE. TONY DID YOU WANT TO ADD ANYTHING? >> I THINK IT WAS IMPORTANT WE HAD THE DISCUSSION BECAUSE I THINK THERE WILL BE A LOT OF MISUNDERSTANDING ABOUT HOW ALL OF THIS ULTIMATELY CAME ABOUT AND I THINK YOU MADE A GOOD POINT, YEARS AGO WHEN WE WERE LOOKING AT WAYS HOW YOU'RE GOING TO SPEND THE MONEY, NOW WE KNOW EXACTLY HOW WE WANT PHONE IT AND WE DON'T HAVE ENOUGH OF IT. SO WE HAVE TO REPRIORITIZE TO SPEND MONEY ON THE THINGS WE REALLY THINK ARE VITALLY IMPORTANT TO ENDING THE AIDS EPIDEMIC. THERE ARE THINGS THERE THAT ARE THERE BUT WE DON'T HAVE ENOUGH MONEY, YEARS AGO IT WAS SWING OF THE SPECTRUM, WE'RE GIVE I DON'T GO THE MONEY, LET'S DO THE BEST WE CAN WITH THIS MONEY AND WE WERE PLUCKING THINGS IN, NOW WE'RE FOCUSING IT. THAT IS THOSE FOUR PRIORITIES ARE, TO DOING ON ENDING THE EPIDEMIC. >> A FINAL COMMENT, I'M SATISFIED WITH THE HISTORICCAL EXPLANATION BECAUSE I FELT LIKE I ASKED THE QUESTION AND GOT A DIFFERENT ANSWER SO I NEED TWO OR THREE REPETITIONS. THEN ONE COMMENT, ONE OF THE BIGGEST STEPS BACK IN THE AIDS EPIDEMIC RIGHT NOW HAS BEEN THE OPIOID EPIDEMIC, MANY PEOPLE ARE DYING OF OPIOID OVERDOSES LEGAL AN ILLEGAL MANY THIS COUNTRY THIS YEAR AS ARE DIEING OF AIDS THIS YEAR. SO IT'S A HUGE PROBLEM ON ITS OWN SO THOSE ARE REALLY GOOD -- I'M HOPING THOSE ARE IN THE HIGH PRIORITY AREAS. >> THE STATISTICS WHICH I THIS I JUST SAW YESTERDAY FROM NORA VOLKOW THE DEATH FROM HEROIN AN PRESCRIPTION OPIOIDS BUMPED UP AGAIN AND -- >> SO GREAT TO REALLOCATE NEW MONEY TO ALLOCATE INTO TEARIAS OF PRIORITY, WITHIN THE AREAS OF PRIORITY THE SAME EXERCISE? THERE'S NOTHING THAT SAY EVERY PROGRAM ON VACCINES ARE ON DRUG, IT WAS SHARPLY FOCUSED ON -- MAINLY AN INTEREST IN TRYING TO FREE NEW MONEY FOR HIGH RISK REALLY TRANSFORMATIVE IDEAS. THERE'S A LOT OF NEW STORIES. >> GREAT POINT. NOBODY SHOULD ASSUME BECAUSE THERE ARE FOUR PRIORITIES THAT EACH SHOULD HAVE 25% OF THE AIDS DOLLARS THAT WILL DEFINITELY NOT BE THE RIGHT ANSWER. >> CORRY NOT GOING ONE WAY, BUT JUST GIVE AN EXAMPLE OF DIFFICULT DISCUSSIONS WE HAVE, YOU MAKE A GOOD POINT ABOUT THE OPIOID EPIDEMIC. IF YOU LOOK AT ITS RELATIONSHIP TO AIDS, NEEDLE EXCHANGE TAKE THAT OFF THE TABLE WITH AIDS. THAT REALLY AN AIDS ISSUE OR IS THAT AN IMPLEMENTATION OF NEEDLE EXCHANGE ISSUE? WE HAVE TO BE CAREFUL THAT IT'S HORRIBLE THAT WE HAVE THIS OPIOID EPIDEMIC. BUT IS THAT REALLY AIDS OR NOT? THAT'S REALLY IMPORTANT POINT. NOT SURE IT IS BECAUSE I HAVE SEEN THE INJECTION DRUG USE PROPORTION PROPORTION OF THE PIE GO FROM FROM THIS TO THIS WHERE IT'S LESS THAN 4%, IS A REAL PROBLEM IN INDIANA BUT WITH REGARD TO AIDS IT'S DOWN TO LESS THAN 4% WITH NEEDLE EXCHANGE. IS THAT BEHAVIORAL RITEK TAKING BEHAVIOR BECOMES RELEVANT. >> YOU WOULDN'T WANT TO VACCINATE EVERYBODY YOU WANT TO VACCINATE PEOPLE IN HIGHER RISK CATEGORY. EXACTLY. AND THAT'S EASY TO IDENTIFY WHO IS IN THE HIGH RISK CATEGORY. >> ARE (OFF MIC) >> NO, ACTUALLY 65% OF THE NEW INFECTIONS IN THIS COUNTRY ARE AMONG MEN WHO HAVE SEX WITH MEN, 45% WHICH ARE AFRICAN AMERICAN MEN, 65% WHICH POOR AFRICAN AMERICAN WOMEN SO WHEN YOU TALK RISK CATEGORY WE KNOW THAT 65 PEST ARE AMONG MEN WHO HAVE SEX WITH MEN. IN OTHER COUNTRIES COMMERCIAL SEX WORKERS, INDIVIDUAL -- THOSE ARE HIGH RISK GROUP. THE EPIDEMIC IN THE UNITED STATES IS NOT A GENERALIZED EPIDEMIC, IT'S FOCALIZED. IN SUBIS A HAIR RNA EPIDEMIC IT'S A GENERALIZED EPIDEMIC SO IT DEPENDS ON WHERE YOU ARE DICTATE WHOSE YOU VACCINATE. >> FASCINATING TIME SCIENTIFICALLY, WHAT DO YOU THINK THE PATHWAY WHERE WE ARE AN GETTING TO THAT SUCCESSFUL VACCINE AND WHY ARE YOU AND OTHERS THAT I TALK TO IN THIS FIELD GAINING OPTIMISM AFTER WHAT'S BEEN A VERY LONG PAINFUL PROCESS OF LOTS OF DISAPPOINTMENT? >> WITH REGARD TO VACCINE FIELD ITSELF, WHAT HAS EMERGED OVER THE LAST TEN YEARS OR SO, WE HAVE TWO THINGS IN PARALLEL, ONE EMPIRIC APPROACH NOW WELL KNOWN RV 144 TIE VACCINE STUDY WE DID LIKE WE DO WITH ANY VACCINE, YOU GET AN IMMUNOGEN AND YOU INJECT SOMEBODY AND YOU HAVE SOME KIND OF RESPONSE YOU ADJUVANT OR DOSE OR WHAT HAVE YOU, 31%. IN PARALLEL WITH THAT IS THE BROADLY NEUTRALIZING ANTIBODY RESPONSE WHICH IS REALLY BEEN EXTRAORDINARILY EXCITING, WE'RE FINALLY THROUGH A LOT OF CONFIRMATIONAL CRYSTAL GRAPHIC STRUCTURES WE'RE ABLE TO GET THE ENVELOPE TRIMER IN A STABLE FORM WHERE IT BINDS ONLY TO NEUTRALIZING ANTIBODIES AND NOT THE NON-NEUTRALIZING ANTIBODIES. NOW WE DON'T HAVE ENOUGH RESOURCES TO DO THE THINGS WE WANT TO DO. THAT IS TO MAKE IMMUNOGENERALS WITH THE VARIOUS CONFIRMATIONS TO START TESTING THEM IN A VARIETY OF PHASE 1 TRIALS, AND IF IN FACT WE CAN INDUCE NEUTRALIZING ANTIBODIES WITH THIS NEW APPROACH TO A STABLE TRIMER THAT WE WERE NOT ABLE TO DO BEFORE, THAT'S A HUGE STEP TOWARDS VACCINE SO I CAN GUARANTEE IT WILL HAPPEN BUT THAT'S WHERE FEEL IS GOING RIGHT NOW, WE NEED TO MAKE MONOCLONAL ANTIBODIES TO PROVE WHEN YOU HAVE A MONOCLONAL ANTIBODY OF A NEUTRALIZING TYPE IN A PERSON YOU CAN PREVENT INFECTION SO WE'RE ALREADY STARTING A STUDY BOTH IN THE UNITED STATES AND IN AFRICA OF USING PASSIVE TRANSFER OF NEUTRALIZING ANTIBODIES BUT YOU HAVE TO TO MAKE THEM. THEY COST MONEY. IT COSTS MONEY TO MAKE THE IMMUNOGENS AN THOSE ARE THE THINGS THAT WE HAVE BEEN STRUGGLING WITH, THAT'S OUR HIGHEST PRIORITY WHICH WE REALLY NEED RESOURCES FOR. >> IT'S BEEN A USEFUL DISCUSSION AND BOB, AS I SAID AT THE BEGINNING YOU AND YOUR TEAM DESERVE A LOT OF CREDIT FOR PRODIYOUS AMOUNT OF WORK GRANT BY GRANT BY GRANT TO COME UP WITH CONCLUSION AND PUT US IN A POSITION TO PLEA AGREEMENT THESE PRIORITIES, THANKS TO THE ACD FOR YOUR THOUGHTFUL COMMENTS, I TANK THE POINT CLEARLY CONVEYED, WE IMMEDIATE TO WORK HARD IN COMMUNICATION ABOUT EXACTLY WHAT WE'RE DOING HERE AND WHAT THE HISTORY IS BECAUSE THIS IS A COMPLICATED SITUATION, SOME HAVE BEEN LIVING AND THINKING ABOUT IT FOR SEVERAL MONTHS OR EVEN A COUPLE OF YEARS, MAY NOT APPRECIATE IMMEDIATELY WHY THIS SEEMS TO BE SUCH AN UNUSUAL CIRCUMSTANCE, WE WILL KEY WORK VERY HARD TO MAKE SURE WE ACHIEVE THAT COMMUNICATION CLARIFY. WE CAN NOW WINDS THIS PART OF THE ACD MEETING UP. WE ARE DOING PRETTY WELL WITH TEN MINUTES AHEAD OF OF SCHEDULE. IF PEOPLE ARE DESPERATE WE DO HAVE FIVE MINUTE BIOBREAK AND GIVE PEOPLE A CHANCE TO STRETCH LEGS BECAUSE WE'RE SITTING HERE SINCE NINE O'CLOCK, COME BACK QUICKLY AND PHIL BOURNE WILL TELL YOU ABOUT BD2K. >> THE FINAL PRESENTATION OF OUR DAY AND A HALF. AND THIS ACD HAS PLAYED A CRITICAL ROLE OVER THE COURSE OF THE LAST THREE YEARS IN OUR FOCUS ON WHAT WE NEED TO BE DOING ABOUT BIG DATA OR DATA SCIENCE. RALPH IN PARTICULAR PLAYED A FORM ACTIVE ROLE IN SOME OF THE THINGS NOW HAPPENING AND I'LL SURE WE'LL HAVE INTERESTING ON VARIATIONS AND QUESTIONS ABOUT THE STATE THAT WE HAVE ARRIVED AT. SO ONE RECOMMENDATION WAS WE NEED TO RECRUIT SOMEONE WHO ACROSS ALL NIH WOULD HAVE THE EXPERTISE AND LEADERSHIP ABOUT DATA SCIENCE SO WE CREATED THIS NEW POSITION ASSOCIATE DIRECTOR FOR DATA SCIENCE AN RECRUITED PHIL BOURNE FROM UC SAN DIEGO TO TAKE ON THAT ROLE. A CHALLENGING ROLE, HEARDING A LOT OF CATS IS PART OF THE EFFORT BUT HEARDING THEM IN A WAY THAT IS CLEARLY NEEDED IN ORDER FOR OUR FUTURE AS A BIOMEDICAL RESEARCH ENTERPRISE THAT DEPENDS INCREASINGLY DAY BY DAY ON DATA THAT WE GENERATE THAT WE NEED ACCESS TO THAT WE NEED TO STANDARDIZE THAT WE NEED TO NURTURE IN ALL KINDS OF WAYS. ONE PROGRAM THAT'S PART OF THIS IS THE BIG DATA TO KNOWLEDGE OR BD2K EFFORT ANOTHER THING THAT CAME OUT OF THAT ACD SET OF RECOMMENDATIONS. SO THOUGHT IT WOULD BE HIGHLY APPROPRIATE FOR THIS GROUP TO HEAR WHERE WE ARE AND TO HEAR FROM PHIL. THANK YOU FOR JOINING US. PLEASE TELL US WHAT YOU LIKE TOWS HEAR ABOUT BD2K. >> THANK YOU, FRANCIS. THANKS, EVERYONE FOR BEING HERE. I SHOULD SAY I ALSO LIKE TO SHOUT OUT TO RALPH WHO IS ONE OF THE MEMBERS OF THE ORIGINAL INFORMATICS WORKING GROUP THAT GOT US, ALSO ERIC GREEN SO CAPABLY CARRIED THE BALL AND MY COLLEAGUES WHOM ARE PART OF OUR LITTLE TEAM CARRYING A LIST FORWARD. IT'S BEEN I WOULD SAY THE CATS I HAVE TO SAY ARE VERY RECEPTIVE SO IT MAKES IT PRETTY STRAIGHT FORWARD. SO I WANT TO GIVE A LITTLE UPDATE WHERE WE ARE IN THE TIME GOING ON, I THINK IT'S AN OPPORTUNE TIME BECAUSE A LITTLE OVER A YEAR INTO THIS WITH RESPECT TO HOW LONG THE FUNDING HAS BEEN OUT THERE. WE HAVE HAD TWO ALL HANDS MEETINGS NOW, THE FIRST ONE I HAVE TO SAY I THINK WITH THE NEW PROGRAM LIKE THIS, THERE WERE SOME SORT OF LITTLE CONFUSION ABOUT WHERE WE WERE HEADED AS A PROGRAM. I HAVE TO SAY THE MEETING WE HAD THREE OR FOUR WEEKS AGO WAS REALLY QUITE SPECIAL. I THINK THINGS HAVE SETTLED DOWN, PEOPLE HAD A YEAR TO WORK ON VARIOUS RESEARCH PROJECTS COUPLE WHICH I WILL TELL YOU ABOUT. BUT I THINK THERE'S ALSO I THINK WE GOT THIS TOO FROM THE WORK GROUP NATIONAL EYE INSTITUTE, THIS -- THE IMPORTANCE OF THIS COLLABORATION AND SHARING AND COOPERATION THAT'S SOMETHING THAT REALLY IS A HALLMARK OF WHAT'S GOING ON IN THIS PROGRAM. SO ABOUT 400 PEOPLE GOT TOGETHER, I JUST GENERATED SOME QUOTE THAT I DIDN'T GENERATE THEM MYSELF, THEY WERE GIVEN TO ME, AND I HAVE TO SAY A LOT ARE FROM PEOPLE WHO ACTUALLY HAVE GRANTS IN THE PROGRAM. SO ONE STANDS OUT I THINK FROM JANET THORNTON SOME OF YOU MAY KNOW, SHE WAS THE UNTIL RECENTLY THE HEAD OF EBI THE EUROPEAN BIOINFORMATICS INSTITUTE, THE NCB EQUIVALENT IN EUROPE. SHE CAME JUST ACTUALLY TO SEE WHAT WAS GOING ON. SHE SAID BD2K IS ALREADY CHANGED THE LANDSCAPE OF BIOMEDICAL RESEARCH IN THE USA. THE ALL HANDS MEETING CAPTURED THE EXCITEMENT CHANGE IN THE CULTURE THAT IS HAPPENING ACROSS BIOMEDICAL SCIENCE AND I WON'T GO ON BUT IT WAS GREAT SCIENCE TOO. I THINK THAT IS SOMETHING THAT WE SORT OF ALL FELT AT THE MEETING THERE WAS SOMETHING GOING ON IN THE JUST LARGE DATA BUT INTEROPERABILITY OF DATA AND SOME OF THE ACTIVITIES AROUND THAT. AND THE SCIENCE IT WAS LIKELY TO COME FROM IT AND ALREADY STARTING TO APPEAR. I WANT TO GIVE YOU A SENSE OF THAT, BEFORE I DO, LET ME CAST WHAT WE'RE DOING RELATIVE TO ORIGINAL RECOMMENDATIONS AND WORKING GROUP REPORT WHICH CAME OUT IN 2012. FRANCIS MENTIONED. THE SHARING OF DATA AND SOFTWARE THROUGH INDEXES IS ONE RECOMMENDATION, ADVANCING THE METHODS WE NEED, EXPANDING ON TRAINING INCLUDING DIVERSE ACTIVE OF TRAINING AND TRAINING FOR DIVERSITY AND CONTINUED SUPPORT THROUGHOUT THE LIFE CYCLE WHICH TOUCHES ON VARIOUS THINGS INCLUDING SUSTAINABILITY. I HAVE TO SAY BEFORE I CAME HERE AND READ THAT REPORT SOMETHING I FEEL VERY MUCH BLUEPRINT, WE HAVE BEEN USING IT RELIGIOUSLY IN THAT WAY. SO I WILL NOW DESCRIBE TO YOU BRIEFLY OVER THE NEXT FEW MINUTES THE IMPLEMENTATION WE PUT IN PLACE RELATIVE TO THOSE WHICH TIE CLOSELY TO THOSE RECOMMENDATIONS. SO THE FIRST ONE IS A NOTION OF WHAT WE CALL THE COMMONS, I'LL EXPLAIN THAT MORE IN A MINUTE BUT IT'S REALLY ABOUT CREATING A SHARED USEFUL COLLABORATIVE SPACE THAT MAKES US POTENTIALLY MORE PRODUCTIVE THAN WE ARE CURRENTLY WHEN IT COMES TO THIS DIGITAL ECOSYSTEM. VARIOUS RESEARCH PROGRAMS WE PUT IN PLACE INCLUDING A NUMBER OF CENTERS AND THE TRAINING, A WHOLE SERIES OF PROGRAMS, SUSTAINABILITY IS A KEY PART OF THAT AS WELL. SO QUICKLY LOOKING AT THE BUDGET SPENDING 2006 DISTRIBUTION OF THAT BUDGET WITH RESPECT TO THESE DIFFERENT AREAS. THE IDEA OF THIS NOTION OF SUPPORTING INCONNECTSING AND ACCESSIBILITY THE PROBLEM IS FOR MANY THINGS TOOLS AND DATA WE NEED YOU CANNOT GOOGLE THESE THINGS. YOU CANNOT FIND WHAT YOU NEED. SO CREATING THE INDECKS WHICH IS A RECOMMENDATION, THIS IS SOMETHING ACTIVELY GOING -- ONGOING. WE'RE EMPLOYING INNOVATIVE MODELS FOR EXPLOITING THAT CAPABILITY. ALSO THE ACTUAL AWARDS ITSELF DEPENDING HOW YOU COUNT WE FUNDED 13 CENTERS EACH WHICH HAS A NUMBER OF SUBNODES, QUITE A CAST OF CHARACTERS DOING INTERESTING THINGS. WE HAVE TARGETED SOFTWARE AWARDS, IN THE FIRST YEAR RELATED TO DAILY COMPRESSION, VISUALIZATION, PROMINENCE AND JUST DATA WRANGLING ALL WHICH ARE CRITICAL TO THE ENTERPRISE. I'LL SAY SOMETHING ABOUT THE OTHER THINGS. THEN THE TRAINING AND WORK FORCE WE'RE DEVOTING ABOUT 16% BUDGET TO THAT IN A SERIES OF FAIRLY STANDARD WAYS BUT ALSO DOING SOME UNUSUAL THINGS, I SHOULD ALSO SAY A LITTLE MORE ABOUT THIS. BUT THE NECESSITY TO TRAIN VERY BROADLY INCLUDING OURSELVES AT THE NIH AND HOW WE THINK ABOUT THE PROGRAMS WE'RE FUNNING AS THEY BECOME MORE ANALYTICAL AND DATA RICH. WE NEED OOH WORK FORCE PREPARED TO DEAL WITH THAT INTERNALLY AS WELL AS EXTERNALLY. SO HERE IS A DISTRIBUTION OF SENSORS AND THE VARIOUS SUBCOMPONENTS OF THOSE CENTERS. LET ME GIVE YOU AN EXAMPLE, I'M GOING TO DESCRIBE ONE -- I COULD HAVE PICKED EXAMPLES FROM ANY 12 OR 13 CENTERS THAT REALLY EXEMPLIFY THE KIND OF THING THAT'S HAPPENING. I HAPPEN TO PICK ONE FROM SCOTT AT STANFORD BUT I THINK WHAT THEY WERE CHARACTERIZED BY IS A LOT OF TYPES OF DATA FROM GENOTYPE O PHENOTYPE, IMAGING DATA, MANY DIFFERENT TYPES OF APPLICATIONS ALL INTEGRATED IN VARIOUS WAYS TOWARD A NEW TYPES OF OUTCOMES. SO LET'S QUICKLY LOOK AT LOOK AT ONE FROM SCOTT'S WORK. THEY DID -- THIS IS ONE INSTANCE OF WHAT THEY DO AROUND MOBILITY. THE SMART PHONE APP, THEY GOT DATA FROM THESE FOLKS -- TWO MILLION SUBJECTS WORLDWIDE GLOBAL STUDY AND TOTAL 74 MILLION DATE OF ACTIVITY. EFFECTIVELY 100 BILLION DATA POINTS THEY COLLECTED FROM THE DEVICES WHICH IS MORE THAN A THOUSAND TIMES CDC STUDY N HAYNES AND OTHER THINGS DONE. WHEN YOU LOOK AT THE DISTRIBUTION ON THE RIGHT YOU SEE EFFECTIVELY WHAT YOU HAVE IS CLOSE COMPLIANCE SO YOU HAVE A GOOD DISTRIBUTION IN THE POPULATION AND WHEN YOU LACK AT BMI WHEN YOU LOOK AT THIS DATA SOME INTERESTING THINGS ARISE, I WILL SHOW YOU A COUPLE OF THINGS, THIS IS INTUITIVE BUT WHAT HAPPENS HERE IN THE DATA SCIENCE SPACE IS WE'RE STARTING TO USE THE PREVIOUSLY OBTAINABLE TYPES OF DATA TO VALIDATE INTUITIONS THAT WE HAVE HAD AND LATER TO DRILL DOWN AND START TO DO SOME REALLY INTERESTING THINGS WITH THEM. SO STEPS PEOPLE TAKE RELATIVE TO BMI, OF COURSE THERE IS A RELATIONSHIP, PERHAPS COUPLE OF THINGS NOT SO OBVIOUS, VIRTUALLY NO ONE SEEMS TO GET TO 10,000 STEPS A DAY THAT'S RECOMMENDED. ALSO THE SIGNIFICANT GENDER DIFFERENCE BEING PREVIOUSLY NOTED BUT NOT AT THIS TYPE OF SCALE. MORE INTERESTING IS IMPACT ABOUT DURATION SO JUST WHEN YOU HAVE A CONCERTED BOUGHT OF ACTIVITY, HOW THAT RELATES TO BMI. WHAT YOU SEE IS THAT IF YOU HAVE OCCASIONAL BOUTS OF ACTIVITY ON A DAILY BASIS, THAT EFFECTS BMI QUITE SIGNIFICANTLY. BUT AFTER 1 SUSTAINED BOUGHT, IT FLAT TN OFF IN TERMS OF IMPACT IT HAS ON BMI. SO HOW WE THINK ABOUT HOW WE EXERCISE OBVIOUSLY HOW THIS DATA STARTS TO SHOW. ANOTHER ASPECT OF LOOKING AT THIS ON A PLANETARY SCALE, THIS IS DATA CHECKED FROM ALL OVER THE PLANET IS THIS NOTION OF THE WHAT IS MEASURED WITH A GENE CO-EFFICIENT USED TO MEASURE DIFFERENT ECONOMIC CAPABILITY OF A POPULATION SO IT'S THE SPECTRUM, THE LARGER THE NUMBER, THE LARGER THE CO-EFFICIENT THE BIGGER THE SPECTRUM IS. IN AN ECONOMIC SENSE. HERE IT'S APPLIED TO ACTIVITY. YOU CAN SEE A CORRELATION, BETWEEN OBESITY AND ACTIVITY AND EQUALITY BUT THERE ARE OUTLIERS LIKE THINGS GOING ON IN VIETNAM. WHAT YOU SEE EFFECTIVELY THESE DIFFERENTIALS YOU HAVE LARGE NUMBER OF PEOPLE WHO DON'T EXERCISE IN SOME CASES EXERCISE AND YOU HAVE CORRELATIONS WITH OBESITY. WHAT'S MORE INTERESTING IS WHEN YOU START PULLING THIS IN WITH OTHER DATA, I THINK THIS IS JUST THE SIGN OF WHAT IS TO COME. THIS IS DATA ACROSS OBESITIES IN DIFFERENT CITIES IN THE US. AND USING DATA THAT WAS FREELY AVAILABLE FROM YALE DETERMINEING WHAT THE CONCENTRATION OF FAST FOOD RESTAURANTS WAS IN THESE GIVEN CITIES. YOU CAN SEE A CORRELATION. SO THE MORE FAST FOOD RESTAURANTS THE OVERALL LEVEL OF OBESITY IN THESE CITY. SO WHAT YOU MAKE OF THAT DATA IS I THINK YOU START DRILL DOWN AND SEE VERY INTERESTING THINGS. I DON'T HAVE TIME TO GO INTO EXAMPLES WHERE THAT'S HAPPENING BUT THERE ARE INTERESTING CASES ALREADY, OTHER SORTS OF DATA THEY'RE WORKING WITH. SO POINT BEING SOMETHING SOMEWHAT DIFFERENT IN THE WAY WE THINK ABOUT ANALYZING DATA IS GOING ON HERE BOTH SCALE OF WHAT WE'RE DOING SO TELL YOU ABOUT THE THE TRAIN A CRITICAL PART OF THIS, WE HAVE TWO FACETS ONE TO TRAIN FROM THE GROUND UP AND ONE IS TO PROVIDE PEOPLE WHO ARE ARE ALREADY TRAINED MORE SAY IN GENERAL BIOMEDICAL SCIENCES, TO HAVE THE OPPORTUNITY TO HAVE ACCESS TO TRAINING AND ANALYTICS WHICH THEY CAN TAKE BACK TO THEIR RESPECTIVE LABS. ALSO WORK WITH DIVERSITY PROGRAMS, WORKING WITH HOWARD VALENTINE'S GROUP TO MAKE SURE THAT WE HAVE DIVERSITY INCLUDED IN ALL THIS. WE'RE USING SOMEWHAT STANDARD MECHANISMS BUT ALSO DOING A WHOLE SERIES OF ACTIVITIES THAT ARE OUTSIDE THE NORM I WOULD SAY SO WE JUST TO RAISE AWARENESS OF THE IMPORTANT OF ANALYTICS WE HAD A BIG CELEBRATION IN PIE DAY, I HAVE TO SAY THAT ERIC LAND CAME AND GAVE AN OUTSTANDING TALK TO NOT JUST THE NIH COMMUNITY, IT WAS OBVIOUSLY VIDEOCAST BUT ALSO WE HAD A LOT OF HIGH SCHOOL STUDENTS. I HAD THE HONOR OF HAVING LUNCH WHERE I WAS THE FELLOW (INAUDIBLE) I HAD TO SAY IT WAS EXTREMELY HARD ACT TO FOLLOW. I THINK IT WAS A REALLY INTERESTING DAY AND IT GOT A LOT OF N GOING WITHIN OUR COMMUNITY -- ENERGY GOING WITHIN OUR COMMUNITY. IN THAT VEIN WE HAVE ALSO STARTED A WHOLE SERIES OF ACTIVITIES THAT BROADCAST ACCESSIBLE TO THE COMMUNITY AT LARGE SO WE HAVE A DISTINGUISHED LECTURE SERIES, SO WE DID A LECTURE EARLIER ON AND COLLABORATION WITH BRAIN WITH HENRY BROWN CHRIS TO HAVE COB TALK MORGUE ABOUT DATA ASPECTS OF WHAT THEY DO AND THAT WAS REALLY I THINK A REALLY -- TALKING MORE ABOUT WHAT THEY DO AND THAT WAS A JOINT INITIATIVE THAT LED TO A LOT OF CROSS TALK BETWEEN THE BRAIN INITIATIVE AND WHAT WE'RE DOING BD2K. WE HAVE VARIOUS FRONTIERS SERIES WHICH DIG IN AND THEN HANDS-ON THING LIKE SOFTWARE CARPETRY WHICH INCLUDES TRAINING TRAINERS. SEW WE TRAIN PEOPLE TO ACTUALLY THEN GO OUT AND TRAIN OTHERS IN BASIC ANALYTICAL TECHNIQUES. I HAVE TO BECOME SUCCESSFUL MOVING THE BALL FORWARD AS WELL. PART OF WHAT I'M CERTAINLY WE'RE INTERESTED IN DOING WHAT I WAS PARTICULARLY INTERESTED IN DOING COMING HERE IS THAT SO MUCH OF THIS WHAT WE DO IN DATA, THERE IS BOUNDARIES ON FUNDING BUT NOT BOUNDARIES ON THE DATA. AND SO WE HAVE BEEN TRYING TO WORK MORE WITH AGENCIES NATIONALLY AND INTERNATIONALLY TO COME UP WITH JOINT INITIATIVES THAT REALLY MAKE US MORE COST EFFECTIVE AND ADDRESS ISSUES WE'RE HAVING. AN EXAMPLE, I'LL GIVE ONE EXAMPLE, TESTIFY INNOVATIONS LAB WITH THE NATIONAL SCIENCE FOUNDATION, YES HAD PEOPLE DOCUMENT IN FOR A WEEK. SO WE HAD PEOPLE COMING IN, IT WAS A MIX OF PEOPLE MORE TECHNOLOGY ENGINEERING AND COMPUTER SCIENCE OR YENNED WORKING WITH BIOMEDICAL FOLKS WHERE THEY FORMULATED PROPOSALS THAT THEN WENT INTO A REGULAR FUNDING MECHANISM BETWEEN NSF AND NIH. AND I THINK THERE WAS NO QUESTION THAT THE SUCCESS RATE OF THOSE FUNDING WAS OVER TWICE WHAT -- I'M SORRY, ABOUT TWICE WHAT IT WAS FOR THOSE ATTENDED THE WORKSHOP. SO IT WAS DEFINITELY BENEFICIAL AND JUST AN EXAMPLE ACROSS THINGS WITH THE AGENCIES, WE'RE DOING MORE OF THAT SO ANOTHER EXAMPLE IS WE IN FACT I WAS ON A WEBINAR WHERE WE WERE DESCRIBING IT WORK WITH WELCOME TRUST AN HOWARD HUGHES MEDICAL INSTITUTE ON OPEN SCIENCE WHERE WE'RE ENCOURAGING INTERNATIONAL COLLABORATION USING OPEN ACCESS SOFTWARE TO COME UP WITH INNOVATIVE NEW WAYS OF ANALYZING WITH THE IDEA OF COMING UP WITH NEW RESULTS. AND WE'LL SEE HOW THAT WORKS OUT THE FIRST PHASE CLOSES IN FEBRUARY. NOW WE SAY LITTLE BIT ABOUT THE UNDERLYING WORK GOING ON, IT WAS ONE OF THE RECOMMENDATIONS AROUND HOW TO FACILITATE BETTER SHARING OF SOFTWARE AND DATA. IN FACT OTHER ASPECTS, RESEARCH LIFE CYCLE FOR HA MATTER. AS I MENTIONED WE'RE FUNDING A SERIES OF CENTERS, NOW THOSE CENTERS HAVE THEIR OWN RESEARCH THEY'RE DOING AROUND A WHOLE DIFFERENT SET OF DATA TYPES WE FUN AD DATA DISCOVERY INDEX CONSORTIUM TO INDEX BOTH THE CONTENT OF DATA AND SOFTWARE AND STANDARDS EVENTUALLY THAT ARE COMING FROM EACH OF THOSE CENTERS BUT ALSO MORE BROADLY THAN THAT. SO THE IDEA IS THAT CREATE AN INDEX OF THIS AND YOU CAN IMAGINE IN THE END WHAT WE WOULD LIKE TO SEE IS A PLACE WHERE YOU CAN GO AND FIND THE MOST THAT SAY RELEVANT DATA SETS PARTICULAR TASK, WHAT YOU MIGHT ALSO BE ABLE TO DO THIS IS A FUNCTION HOW THIS WORKS OUT WITH THE COMMUNITY, WHOSE WORKING ON THIS, BOTH HOW MUCH ACCESS THERE IS TO THAT PARTICULAR DATA SET, WHAT COMMENTARY THERE IS ON THAT PARTICULAR DATA SET. I THINK THESE ARE FACILITATIVE ACTIONS THAT WILL HOPEFULLY MAKE US MORE PRODUCTIVE. WE'RE DOING ALL THIS IN AN ENVIRONMENT WE'RE CALLING THE COMMONS. THE BASIC IDEA, WE'RE PUTTING RESOURCES TO H OVER THE NEXT COUPLE OF YEARS IS TO ENCOURAGE MOVEMENT OF DATA SOFTWARE INTO THIS ENVIRONMENT. IT'S PRIMARILY RUNNING ON PUBLIC CLOUDS BUT THERE'S NO ABSOLUTE REQUIREMENT FOR THAT. THE IDEA IS WE -- ONCE IT'S IN THAT ENVIRONMENT WE HAVE ACCESS AND CAPABILITIES TO MEASURE USABILITY IN WAYS WE DON'T HAVE NOW. WE HAVE NO IDEA WHEN WE -- WHEN DATA IS GENERATED BY EXTRAMURAL INVESTIGATOR HOW THAT IS REUSED. IN THIS ENVIRONMENT WE BEGIN TO GET A HANDLE ON THAT. SO THAT IS JUST ONE ASPECT OF IT. OTHER LABS ARE INVOLVED IN THIS AS WELL. SO LET ME ILLUSTRATE THAT IDEA OF THE COMMONS WITH A SPECIFIC EXAMPLE. WE'RE ALSO VERY INTERESTED IN WORKING WITH COMMUNITIES AND THERE A NUMBER OF COMMUNITY WORKING MANY THIS DATA SPACE AN BEYOND, THE GLOBAL ALLIANCE FOR GENOMIC HEALTH IS AN EXAM P, TRYING TO FIGURE OUT WAYS TO FACILITATE THOSE KINDS OF ACTIVITIES BUT THERE ARE OTHERS RESEARCH DATA NATIONAL DATA SERVICE, THE FUTURE OF RESEARCH COMMUNICATION AND SCHOLARSHIP, THERE'S SERIES OF THESE EFFORTS GOING ON. JUST TO GIVE YOU AN EXAMPLE OF HOW IN THIS COMMONS ENVIRONMENT WE'RE FACILITATING ONE OF THOSE. IT'S THE BEACON PROJECT, JIM'S (INDISCERNIBLE) ORANGENAL IDEA NCBI, IT'S THE BASIC NOTION THAT AN ORGANIZATION LIKE -- WHEN THEY LIGHT A BEACON, IT'S SAYING WE'RE EPIABLELING A SIMPLE QUESTION TO BE ASKED. I HAVE THIS HUMAN SUBJECTS DATA, GENOMIC INFORMATION ASSOCIATED, I'M GOING TO ALLOW VERY SIMPLE QUESTION TO BE ASKED WHICH IS GIVEN SPECIFIC VARIANT DOES IT EXIST AT THIS PARTICULAR POSITION ON A CHROMOSOME? YOU CAN ASK THAT ACROSS THE WHOLE SERIES OF RESOURCE AND GET AN AGGRAVATED RESULT. SO THE VALUE OF THAT REALLY IS MULTIPLE BUT WHAT IT TELLS YOU, IT'S FIRST THESE ORGANIZATIONS AND NOW THEY'RE OVER 100 SIGNED UP, 200, SORRY. WILLING TO SHARE THIS KIND OF INFORMATION. ALSO DEVELOP APIs TO LOOK INTO THIS INFORMATION IN A CONTROLLED WAY. BEING ONE OR TWO ISSUES BUT IT'S REALLY AN EXAMPLE OF HOW THIS IS TAKING OFF. SO THAT'S IN THIS KIND OF COMMONS ENVIRONMENT. SO YOU'RE PROVIDING THE ACCESS INTO THE DATA AND THE TOOLS THAT ACCESS THE DATA ALSO EXIST IN THE ENVIRONMENT AVAILABLE FOR EVERYBODY TO USE. THE IDEA IS TO POTENTIALLY HELP WITH SUSTAINABILITY BUT CERTAINLY MAKE THESE THINGS MORE COST EFFECTIVE. ANOTHER ASPECT WE'RE EXPERIMENTING WITH, THIS IS A PILOT PHASE, IS CHANGING THE BUSINESS MODEL WHICH WE MAY COMPUTE RESOURCES AVAILABLE. WHAT WE DO, IN APRIL WE'LL TEST THIS, I EXPLAIN WITH A SIMPLE EXAMPLE. WHEN YOU WRITE A GRANT NOW YOU GET THE -- SAY YOU ASKED FOR $100,000 WITH COMPUTING. YOU BUY A SET OF SERVER AND THEY SIT SOMEWHERE AND COMPUTE IN YOUR LAP OR WHATEVER. WE DON'T REALLY KNOW HOW EFFECTIVELY USED THEY ARE. AND WE DON'T REALLY KNOW MUCH ABOUT, WE DON'T KNOW WHETHER YOU BUY THOSE THINGS. SO ONE OF THE IDEAS IS TO PROVIDE INSTEAD OF ACTUALLY GIVING YOU HARD MONEY, GIVE YOU CREDIT. YOU CAN SPEND THAT CREDIT IN ANY COMMONS COMPLIANT RESOURCE THAT YOU WANT. SO THIS DRIVES CONTENT INTO THE COMMONS. IT ALSO ENABLES US TO MAP SUPPLY TO DEMAND SO WE'RE ONLY PAYING FOR WHAT YOU USE. AND WE'RE IN A POSITION TO MEASURE MORE ACCURATELY HOW THINGS ARE USED, OR MAKE BETTER INFORMED DECISIONS WHAT WE DO WITH THAT CONTENT WHEN THE GRANT RUNS OUT. SO I SHOULD SAY WE'RE JUST EVALUATING THIS, WE HAVE VARIOUS PHASES OF THIS, FIRST IS JUST TO AROUND APRIL IS TO OFFER THIS CREDIT TO NIH INVESTIGATORS ON SMALL SCALE, TO SEE WHAT THE UPTAKE IS. WE ALREADY HAVE A BROKER LINED UP TO DO THIS, WE ALREADY HAVE RESOURCES, MAINLY CLOUD PROVIDERS WHO SIGNED UP TO PARTICIPATE IN THIS EXPERIMENT. SO INTERESTING TO SEE HOW THAT WORKS OUT. I'M VERY INTERESTED TO SEE WHETHER WE CAN GET WHAT WE BELIEVE IS A PRODUCTIVITY GAME OUT OF IS THIS KIND OF EMPERIMENT. SO THAT'S SOME OF THE THINGS WE'RE DOING, GOING FORWARD THIS IS SORT OF JUST A BUDGET BREAK OUT FOR 17, THE PROPORTION OF HOW WE'RE SPENDING THE BUDGET RELATIVE TO THE ORIGINAL RECOMMENDATIONS STAYS PRETTY MUCH AROUND THE SAME. WE ARE PUTTING REFERENCE DATA SETS INTO THE COMMON ENVIRONMENT, THAT'S ONGOING. TCGA IS IN WILL FOR EXAMPLE. WE'RE STARTING TO BUILD A COMPLIMENT OF SOFTWARE AND TOOLS MANY THIS ENVIRONMENT WHEREUPON WE CAN MEASURE HOW WELL THIS WORKS. TARGETED DATA SCIENCE RESEARCH, TARGETED SOFTWARE, WE'RE FOCUS ON THINGS THAT HAVE RELEVANT TO DATA PRIVACY, REPURPOSING, APPLYING OF METADATA WHICH IS CRITICAL. ALSO INTERACTIVE DIGITAL MEDIA. SO INTERACTIONS WITH VARIOUS GROUPS WHO WORK IN THIS SPACE, WE HAVE VERY EXCITING AMLYCATIONS IN RESPONSE TO RFA AND WE'RE ABOUT TO FUND THOSE ALREADY. WE ARE WORKING ON COMMON DATA ELEMENT AND A SERIES OF OTHER THINGS. COUPLE OF THINGS ABOUT TRAINING. ONE OF THE ACTIVITIES CONTINUE BUT ONE THINGS AGAIN ON A INTERNATIONAL SCALE, IS THE IDEA THERE'S COURSE MATERIALS VIRTUAL AND PHYSICAL THAT ARE OUT THERE. AGAIN, THEY'RE NOT INDEXED. THEY'RE NOT NECESSARILY EASY TO FIND SO WE'RE WORKING ACTUALLY REGROUPS IN EUROPE PARTICULARLY TO WORK ON METADATA DESCRIPTIONS FOR THESE CAUSES AND CREATE AN INDEX OF THOSE AS WELL. THIS ISN'T A VERY EARLY STAGE BUT THAT'S SORT OF THE SAME IDEA. SO THAT'S REALLY ALL I WANTED TO SAY, THERE'S A WHOLE ORGANIZATIONAL STRUCTURE AROUND WHAT WE'RE DOING. LED BY SCIENTIFIC DATA COUNCIL WHICH IS PART OF THE PROCESS. WITH REFORMULATED TO SOME EXTENT AND CARRY MORE DAIRY IS AT THE BACK OF THE ROOM, CO-CHAIRS MYSELF WITH JOHN LORSCH AND THERE'S A SET OF WORKING GROUPS BEING SET UP THAT WORK MANY THIS SPACE. SO THAT'S AN UPDATE WHERE WE ARE. AND I'LL BE HAPPY TO ANSWER ANY QUESTIONS. THANK YOU. >> THANK YOU. [APPLAUSE] >> QUESTIONS? >> THE WAY THE BIG DATA IS DESCRIBED IS MOSTLY DESCRIBE THINGS LIKE SEQUENCE DATA AND MEDICAL DATA, ARE YOU ALSO CONSIDERING IMAGE DATA WHICH IS INCREASINGLY IMPORTANT? >> >> THERE'S TWO CENTER FOCUSED ON THAT, IN ENGLAND FOR EXAMPLE AND (INAUDIBLE) EFFORTS, IN TERMS OF NEUROIMAGING THAT'S -- YEAH. >> THE SECOND IS JUST A WORD OF I'M SURE YOU'RE AWARE OF THIS BUT IN TERMS OF THE COMMONS IN THIS NEW FORMAT, THERE HAVE BEEN SOME PRETTY BAD EXPERIENCES WITH PEOPLE BELIEVING THEY WERE GOING TO CREATE SOMETHING AND EVERYONE WOULD COMMENT THAT NO ONE CAME. SO JUST BE MINDFUL WHAT EXPERIMENTS YOU DO WITH THAT AND BE REALLY TOUGH WITH EVALUATING. >> I HAVE BEEN INVOLVED WITH VARIOUS PROGRAMS OVER THE YEARS, BUILD AND COME MODELS. I DIDN'T EMPHASIZE ENOUGH SO THANK YOU. THIS IS NOT LIKE THAT. FIRST WE'RE NOT BUILDING AN INFRASTRUCTURE OURSELVES WE'RE USING PUBLIC INFRASTRUCTURE. AND WE'RE DOING IT IN A VERY AGILE WAY. IN OTHER WORDS WE'RE RUNNING A FEW EXPERIMENTS TO SEE -- AND THEN EVALUATE WITHING IF THIS IS WORKING WELL WHERE PEOPLE ARE BEGINNING TO ADOPT IT THEN MOVE TO THE NEXT STEP. BECAUSE I'M CONSCIOUS OF SIGNIFICANT FAILURES IN THE PAST ON BUILDING INFRASTRUCTURE. >> THE THING THAT GIVES ME A LITTLE OPTIMISM IS STUDENTS LOVE TO GET CYCLES TO DO THEIR COMPUTATION ON AND P YOU GIVE THEM A PLACE THEIR DATA SETS ARE ALREADY SITTING AND YOU'RE GIVING THEM LOTS OF COMPUTER POWER THROUGH AMAZON, I DON'T KNOW WHO THE CREDENTIAL PEOPLE ARE, BUT THAT HAS A CHANCE OF GETTING THEIR ATTENTION AND HAVING THEM USE IT BECAUSE I CAN ONLY OFFER THEM A CERTAIN AMOUNT OF CPU BASED ON MY GRANT CAPACITY. AND IF YOU CAN GET 10,000 FOR A SHORT PERIOD TO DO SOME CALCULATION, THAT MIGHT GET PEOPLE'S ATTENTION BUT I A AGREE THIS IS A CONCERN. WHAT I WANTED TO SAY IS FIRST IT'S QUITING TO SEE YOU PUT FLESH ON THE MEAT. REPRESENTATIONS WE MADE, SOMEBODY HAS TO FIGURE HOW TO DO THIS SO CONGRATULATIONS ON HAVING A PLAN FOR VIRTUALLY EVERY PART OF THE WORKING GROUP WHICH IS NOW ANCIENT HISTORY I RECOGNIZE. >> TEAM EFFORT. >> YES. >> MY QUESTION IS, HOW -- SO A LOT OF THIS IS OR YEN TOED PROFESSIONAL DATA SCIENCE STUFF, ONE CONCERN ON THE WORKING GROUP MAKING SURE THE ICs WERE BROUGHT ALONG IN ALL OF THIS AND SCIENTIST WHOSE DON'T CONSIDER THEMSELVES DATA SCIENTISTS PRIMARILY BUT NEUROSCIENTISTS OR CELL BIOLOGISTS ORING WE SCIENTIST, THE BEST POSSIBLE WAY OF REGULAR, THEY'RE ALSO BENEFITING AND HAVING CONNECTIONS MADE, SO CAN YOU TELL US HOW THAT RELATIONSHIP BUILDING IS GOING AS MUCH >> WE WERE TALKING EARLIER. I MEAN, I THINK THAT THERE'S NO DOUBT -- QUITE UP FRONT, IT'S A CHALLENGE, IT'S ACTUALLY TURNED OUT TO BE -- I DIDN'T ANTICIPATE IT THIS WAY, IT'S REALLY ABILITY TO COMMUNICATE WHAT WE'RE RYING TO DO AND GET THE LEVEL ENGAGE MENT WE THINK IS NECESSARY. AND IT IS A PROCESS. I THINK THE IDEA FOR EXAMPLE -- FIRST WE HAVE WORK -- I SHOULD SAY IN A GOVERNANCE WAY WE HAVE GREAT REPRESENTATION FROM VIRTUALLY ALL THE ICs, WE HAVE A BD2K EXECUTIVE COMMITTEE. WE ALSO HAVE A MULTI-COUNCIL WORKING GROUP WHERE THIS REPRESENTATION OF MANY COUNCILS SO WE HAD COMMUNICATION CHANNELS TO THE VARIOUS ICs, AND WE'RE WORKING WITH A NUMBER IDENTIFY WHERE THEY CAN BE HELPFUL. SO INITIALLY THE IDEA OF PROVIDING REFERENCE DATA SETS THEY HAVE, BY THAT I MEAN DATA SETS LIKELY USED, MAYBE UNDERUTILIZED BUT COULD BE UTILIZED MORE FREQUENTLY BUT HAVE A MEASURE OF DESCRIPTION THROUGH METADATA. ESSENTIALLY PUT THOSE IN THAT ENVIRONMENT AND HELP WITH TRACKING. THAT'S GOING ON, WE'RE TALKING MORE EXAMPLE WITH GETTING INFORMATION INTO THIS ENVIRONMENT. THAT'S 40 TERABYTES IN THAT DATA IN AWS AND GOOGLE. OBVIOUSLY THAT DATA CAN'T BE MOVED SO IT'S A PLAYGROUND FOR THE STUDENTS AS YOU DESCRIBE TO WORK ON SO THOSE ARE THINGS WE'RE NOW STARTING -- TALKING LATE THIS AROUND I'M GOING TO TALK FAST ABOUT TRAINING PROGRAM INTERNAL TRAINING PROGRAM TO REALLY BEGIN TO AT ONGOING BASIS RA HER THAN WHAT WE'RE DOING NOW IS A SERIES OF ONE OFFS, IMPORTANT AREAS BUT THE IDEA OF TAKING PEOPLE THROUGH A TRAINING PROGRAM I THINK IS IMPORTANT. >> JUST AS FOLLOW-UP HAVE THE ICs SHOWN -- BEEN PARTICIPATING IN FUNDING OF ANY OF THE -- ANY OF THE CENTERS Q. PERHAPS ON A PRO RATA BASIS REFERENCING OUR PREVIOUS CONVERSATION. >> THE BUDGET AS IT STANDS IS FROM COMMON FUND AND FROM ICs, OVER THE FORTHCOMING YEARS THE COMMON FUND CONTRIBUTION DROPPED -- THE BUDGE SAY STAYS ROUGHLY THE SAME, $110 MILLION A YEAR. THE COMMON FUND CONTRIBUTION DROPS OFF. AND SUBJECT ARE AVAILABLE FUNDS, THE IC PART GOES UP. SO I'M VERY CONSCIOUS OF THE NEED TO THE MISSION OF THE INSTITUTE AN CENTERS, IT'S A CHALLENGE, I'M AN OPEN GUY BUT THAT'S HALF THE FUN AS WELL. >> I'M VERY EXCITE, I LOVE YOUR PROJECT, IT'S MY FAVORITE. WE ALL HAVE ONE. CAN YOU GO TO SLIDE 8? >> NOT SURE WHICH ONE THAT WAS. >> THAT'S THE MAP WHERE THE CENTERS ARE. >> YES, SO WE KNOW THAT DIVERSITY IS NOT BEEN ACHIEVED BY BIOMEDICAL RESEARCH TRAINING OR NSF TRAINING COMPARED TO 50 YEARS AGO. THE NUMBERS HAVEN'T CHANGED SIGNIFICANTLY. AND SOME OF THAT IS PRODUCT ARE, WHERE THE HOT CENTERS FOR RESEARCH ARE COMPARED TO WHERE THE POPULATIONS THAT ARE DIVERSE POPULATIONS ARE. AND SO THE HOPE IS THAT BECAUSE THIS IS COMPUTATION, YOU CAN ACTUALLY ACHIEVE GREATER DIVERSITY THROUGH COMPUTATIONAL APPROACHES SO WHEN I LOOK AT THE MAP, IT'S ALMOST THE NEGATIVE SPACE WHERE MINORITY POPULATIONS ARE LOCATED. SO I WOULD LIKE TO TALK A LITTLE BIT ABOUT THAT. I KNOW YOU'RE INVESTING IN TRAINING, WHAT ARE YOU GOALS FOR DIVERSITY, WHAT DO YOU ENVISION DIVERSITY AND HOW ARE THESE CENTERS WITH THE MID OF THE COUNTRY, NORTHERN PART WHERE THE NATIVE AMERICAN TRIBES ARE, SO FORTH. >> VERY GOOD QUESTIONS. I WOULD WELCOME INPUT INTO HOW WE CAN DO BETTER AT THIS BECAUSE I'M BY NO MEANS SATISFIED. WE HAVE BEEN WORKING WITH THE BUILD PROGRAM, ALSO WE'RE DOING WE'RE MAKING A AWARDS WHERE TO MINORITY INSTITUTIONS SO THAT THE PEOPLE IN THOSE INSTITUTIONS ACTUALLY GO AN WORK ON HE CAN TENDED PERIODS WITH PEOPLE IN THE CENTERS. THAT'S ONGOING. I WOULD LIKE TO DO MORE OF THAT, YOU NEED TO LOOK CAREFULLY WHAT THE UPTAKE OF THAT IS AND HOW SUCCESSFUL IT'S BEEN. THAT'S AN EXAMPLE BUT WE DO NEED TO DO MORE, THERE'S NO QUESTION. >> ARE YOU MEASURING DO YOU HAVE SOME GOAL? MEASURING DIVERSITY IN THE CENTERS WHEN CENTERS ARE FUNDED DO THEY GIVE YOU INPUT ABOUT DEMOGRAPHICS OR THEIR GOALS IS THERE REPORTING? >> WE JUST GOT INTO -- WE HAD ONE REPORT FROM THE CENTERS BUT YES, THEY ALSO THEMSELVES IT GOES TWO WAYS. GOING TO MINORITY INSTITUTIONS, BUT ALSO SATISFIED FUNDING TO THE CENTERS TO SUPPORT MINORITY TRAINING, THEY'RE REACHING OUT AND SO WE HAVE THE TRAINING AND OUTREACH COORDINATOR MICHELLE DUNN. CAN YOU SAY ANYTHING ABOUT THE NUMBERS AT THIS STAGE? (OFF MIC) >> IT MIGHT BE WORTH LOOKING AT -- A HANDFUL OF STUDENTS WON'T HAVE A BIG IMPACT. >> HAPPY TO TALK TO YOU ABOUT THAT OFFLINE. I HAVE BEEN VISITING VARIOUS PLACES AS PART OF THESE ACTIVITIES AND I WAS IN MOORE HOUSE RECENTLY FOR EXAMPLE, CLEARLY THAT'S INTEREST, THAT GOT SOME THINGS GOING BETWEEN GEORGIA TECH AND THINGS LIKE THAT THROUGH THE CONNECTIONS WE HAVE THERE. WE NEED TO DO MORE. >> I WOULD BE HAPPY TO TALK TO YOU. THE OTHER THING I WOULD SUGGEST IS WORK LATER IN THE PIPELINE WITH REGARD TO DIVERSITY HOW DID THE R-25 WENT FOR UNDERGRADUATE INSTITUTIONAL FUNDING. THERE'S A LOT OF VERY DYNAMIC YOUNG MINORITY FACULTY AND POST DOCS THERE IS A WINDOW OF OPPORTUNITY THERE. WHERE I THINK YOU WILL HAVE A HIGHER IMPACT MORE QUICKLY THAN TRAINING A UNDERGRAD. THANK YOU. >> I -- THE POINT YOU MADE RECENTLY, THIS IS -- THIS KIND OF WORK IS A SPECIAL CASE BECAUSE THE RESOURCES TO GET INTO THIS BUSINESS ARE RELATIVELY SMALL. THE IDEA OF MAKING THIS AVAILABLE IN THE COMMON HELP FACILITATE THAT KIND OF THING. >> ABSOLUTELY. THANK YOU. >> I MAY HAVE MISSED THIS BUT I DON'T REMEMBER HEARING THAT MUCH ABOUT FOCUS ON -- SURE THERE'S SOME FOCUS BUT HOW MUCH OF A FOCUS IS THERE IN THIS INITIATIVE ON USE OF EHR DATA FOR CLINICAL RESEARCH AND IMPLEMENTATION SCIENCE? THERE'S SEVERAL PROJECTS THAT WORK WITH EHR QUITE HEAVILY. JUST GIVE YOU ONE EXAMPLE TO ILLUSTRATE THE POINT. ZACK CAHONI CENTER AND THE I 2B 2s THE PREVIOUS GENERATION OF THIS WHICH HAS A LOT OF IMPACT IN TERMS OF USAGE OF EHR. BACK THEY'RE NOW DOING WHOLE VARIETY OF DIFFERENT THINGS, ONE THING THAT STRUCK ME INTERESTING WHEN I WAS UP THERE RECENTLY, IS THEY HAVE A NEW SET -- NEW APPROACH TO THE IDEA OF PATIENT HOMOGENEIZATION ACROSS EHRs SO SOUNDS TRIVIAL BUT IT'S NOT TRIVIAL PROBLEM. SO MAKING PROGRESS IN THAT KIND OF THING TO RECONCILE THE POPULATION, COMING FROM THESE DIFFERENT SYSTEMS IS AN EXAMPLE OF IMPORTANT USE OF -- AN EXAMPLE OF APPLICATION THAT'S DIRECTLY APPLIED TO EHR. THERE'S A FAIR AMOUNT -- THERE'S A WHOLE PHENOTYPING EFFORT THAT'S USING EHR DATA TO DO PREDICTIVE PHENOTYPING OUT OF MARK CRAVN CENTER IN IS WISCONSIN, THAT'S JUST ANOTHER EXAMPLE. >> BILL THANK YOU VERY MUCH. I'M SURE THE ACD WILL WANT TO HEAR HOW THIS IS GOING BECAUSE THIS IS A MAJOR INVESTMENT BY THE ICs AND COMMON FUND AND NIH IN GENERAL AND MUCH WRITING ON SUCCESS OF THE ENTERPRISE. >> THANK YOU. >> BENEFIT FROM OUR DATA RATHER THAN DROWNING IN IT. WELL, EVERYBODY, CONGRATULATIONS. YOU HAVE MADE IT THROUGH. ANOTHER ACD MEETING WITH RATHER FULL AND COMPLEX AGENDA. YOU HAVE GIVEN OUTS WISE ADVICE THAT WE ARE TAKING WITH GREAT SERIOUSNESS. WE WILL NO DOUBT BE COMMUNICATING WITH YOU ABOUT THE THIS AND IT SOUNDS LIKE WE PROBABLY WOULD NEED TO HAVE A CONFERENCE CALL WITH YOU SOMETIME IN THE SPRING WHEN WE GET THE REPORT FROM THE RED TEAM, THAT IS A WORKING GROUP OF THE ACD AND WE AIM TO TRY TO HAVE THAT REPORT WELL BEFORE JUNE. SO ONE WE HAVE A BETTER SENSE OF THE TIMING OF THAT WE WILL REACH OUT AND TRY TO GET ON YOUR CALENDAR FOR A TELECONFERENCE VERSION OF THE ACD. THEN I THINK YOU MAY HAVE SEEN IN YOUR BOOKS OR IF YOU DID NOT, YOU MIGHT WANT TO QUICKLY LOOK AT PAGE -- SORRY, TAB 4, WHICH HAS THE MEETING DATES FOR 2016 AND 2017. AGAIN, I HOPE THOSE ARE ALREADY ON YOUR CALENDAR, IF NOT PLEASE PUT THEM THERE. AGAIN, WHEN WE MEET IN JUNE THERE WILL BE NEW FACE AROUND THE TABLE SINCE WE HAD TO SAY GOODBYE TO SOME OF OUR WONDERFUL FRIENDS WHO WHO WERE HERE FOR THEIR LAST MEETING BUT WE PROMISE YOU WHICH WILL FIND INTERESTING CHARACTERS TO JOIN REMARKABLE GROUP. AGAIN, JUST FOR MYSELF, THE OPPORTUNITY TO BE ABLE TO WORK WITH PEOPLE WITH YOUR STATURE, WITH YOUR VISION, WITH YOUR WISDOM, WITH YOUR GOOD COMMON SENSE IS ENORMOUSLY HELPFUL AND HAS GUIDED ME I THINK UNFAILINGLY OVER THE LAST SIX AND A HALF YEARS TO MOVE THIS REMARKABLE SHIFT CALLED NIH IN THE RIGHT DIRECTION SO I CAN'T THANK YOU ENOUGH FOR THE TIME YOU PUT INTO THIS AND MAKING THIS THE KIND OF GATHERING WHERE PEOPLE FEEL TOTALLY FREE TO SPEAK THEIR MINDS AND SAY WHAT THEY LIKE AND WHAT THEY DON'T LIKE, THAT'S WHAT WE NEED, WHAT YOU HAVE GIVEN US. SO WITHOUT FURTHER ADIEU, I THINK I CAN NOW THRIFT GAVEL AND SAY WE ARE ADJOURNED. [APPLAUSE]