OKAY, SO BEFORE THE NIH DIRECTOR
OPENS THE MEETING, I'M GOING TO
GO THROUGH SOME HOUSEKEEPING,
OKAY?
SO, JUST TO REMIND YOU ALL, THIS
MEETING IS LIVE.
WE ARE BEING LIVE STREAMED AND
THESE MICs ARE PRETTY
SENSITIVE SO EVEN IF YOUR MIC IS
OFF, IF SOMEBODY ELSE IN THE
ROOM HAS 1 ON, CONSIDER YOURSELF
HAVING A HOT MIC.
ALL OF THE MATERIALS THAT YOU
WILL SEE AND ANY SUPPLEMENTAL
MATERIALS ARE ON THE ACD WEBSITE
AND THAT WILL BE POSTED VERY
SHORTLY.
THE MEETING WAS ANNOUNCED ON THE
FEDERAL REGISTER ON
NOVEMBER 17th, OF NOTE WE DID
NOT RECEIVE PUBLIC COMMENT AND
SO THERE IS NOTHING TO REVIEW IN
THAT REGARD FOR THIS PARTICULAR
MEETING.
WE'RE GOING TO BE USING A HYBRID
FORMAT THROUGHOUT THE MEETING.
ACD MEMBERS AND PRESENTERS
ALIKE.
SINCE SOME OF OUR TEAM HAVE TO
JOIN US VIRTUALLY ALTHOUGH IT IS
WONDERFUL TO SEE SO MANY PEOPLE
IN PERSON, SO THAT'S GREAT.
WHEN YOU DO WISH TO MAKE A
COMMENT, IF YOU'RE CONNECTED
INTO ZOOM, RAISE YOUR HAND
VIRTUALLY, IF NOT, JUST WAVE AT
ME AND I'LL ACKNOWLEDGE YOU AND
I THINK YOU MAY HAVE SEEN WHEN
YOU ARRIVED, WHEN YOU EXIT THE
ROOM TO YOUR RIGHT, THERE ARE
RESTROOMS ON THIS FLOOR EMPLOY
ANY OTHER QUESTIONS, BRITNEY AND
CINDY CAN USUALLY ANSWER THEM
MUCH QUICKER THAN I CAN.
SO THEY'RE PROBABLY THE PEOPLE
TO ASK.
OKAY, SO LOGISTICS ASIDE, I WILL
NOW TURN THE MEETING OVER TO
DR. BERTAGNOLLI.
>> THANK YOU SO MUCH DR. TABAK
AND I ACTUALLY HAVE IN MY HAND A
GAVEL.
SO I WILL OFFICIALLY GAVEL IN
THIS MEETING OF THE ADVISORY
COMMITTEE TO THE DIRECTOR.
THERE WE GO.
I CAN'T TELL YOU HOW THRILLED I
AM TO BE HERE WITH YOU TODAY AND
WHAT I WANT TO DO FIRST IS LET'S
JUST START WITH QUICK
INTRODUCTIONS OF THE MEMBERS
TODAY AND YOU KNOW WE ALSO HAVE
OTHER SPECIAL GUESTS HERE TODAY,
BUT YOU KNOW LET'S JUST GO AHEAD
AND GO ARK ROUND THE TABLE HERE
AND EVERYONE DO AN INTRODUCTION
AND I WILL START FIRST.
I AM MONICA BERTAGNOLLI,
THRILLED TO BE HERE IN MY NEW
ROLE AS NIH DIRECTOR AND ALSO
THRILLED TO BE ABLE TO ANNOUNCE
THAT DR. LARRY TABAK HAS AGROWED
TO SERVE AS OUR PRINCIPAL DEPUTY
DIRECTOR, YAY.
[LAUGHTER]
AND THAT DON BERKLOW HAS NOW
JOINED US AS THE CHIEF OF STAFF.
SO MAYBE WE BEING START OVER
HERE IN.
>> YEAH, PRESS THE BUTTON AND
THAT SHOULD TURN IT ON.
>> ALEXIA KIMBLE, I AM CEO OF
HARVARD MEDICAL PHYSICIANS
PRACTICE PLAN AFFILIATED WITH
HARVARD AND THE ISRAEL DECONNIST
MEDICAL CENTER, PRACTICING
DERMATOLOGIST AND CLINICAL
TRIALIST IN TRAINING.
>> GOOD MORNING COREY MOORE,
SERVING AS PRINCIPAL
INVESTIGATOR FOR 2 RESEARCH AND
TRAINING CENTERS FUNDED THROUGH
THE NATIONAL EN--STRATEGIESITUTE
ON DISABILITY AND INDEPENDENT
LIVING AND LIVING RESEARCH.
I'M AT LANG STON UNIVERSITY,
HBCU IN OKLAHOMA, FLAD TO BE
HERE.
>> GOOD MORNING, FANTASTIC TO BE
HERE, NEUROSCIENTIST, ENGINEER
AND NEUROPSYCHIATRIST WITH DUKE
UNIVERSITY AND INVESTIGATOR WITH
HOWARD HUGH'S MEDICAL INSTITUTE
NGOOD MORNING, WONDERFUL TO BE
HERE AND WELCOME.
AND I'M [INDISCERNIBLE], I'M THE
PROFESSOR OF MEDICINE AND
EPIDEMIOLOGY AT COLUMBIA
UNIVERSITY, ALSO THE EXECUTIVE
VICE PRESIDENT FOR COLUMBIA
GLOBAL.
>> GOOD MORNING I'M JOEL BEAUT,
UNIVERSITY OF CALIFORNIA
SAN FRANCISCO AS A DISTINGUISHED
PROFESSOR AND INSTITUTE DIRECTOR
WITH ABOUT A HUNDRED FACULTY AND
DATA COMPUTATION, I'M ALSO THE
CHIEF DATA SCIENTIST ACROSS THE
ENTIRE UNIVERSITY OF CALIFORNIA
HEALTH SYSTEM, ALL 6 SCHOOLS,
RESEARCH IN DATA GENOMICS AND
ELECTRONIC HEALTH RECORDS ISSUE
TECHNICALLY A PEDIATRICIAN ON
THE SIDE AND I'VE BEEN NIH
FUNDED FOR 25 YEARS.
NGOOD MORNING, EVERYONE, I'M
HOWARD CHANG, PHYSICIAN
SCIENTIST, PRACTICING
DERMATOLOGIST AND GENOME
SCIENTIST AND A MEMBER AT
STANFORD UNIVERSITY AND
INVESTIGATOR OF THE HOWARD
HUGHES MEDICAL INSTITUTE.
DPLAD TO BE HERE.
>> GOOD MORNING EVERYBODY I'M
BRIAN [INDISCERNIBLE], I'M ON
THE FACULTY AT NORTHWESTERN
UNIVERSITY WHERE I DIRECT THE
THIRD CO CENTER FOR AIDS
RESEARCH, PSYCHOLOGIST BY
TRAINING, WE ALL SAY WHAT WE DO
BY TRAINING AND THEN WE DO
ANOTHER THING WHEN WE GET INTO
THE FIELD AND I STUDIED THE
ENDEMICS OF SUBSTANCE USE, HIV,
VIOLENCE, MENTAL HEMGHT AMONG
LGBTQ COMMUNITIES.
>> AND GISWREL?
>> GOOD MORNING AND
CONGRATULATIONS DR. BERTAGNO
LLI, WE ARE SO EXCITED TO HAVE
YOU IN THIS ROLE, MY NAME IS
GISCERTAINLY--CERTAINLY
LLE CORBIE, I'VE BEEN DOING
HEALTH COMMUNITY ENGAGEMENT
RESEARCH FOR THE LAST 23 YEARS
WITH THE POPULATIONS IN RURAL
AFRICA AMERICAN POPULATIONS IN
THE EASTERN PART OF OUR STATE,
I'M THRILLED TO BE HERE AND ONLY
REGRET I CAN'T BE HERE IN PERSON
WITH YOU ALL, I HAVE SEVERAL
COMMITMENTS LIEWT THE DAY SO I
WILL BE IN AND OUT.
NTHANK YOU.
GARTH.
>> GRAGHT GRAHAM, I AM SO
THRILLED TO BE HERE VIRTUALLY
AND I HAVE COVID SO I AM
ATTENDING VIRTUALLY EMPLOY AM A
CARDIOLOGIST, BACKGROUND IN
HEALTH DISPARS RESEARCH, AND NOW
I'M 1 OF THE DIRECTORS OF PUBLIC
HEALTH AT GOOGLE WHERE WE'RE
RUNNING A LOT OF THE ACTIVITIES
WE'RE DOING AROUND HEALTHCARE
PUBLIC HEALTH AND HOW WE USE
TECH TO IMPROVE THE LIVES OF
UNDERSERVED COMMUNITIES.
>> HOPE YOU FEEL BETTER SOON.
THANK YOU FOR BEING HERE IN
SPITE OF BEING URNTD THE
WEATHER.
>> LUCILLA?
>> LUCILA, [INDISCERNIBLE] WITH
THE YALE SCHOOL OF MEDICINE
BIOINFOMATTICS AND CHAIR OF BI
ONY INFORMATIC ANDS DATA
SCIENCE.
MY RESEARCH IS PRIMARILY ON DATA
SHARING DATA PRIVACY AND MACHINE
LEARNING.
>> OKAY, HAVE I LEFT ANYBODY
OUT?
OKAY, GREAT.
>> LOOKS LIKE WE'RE GOOD, THANK
YOU LARRY AND THANK YOU SO MUCH
FOR ALL OF YOU BEING HERE TO
HELP US WITH THIS VERY IMPORTANT
ROLE WE ALL HAVE TODAY EMPLOY I
THOUGHT, LET'S SEE HOW WE'RE
DOING HERE WITH GETTING ON WITH
SLIDES.
THERE WE GO.
THERE THEY ARE.
YAY, THERE WE GO.
OKAY, I THINK I HAVE THE ABILITY
TO ADVANCE THEM SO LET'S SEE.
WELL, OKAY, ID LIKE TO FIRST
INTRODUCE MYSELF AND TO START BY
SHOWING YOU WHERE I CAME FROM.
I GREW UP ON A CATTLE RANCH IN
CENTRAL WYOMING.
IT WAS 18-MILES OF DIRT ROAD
BEFORE YOU HIT PAVEMENT BUT
FORTUNATELY IT WAS AN INCREDIBLY
RICH ENVIRONMENT.
I WOULD MOVE WITH MY MOM A
HUNDRED MILES TO GO TO SCHOOL
EVERY FALL, AND BACK AND FORTH
ON THE WEEKENDS AND THEN COME
BACK EVERY SUMMER AND FORTUNATE
LOW AS YOU CAN SEE, I STILL HAVE
THE ABILITY TO SPEND TIME THERE
IN THE SUMMERS.
THIS IS ALSO A PHOTO OF 2 EVENTS
VERY RECENT EVENTS, MY SWEARING
IN WITH MY HUSBAND ALEX AND THE
SECRETARY OF HHS, JA'VIER
BICETTA, AND THEN ALSO ASSISTING
IN SURGERY AT THE CLINICAL
CENTER WITH DR. STEPHANIE
GOFF LAST WEEK, FORMER POST DOC
AT MY LAB, AND TRAINEE AT
BRIGHAM WOMEN'S HOSPITAL AND NOW
SHE IS A SPECTACULAR SENIOR
SURGEON IN THE CLINICAL CENTER
WORKING WITH STEVE ROSENBERG'S
GROUP TO REALLY DEVELOP
IMMUNOTHERAPY FOR OUR PATIENTS
SO WHAT AN HONOR TO COME BACK
AND BE HER FIRST ASSISTANT.
WHAT A PLEASURE FOR ANY MENTOR.
CAN YOU DO THE NEXT SLIDE.
THIS DOESN'T SEEM TO BE GOING.
OKAY.
WHAT DREW ME TO NIH WAS VERY
SIMPLE, THE MISSION AND WORKING
WHERE PEOPLE HAVE JUST 1 GOAL IN
MIND, TO IMPROVE THE HEALTH OF
AMERICAN PEOPLE.
AND A GUIDING PRINCIPLE
UNDERPINNING ALL THAT NIH DOES
IS THE MANDATE THAT OUR JOB IS
NOT DONE WHEN SCIENTIFIC
DISCOVERIES ARE MADE, YOU'VE
HEARD THIS BEFORE, WE ARE NOT
THE NATIONAL INSTITUTES OF
DISEASE, WE ARE THE NATIONAL
ENITUTES OF HEALTH, AND THAT IS
CRITICAL.
RIGHT NOW WOE HAVE AN
UNPRECEDENTED OPPORTUNITY TO
EMBRACE AND CREASE ACCESS TO
INNOVATION, HAS THERE EVER BEEN
AN ENVIRONMENT LIKE WE ARE IN
RIGHT NOW.
FUNDAMENTAL SCIENCE REMAINS
CRITICAL, YOU WILL HEAR A LOT
FROM ME ABOUT APPLICATION TO THE
CLINICAL ENVIRONMENT BUT PLEASE
DO NOT EVER THINK THAT OUR
COMMITMENT TO FUNDAMENTAL
SCIENCE IS WAIVERRING IN ANY
WAY.
WE UOF THE --JUST WANT TO SEE
THAT AMAZING RESEARCH POTENTIAL
COMING OUT OF LABORATORIES GET
TO PEOPLE FASTER AND SO YOU WILL
HEAR SOME OF THAT.
WHAT DO WE NEED TO DO?
WELL WE HAVE SOME INTERESTING
NEW OPPORTUNITIES.
WE NEED TO CAPITALIZE ON
LEARNING BASED ANALYTICAL TOOLS
SO THAT WE CAN HARNESS DATA INTO
ADVANCES THAT BENEFIT PROVIDERS
AND PATIENTS.
WE NEED TO MAKE CLINICAL TRIENS
MORE EFFICIENT, MORE INCLIEWZIVE
AND MORE RESPONSIVE TO THE
ACTUAL NEEDS OF PEOPLE.
AND WE NEED TO FOCUS ON HEALTH
DELIVERY RESEARCH AND
IMPLEMENTATION SCIENCE TO
IMPROVE ACCESS.
IT IS NOT ENOUGH IF WE'VE
DISCOVERED A BRAND NEW AND
REALLY VERY EFFECTIVE THERAPY OR
PREVENTION MODALITY.
IT HAS TO GET TO PEOPLE OR OUR
YOB AT NIH IS NOT DONE.
AND WE ALSO NEED TO FOCUS MORE
ON TAKING ADVANT ANNUALS OF
COMMONALITIES--ADVANTAGE OF
COMMONALITIES ACROSS DISEASE
AREAS THIS, IS A HUGE BENEFIT OF
FUNDAMENTAL SCIENCE,
UNDERSTANDING THERE ARE
STRUCTURAL UNDERPINNING OF SO
MANY DIFFERENT DISEASE AND THINK
ABOUT HOW WE TARGET THAT FOR THE
MULTIPLE END POINTS ACROSS OUR
INSTITUTES AND CENTERS.
DRIVERS OF DEC THAT AFFECT
MULTIPLE ORGAN SYSTEMS SUCH AS
INFLAMMATION, METABOLIC
SYNDROME, IMMUNE DYSFUNCTION,
THESE ARE THE WEALTH OF
FUNDAMENTAL BIOLOGY, WE NEDRA TO
DO BETTER AT MAKING SURE THAT IT
IS--THAT THEY ARE USED TO THE
BEST EFFECT.
NEXT SLIDE, PLEASE.
HERE'S A CHALLENGE AND THIS 1
MAKES US ALL SAD, VERY SAD, A
RECENT PEW STUDY SHOWED WHAT
MANY OF US HAVE NOTICE INDEED
OTHER WAYS, TRUST IN SCIENTISTS
HAS DECLINED IN THE PAST FEW
YEARS.
I'D LIKE TO DO EVERYTHING THAT I
POSSIBLE SEE CAN TO HELP RESTORE
TRUST IN SCIENCE.
I BELIEVE THAT MEANS THAT WE
HAVE TO DIRECTLY ENGAGE PEOPLE
IN SCIENCE PROMOTING EQUIT
NEUROECTODERMAL OUR RESEARCH AND
LEAVE MOW 1 OUT.
WE WILL GO FAR TOWARD RESTORING
TRUST IN SCIENCE WHEN PEOPLE WHO
STAND TO BENEFIT FROM OUR
RESEARCH BECOME RESEARCH
PARTNERS WHEN WE DESIGN STUDIES
THAT ENGAGE THEM AND RESPECT
THEIR NEEDS AND WHEN PEOPLE SEE
THAT THE RESULTS OF OUR WORK
MAKE THEIR LIVES BETTER.
WE NEED TO MEET PEOPLE WHERE
THEY ARE AND REACH OUT TO PEOPLE
UNDERREPRESENTED IN RESEARCH
WHETHER THAT'S BECAUSE THEY LIVE
FAR FROM A MAJOR MEDICAL CENTER
OR IF THEY'RE PART OF A
COMMUNITY THAT IS PARTICULARLY
MISTRUSTFUL OF SCIENTISTS.
WE NEED TO MEET PEOPLE AT THEIR
CURRENT STATE OF BELIEF IN 1
SCIENCE HAS TO OFFER THEM AND
ENGAGE THEM DIRECTLY IN THE
PROCESS OF MAKING LIFE BETTER
FOR EVERYONE.
NEXT SLIDE.
SO TOPICS FOR TODAY, A BUSY
SLIDE, I WILL JUST GO RIGHT PAST
THIS.
THIS IS A PREVIEW OF WHAT I PLAN
TO COVER IN MY REPORT TODAY
EMPLOY NEXT SLIDE.
AND WE'RE GOING TO START, NEXT
SLIDE, PLEASE.
OKAY AND CAN YOU GO BEYOND THAT,
WE WILL START BY GOING THROUGH
LEADERSHIP CHANGES.
AS I SAID, WE OWE LARRY TABAK
FOR SERVING SO CAPABLY FOR 2
YEARS AS ACTING NIH DIRECTOR.
I CAN TELL YOU THERE HAVE BEEN
NO CANS KICKED DOWN THE ROAD
UNDER LARRY'S WATCH.
HE HAS KEPT THIS ORGANIZATION
ROBUST AND READY TO MOVE FOR
QUICKLY AHEAD AND FOR THAT WE
SHOULD ALL BE GRATEFUL.
WHILE LARRY WAS ACTING DIRECTOR
TARA SCHWETZ, SHE WAS ACTING AS
PRINCIPAL DEPUTY DIRECTOR.
SHE WILL NOW I'M VERY GRATEFUL
TO SAY WILL LEAVE THE PROGRAM OF
COORDINATION AND PLANNING AND
STRATEGIC INITIATIVES IN THE
OFFICE OF DIRECTOR.
THANK YOU TARA.
VERY WIDE RANGING MISSION TO
IDENTIFY, MERGING SCIENTIFIC
OPPORTUNITIES TO OVERSEE THE
COMMON FUND FOR THE GOOD OF ALL
AND TO COORDINATE AND SUPPORT
ACROSS IC RESEARCH RELATED TO
AIDS, WOMEN'S HEALTH, TRIBAL
HEALTH, DATA SCIENCE, NUTRITION
AND MORE AND THE MORE I THINK
YOU'VE HEARD HEARD FROM ME.
WE NEED TO THINK ABOUT THE
COMMON UNDERPINNINGS OF DISEASE
AND DO BETTER COORDINATION
ACROSS ALL OF OUR PROGRAMS.
SO THANK YOU TARA.
JUST TO MENTION TARA HAS HELD
MULTIPLE LEADERSHIPS AT NIH,
BOTH WITHIN THE OFFICE OF THE
DIRECTOR AND MULTIPLE ICs SO
SHE'S--IN HER SPECTACULAR
LEADERSHIP OVER THE LAST 2 YEARS
SHE IS REALLY READY TO LEAVE IN
IMPORTANT GROUP AND WE ALSO WANT
TO THANK, GIVE A ROUND OF
APPLAUSE TO ROBERT ISINGER SINCE
OF DPC SI, THANK YOU.
NEXT SLIDE DR. GENE MORAWRRKS
ZO, JOINED THIS LAST FOUL.
SHE'S HERE.
SHE WILL OVERSEE NIAID'S 6.6
BILLION DOLLAR BUDGET WHICH OF
COURSE RESEARCH IN THE U.S. AND
ACROSS NIAID'S 21 LABS BUT ALSO
REALLY ACROSS THE GLOBE IN
FECTIOUS DISEASE, AND PRIOR TO
THAT WAS A PROFESSOR AT THE
UNIVERSITY OF WASHINGTON IN
SEALT.
SHE HAS BEEN CONTINUOUSLY FUNDED
AS A PI AND NIH GRANT SINCE
1997.
HER RESEARCH HAS FOCUSED ON THE
HUMAN MICROBIOME SPECIFICALLY AS
IT RELATES TO THE FEMALE
REPRODUCTIVE TRACT INFECTIONS,
AND HORMONAL CONTRACEPTION
EMPLOY PREVENTION OF HIV
INFECTION AND THE MANAGE AM OF
OTHER SEXUALLY TRANSMITTED
DISEASES AND ANTIBIOTIC
RESISTANCE, SO CAN YOU SEE SHE
JUST BRINGS A WEALTH OF CRITICAL
KNOWLEDGE FOR THIS KEY
INSTITUTE.
NEXT SLIDE, PLEASE.
I AM ALSO JUST THRILLED TO SAY,
THAT PRESIDENT BIDEN HAS
ANNOUNCED HIS INTENT TO APPOINT
DR. KIM [INDISCERNIBLE] AS THE
NCI DIRECTOR SO WE ARE EAGERLY
AWAITING THE NEXT STEP TO MAKE
THIS OFFICIAL FOR HER.
SHE'S AN EXPERT IN KIDNEY CANCER
AND IS AN IDEAL CANDIDATE TO
LEAD THE CANCER MOONSHOT
INITTATIVE THAT AIMS TO END
CANCER AS WE KNOW IT.
SHE'S CURRENTLY THE CHAIR AT
VANDERBILT UNIVERSITY AND HER
LAB FOCUSES ON THE MOLECULAR
BIOLOGY OF KIDNEY CANC, HER LAB
HAS DETECTED WAYS TO TREAT AND
CURE CANCER USING MOLECULAR
BIOMARKERS.
IENTIOUS SPECIALLY ADMIRE OR
DEDICATION FOR TRAINING, SO
CRITICAL FOR A ROLE AT NIH,
UNTIL 2022, SHE WAS ELECTED TO
THE NATIONAL ACADEMY OF
MEDICINE, SHE SERVED ON TD NCI'S
BOARD OF SCIENTIFIC ADVISORS AND
PART OF THE CANCER GENOMEAT
LAS PINTAS PROGRAM SO SHE IS
WELL AWARE OF THE CHALLENGES
THAT THE NCI DIRECTOR WILL FACE
AND I ALSO WANT TO THANK OUR
DEAR COLLEAGUE AN INPIRRATIONAL
LEADER DR. DOUG LOWY WHO IS
EVERYBODY ISING AS NCI DIRECTOR,
HIS FOURTH TIME, SORRY FOURTH
TIME IN THAT ROLE UNTIL
DR. RATHMELL TAKES OFFICE.
SO A ROUND OF APPLAUSE FOR BOTH
OF THEM.
NEXT SLIDE.
SO SOME RETIRE AM, DR. PATRICIA
BRENNAN RETIRED AFTER BEING THE
DIRECTOR FOR THE NLM.
DR. BRENNAN WAS THE FIRST NURSE,
INDUSTRIAL ENGINEER AND WOMAN TO
LEAD THE NLM.
SHE STARTED TO INTEGRATE HELT
INFORMATION MANAGEMENT WITH
ARTIFICIAL INTELIENCE AND
MACHINE LEARNING AND DEEP
LEARNING METHODS.
WE'RE GRATEFUL TO DR. STEPHEN
SHERRY FOR SERVING AS ACTING NLM
DIRECTOR AT THIS TIME.
HE PREVIOUSLY SERVED AS THE
NLM'S CENTER FOR BIOTECHNOLOGY
AND DATA FOR SCIENTIFIC
RESOURCES.
NEXT SLIDE.
DR. KATE [INDISCERNIBLE] BECAME
THE DIRECTOR OF THE NIH OFFICE
OF LEGISLATIVE POLICY AND
ANALYSIS ON OCTOBER 22nd.
BEFORE THIS, SHE SPENT 4 YEARS
AT FDA, ROB KALIFF IS GIVING ME
GROVE OVER HAVING LOANED HER,
BUT WE'RE GRATEFUL.
THERE SHE SERVED AS DEPUTY
RECTIFIEDOR FOR THE OFFICE OF
APPROPRIATIONS AND ACTING
DIRECTOR OF THE OFFICE SINCE
JUNE 2022, BEFORE HERE TIME AT
FDA, SHE WAS SENIOR LEGISLATIVE
ANALYST IN THE NIH
[INDISCERNIBLE] AND MANAGED
NIH'S INTERACTIONS AND
RELATIONSHIPS WITH THE
CONGRESSIONAL APPROPRIATIONS
COMMITTEE.
WE'RE ALSO GRATEFUL TO MISS
LAUREN HIGGINS AS SERVING AS
ACTING DIRECTOR FOR OLPA AND NOW
CONTINUING IN HER ROLE AS THE
DEPUTY DIRECTOR.
NEXT SLIDE, PLEASE.
AND JUST STRAIGHT HOT OFF THE
PRESS, ANNOUNCE AM WENT OUT
TODAY THAT DR. [INDISCERNIBLE]
HAS BEEN PROMOTED TO DIRECTOR
FOR SCIENCE POLICY EMPLOY SERVED
AS ACTING DIRECTOR OF THE OFFICE
FOR SEVERAL YEARS.
SHE HELPED LEAD THE DEVELOPMENT
OF NUMEROUS HIGH IMPACT SCIENCE
AND POLICY INITTIAIVE ITS AT NIH
INCLUDING THE BRAIN INITIATIVE
AND THE LAUNCH OF NCATS.
WE'RE REALLY FORTUNATE TO COUNT
ON HER ADVICE AND LEADERSHIP ON
POLICY QUESTIONS THAT ARE
CRITICAL TO NIH'S SUCCESS.
NEXT SLIDE.
DR. JAMES MOONY YOINED ON YELL
30th TO LEAD THE OFFICE OF
BEHAVIORIAL AND SOCIAL SCIENCES
RESEARCH.
SHE BRINGS MORE THAN 25 YEARS OF
RESEARCH FOCUSED ON HEALTH
DISPARITIES AND RESILIENCE
ESPECIALLY AMONG POPULATIONS
THAT HAVE BEEN SOCIALLY
MARGINALIZED.
HER RESEARCH IS EXAMINING
BEHAVIORING ASPECTS OF CHRONIC
ILLNESS USING MICKED METHODS AND
CLINICAL TRIALS.
SHE'S ALSO A CLINICAL
PSYCHOLOGIST WHO JOINED THE NIH
FROM THE UNIVERSITY OF
WASHINGTON IN SEATTLE.
SO WE ARE VERY THRILLED TO HAVE
HER ON BOARD.
NEXT SLIDE.
ANDREW GRAHAMAR BEGAN SERVING AS
THE OFFICE OF NUTRITIONAL
RESEARCH IN SEPTEMBER.
THIS OFFICE WORKS WITH ALL NIH
EN--STRATEGIESITUTE ANDS CENTERS
TO ADVANCE AND COORDINATE
NUTRITION RESEARCH AND
PARTICIPATE IN THE DEVELOPMENT
OF NEW TRANS NIH FUNDING AND
WORKSHOPS, DREW IS A PEDIATRIC
ENDOCRINOLOGIST AND HAS A
Ph.D. IN PHARMACOLOGY AS WELL.
PREVIOUSLY HE WAS THE CHIEF OF
THE PEDIATRIC GROWTH AND
NUTRITION BRANCH AT NICHD.
NEXT SLIDE.
I ALSO ANNOUNCED DON BERKLOW IS
OUR CHIEF OF STAFF, HE'S BEEN
SELECTED AS CHIEF OF STAFF AFTER
SERVING AS ACTIVE CHIEF SINCE
APRIL 2021 SO WE'RE TBLAD TO
FINALLY MAKE THIS OFFICIAL,
JOHN.
HE PROVIDES TRANSLATIONAL
RESEARCH TEEJIC COUNCIL WITHIN
NIH, CREATES AND MAINTAINS
DEPARTMENTMENTAL RELATIONSHIPS
WITHIN HEALTH AND HUMAN
SERVICES, ABSOLUTELY CRITICAL
FOR OUR EFFECTIVENESS IN OUR
PLACE WITHIN THE REST OF
GOVERNMENT AND THE AGENCY.
JOHN LED THE OFFICE OF
COMMUNICATIONS AND PUBLIC
LIAISON FOR MANY YEARS AND HE
HAS HELD PROGRESSIVE LEADERSHIP
POSITIONS IN COMMUNICATION AT
NIH SINCE YOINING NCI IN 1986.
OKAY, INCOME SLIDE EMPLOY NOW,
AWARDS.
NEXT.
I AM JUST THRILLED TO SAY THAT
IN OCTOBER PRESIDENT BIDEN
AWARDED DR. STEVEN ROSENBERG THE
NATIONAL MED OF INNOVATION AND
TECHNOLOGY, THE NATION'S HIGHEST
HONOR FOR TECHNOLOGICAL
ACHIEVEMENT.
THIS AWARD RECOGNIZES HIS
PIONEERING WORK TO DEVELOP THE
FIRST EFFECTIVE IMMUNOTHERAPIES
FOR PATIENTS WITH ADVANCED
CANCER.
HE JOINED NIH IN 1974 AS CHIEF
OF THE SURGERY BRANCH AT THE
CENTER FOR CANCER RESEARCH AT
NCI, HE AND HIS TEAM WERE FIRST
TO IDENTIFY THE ANTICANCER
PROPERTIES OF INTERLEUKIN 2
WHICH BECAME THE FIRST FDA ASHES
PROVED IMMUNOTHERAPY TO
CHARACTERIZE 2 INFILTRATING
LYMPHOCYTES AND PROVIDE ADOPTIVE
CELL TRANSFER IMMUNOTHERAPY AND
INTRUS FOREIGN GENES INTO PEASHS
OPENING THE FIELD OF HUMAN
GENOME THERAPY.
FIRST TO USE TBENETICALLY IMMUNE
CELLS, OR CAR-Ts TO TREAT
PATIENTS WITH LYMPHOMAS AND I
HAVE TO SAY AS A FELLOW BRIGHAM
WOMEN'S SURGICAL TRAINEE, HE HAS
LONG BEEN A TBRAIT INSPIRATION
TO ME EMPLOY NEXT SLIDE.
NIH TBRANTEES, DR. CAITLIN
[INDISCERNIBLE], AND DR. DREW
WEISMAN HAVE JOINTLY BEEN
AWARDED THE 2023 NOBEL PRIZE FOR
NUCLEOTIDE BASED MODIFICATIONS
THAT ENABLE THE EFFECTIVE
DEVELOPMENT MRNA VACCINES
AGAINST COVID-19.
THEY BEGAN COLLABORATING AT THE
UNIVERSITY OF PENNSYLVANIA IN
1997.
DR. [INDISCERNIBLE] RECEIVED
FUNDING FROM NHLBI AND NIESHES
NDS OVER THE COURSE OF HER
CAREER AND DR. WI SEMAN HAS BEEN
SUPPORTED BY NIBIB, NCI, AND
DURING HIS TRAINING HE COMPLETED
A FELLOWSHIP IN DR. TONY
FAUCIEKS' LAB.
NEXT SLIDE.
THIS YEAR 2 RESEARCHERS FROM NIH
WERE SELECTED TO THE NATIONAL
ACADEMY OF SCIENCES AND 2
INSTITUTE DIRECTORS WERE ELECTED
TO THE NATIONAL ACADEMY OF
MEDICINE.
ANDREW [INDISCERNIBLE] IS CHIEF
OF THE LABORATORY OF GENOME
INTEGRITY IN THE NIH'S CENTER
FOR CANCER RESEARCH AND THE
STUDY'S DOUBLE STRANDED DNA
BREAK REPAIR.
JOHN O'SHAY IS SCIENTIFIC
DIRECTOR AT NIAMS OVER SEEING
THE INTRA MIEWR EVERL PROGRAM.
HE ALWAYS CHIEF OF THE
INFLAMMATION BRANCH AND STUDIES
CYTOKINE SIGNALING TRANSDUCTION,
BOTH HAVE BEEN ELECTED TO THE
NAGGAL ACADEMY OF SCIENCES.
MICHAEL CHANG IS A DIRECTOR OF
NEI AND IS A PIONEER IS
BIOMEDICAL INFORMATICS AND
INTEGRATING DATA SCIENCE INTO
PATIENT CARE.
AND ERIC GREEN IS THE DIRECTOR
OF NHGRI, AND WAS RECOGNIZED FOR
DEVELOPING TECHNOLOGIES AND
TOOLS TO TRANSLATE GENOMICS INTO
CLINICAL PRACTICE BOTH ELECTED
TO THE NATIONAL ACADEMY OF
MEDICINE THIS YEAR.
NEXT SLIDE.
SO NOW TO SHOW A FEW PHOTOS OF
VARIOUS VISITS AND EVENTS AT NIH
SINCE THE LAST ACD MEETING.
NEXT, PLEASE.
THREE DAYS AFTER I BECAME NIH
DIRECTOR I WAS PLEASED TO ATTEND
A SIGNING FOR THE FIRST EVER
INITIATIVE SIGNING ON WOMAN'S
HEALTH RESEARCH.
THIS INITIATIVE WILL BE LED BY
DR. JILL BIDEN AND THE
WHITE HOUSE GENDER POLICY
COUNCIL.
THE INITIATIVE INVOLVES AGENCIES
ACROSS THE FEDERAL GOVERNMENT
AND WILL MAKE RECOMMENDATIONS TO
IMPROVE RESEARCH ON WOMEN'S
HEALTH.
NEXT SLIDE.
ON OCTOBER 25th, IT WAS AN
HONOR TO JOIN DR. TABAK, IN
WELCOMING THE FIRST LADY OF THE
UNITED STATES, DR. JILL BIDEN
AND ALSO MISS YOADY HAYDEN OF
AUSTRALIA TO THE NIH DURING
THEITATE VISIT FROM THE
AUSTRAILIAN PRIME MINISTER.
WE SHARED NIH'S PROGRESS IN
PEDIATRIC CANCER RESEARCH DURING
A VISIT TO THE NIH CLINICAL
CENTER AND ALSO PICTURED HERE,
YOU WILL SEE THE CHILDREN'S INN,
AND CEO DR. JAMES
[INDISCERNIBLE].
NEXT SLIDE.
THE ACD WORKING GROUP ON
DIVERSITY AND SUBGROUP OF
INDIVIDUALS WITH DISABILITIES
ISSUED A REPORT LAST DECEMBER
WHERE YOU ALL PROVIDED
RECOMMENDATIONS CONCERNING HOW
NIH CAN SUPPORT INCLUSION OF
PEOPLE WITH DISABILITIES IN THE
SCIENTIFIC RESEARCH AND IN THE
RESEARCH ENTERPRISE.
WE SINCERELY APPRECIATE THE
SUBGROUPS EFFORTS IN EXAMINING
THIS CRITICAL ISSUE IN DEPTH AND
TODAY I WOULD LIKE TO DISCUSS
THE PROGRESS THAT NE H HAS MADE
ON YOUR SUGGESTIONS.
NEXT SLIDE.
ONE RECOMMENDATION WAS TO UPDATE
THE CURRENT NIH MISSION AT THE
SAME TIME TO REMOVE, REDUCING
DISABILITY, BECAUSE THIS
LANGUAGE COULD BE INTERPRETED AS
PERPETUATING ABLEIST PLEEFS THAT
PEOPLE WITH DISABILITIES ARE
FLAWED AND NEED TO BE FIXED.
IN RESPONSE WE'RE UPDATING OUR
MISSION STATEMENT TO REFLECT
BETTER THE SPIRIT OF THE
AGENCY'S WORK TO HELP ALL PEOPLE
MUCH THE PROPOSED NEW STATEMENT
IS AS FOLLOWS.
TO SEEK FUNDMENTAL KNOWLEDGE
ABOUT THE NATURE AND BEHAVIOR OF
LIVING SYSTEMS AND APPLY THAT
KNOWLEDGE TO OPTIMIZE HEALTH AND
PREVENT OR REDOUSE ILLNESS FOR
ALL PEOPLE.
--REDUCE ILLNESS FOR ALL PEOPLE.
NEXT SLIDE, PLEASE.
SUBGROUP ALSO RECOMMENDED THAT
PEOPLE WITH DISABILITIES BE
FORNLALLY DESIGNATED AS A HEALTH
DISPARITY POPULATION POPULATIO.
AFTER CAREFUL CONSIDERATION OF
THE NATIONAL ADVISORY COUNCIL ON
MINORITY HEALTH AND HEALTH
DISPARITIES FINAL REPORT, INPUT
FROM THE BUSINESS
PROGRAMSABILITY COMMUNITY AND A
REVIEW OF THE SCIENCE AND
EVIDENCE, NIH FORMALLY
DESIGNATED PEOPLE WITH
DISABILITIES AS A POPULATION
WITH HEALTH DISPARITIES ON
SEPTEMBER 26th, 2023.
THE NATIONAL INSTITUTE ON HEALTH
ON MINORITY AND MINORITY
DISPARITIES RELEASED A FUNDING
OPPORTUNITY FOR RESEARCH ON
FOCUS AND NOVEL INTERVENTIONS TO
ADDRESS THE INTERSECTIONS OF
DISABILITY, RACE, ETHNICITY AND
SOCIOECONOMIC STATUS ON
HEALTHCARE ACCESS AND HEALTH
OUTCOMES.
NEXT SLIDE.
WE ARE IN THE PROCESS OF
REVIEWING ADDITIONAL
RECOMMENDATIONS FROM THE ACD
SUBGROUP, MUCH OF WHAT WAS
RECOMMENDED IS CONTAINED IN THE
MARCH 2023 DEIA TRANSLATIONAL
RESEARCH STRAY JECTORY STEINIC
PLAN.
AND WE ALSO HAD A STEERING
COMMITTEE OF THE DEIA WORKING
DPROWP TO INSURE GOING FORWARD
THAT WE ADDRESS ALL THE
RECOMMENDATIONS WITHIN THE
REPORT.
THE SUBGROUP FOCUSES ON CULTURE,
ABLEISM, AND RESEARCH POLICIES
AND SYSTEMS.
AND LET ME JUST SAY AGAIN, THANK
YOU TO THIS COUNCIL FOR YOUR
INCREDIBLE SUPPORT IN THIS NEW
EMPHASIS FOR NIH, WE THINK THIS
IS A HUGE CONTRIBUTION.
NEXT SLIDE.
SIMPLIFIED REVIEW CRITERIA,
SOMETHING EVERYONE WANTS TO SEE.
NEXT SLIDE.
THE NIH CENTER FOR SCIENTIFIC
REVIEW PREPARED A PROPOSAL FOR
SIMPLIFIED REVIEW CRITERIA WITH
SIGNIFICANT INPUT FROM THE MAJOR
EXTRAMURAL COMMUNITIES OF THE
NIH INCLUDING OUR INSTITUTE AND
CENTER LEADERS.
LET ME BE CLEAR, THE GOAL IS TO
FIND THE BEST SCIENCE, THE MOST
INNOVATIVE SCIENCE, THE SCIENCE
THAT'S GOING TO ACHIEVE OUR
GOALS FOR HEALTH.
AND THAT IS WHAT THIS SIMPLIFIED
REVIEW CRITERIA IS DESIGNED TO
DO.
AN RFA CLOSED MARCH 2023 AND
RECEIVED MORE THAN 800 RESPONSES
FROM INDIVIDUALS AND SCIENTIFIC
SOCIETIES.
THE VAST MAJORITY OF RESPONSES
SUPPORTED THE PROPOSED CHANGES
BUT THE COMMUNITY REQUESTED
COMMUNICATIONS BEFORE A NEW
REVIEW FRAMEWORK IS IMPLEMENTED
INCLUDING GUIDANCE AND TRAINING
RESOURCES FOR REVOWERS AND NIH
STAFF.
THE SIMPLIFIED FRAMEWORK IS
BETTER INTENDED TO FOCUS PEER
REVIEWERSOT KEY QUESTIONS
NEEDED, TO ASSESS SCIENTIFIC
TECHNICAL MERIT.
PUT SIMPLY, CAN AND SHOULD THE
PROPOSED RESEARCH BE CONDUCTED?
TO REDUCE UNDUE INFLUENCE OF
SCIENTIFIC REPUTATION IN THE
REVIEW PROCESS AGAIN WITH THE
GOAL OF THE BEST SCIENCE, THE
FRAMEWORK CHANGES THE EVALUATION
OF INVESTIGATOR AND ENVIRONMENT
TO EYE BINARY DECISION OF EITHER
SUFFICIENT OR NOT SUFFICIENT IN
THE CONTEXT OF THE PROPOSED
RESEARCH.
REVIEWERS WILL NOT NEED TO
ASSESS POLICY COMPLIANCE AS MUCH
AS IS ON THE PAST SO THEY CAN
BETTER FOCUS ON CONSCIENCE AND
TECHNICAL MERIT AND THIS DOESN'T
MEAN WE NEED TO LESSEN UP OUR
REVIEW OF POLICY COLCOMPLIANCE
BUT ADMINISTRATE OF
RESPONSIBILITIES RELATED TO THIS
WILL SHIFT TO NIH STAFF, WE
THINK THIS IS BETTER USE OF OUR
RESEARCHERS TIME AND EXPERTISE.
NEXT SLIDE.
NEXT STEPS BETWEEN NOW AND YEN
2025 WHEN WE SEE FULL IMPLEMENT
EGG.
THE ROLL OUT BEGAN WITH GUIDE
NOTICE IN 2023, IN A STAFF
WEBINAR AND PUBLIC WEBINAR AS
CALLED FOR BY THE COMMUNITY IN
THE RFI DEVELOPING PLANNING
RESOURCES AND PLAN MANY
COMMUNICATIONS LEADING UP TO THE
IMPLEMENTATION DATE.
ALL INFORMATION BACKGROUND,
RESOURCES, WEBINAR RECORDING CAN
BE FOUNDOT SIMPLIFYING REVIEW
WEBPAGE.
NEXT SLIDE.
ARTIFICIAL INTELLIGENCE AT NIH,
NEXT SLIDE.
THE ARRIVAL OF MACHINE LEARNING
METHODS FOR WIDE SPREAD PUBLIC
USE HAS RAISED PUBLIC AND
CONGRESSIONAL AWARENESS OF THE
POSSIBILITIES FOR USING THESE
ANALYTIC APPROACHES FOR
BIOMEDICAL RESEARCH.
OF COURSE, YOU ALL AROUND THE
TABLE, RESEARCHERS AT NIH HAVE
BEEN EMPLOYING THESE METHODS FOR
QUITE SOMETIME.
UNDERSTANDING THEIR IMPORTANCE
TO ANALYZING COMPLEX DATA SETS
DERIVING FROM OMICS RESEARCH,
COMPUTATIONAL CHEMISTRY AND
OTHER HIGH DENSITY DATA.
NIH MADE SIGNIFICANT INVESTMENTS
IN MAKING DIVERSE AI READY DATA
AVAILABLE TO THE RESEARCH
COMMUNITY AND IN SUPPORTING NEW
COLLABORATIONS AMONG BIOMEDICAL
RESEARCHERS AND AI EXPERTS.
WE ARE ALSO CONTINUING TO
DEVELOP PLANS TO DRAMATICALLY
EXPAND NIH'S CAPABILITIES FOR
DATA SHARING AND USE BY THE
BROADEST POSSIBLE RESEARCH
COMMUNITY.
BEYOND THE FUNDAMENTAL SCIENCE
REALM, AI ANALYTICS SHOW
TREMENDOUS PROMISE AS AN
APPROACH TO PRODUCING INSIGHTS
THAT DIRECT CLINICAL CARE.
AN INITIAL CLINICALAC DOPGZ OF
AI IS IMPROVING IMAMG BASED
DIAGNESTICS ALREADY, HELPING
DETECT DISEASES AND PREDICTING
BEHAVIOR AND NERVE RESPONSES TO
STIMULI.
HOWEVER, MORE WIDE RANGING USE
OF AI METHODS TO DIRECT CLIPICAL
CARE RAISES MANY IMPORTANT
CONCERNS.
WE KNOW THAT BIAS CAN BE
INTRODUCED INTO MACHINE LEARNING
METHODS, AND MODELS AND THAT
CAREFUL STUDY DESIGN MUST
ADDRESS THIS FOR INITANCE, BY
INCLUDING DATA FROM ALL DEMON
GRAPHIC GRUPS INCLUDING
MINORITY, RURAL AND OTHER
UNDERREPRESENTED COMMUNITIES.
WE'VE ALSO HEARD THE HORROR
STORIES ABOUT HOW A LONG
LANGUAGE MODEL SEEM TO MAKE UP A
RESULT THAT MADE NO SENSE.
SO BEGINNING ABOUT A DECADE
PRIOR TO MY ARRIVAL AT NIH, I
PERSONALLY HAVE BEEN ACTIVELY
INROFULLED IN THIS AREA,
BRINGING THE BEST ACCURATE,
CORRECT AND DIVERSE CLINICAL
DATA TO OUR RESEARCH TEAMS AS A
FOCUS FOR GOING FORWARD AND SO,
I'M JUST VERY PLEASED TO SAY
THAT THIS IS A KEY AREA OF
PRIORITY FOR ME.
AI PROMISES SHORTENING TIMES FOR
NEW MEDICAL TREATMENTS AND
IMPROVING SUCCESS RATES BUT WHAT
IS HOLDING AI BACK IN THE
BIOMEDICAL RESEARCH CONTEXT?
SOME OF THE CHALLENGING INCLUDE,
LACK OF DATA, LACK OF ACCESS TO
CLINICAL AND HEALTHCARE DATA
WITH CAREFUL AND ACCURATE
ANNOTATION THAT REPRESENT THE
FULL DIVERSITY OF THE AMERICAN
PEOPLE.
WE ARE TO ACKNOWLEDGE THAT IS A
SIGNIFICANT LACK THAT WE HAVE TO
FIX.
LACK OF DATA ABOUT PEOPLE LIVING
IN DIFFERENT CONTEXTS AND THE
SOCIAL DETERMINANTS THAT AFFECT
THEIR HELT, NEED FOR VALIDATED
ETHICAL AND TRUSTWORTHY AI
ALGORITHMS IN HEALTH SETTINGS,
LACK OF DIVERSITY IN THE AI
WORKFORCE AND CHALLENGES IN
DISSEMINATING AI TECHNOLOGIES TO
DIVERSE POPULATIONS.
AND LAST OF ALL, I AM ACUTELY
CONCERNED OVER LACK OF TRUST
FROM THE PEOPLE WE'RE TRYING TO
SERVE AS BEING A REAL IMPEDIMENT
TO US BEING ABLE TO DELIVER
RESULTS THAT MATTER FOR THEM,
YOU KNOW I WILL JUST SAY AGAIN,
WE DO NOT WANT TO DELIVER
RESULTS ONLY FOR PEOPLE WHO
BELIEVE IN THE VALUE OF
BIOMEDICAL RESEARCH, WE WANTED
TO LEVER RESULS FOR EVERYBODY
AND THAT MEANS WE HAVE TO TACKLE
HEAD ON, THE TRUST ISSUE FOR
EVERYONE.
OKAY, I WILL GO THROUGH A FEW OF
THE NIH PROGRAMS WORKING TO
OVERCOME THE CHALLENGES
DESCRIBED HERE.
NEXT SLIDE.
BUSY SLIDE HERE BUT YOU WILL
HAVE IT AVAILABLE TO REVIEW.
THE NIH BRIDGE TO ARTIFICIAL
INTELLIGENCE OR BRIDGE TO AI
PROGRAM IS BASED ON THE REPORT
OF THE 2019 ACD AI WORKING
GROUP.
YOU CAN SEE, WE WILL PROVIDE YOU
WITH THE LINK REQUIRED TO ACCESS
THIS.
THE IDEA WITH BRIDGE TO AI IS TO
SET THE STAGE FOR WIDE SPREAD
ADOPTION OF THESE LEARNING
METHODS THAT ADDRESS COMPLEX
BIOMEDICAL CHALLENGES.
THE DELIVERABLES OF THE PROGRAM
FOCUS ON GATHERING FLAGSHIP
DATA, DEVELOPING BEST PRACTICE
GUIDELINES AND CRITERIA AND
DEVELOPING CURRICULA FOR HANDS
ON TRAINING.
THE PROGRAM IS STRUCTURED AROUND
4 DATA GENERATION PROGECS
ADDRESSING GRAND CHALLENGES
SHOWN ON THE SLIDE.
THESE PROJECTS ARE COORDINATED
AND INTEGRATED BY THE
CONSORTIUM'S BRIDGE CENTER, A
DEPICTION OF A ROAD ON THE RIGHT
SLIDE TOUCHES THE PROGRAM'S
ACCOMPLISH WANTS SO FAR.
DATA GENERATION, KEY AIM OF THE
PROGRAM IS TO GENERATE NEW
FLAGSHIP DATA SETS AND BEST
PRACTICES FOR MACHINE LEARNING
AND DATA GENERATION PROJECTS
HAVE BEGUN COLLECTING PILOT DATA
SETS.
COMMUNITY ENGAGEMENT, THE
PROGRAM ESTABLISHED A PUBLIC
PORTAL FOR THE PROGRAM, THE
BRIDGE CENTER STARTED A TRAINING
WEBINAR SERIES, REGULAR
PRESENTATIONS ON TOPICS RELATED
TO BEST PRACTICES IN AI AND
MACHINE LEARNING AND THE
CONSORTIUM HOSTING WORKSHOPS AND
SYMPOSIA TO GATHER DIVERSE
VOICES TO INSURE THAT ETHICAL,
LEGAL AND SOCIAL IMPLICATIONS OF
BIOMEDICAL AND BEHAVIORIAL AI
MACHINE LEARNING METHODS ARE
ADDRESSED.
FINALLY A JAMBOREE COMPETITION
IS BEING PLANNED FOR THE SPRING
WHERE AI MACHINE LEARNING EXPERT
CANS INTERACT WITH THE PILOT
DATA AND I WILL JUST EMPHASIZE
AGAIN, WE COOPERATE --CANNOT HAE
THIS BE JUST THE PEOPLE WHO
NATURALLY GRAVITATE TOWARD
ENGAINLING WITH US, WE NEED
EVERYONE'S HELP IN MAKING SURE
THIS WORK SERVES EVERYONE
INCLUDING THOSE FOR WHICH THESE
METHODS MIGHT PRODUCE ANXIETY OR
MISTRUST, ET CETERA.
SO YOU KNOW ANY AND ALL
APPROACHES TO ALL MAKING THAT
POSSIBLE WILL BE MOST WELCOME
FOR ALL OF US.
NEXT SLIDE.
A FEW MORE PROJECTS.
I WANT TO TOUCH ON A FEW OF THE
PROJECTS TO GIVE YOU A TASTE OF
THE BREDTH OF WHAT'S ANYTHING ON
SINCE YOU DELIVERED YOUR REPORT
IN 2019.
THE NUTRITION FOR PRECISION
HEALTH PROJECT IS PART OF THE
NIH COMMON FUND ITS GOAL IS TO
PREDICT ALGORITHMS THAT PREDICT
INDIVIDUAL RESPONSES TO FOOD AND
DIETARY PATTERNS.
THE PROJECT WILL LEVERAGE
ADVANCES IN AI, MICROBIOME
RESEARCH AND THE INFRASTRUCTURE
OF THE LARNL AND DIVERSE ALL OF
US PARTICIPANT PROGRAM.
THE NATIONAL EN--STRATEGIESITUTE
ON MINOR HEALTH AND HEALTH
DISPARITY SCIENCE COLLABORATIVE
FOR HEALTH DISPARITIES, AND AI
BIAS REDUCTION, WHAT A MOUTHFUL
OTHERWISE KNOWN AS SHARE IS A
CLOUD PLATFORM THAT HOLDS AI
READY DATA ON POPULATIONS AND
SOCIAL DETERMINANTS OF HEALTH
AND SERVES AS A RESOURCE FOR
TEST STRATEGIES TO MITIGATE BIAS
AND USE AI FOR HEALTH
DISPARITIES RESEARCH ESPECIALLY
FOR CHRONIC DISEASES.
THE NATIONAL EN--STRATEGIESITUTE
OF AGING CENTER FOR ALZHEIMERS
AND RELATED DEMENTIAS ALSO KNOWN
AS CARD AND AI COLLABORATIONS
BOTH USE THESE METHODS AS
FOUNDATION WILL PARTS OF HOW
THEY OPERATE.
FOR EXAMPLE, USING AI TECHNIQUES
CARD RESEARCHERS RECENTLY FOUND
THAT THERE MAY BE MORE GENETIC
OVERLAP BETWEEN ALZHEIMERS
PARKINSONS AND OTHER
NEURODEGENERATIVE DISEASES THAN
PRIOR ANALYSIS OF THE SAME DATA
SUGGESTED SO ALSO A REALLY
INCREASING RESULT THAT WILL LEAD
TO--THAT WILL LEAD TO MORE
RESEARCH.
A PROJECT UNDERWAY IS ALSO
DEVELOPING TECHNOLOGY WHERE AI
IS PAIRED WITH VOICE ASSISTED
TECHNOLOGY TO DETECT DEMENTIA IN
THE HOME SETTING.
THE NATIONAL INSTITUTE ON DRUG
ABUSE AND DEVELOPING AND
EVALUATING A MACHINE LEARNING
OPIOID PREDICTION AND RISK
STRATIFICATION EPLATFORM.
NCI IS PARTNERING WITH THE
DEPARTMENT OF ENRNLY TO ADVANCE
COMPUTE XG AI FOR CANCER
RESEARCH WITH A FOCUS ON DRUG
DISCOVERY IN PATIENT OUTCOMES.
THE NATIONAL INSTITUTE OF MENTAL
HEALTH HAS A PROGRAM USING AI,
TECHNIQUES TO BETTER UNDERSTAND
HOW NEURAL CIRCUITRY IS LINKED
TO BEHAVIORS.
NOT LISTED ON THE SLIDE, BUT THE
NATIONAL EYE INSTITUTE IS
ADVANCING THE USE OF AI IN
CLINICAL IMAGING TO ADVANCE
TELEMEDICINE, DIAGNOSIS AND
TREATMENT DECISIONS.
NCATS HAS A BIOMEDICAL DATA
TRANSLATOR THAT CONNECTS
COMPARTMENTALIZED DATA ACROSS
DISEASES AND DISCIPLINES USING
AI GUIDED KNOWLEDGE MAPPING TO
HELP REPURPOSE DRUGS, RECLASSIFY
DECS, AND POINT TO POSSIBLE
TREATMENTS FOR RARE OR DIFFICULT
TO TREAT DECS AND THE NLM IS
FUNDING EXTRAMURAL RESEARCHERS
WHO HAVE AAPPLIED AI MISSION
LEARNING APPROACHES.
I HOPE YOU CAN SEE THAT WE ARE
NOT LATE TO THIS PARTY.
WE REALLY HAVE THESE TECHNIQUES,
THESE ANALYTICS HAVE BEEN KNOWN
TO US FOR QUITE SOMETIME.
YOU ALL PRESENTED A ROADMAP FOR
US NOW 4 YEAR AGO THAT YOU CAN
SEE IS NOW WELL, UNDERWAY BUT WE
NEED TO KNOW WE NEED TO CONTINUE
TO INVEST IN RESEARCH AND
ESPECIALLY COMMUNITY ENGAGEMENT
TO INSURE THAT THESE NEW
TECHNOLOGIES ARE USED
RESPONSIBLY, SAFELY, EFFECTIVELY
AND ENCLUESIVELY AND I EXPECT
THAT NIH WILL CONTINUE TO LEAD
IN DEVELOPING AI FOR BIOMEDICAL
AND BEHAVIOR RESEARCH.
OKAY, NEXT SLIDE.
COUPLE PROGRAM ANDS INITIATIVES.
NEXT.
I WOULD LIKE TO PROVIDE AN
UPDATE ON THE COMMUNITY
PARTNERSHIPS TO ADVANCE SCIENCE
FOR SOCIETY OR THE
COMPASQUANTINO PROGRAM.
THE UNITE INITIATIVE INSPIRED
COMPASS AND YOU'LL HEAR MORE
FROM OUR UNITE CO-CHAIRS LATER
THIS MORNING, BUT I WANT TO TAKE
A MOMENT JUST TO EXPRESS MY
COMPLOAT SUPPORT FOR THE UNITE
INITIATIVE.
NIH MUST CONTINUE TO BE A LEADER
IN PROMOTING EQUITY AND ON
IDENTIFYING OPPORTUNITIES TO
ADDRESS STRUCTURAL RACISM WITHIN
NIH, WITHIN OUR OWN HOUSE, AND
ALSO THROUGHOUT THE BIOMEDICAL
AND BEHAVIORIAL RESEARCH
ENTERPRISE.
NOW THIS IS A 10 YEAR PROGRAM
SUPPORTED BY THE COMMON FUND
THAT AIMS TO ADVANCE HEALTH
EQUITY SO THAT EVERY PERSON CAN
ATTAIN THEIR FULL HEALTH
POTENTIAL AND NO 1 IS
DISADVANTAGED BECAUSE OF THEIR
RACIAL OR ETHNIC BACKGROUND OR
ANY OTHER CIRCUMSTANCES THAT
SHAPE THE CONDITION OF DAILY
LIFE.
COMPASS FOCUSED ON FACTORS THAT
CAN PROMOTE HEALTH, ECONOMIC
STABILITY, EMPLOYMENT
OPPORTUNITIES, HEALTHY FOOD,
SAFE SPACES, TRAN PORTATION, AND
QUALITY HEALTHCARE, I HAVE TO
SAY IT AGAIN.
OUR SCIENCE IS NOT DONE UNTIL
PEOPLE ARE LIVING LONG AND
HEALTHY LIVES AND IF WE ARE
GOING TO ACHIEVE THAT, THESE ARE
THE AREAS THAT OUR RESEARCH MUST
ENCOMPASS.
NEXT SLIDE.
THREE INITIATIVES WILL BE USED
TO ACHIEVE THE GOALS OF THE
COMPASS PROGRAM AS LISTED ON
THIS SLIDE.
IN SEPTEMBER 2023, NIH MADE 26
AWARDS TO LARGE COMMUNITY
ORGANIZATIONS AND A COORDINATING
CENTER AS PART OF A COMMUNITY
LED HEALTH EQUITY STRUCTURAL
INTERVENTIONS INITIATIVE.
THESE 26 AWARDS TOTAL
APPROXIMATELY 171 MILLION OVER 5
YEARS.
ILLUSTRATING OUR SIGNIFICANT
COMMITMENT TO THIS.
NEXT SLIDE.
JUST TO GIVE YOU A FEW EXAMPLES
OF THE PROJECTS THAT WERE FUNDED
UNDER COMPASS, 1 PROJECT
SUPPORTS ACCESS TO FOOD AND
UNDERSERVED RURAL COMMUNITIES,
THE TEAM WILL MEASURE WHETHER
INTERVENTIONS REDUCE HUNGER,
IMPROVE DIET QUALITY, IMPROVE
WEIGHT AND PROTECT PEOPLE FROM
CHRONIC DECS SUCH AS DIABETES
AND CARDIOVASCULAR DISEASE
EMPLOY ANOTHER PROJECT ASSESSES
WHETHER EARLY CHILDHOOD
STRATEGIES IMPROVE MENTAL HEALTH
FOR CHILDREN AND GUARDIANS.
AN ADDITIONAL PROJECT WILL
ASSESS WHETHER TELEHEALTH ACCESS
IN RURAL COMMUNITIES CAN PROMOTE
DISEASE MANAGEMENT FOR CANCER
DEPRESSION, DIABETES, HIGH BLOOD
PRESSURE, AND OTHER CHRONIC
DISEASES AMONG AGRICULTURAL
WORKERS, SOMETHING CERTAINLY
NEAR AND DEAR TO MY HEART.
OVERALL THIS ADDRESSES NIH'S
ADVANCEMENT TO HELT INIQUITIES
AND MEET PEOPLE WHERE THEY ARE.
NEXT SLIDE.
THE PRESIDENT AND FIRST LADY
REIGNITED THE CANCER MOONSHOT
LAST FEBRUARY.
THIS HAS HELPED TO GIVE CRITICAL
FOCUS TO ACHIEVING THESE GOALS
HERE, VERY AMBITIOUS GOALS,
DROPPING THE DEATH RIGHT BY 50%
IN THE NEXT 25 YEARS AND
IMPROVING THE LIVES OF PEOPLE
AND THEIR FAMILIES LIVING WITH
AND SURVIVING CANCER.
WE MADE SIGNIFICANT PROGRESS
THROUGH CANCER RESEARCH AND CARE
AND THESE GOALS ARE VERY
AMBITIOUS BUT THERE IS STILL
MUCH WE NEED TO LEARN ABOUT
CANCERS.
--ABOUT SOME CANCERS FOR WHICH
WE DON'T HAVE ADEQUATE
APPROACHES OR EVEN SCIENTIFIC
UNDERSTANDING THAT CAN HELP US
REACH THESE GOALS.
BUT THESE GOALS INN CLUED ALL
CANCERS ANDENTIOUS SPECIALLY
THOSE THAT STILL HAVE A POOR
PROGNOSIS, RARE CANCERS AND SOME
CHILDHOOD CANCERS.
WE WOULD MAKE MAJOR PROGRESS,
ALSO BY JUST INSURING THAT OUR
CURRENT STARRED ARDS OF CARE
REACH AND ARE ADOPTED BY ALL
PEOPLE WHO WOULD BENEFIT THEM
FROM THEM.
UNFORTUNATELY, WE STILL SEE
SERIOUS DISPARITIES BETWEEN
DIFFERENT POPULATIONS, DUE TO
CULTURAL AND STRUCTURAL BARRIERS
THAT STAND IN THE WAY.
AND ALTHOUGH WE CAN ACHIEVE REAL
GAINS IN THE NEAR TERM, THROUGH
POLICY ACTIONS, WE WON'T REACH
OUR GOALS WITHOUT RESEARCH.
FIFTEEN, WONDERFUL TO SEE THIS
ACKNOWLEDGED BY THE CURRENT
ADMINISTRATION.
NEXT SLIDE.
SO THE PRESIDENT AND FIRST LADY
HAVE CALLED FOR AN ALL OF
GOVERNMENT APPROACH, NOT JUST
NIH, TO THE CANCER MOONSHOT AND
THIS REQUIRES COLLECTIVE ACTIONS
ACTIONS
AND COORDINATION ACROSS ALL OF
GOVERNMENT TO MEET THE GOALS
SEEN HERE MUCH THE NATIONAL
CANCER PLAN WAS DEVELOPED BY THE
NCI AS A WAY OF COORDINATING
RESPONSE AMONG THE MANY, MANY
PARTNERS THAT ARE REQUIRED.
EACH OF THE 8 NATIONAL CANCER
PLAN GOALS DRIEBS WHAT SUCCESS
LOOKS LIKE AND ADDRESSES OUR
MOST SIGNIFICANT CHALLENGES IN
CANCER.
SENSE THE PLAN'S LAUNCH LAST
APRIL WE'VE ALREADY WITNESSED
INCREDIBLE NEW COLLABORATIONS
ACROSS THE CANCER COMMUNITY,
ACROSS GOVERNMENT AND ALL OF
SOCIETY IN PURSUIT OF THESE
GOALS.
AND WE LOOK FORWARD TO CONTINUED
PARTNERSHIP TO SPEED PROGRESS
TOWARD ENDING CANCER AS WE KNOW
IT.
NEXT SLIDE.
THE PRESIDENT'S CANCER PANEL HAS
BEEN CHARGED WITH MONITORING THE
ACTIVITIES OF THE NATIONAL
CANCER PLAN AND REPORTS TO THE
PRESIDENT ON PROGRESS AND
BARRIERS TO FURTHER SUCCESS IN
REDUCING THE BURDEN OF CANCER.
TO SUPPORT THIS IMPORTANT WORK,
THE PANEL CONVENED THE FIRST
NATIONAL CANCER PLAN STAKEHOLDER
MEETING ON SEPTEMBER 7th,
BROUGHT TOGETHER PARTICIPANT PRS
ACROSS THE CANCER COMMUNITY,
INCLUDING 12 ORGANIZATIONS,
REPRESENTING ONCOLOGY CARE
PROFESSIONALS, COMMUNITY CANCER
CENTERS, HEALTH INFORMATION
TECHNOLOGY SYSTEMS, AND THE
BUSINESS COMMUNITY AS WELL AS
GROUPS INVOLVED IN RESEARCH AND
ADVOCACY.
PRESENT ANTICIPATIONS AND
DISCUSSION FROM THE MEETING AS
WELL AS PUBLIC COMMENTS WILL
INFORM THE PANELS TO REPORT TO
THE PRESIDENT WHICH WILL
HIGHLIGHT OPPORTUNITIES TO
OPTIMIZE IMPLEMENTATION,
GOVERNMENT WIDE AND SOCIETY WIDE
OF THE NATIONAL CANCER PLAN.
NEXT SLIDE.
A NEW MODELING ANALYSIS
CONDUCKED BY NCI RESEARCHERS
SHOWS HOW MUCH JUST INCREASED
USE OF RECOMMENDED KREENING
COULD HELP US PROGRESS TOWARD
THE MOON SHOT MORTALITY
REDUCTION GOAL.
WE KNOW THAT THE UPTAKE OF
KREENING FOR COMMON CANCER
SYSTEM NOWHERE NEAR WHERE IT
SHOULD BE.
AND BETTER IMPLEMENTATION CAN
HAVE A REAL IMPACT ON PROGNOSIS
AND MORTALITY AT A SOCIETAL
LEVEL.
THIS SLIDE HERE SHOWS THE LIVES
THAT COULD BE SAVED WITH JUST A
10 PERCENTAGE POINT INCREASE IN
SCREENING UPTAKE FOR COMMON
CANCERS.
THIS WORK SHOWS CLEARLY THAT WE
CAN'T ASSUME THAT ANY 1 MEASURE
WILL SUFFICE.
IT'S A SHINING EXAMPLE OF HOW
CURRENT STANDARDS OF CARE, IF
THEY CANNOT REACH OR SERVE ALL
PEOPLE WHO WOULD BENEFIT THEM,
WE WON'T MEET THE CHALLENGES OF
THE CANCER MOONSHOT.
NEXT SLIDE.
ADDITIONAL WORK BY NETWORK CI
RESEARCHER ANDS PARTNERS SHOWS
WE CAN INCREASE CANCER KREENING
THROUGH INITTIAIVE ITS THAT
DIRECTLY ADDRESS SOCIAL
DETERMINANTS OF HEALTH.
THE GREATEST IMPROVEMENTS IN
SCREENING IN THIS WORK CAME FROM
INTERVENTIONS THAT RELATED TO
MULTIPLE DOMAINS, SOMETHING AS
STRAIGHT FORWARD AS ADDRESSING
THE COST OF TRANSPORTATION TO
SCREENING APPOINTMENTS.
WE NEED RESEARCH TO IDENTIFY
SOLUTIONS, TOGETHER WITH
IMPLEMENTATION THROUGH POLICY
INTERVENTIONS AND ACTION BY
PROVIDERS AND OTHERS AT THE
COMMUNITY LEVEL.
AND I THINK THE MOON SHOT REALLY
ILLUSTRATES HOW NIH WILL NOT
REMAIN ISOLATED BUT IS COMMITTED
TO BEING THE PARTNER
ORGANIZATION THAT MAKES--THAT
ACHIEVES OUR GOAL OF HEALTH
THROUGHOUT ALL OF GOVERNMENT AND
ALL OF SOCIETY.
NEXT SLIDE.
AND THEN FINALLY, THIS IS A
TOPIC OF MUCH DISCUSSION, HOW DO
WE ADVANCE CANCER SCREENING?
PULTY DETECTION BLOOD TESTS.
THESE TESTS DO,A PEER TO DETECT
MORE CANCERS EARLIER.
THEY ARE AVAILABLE ON THE MARKET
NOW TO PEOPLE WHO CAN AFFORD
THEM.
THEY DO APPEAR--THEY DETECT MORE
CANCERS EARLIER AND MAY BE
PROMISING IN PARTICULAR CANCERS
WE CURRENTLY DO NOT HAVE
KREENING--EFFECTIVE SCREENING
MODALITIES.
WE CAN DETECT PAN KRISTATTIC
CANCER EARLIER, OVARIAN CANCER,
THOSE ARE JUST 2 OBVIOUS
EXAMPLES, WHERE WE NEED.
BUT THE QUESTION WE MUST ANSWER
AND WE BELIEVE IT WILL TAKE
GOVERNMENT TO ANSWER IS WHETHER
THESE TESTS SAVE LIVES OR
PREVENT MORBIDITY.
OVERDIGITEXTIS OR TREATMENT OF
CANCERS THAT WOULD NOT HARM A
PATIENT IF LEFT UNTREATED IS A
REAL POSSIBILITY.
WE'VE SEEN THIS HAPPEN WITH
OTHER PREVENTION APPROACH OR
EARLY DIAGNOSIS APPROACHES AND
IF THESE TESTS DO SAVE LIVES, WE
MUST MAKE SURE THAT THEY'RE
AVAILABLE AND ACCESS EBL TO
ANYONE WHO CAN BENEFIT NO MATTER
THEIR SOCIOECONOMIC
CIRCUMSTANCES, SO NCI WILL BE
ABLE TO FUND CENTERS TO CONDUCT
THIS WORK AND WILL ANTICIPATE
ANNOUNCING THEM IN JANUARY ALONG
WITH THE NAME OF THE NETWORKS
SUPPORTING THE NCI SPONSORED VAN
GUARD CLINICAL STUDY ON
MULTICANCKER DETECTION.
NEXT SLIDE.
ANOTHER PROJECT WE ARE VERY
PROUD OF IS THE NIH HEAL
INITIATIVE, THE HEAL INITIATIVE
IS DESEENED TO SPEED SCIENTIFIC
SOLUTIONS TO THE OPIOID PUBLIC
HEALTH CRISIS.
AFTER 5 YEARS OF FUNDING WE ARE
MAKING PROGRESS.
ONE OF THE MOST IMPORTANT THINGS
ABOUT THE HEAL INITIATIVE IS
HOPE, THIS IS NOT ABOUT DESPAIR,
THIS IS ABOUT EFFECTIVE
TREATMENTS THAT CAN REALLY BE
BROUGHT TO BEAR TO TRANSFORM
LIVES.
BUT STILL CHALLENGES REMANY AS
THE CRISIS CONTINUES TO EVOLVE
IN INCREDIBLY DANGEROUS WAYS, AT
THIS POINT, NEARLY EVERY
AMERICAN KNOWS SOMEONE WHO'S
AFFECTED BY THIS, NEXT SLIDE.
THIS IS JUST SUCH A SCARY SLIDE.
DRUG OVERDOSE DEATH VS INCREASED
DRAMATIC LOAMACYY IN RECENT
DECADES.
DRIVEN BY DIFFERENT SUBSTANCES
AT DIFFERENT TIMES.
TODAY OVERDOSES FROM THE
SYNTHETIC OPIOID FENTANYL, AND
STIMULANTS LIKE METHAMPHETAMINE
ARE CAUSING RECORD HIGH NUMBERS
OF DEATHINGS EVEN AS WE MAKE
PROGRESS FOR OTHERS.
FROM 2010 THERE'S BEEN A RAPID
INCREASE IN HEROIN INVOLVED
OVERDOSES.
IN 2013 FENTANYL OVERDOSES
BECAME COMMON AND FOR 2021 THE
YEAR FOR WHICH WE HAVE THE MOST
RECENT COMPLETE DATA MOST
OVERDOSE DEATHS INVOLVED
FENTAFYL, BUT 23 PRS INVOLVED A
STIMULANT IN COMBINATION WITH
FENTANYL, SOME OF THESE HAVE
BEEN EXTREMELY HARD HIT.
THE AMERICAN INDIAN AND ALASKA
NATIVE COMMUNITY AND BLACK
AMERICANS.
NEXT SLID.
PAIN IS AN IMPORTANT PART OF THE
CHALLENGE.
I THINK WE ALSO KNOW SOMEONE IN
OUR IMMEDIATE COPE WHO SUFFERS
FROM CHRONIC PAIN.
IT IS CHRONIC PAIN IS HORRIBLE.
UNTREATED AND POORLY TREATED
PAIN CAUSES CONSIDERABLE
SUFFERING AND IS THEN A DRIVER
OF OPIOID USE.
CHRONIC PAIN REMAIPS A PUBLIC
HEALTH CRISIS THAT I THINK HAS
BEEN UNDERAPPRECIATED.
ACCORDING TO A RECENT NIH STUDY
THAT REANALYZED GOVERNMENT
HEALTH DATA NEW CASES OF CHRONIC
PAIN NOW OUTNUMBER THOSE OF
OTHER CHRONIC CONDITIONS SUCH AS
DIABETES, DEPRESSION AND HIGH
BLOOD PRESSURE.
THE PREVALENCE OF PAIN INCLUDING
CHRONIC PAIN THAT INTERFERES
WITH LIFE, INCREASES WITH AGE
AND IS HIGHER AMONG PEOPLE IN
RURAL AMERICA.
THERE IS MEAGER PRIVATE
INVESTMENT IN THE DEVELOPMENT OF
NONADDICTIVE PAIN OR ADDICTION
THERAPEUTICS AND THEREFORE NIH
CAN PLAY AN EXTREMELY IMPORTANT
ROLE BY BOLSTERING THOSE
EFFECTS, DERISKING THERAPEUTIC
APPROACHES.
THIS IS WHEN WE'RE HERE TO DO TO
TAKE ON CRITICAL AREAS WHERE
PRIVATE INVESTMENT HAS NOT
THOUGHT TO PURSUE MUCH NEXT
SLIDE.
IN ITS FIRST 5 YEARS HEAL BEP
UPON DEVELOPED AN EXPANSIVE
RESEARCH PORTFOLIO PHOBEUSING ON
ALL ASPECTS OF THE OPIOID
CRISIS, MISUSE AND OVERDOSE.
TODAY 3 BILLION INITIATIVE--THE
3 BILLION INITIATIVE DOLLAR
INITIATIVE, FUNDS MORE THAN 1800
RESEARCH PRONG --PROJECTS ACROE
UNITED STATES.
THIS WORK IS COORDINATED BY
NIDA AND NINDS BUT ALL OTHER
INSTITUTE ANDS CENTERS ARE
PARTICIPATING EMPLOY THIS IS
ESSENTIALLY IMPORTANT BECAUSE
PEOPLE WHO SUFFER THESE
DISORDERS OFTEN HAVE OTHER
COMORBID DISORDERS SUCH AS
DIABETES, CARDIOVASCULAR DISEASE
AND INFLAMMATORY DISEASE.
AND HEAL HAS A GREAT TRACK
RECORD, FDA AS APPROVED HEAL
ASSOCIATED 42 APPLICATIONS FOR
CLINICAL TESTING OF
INVESTIGATIONAL NEW DRUGS OR
DEVICES, MORE THAN 300 CLINICAL
TRIALS ARE UNDERWAY INCLUDING
REAL WORLD RESEARCH DONE IN
PRAGMATIC TRIALS THAT TEST
INTERVENTIONS THAT HAVE BEEN
SHOWN TO WORK IN LARGE CONTROL
STUDIES, BUT ARE UNDERUSED IN
ROUTINE HEALTH SETTINGS.
NONPHARMAICOLOGICAL TREATMENTS
FOR PAIN AND STUDIES EMBEDDED IN
HEALTH SYSTEMS THAT EVALUATE HOW
TO INCREASE USE OF HIGHLY
EFFECTIVE TREATMENTS FOR
ADDICTION THAT REMAIN
DRAMATICALLY UNDERUSED.
A CORE HEAL VALUE IS
COLLABORATION, WORKING HAND IN
HAND WITH COMMUNITIES, PATIENT
ADVOCATES, FEDERAL STATE AND
LOCAL AGENCIES, INDUSTRY AND
ACADEMIA AND I JUST WANT TO END,
OH LET ME--NEXT SLIDE, SORRY, 1
LAST THING, BEFORE I MOVE ON,
HEAL PROGRESS.
AGAIN BUSY SLIDE, I WILL GO
QUICKLY, CURRENTLY IN CLINICAL
TESTING AN ANTIBODY TO PREVENT
FENTANYL OVERDOSE, A NOVEL SMALL
MOLECULE TREATMENT FOR CHRONIC
PAIN.
REALTIME MEASUREMENT OF CHRONIC
PAIN SIGNATURE PAVING THE WAY
TOWARDS PERSONALIZED
NONADDICTIVE PAIN MANAGEMENT
APPROACHES.
HE'LL RESEARCH HAS DEMONSTRATED
DEFINITIVELY AN EXISTING
MEDICATION FOR OPIOID USE
DISORDER BUPRENORPH REMAINS SAFE
AND EFFECTIVE FOR PEOPLE WHO US
FENTANYL, DESPITE CONCERNS
PREVIOUSLY ABOUT PRECIPITATING
WITHDRAWAL FOR THOSE WHO USE
FENTANYL.
FINDINGS ARE ALREADY INFLUENCING
STATE LEVEL PRACTICE GUIDELINES,
OUR FEDERAL PARTNER THE
SUBSTANCE ABUSE AND SAMHSA IS
PUTTING HEAL TO PRACTICAL USE.
GRANTEES ARE USING FUNDED
MODELING WORK FOR STATE LEVEL
PLANS FOR NALOXONE, DEPENDING ON
THE NEED, AND ALSO PUBLISHING A
PRACTICE GUIDE FROM THE HEALING
COMMUNITY STUDY TO CREATE
COALITIONS FOR DISORDERS,
PRESSURES AND COMMUNITIES.
TO NOTABLE PROGRAMS WITHIN THE
HEAL INITIATIVE FOCUS ON
POPULATIONS THAT ARE
DISPROPORTIONATELY AFFECTED BY
THIS PUBLIC HEALTH CHALLENGE.
THE NATIVE COLLECTIVE RESEARCH
EFFORTS ENHANCE WELLNESS WILL
FUND COMMUNITY-DRIVEN RESEARCH
TO TREASES OVERDOSE, SUBSTANCE
USE, MENTAL HEALTH AND PAIN IN
COMMUNITIES AND TO IMPLEMENT
BEST PRACTICES TOWARD ENHANCING
HEALTH EQUITY FOR THIS
POPULATION.
AND NOW I JUST WANT TO END THIS
DISCUSSION ABOUT OUR WORK TO
ELIMINATE SUBSTANCE USE
DISORDERS AND BETTER MANAGE
PAIN, WITH SOMETHING THAT WAS--I
WAS TAUGHT BY BOTH NORA VOLKOW,
OUR DIRECTOR OF NIERK DA AND
JOARNL, OUR DIRECTOR OF N IAAA,
PEOPLE WITH SUBSTANCE USE
DISORDERS DON'T ADOPT THOSE
BEHAVIORS TO MAKE THEMSELVES
FEEL GOOD.
THEY ADOPT THOSE DISORDERS TO
MAKE THEMSELVES FEEL LESS BAD.
AND IT'S ABSOLUTELY CRITICAL
THAT WE ALSO ADDRESS THE STIGMA
THESE COMMUNITIES HAVE.
THIS IS NOT ABOUT PARTY PEOPLE,
THIS IS ABOUT PEOPLE WHO TRULY
ARE SUFFERING AND HAVE TURNED TO
THESE METHODS TO HELP THEM WITH
THIS AND THAT IS WHAT NIH IS ALL
ABOUT, FINDING WAYS TO HELP IN
THIS SITUATION.
SO, THANK YOU.
NEXT, PANDEMIC PREPAREDNESS.
WE ARE WORKING TO DEVELOP
COUNTERMEASURES FOR SELECT
PATHOGENS WITH PANDEMIC
POTENTIAL.
NEXT SLIDE.
RESEARCH AND COVID TO ENHANCE
RECOVERY OR RECOVER, AIMS TO
IMPROVE OUR UNDERSTANDING OF
ABILITY TO PREDICT, TREAT AND
PREVENT LONG COVID.
THINK ABOUT THIS.
IN THE MIDDLE OF A PANDEMIC
CAUSING DEATH EVERYWHERE, WE
HAVE A COMPLETELY NEW DISEASE
THAT HAS NOT BEEN BIOLOGICALLY
CHARACTERIZED IN ANY WAY.
AND IT'S A DISEASE THAT AFFECTS
EVERY ORGAN IN THE BODY.
JUST IMAGINE THE UNDERTAKING AND
I AM REALLY, REALLY, JUST CANNOT
SAY ENOUGH ABOUT WHAT THE ENTIRE
RECOVER COMMUNITY HAS DONE TO
ADDRESS THAT SO QUICKLY.
THE INITIATIVE CO DESIGNED BOTH
FOR RESEARCHERS AND PATIENTS
USES A MULTIPRONGED APPROACH TO
THE PROBLEM OF LONG COVID BY
INTEGRATING ELECTRONIC HEALTH
RECORDS, REAL WORLD CATA,
CLINICAL TRIALS AND
OBSERVATIONAL STUDIES, STUDIES
OF PATHOGENESIS AND LONG-TERM
FOLLOW UP.
BUILDING THE AIRPLANE AS THEY
WERE FLYING IT BECAUSE THIS IS A
CRISIS TO GET NEW TREEPTS TO
PEOPLE NOT ONLY WITH COVID BUT
THEN SUFFERING FROM LONG COVID.
SO JUST AN ENORMOUS UNDERTAKING,
AND YES, WE ARE GRATEFUL FOR
INCREDIBLE FUNDING FROM CONGRESS
TO BE ABLE TO UNDERTAKE THIS AND
THE WORK HAS BEEN TRULY
IMPRESSIVE.
NEXT SLIDE.
AS YOU KNOW LONG-TERM EFFECTS OF
COVID MAY BE DIFFERENT FOR
EVERYONE.
THEY CAN AFFECT MANY DIFFERENT
PARTS OF THE BODY, RESULT IN
MANY DIFFERENT SYMPTOMS AND
THESE SYMPTOMS CAN COME AND GO
AND THEY MAY LAST FOR A FEW
WESTBOUNDS, OR MONTHS OR PERHAPS
EVEN LONGER.
INCREDIBLE COMPLEXITY.
AND SO FORRECOVERS LONGITUDINAL
STUDIES IN EHR AMALSIS THAT
PROVIDE VALUABLE INFORMATION,
PRACTICAL INFORMATION ABOUT THE
PREVALENCE OF AND RISK FACTORS
FOR THE COMPLICATION OF LONG
COVID.
NEXT SLIDE.
WITH THIS KNOWLEDGE OF RISK
FACTORS AND PREVALENCE, RECOVER
HAS NOW LAUNCHED CLINICAL TRIALS
TO EVALUATE POTENTIAL TREATMENTS
FOR LONG COVID.
FIVE MASTER PROTOCOL DRIVEN AND,
DATA PROTECTIONIVE PLATFORM
TRIALS THAT FOCUS ON TREATMENTS
FOR SYMPTOMS THAT PATIENTS CARE
ABOUT, IT IS NOT A SHOTGUN
APPROACH, IT IS A HYPOTHESIS
DIRECTED PATIENT-CENTERED
SYMPTOM-MANAGE AM AS WELL AS
OVERARCHING BIOLOGY APPROACH.
THESE MASTER PROTOCOLS ARE
ADDRESSING BRAIN FOG, AUTONOMIC
DYSFUNCTION, SLEEP PROBLEMS,
EXERCISE TOLERANCE, FATIGUE, ET
CETERA.
STUDIES ARE CURRENT LE ENROLLING
PATIENTS INTO 2 TRIALS
ADDRESSING VIRAL PERSISTENCE AND
COGNITIVE DISFUNCTION AND
ADDITIONAL TRIALS WILL OPEN IN
COMING MONTHS.
STUDIES FOR THESE TRIALS HAVE
BEEN SELECTED IN PART BECAUSE
THESE EXTINGUISHING AREAS OF
RESEARCH, AND THEIR CAPACITIES
EFFECTIVELY FROM THEIR OWN
PATIENT POPULATIONS ANDENTIOUS
SPECIALLY SURROUNDING DIVERSE
COMMUNITIES AND BECAUSE ALL OF
THESE TRIALS ARE DESEENED TO BE
ADAPTIVE, WE CAN PIVOT TO TEST
NEW INTERVENTIONS AS
APPROPRIATE.
THIS IS A DYNAMIC AND LEARNING,
CONTINUALLY LEARNING SYSTEM.
EACH TRIAL FOCUSES ON A SUBSET
OF SYMPTOMS BUT TO CONTRIBUTE TO
THE COLLECTIVE KNOWLEDGE ABOUT
WHAT THIS NEW DISEASE MEANS,
ALSO COLLECTS DATA ABOUT HOW
INTERVENTION AFFECTS SYMPTOMS
AND ABOUT THE BIOLOGICAL
UNDERPINNINGS OF THE DISEASE
EMPLOY INTEGRATED TRIALS COULD
AND WILL INFORM CLINICAL CARE IN
A BROAD RANGE OF LONG COVID
PATIENTS AND IMPORTANTLY, WE
WILL BE ABLE TO BE CONFIDENT IN
OUR CONCLUSIONS BECAUSE OF
RIGOROUS TRIAL DESIGN THAT IS
INFORMED BY RECOVER LED
CHARACTERIZATION, FUNDAMENTAL
SCIENCE CHARACTERIZATION, OF
CLINICAL CONDITIONS AND DISEASE
PATHOPHYSIOLOGY.
AS CAN YOU TELL, I THINK WE ARE
REALLY INCREDIBLY ENTHUSIASTIC
AND I AM JUST SO PROUD OF WHAT
THE COMMUNITY, THE BIOMEDICAL
RESEARCH COMMUNITY HAS DONE IN
THIS AREA.
NEXT SLIDE.
ACCELERATING MEDICINE'S
PARTNERSHIP, LET ME SAY THAT
VERY QUICKLY THAT THE AMP
PROGRAM MANAGED BO I OUR
WONDERFUL PARTNER FOUNDATION FOR
THE NATIONAL INSTITUTES OF
HEALTH IS A PUBLIC-PRIVATE PART
MERSHIP WITH FDA, NIH, MULTIPLE
BIOMEDICAL AND LIFE SCIENCES
COMPANIES AND OTHER NONPROFIT
ORGANIZATIONS TO WORK TOGETHER
TO IDENTIFY BETTER TARGETS FOR
DRUG DEVELOP EXPMENT REDUCE THE
TIME AND COST OF DEVELOPING
THEM.
WE WANT TO USE OUR PUBLIC
DOLLARS, OUR PRECIOUS PUBLIC
DOLLARS IN THE VERY BEST
POSSIBLE WAY.
WE DO NOT WANT TO DUPLICATE WORK
THAT IS DONE BY THE PRIVATE
SECTOR EMPLOY WE HAVE TO DO IT
IN CONCERT, IN CAREFUL CONCERT
SO THAT WE REALLY MAXIMIZE THE
BENEFIT OF EVERY DOLLAR WE GET
AND AMP IS 1 WAY WE ARE ABLE TO
REALLY OPERATIONALIZE THAT.
ORIGINALLY FOCUSED ON
ALZHEIMER'S DISEASE, TYPE 2
DIABETES, RHEUMATOID ARTHRITIS
AND LUPUS, THIS PROGRAM HAS
GROWN TO 10 INDIVIDUAL PROJECTS
REPRESENTING THE CONTRIBUTIONS
AND PARTICIPATION OF 16 OF NIH
INSTITUTES AND OVER70 PRIVATE
SECTOR PARTNERS.
NEXT SLIDE.
I JUST WANT TO ANNOUNCE SOME NEW
PROJECTS THAT HAVE BEEN
UNDERTAKEN THE IMPORTANCE OF
THEM.
WE WILL LAUNCH 2 NEW 1S IN THE
FIRST HALF OF 2023.
FIRST PARKINSON'S DEC AND
RELATED DISORDIERS, THIS WILL
BUILD ON THE 2017 PROJECT WITH
ARK DITIONAL DAT INCLUDING NOVEL
TYPES AND MULTIMODAL DATA
ANALYSIS, INCREASE DIVERSITY IN
PATIENT WOHOTTERS TO IMPROVE
UNDERSTANDING OF CLINICAL
VARIATION AND DEVELOP MORE
TARGETED TREATMENTS AND SECOND A
NEW AMP IN ALS, IT IS DESIGNED
TO CONNECT AND HARMONIZE
CLINICAL DATA SAMPLES AND
RESEARCH RESOURCES AND WILL
INTEGRATE CLINICAL DATA WITH
BIOLOGIC MEASURES TO IDENTIFY
BIOMARKERS FOR DISEASE DIAGNOSIS
AND PROGRESSION.
SUCH A CRITICAL UNDER--SUCH A
CRITICAL COMMUNITY FOR WHICH WE
DO NOT YET HAVE ANY EFFECTIVE
ANSWERS.
REALLY PLEASED TO SEE THESE 2
INITIATIVES GO FORWARD.
TWO OTHER PROGECS SUSPECTED TO
BE LAUNCH INDEED 2024 OR 20 WITH
25, SYSTEMS BIOLOGY IN
INFLAMMATION IN MY OWN PAST
RESEARCH HAS BEEN INVOLVED AND
SO I'M REALLY THRILLED TO SEE
THIS 1 AND TO HARMONIZE, THAT
WILL HARMONIZE DATA ACROSS
MULTIPLE AMPS, AND A CELL BASED
THERAPY CONSORTIUM WHICH WILL
LEVERAGE THE MODEL OF THE
BESPOKE GENE THERAPY CONSORTIUM
TO FOCUS ON CELLULAR THERAPIES,
THIS PROJECT, IT WILL LIKELY
FOCUS ON INDUCED PLURIPOTENT
STEM CELLS AND COMMON DISEASES,
AND NEXT SLID, WE'RE COMING TO
10 YEARS SINCE THE AMP PROGRAM
FIRST BEGAN AND WE'RE HOSTING
SCIENTIFIC SYMPOSIUM IN FEBRUARY
TO LAUNCH THIS MILESTONE.
I INVITE YOU ALL TO ATTEND.
IT WILL HIGHLIGHT SUCCESSFUL
INNOVATION AND COLLABORATION IN
EACH OF THE INDIVIDUAL AMP
PROJECT AREAS, AND PROVOID A
FORUM FOR DISCUSSION AND CRASS
COLLABORATION THROUGHOUT THIS
ENTIRE AMP RESEARCH COMMUNITY.
NEXT SLIDE.
I'M JUST GOING TO END THERE, I
COULD--I'VE GONE ON A LONG TIME,
I COULD GO ON ALL DAY ABOUT
SCIENCE HIGHLIGHTS BUTIME JUST
XG TO PICK 1 FOR NOW.
LASTLY, NEXT SLIDE, I WANT TO
HIGHLIGHT EXCEPTIONAL WORK FROM
INTERNATIONAL RESEARCH TEAMS,
PART OF THE BRAIN INITIATIVE
CELL CENSUS NETWORK.
THIS IS JUST SUCH A GREAT
RESOURCE AND AN EXAMPLE OF A
RESOURCE THAT CAN CONTRIBUTE SO
MUCH ELSE THAT WE NEED TO DO.
THE EFFORT CHARACTERIZED MORE
THAN 3000 HUMAN BRAIN CELL TYPES
AND WILL HELP LEAD TO NEW
INSIGHTS FOR IMPROVING
TREATMENTS FOR A WHOLE HOST OF
MENTAL CONDITIONS AND BRAIN
DISORDERS.
YOU CAN FIND DETAILS ABOUT THIS
IN MORE THAN 20 PAPERS ALREADY
PUBLISHED IN SCIENCE, SCIENCE
ADVANCES AND SCIENCE
TRANSLATIONAL MEDICINE.
YOU CAN SEE A LINK HERE THAT
WILL HELP AND THIS IS A GREAT
EXAMPLE OF THE KIND OF CROSS
CUTTING FUNDAMENT WILL RESEARCH
THAT WILL DRIVE THE NEXT
ITERATION OF THE DIAGNOSTIC AND
THERAPEUTIC RESEARCH WHERE SO
MANY COMMON DEVASTATING DISEASES
OF THE BRAIN.
INCLUDING MENTAL HEALTH
DISORDERS, DEVELOPMENTAL
DISORDERS AND CANCER.
SO WITH THAT LET ME THANK YOU SO
MUCH FOR BEING HERE TO HELP GOID
NIH AS WEB CONNECTED WORK TO
MEET THE MANY CHALLENGES OF
PROMOTING HEALTH AND WELL BEING
FOR EVERYONE.
YOUR TIME IS VERY VALUABLE AND
WE ARE SO TBRAITFUL --GRATEFUL
THAT YOU ARE HERE TO HELP US.
I LOOK FORWARD TO YOUR
QUESTIONS.
THANK YOU.
YEAH, BEFORE WE TAKE QUESTIONS
FROM EVERYBODY, I THINK WE WILL
TURN IT OVER, WE WILL GIVE YOU
THE 2 OTHER REALLY IMPORTANT
REPORTS, SO NEXT WE'RE GOING TO
NEAL SHAPIRO, ARE YOU READY?
UP TO THE PODIUM IN AND WE'RE
GOING TO HEAR ABOUT OUR FINANCES
AND OUR BUDGET.
YAYN. A--YAY!
>> GREAT.
THANK YOU.
SO WE ARE IN THE VERY
CHALLENGING BUDGET ENVIRONMENT
THESE DAYS AS YOU MAY LIKELY
HAVE GATHERED JUST FROM THE
NEWS.
IF I CAN ADVANCE, YES, NO, AH,
THANK YOU.
SO WE'RE CURRENTLY UNDER A
CONTINUING RESOLUTION.
THE GOOD NEWS THERE IS THAT THE
GOVERNMENT HAS NOT SHUT DOWN.
THAT WOULD BE A PROBLEM
INCLUDING FOR HOLDING THIS
MEETING BUT THE CONTINUE
RESOLUTION WAS PASSED THROUGH
NOVEMBER 17th AND THEN IT WAS
FOLLOWED BY A SECOND 1 IN THE
CASE OF NIH AND THE OTHER
AGENCIES IN THE SAME
APPROPRIATIONS SUBCOMMITTEE THAT
WE ARE THAT LASTS THROUGH
FEBRUARY 2nd.
I SAY THAT BECAUSE THE WAY THIS
CR WAS PASSED THERE WERE 2
DEADLINES, 1 IN YEN,
JANUARY 19th FOR 1 GROUP OF
APPROPRIATIONS BILLS AND THE
SECOND IN FEBRUARY 2nd.
AND THE REASON FOR THAT IS
BASICALLY WAS EXPRESSING IN
CONGRESS, THERE IS A PRINCIPLE
THAT EVERY APPROPRIATION BILL IS
SUPPOSED TO PASS INDIVIDUALLY,
THAT RARELY HAPPENS, I THINK
ABOUT ONCE IN 20 YEARS, SO THE
BILL'S TEND TOWARDS THE END OF
THE PROCESS TO GET PACKAGED UP
INTO AN OMNIBUS WHICH COVERS THE
ENTIRE GOVERNMENT AND IN THE
VIEW OF SOME THAT MAKE ITS MORE
DIFFICULT FOR CONGRESS TO WEIGH
IN ON THESE SPECIFIC BILL ANDS
SPECIFIC EAMTION BUDGETS.
O THERE WAS A GOAL TO TRY TO
AVOID THAT SINGLE OMNIBUS THIS
YEAR LEADING TO THOSE 2
DEADLINES IN THE CR.
WE WILL SEE WHAT HAPPENS NEXT
BUT THE ASSUMPTION THERE WILL E
THAT A BILL WOULD PASS FOR THE
FIRST GROUP OF AGENCIES AND THEN
LATER WHEN THE SECOND DEADLINE,
ANOTHER BILL WOULD PASS FOR THE
REMAINING AGENCIES EMPLOY
REMANYS TO BE SEEN AND AS I NOTE
HERE THERE'S A LOT TO GET DONE
BEFORE CONGRESS WILL BE ABLE TO
REACH THAT POINT.
THEY'LL NEED TO HAVE AGREEMENTS
ON HIGH LEVEL SPENDING AS WELL
AS HOW TO DIVIDE IT UP AMONG THE
INDIVIDUAL SUBCOMMITTEES,
INCLUDING THE 1 THAT HANDLES THE
NIH BILL.
SO A LOT TO DO FOR US BETWEEN
MOW AND FEBRUARY 2 AND KATE WILL
GIVE YOU A LITTLE MORE ON SOME
OF THE DYNAM ICS THERE THAT ARE
CURRENTLY GOING ON.
I DID WANT TO MENTION THE TYPE 1
DIABETES FUNDING SO THAT IS
SEPARATE, THAT DOESN'T GET
INCLUDED IN THE REGULAR ANNUAL
APPROPRIATIONS BILL.
IT OFTEN WILL PASS FOR A COUPLE
OF YEARS AT THE TIME BUT THE
CURRENT AUTHORIZATION OF THOSE
FUNDS EXPIRED IN 2023, SO
THE--AN EXTENSION, A SHORT-TERM
EXTENSION, LIKE THE CONTINUING
RESOLUTION HAS BEEN INCLUDED FOR
THOSE FUNDS AS WELL, SO THOSE
ARE SORT OF ON A PAY AS YOU GO
SYSTEM LIKE THE REST OF THE BILL
AT THE MOMENT, THE ASSUMPTION
BEING THAT IT WILL BE CONTINUED
HOPEFULLY FOR MORE THAN 1 YEAR
BUT THAT REMAINS TO BE SEEN.
SO NEXT LET ME TALK A LITTLE BIT
ABOUT WHAT HAS HAPPENED IN
CONGRESS.
FIRST ON THE HOUSE SIDE, SO
THERE HAS BEEN MORE OF A FOCUS
ON THE HOUSE SIDE IN TERMS OF
TRYING TO LIMIT SPENDING AND AS
A RESULT, THE BILL THAT INCLUDES
NIH HAS REDUCTIONS COMPARED TO
LAST YEAR OVERALL INCLUDING ALL
OF N NIH, WITH ARP A-H, AND IT'2
BNT 8 BILLION LESS FOR THE REST
OF NIH AND THERE ARE A COUPLE
ELEMENTS OF THAT I WILL TALK
ABOUT EMPLOY IT WAS NOT WIDE
SPREAD ACROSS THE BOARD TYPE
PRODUCTIONS, VERY TORGETTED, A
COUPLE DIFFERENT THINGS MOST OF
THE INSTITUTE ANDS CENTERS WERE
LEFT FLAT TO 2023 BUT THERE WAS
A CUT TO NIAID AND ALSO TO THE
21st CENTURY CURES ACT
PROGRAMS.
SO THOSE PROGRAMS, THE CANCER
MOONSHOT, THE ALL OF US RESEARCH
PROGRAM AND THE BRAIN
INITIATIVE, THEY HAVE A SOURCE
OF FUNDING THAT IS PRIVILEGED IN
SOME RESPECTS, IT DOESN'T COUNT
AGAINST THE DISCRETIONARY CAPS,
BUT IT'S SEPARATE FROM THE
APPROPRIATIONS BILL, IT GETS
PULLED IN, BUT IT'S ON THE
DEFINITE TRACK AND
UNFORTUNATELY, THE PEAK SPENDING
UNDER THAT BILL WAS IN 2023 AND
IT'S COMING DOWN IN 2024 AND
2025 FROM THIS SEPARATE SOURCE
IN THE CURES ACT AND AS A ACCEPT
RETIRED RESULT, THERE ARE
PROGRAMS TRYING TO MAINTAIN
THOSE REDUCTIONS BECAUSE OF THE
LOWER FUNDING PROFILE THAT WAS
ESTABLISHEDDIERS AGO
INDEPENDENTLY OF CURRENT NEDRAS
N
E
D
R
A
S
N
E
D
S
.
SO IN THIS CASE, IF IN THE BACK
BILL THEY DID NOT DO THOSE
REDUCTIONS SO THERE WAS
$670 MILLION THAT CAME OUT
INCLUDING ALL OF THE CURRENT
FUNDS FOR THE CANCER MOONSHOT
AND MUCH OF THE FUNDS FOR THE
OTHER 2 PROGRAMS AND THAT IS
SOMETHING WE'VE BEEN TRYING TO
ADDRESS TO KEEP THOSE PROGRAMS
OPERATING AT THEIR PREVIOUS
LEVEL AND THAT'S GOING TO BE A
CONTINUING ISSUE GOING FORWARD.
I DID WANT TO SAY A LITTLE BIT
ABOUT WHEN HAPPENED IN THE FLOOR
ACTION IN THE HOUSE.
SO THE BILL CAME OUT OF THE
SUBCOMMITTEE IN THE SUMMER.
THE HOUSE BROUGHT IT TO THE
FLOOR.
THERE WERE A NUMBER OF
AMENDMENTS.
THE FINAL BILL DIDN'T PASS BUT
INTERESTINGLY SOME OF THE
AMENDMENTS DID TAKE MORE MONEY
FROM NIH BUT WHAT WAS KIND OF
MOST TELLING WAS THE AMENDMENTS
THAT PASSED WITH REDUCTIONS WERE
ALL BY A VOICE VOTE AND THE
VOTES WHERE THEY ACTUALLY
RECORDED WHO WAS FOR OR AGAINST,
THOSE ATTEMPTS TO REDUCE THE NIH
BUMET WERE VOTED DOWN.
SO IT APPEARS THAT THE MAIORITY
OF CONGRESS WAS NOT WILLING TO
GO ON THE RECORD AS WANTING TO
REDUCE NIH FUNDING FURTHER,
PROBABLY A GOOD THING.
NEXT TURNING TO THE SENATE, THEY
GOT THE BILL OUT THIS YEAR, LIKE
MOST, THEY HAVE FLAT FUNDING SO
THE SAME LEVEL AS 2023.
THERE WERE SOME INCREASES, I
MENTIONED ALZHEIMER'S DISEASE,
MENTAL HEALTH, THOSE WERE
TARGETED IN A COUPLE AREAS, WAS
NOT ACROSS THE BOARD BUT ALSO
THE SENATE DID MAKE TAIN THOSE
CURES PROGRAMS BY MAKING
EMERGENCY FUNDS SO A SOURCE THAT
WOULD NOT COUNT ON THE CAPTIVES
BUYING TO THE REST OF THE MONEY
IN AN ATTEMPT TO KEEP THOSE
PROGRAMS FROM TAKING A CUT.
SO CERTAINLY STRONGER SUPPORT
FOR THOSE PROGRAMS OVER ON THE
SENATE SIDE.
AND HERE THE NUMBERS, YOU CAN
SEE TD PRESIDENT'S BUDGET HAD
INCREASES FOR ARP A-H, AND THIS
INCLUDED AN INCREASE FOR THE
CANCER MOONSHOT AND YOU CAN SEE
THE HOUSE AND SENATE MARKS
THERE, HOW THEY DEALT WITH THE
ADDITIONAL FUNDS FOR THE MOON
SHOT WERE NOT ON EITHER BILL BUT
THE SENATE DID MAINTAIN THE
MONITOR --MOON SHOT AT THE 2023
LEVEL.
I DID WANT TO MENTION THIS WAS A
PROPOSAL, HHS WIDE PROPOSAL FOR
PAB DEMIC PREPAREDNESS, THAT
FOLLOWS ON FROM ALL THE WORK
WE'VE DOING ON COVID-19, IT WAS
AN ATTEMPT TO CONTINUE AND TO
PREPARE FOR A FUTURE PANDEMIC,
SO WE WILL BE IN BETTER SHAPE.
THAT WAS A 20 BILLION DOLLAR
PROPOSAL ISSUES 2.69 WAS THE NIH
PIECE OF THAT, THAT HAS NOT
GOTTEN SUPPORT YET IN CONGRESS
BUT I DID WANT TO MENTION
ESPECIALLY SINCE MONICA BROUGHT
UP THE PROGRESS ON THE RECOVER
PROGRAM, WE WERE ABLE TO GET AN
ADDITIONAL $200 MILLION FOR
RECOVER.
THAT WAS ORIGINALLY FUNDED 3
YEARS AGO WITH 1.15 BILLION AND
NOW THIS ADDITIONAL 200 MILLION
THAT WE'VE BEEN ABLE TO
OBLIGATIONS TAKEN FROM THE
DWINDLING AMOUNT OF SUPPLEMENTAL
APPROPRIATIONS LEFT OVER FROM
COVID, THAT WILL ALLOW US TO DO
A SECOND ROUND OF CLINICAL
TRIALS AND SERIOUSLY HELP THE
DEDICATION THAT WE'VE MADE TO
THIS IMPORTANT TYPE OF RESEARCH.
WITH THAT, LET ME HAND IT OFF TO
KATE AND THEN WE CAN ALL TAKE QUESTIONS.
WHILE THIS IS COMING UP, LET
ME JUST SAY HELLO ASK WELCOME
EVERYBODY AGAIN.
AS DR. BERTOGNOLLI, MENTIONED, I
YOINED IN OCTOBER IN MY NEW ROLE
AND IT'S BEEN A WHIRL WIND FEW
WEEKS BUT I AM SO GRATEFUL TO BE
HERE AND I LOOK FORWARD TO
WORKING WITH ALL OF YOU.
SO I'M GOING TO GIVE, NEIL
PROVIDED SOME BACKGROUND ON THE
APPROPRIATIONS SIDE OF THE
LEDGER IN TERMS OF OUR
CONGRESSIONAL ENGAGE AM.
I WILL GIVE A LITTLE ADDITIONAL
COLOR ON WHERE WE ARE ON THE
FY24 PROCESS BUT ALL WANT TO
GIVE A FEW OTHER UPDATES AS
WELL.
BEFORE I GET HERE I WANT TO SET
THE TAIJ A LITTLE BIT AND SHARE
CONTEXT ABOUT WHAT MY TEAM AND I
DO HERE AT NIH MUCH WE WORK TO
DEVELOP AND EXECUTE NIH'S
LEGISLATIVE AGENDA.
WE LOOK FOR OPPORTUNITIES FOR
THE DIRECTOR TO ENGAGE WITH
MEMBERS OF CONGRESS ON AGENCY
PRIORITIES AND PROGRAMS.
WE WORK TO INSURE THAT ALL OF
THE INSTITUTE DIRECTORS AND
THEIR INCREDIBLE SUBJECT MATTER
EXPERTS HAVE OPPORTUNITIES TO
SHARE THE INCREDIBLE WORK THAT
THEY'RE DOING WITH CONGRESS AND
WE ALSO WANT ON MAKE SURE THAT
OUR CONGRESSIONAL PARTNERS ARE
AUTHORIZING APPROPRIATIONS,
OVERSIGHT COMMITTEES HAVE ALL
THE INFORMATION THAT THEY NEED
TO SUPPORT OUR WORK AND PROVOID
APPROPRIATE OVERSIGHT.
LET ME GIVE SOME ARK DIGGAL KEY
CONGRESS WILL LEADERSHIP UPDATES
AND THEN WE WILL TALK ABOUT MORE
NIH HIGHLIGHTS.
I'M SURE MANY OF YOU ARE AWARE
SIN THE NEWS, THERE'S BEEN A
SIGNIFICANT CHANGE IN HOUSE
LEADERSHIP IN THE HOUSE MEETING.
BACK IN YEN AT THE START OF THIS
CONGRESSIONAL SESSION IT WAS AN
UNUSUALLY CONTENTIOUS ELECTION
FOR SPEAKER BEFORE FORMER
SPEAKER KEVIN MCCARTHY WAS
ELECTED HOWEVER HIS TENURE CAME
TO AN END IN EARLY OCTOBER AFTER
HE ALLOWED A TEMPORARY FUNDING
BILL TO PASS THE HOUSE IF
DEMOCRATIC SUPPORT IT DID AVERT
A GOVERNMENT SHUT DOWN BUT HE--1
OF HIS MEMBERS CALLED FOR A
MOTION TO VACATE AND HE WAS
VOTED OUT OF OFFICE.
SO FOLLOWING HIS REMOVAL THERE
WAS A COUPLE WEEK'S LONG PROCESS
FOR THE CAUCUS TO SELECT A
NUCLEOTIDES
NUCLEOTIDES--NEW SPEAKER.
THEY HAVE DONE THAT.
REPRESENTATIVE MIKE JOHNSON FROM
LOUISIANA, HE HAS TAKEN OVER
THAT ROLE AND BUILDING HIS
LEADERSHIP TEAM AND STAFF AND
HAS BEEN SERVING THE PAST FEW
WEEKS.
I WILL JUST NOTE THAT HE WILL
CONTINUE TO FACE MANY OF THE
SAME CHALLENGES THAT HIS
PREDECESSOR FACED IN TERMS OF
GREAT DIVERSITY IN THE
REPUBLICAN CAUCUS ON A NUMBER OF
DIFFERENT VIEWS AND ISSUES.
SO WE WILL SEE HOW THAT PLAYS
OUT, BUT AS WE KNOW CONGRESS
MUST STILL FINALIZE A PLAN FOR
FISCAL YEAR 24 APPROPRIATIONS
AND I THINK THAT WILL BE A
CHALLENGE.
I ALSO JUST WANT TO REMIND
EVERYBODY THAT NEXT YEAR IS AN
ELECTION YEAR.
I'M SURE YOUR ALL AWARE.
BUT JUST TO FLAG THAT IN
ADDITION TO THE PRESIDENTIAL
ELECTION, ALL 435 CONGRESSIONAL
HOUSE DISTRICTS ARE UP FOR
GENERAL ELECTION AND THEN THERE
ARE ALSO 33 U.S. SENATE SEATS
THAT ARE UP FOR EELECTION.
TEN SEATS THAT ARE HELD BY
REPUBLICANS AND 20 THAT ARE HELD
BY DEMOCRATS.
SO I JUST FLAG THIS FOR A COUPLE
REASONS.
THERE HAVE BEG YOUR PARDON A
NUMBER OF RETIREMENT
ANNOUNCEMENTS BOTH IN THE HOUSE
AND SENATE, SO THERE ARE GOING
TO BE A LOT OF FAMILIAR FACES, A
LOT OF MEMBERS THAT WOE HAVE
WORKED WITH AND CULTRATED
RELATIONSHIPS WITH THAT ARE
STEPPING DOWN.
BUT A LOT OF NEW MEMBERS WHO ARE
MEMBERS WHO HAVE SERVED IN OTHER
POSITIONS TAKING NEW LEADERSHIP
ROLES AND SOME OF OUR RELEVANT
COMMITTEES SO WE WILL HAVE NEW
OPPORTUNITIES TO WORK WITH THEM
BUT IT DOES ALSO MEAN THERE
COULD BE A CHANGE IN CONTROL OF
HOUSE OR SENATE.
IT'S TOO EARLY TO OPINE ON ANY
OF THAT AND I'M FOCUS ON THE
GOING TO, BUT I JUST WANTED TO
FLAG THAT AND ALSO NOTE IT WILL
AFFECT THE CONGRESSIONAL
CALENDAR AND CADENCE NEXT YORE,
CONGRESS WILL SORT OF HAVE THE
DUAL GOALS OF BEING PRODUCTIVE
AND WORKING THROUGH LEGISLATIVE
GOALS BUT ALSO WANTING TO BE
HOME IN THEIR DISTRICTS AS OFTEN
AS THEY CAN TO BE ENGAGING WITH
VOTERS.
SO I JUST WANT TO NOTE, BRIEFLY,
WE DO HAVE DR. BERTAGNOLLI HERE,
SHE WENT THROUGH THE
CONFIRMATION PROCESS EARLIER
THIS YEAR.
SHE HAD A HEALTH COMMITTEE
HEARING IN OCTOBER.
SOME OF THE ISSUES THAT CAME UP
AT THAT HEARING IF YOU WEREN'T
ABLE TO WOWCH TISSUING DRUG
PRICING CAME UP QUITE A BIT ON
CLINICAL TRIALS, QUESTIONS
AROUND DIVERSITY OF CLINICAL
TRIALS, SAFETY, SOCIAL EFFECTS
ON YOUTH, CHALLENGES OF USING
BIG DATA AND AI IN BIOMEDICAL
RESEARCH AND MAKING SURE THAT
RURAL COMMUNITIES ARE BEING
CARED FOR AND EPS TUITIONS THAT
ARE NOT ON THE EAST OR WEST
COAST ALSO HAVE OPPORTUNITY TO
ACCESS RESEARCH DOLLARS.
THOSE ARE JUST A FEW OF THE
ISSUES THAT CAME UP THAT I
WANTED TO GIVE YOU THAT PREVIEW
OF SOME OF THE THINGS THAT
MEMBERS WERE THINKING ABOUT.
THE FULL SENATE VOTED ON IN
NOVEMBER, WHICH WAS ALSO
BIPARTISAN WHICH IS WONDERFUL
AND ON NOVEMBER 9th
DR. BERTAGNOLLI,A RIEFED SO THAT
WAS A BIG LEGISLATIVE WIN FOR
THE AGENCY THIS YEAR.
I ALSO WANT TO GIVE A BRIEF
SNAPSHOT OF ALL THE WORK THE NIH
HAS BEEN DOING HERE, WE HAVE AN
INCREDIBLE TEAM HERE, AND THIS
IS JUST A NAP SHOT OF WHAT THEY
HAVE BEEN DOING HERE, 4 CAMPUS
VISITS, 15 CAMPUS VISITS, 8
ROUND TABLES, 132 BRIEFINGS AND
550 REQUESTS FOR INFORMATION ON
A RANGE OF TOPICS, I MEAN WE GET
QUESTIONS ON ANYTHING AND
EVERYTHING RELATED TO WHAT GOES
ON HERE.
SO I JUST WANT TO GIVE YOU A
SENSE OF KIND OF THE SCALE OF
INCOMING THAT WE HAVE.
DURING AN AVERAGE YEAR.
WE WILL BE BUILDING UPON THIS
NEXT YEAR.
AND THEN, JUST UPCOMING
DEADLINES, NALGAL DEFENSE
REAUTHORIZATION ACT MOVING
THROUGH CONGRESS THIS WEEK, IT
HAS NOW BEEN VOTED THROUGH THE
SENATE AND WILL BE MOVING BACK
TO THE HOUSE.
I THINK THIS WILL BE THE ACTUAL
LAST LEGISLATIVE ACTIVITY OF THE
YEAR AND THEN AS NEIL DISCUSSED
WE HAVE THE UPCOMING EXPIRATIONS
THE FUNDING DEADLINES.
WE ARE IN THE SECOND TRENCH,
THIS SORT OF CALLED THE LADDER,
STEP STOOL, A FEW DIFFERENT WAYS
TO DESCRIBE IT BUT THE KEY THING
IS THERE ARE 2 DATES.
I ALSO JUST WANTED TO NOTE AN
ARK DITIONAL DYNAMIC--ARK
DITIONAL DYNAMEC THAT I KNOW HAS
BEEN AT PLAY THAT I'M SURE YOU
MAY HAVE BEEN AWARE OF AND THIS
WAS BACK IN JUNE PRESIDENT BIDEN
FINED THE FISCAL RESPONSIBILITY
ACT.
THIS LEGISLATION ADDRESSED THE
NEED TO RAISE THE DEBT CEILING,
IF YOU RECALL THIS WAS A BIG
TOPIC OF CONVERSATION THIS YEAR
BUT IT ALSO ATTEMPTED TO SET
SOME OF THOSE TOP LINE SPENDING
CAPS THAT NEIL WAS REFERRING TO
IT ALSO INCLUDED A NEW NOVEL
MECHANISM TO TROY TO PUSH
CONGRESS NOT TO FALL BACK ON
JUST DOING A CONTINUING
RESOLUTION WITH FLAT FUNDING
AGENCIES.
SO IT INCLUDED LANGUAGE THAT IF
ANY PART OF THE GOVERNMENT IS
FUNDED BY A C. R. ON
APRIL 30th, THERE WOULD BE A
1% CUT TO GOVERNMENT
DISCRETIONARY SPENDING.
I JUST WANT TO NOTE THAT
THE--THAT THERE HAS BEEN AND
THERE CONTINUES TO BE A LOT OF
DISCUSSION ABOUT HOW THAT
MANDATORY CUT WILL BE
INTERPRETED AND APPLIED IF WE
WERE IN THIS SITUATION.
THERE IS LEGISLATIVE TEXT BUT AS
MANY OF YOU KNOW SOMETIMES THERE
WILL BE ADDITIONAL SORT OF
INTERPRETATION AND LEGAL REVIEWS
AND THINGS LOAMACYIC THAT, SO,
ALL OF THAT IS OPERATING
GLOBALLY GOING AND I THINK YOU
KNOW BOTH IN SORT OF THE BUDGET
COMMUNITY AND ON THE HILL WE'RE
WORKING TO UNDERSTAND WHAT THAT
MIGHT LOOK LIKE.
BUT I THINK WE ALL HOPE THAT
CONGRESS WILL BE ABLE TO REACH
AN AGREEMENT ON THOSE TOP LINE
NUMBERS CAN AND THEN MOVE INTO
THE NEXT AREA OF NEGOTIATING A
FULL YEAR BILL BUT WE'RE WAITIG
TO SEE THAT.
IT NEEDS TO HAPPEN SOON.
MANY MEMBERS ARE GETTING READY
TO GO HOME, I THINK WE HOPED
THAT MANY OF US WOULD HAVE THAT
CLARITY ON THE TOP LINES BEFORE
THE END OF THE YEAR BECAUSE
JANUARY WILL BE HERE VERY
QUICKLY AND THAT FIRST DEADLINE
WILL BE HERE JANUARY 19th
BEFORE WE KNOW IT BUT WE WILL
CERTAINLY GET MORE INSIGHT IN
JANUARY ABOUT HOW THE
APPROPRIATIONS PROCESS WILL PLY
OUT EMPLOY SO I WILL LEAVE IT
THERE.
>> OKAY, WE ARE OPEN FOR
QUESTIONS, FOR THE 3 OF US.
>> OKAY, SO IF THE COMMITTEE
MEMBERS ONLINE OR IN PRESENT
WOULD LIKE TO HAVE ANY COMMENTS
OR QUESTIONS?
NJUST A QUICK QUESTION WITH THE
FLAVOR AROUND ARP A-H, GIVEN
IT'S SUCH A FLASHY NEW
INITIATIVE, I'M SURPRISED THAT
PROPOSALS TO CUT 2/3RDS OF ITS
FUNDING SO QUICKLY?
>> YEAH.
I MEAN, I WILL JUST SAY, I THINK
AS ALL OF YOU HAVE PROBABLY SEEN
THROUGHOUT THE YEAR IN THE NEWS
AND IN GENERAL PRESS, THERE HAS
BEEN VERY STRONG EMPSCIZZ ON THE
HOUSE SIDE AROUND CUTTING
SPENDING AND THAT HAS TOUCHED
EVERY SINGLE AGENCY.
REALLY THERE'S BEEN NO FEDERAL
AGENCY THAT HAS BEEN EXEMPT.
THERE'S BEEN MORE CONVERSATION
THAN USUAL ABOUT DEFENSE
SPENDING LEVEL ANDS WHETHER
THOSE ARE TOO HIGH AND I THINK
IT REALLY IS A FACTOR OF THE
ENVIRONMENT.
>> I JUST WANT TO MAKE A FEW
COMMENTTHAT PART OF OUR BUDGET,
OUR BUNLET REALITY FOR 2024 WE
THINK IS JUST GOING TO BE A
REALLY TOUGH YEAR, BASED ON WHAT
WE'RE HEARING AND I CAN TELL YOU
THAT OUR BIGGEST CONCERN, WE'VE
SEEN BUDGET CONTRACTIONS IN THE
PAST AND EVERY TIME THAT HAPPENS
IT'S THE YOUNG GENERATION, THE
UP AND COMING, OUR TRAINEES, OUR
JUNIOR FACULTY WHO REALLY GET
HURT.
THE MORE ESTABLISHED
INVESTIGATORS WHO ARE MERE
SENIOR ARE ABLE TO WEATHER THE
STORM BETTER AND I THINK WE'RE
ALL STRUGGLING WITH HOW WE
PRESERVE YOU KNOW OUR SUPPORT
FOR JUNIOR INVESTIGATORS.
I DON'T HAVE ANY GREAT, YOU
KNOW, I DON'T HAVE ANY IMRAIT
IDEAS HERE.
THIS WILL BE PAINFUL.
THE ONLY THING I WILL SAY TO
EVERYONE IS YOU KNOW, THINK
ABOUT WHAT IT WILL MEAN.
YOU KNOW, A FLAT BUDGET IS A
CONTRACTING BUDGET, A FLAT
BUDGET IS A REDUCED BUDGET AND I
JUST THINK EVERYONE, WE'RE
ASKING EVERYONE TO TAKE IT
REALLY SERIOUSLY IMMEDIATELY
THAT NEXT YORE'S GOING TO BE
REALLY, PROBABLY IS GOING TO BE
VERY DIFFICULT AND THEN WE'RE
ALWAYS OPEN TO SUGGESTIONS FOR
THINGS TO DO TO HELP, BUT THE
BIGGEST THING IS TO PREPARE FOR
IT AND PLN FOR WHATEVER YOU CAN
DO TO HELP ESPECIALLY PRESERVE
THE TRAINEES AND JUNIOR
RESEARCHERS.
>> GARTH, YOU'RE NEXT, PLEASE,
I'M TRYING TO TURN MY CAMERA ON
BUT IT WON'T WORK SO THAT'S
FINE.
MY QUESTION IS FOR KATE, AND
KATE WHAT ARE THE IMPLICATIONS
FOR A C. R. IN TERMS OF THE
PRACTICAL DYNAMICS FOR
RESEARCHERS OR DOES NOT NOT
FILTER DOWN TO THAT LEVEL IN THE
C. R. PROCESS AND MY OTHER
QUESTION WILL BE FOR NEIL AS
WELL WHICH IS KIND OF RELATED
WHICH IS NEIL IS THERE ABSOLUTE
DIFFERENCE BETWEEN THE HOUSE AND
THE SENATE BUJ FET REALLY JUST
NIAID AND ARP A-H FUND XG ALL
THE OTHER INSTITUTES ARE PRETTY
MUCH THE SAME?
WAS I READING THAT SLIDE
CORRECTLY?
>> I JUST WANT TO MAKE A QUICK
FOLLOW UP COMMENT TO THE LAST
QUESTION, TOO IS THAT THE FISCAL
RESPONSIBILITY ACT, THE DEBT
SEALING DEAL I MENTIONED EARLIER
IT ALSO SET THE CAPS FOR FY25 AS
WELL, SO UNFORTUNATELY JUST
FOLLOWING UP ON
DR. BERTAGNOLLI'S POINT, THIS
WILL BE A TOUGH YEAR BUT SO WILL
THE YORE AFTER AND YOU KNOW WE
HAVE THOSE LEVELS ALREADY IN
PLAY AS I MENINGED.
IT'S AN ELECTION YEAR AND THAT
CAN OFTEN AFFECT THE DYNAMICS
AROUND SPENDING DECISIONS EVEN
MORE SO, SO I JUST WANTED TO
ALSO FLAG THE FOLLOWING YEAR
WILL BE A REAL CHALLENGE AS
WELL.
IT WON'T BE LIMITED TO NEXT
YEAR.
>> YEAH, I WOULD JUST SAY IN
TERMS OF THE PARTICULAR
PROGRAMS, CERTAINLY THE HOUSE
WHEN AFTER NIAID, THE SENATE DID
NOT ISSUES THE OTHER HOUSE CUTS
ARE REALLY TARGETED AT THE
OFFICE OF THE DIRECTOR, AS WELL
AS THOSE 3 CURES PROGRAMS THAT I
MENTIONED AND THERE'S A
STRUCTURAL ISSUE THERE TO DEAL
WITH, BUT NIH POLICY IS THAT
THOSE PARTICULAR PROGRAMS SHOULD
NOT BE GETTING TREATED, WORSE
THAN THE REST OF OUR RESEARCH
CAUSE OF THAT STRUCTURAL BUDGET
ISSUE.
>> THANK YOU.
>> SO THIS IS MORE OF A POINT OF
PERSONAL PRIVILEGE THAN A
QUESTION.
AND I'M A MEMBER OF THE BRAIN
INITIATIVE MULTICOUNCIL WORKING
GROUP AND I REMEMBER HEARING
ABOUT THE BRAIN INITIATIVE IN
2013 AS A JUNIOR FACULTY MEMBER
WITH THE CREATE OF CREATING NEW
TOOLS AND TECHNOLOGIES TO
UNDERSTAND THE HUMAN BRAIN.
AND EVEN THEN THE IDEAS IN THEIR
SEEM SO PIE IN THE SKY, RIGHT?
EVEN BEYOND THE MOON SHOT IT
SOUNDED LIKE A MARS SHOT, AND IN
2018 I GOT TO PARTICIPATE IN
HELPING THINK ABOUT THE VISION
FOR THE SECOND HALF AND THIS
IDEA OF HAVING A CELL ATLAS OF
THE HUMAN BRAIN SEEMED JUST
REALLY OUT THERE.
AND EVEN BEFORE 2025, WE HIT THE
MARK SO I DON'T WANT IT TO BE
LOST ON ANYBODY HOW EXCITING
THAT DISCOVERY IS TO BE ABLE TO
ACHIEVE THAT IN A TIMELINE ARK
HEAD OF TIME KNOWING IN THE
MITSD OF THAT, WE HAD LABS THAT
WERE SHUT DOWN AND STILL WE WERE
ABLE TO MAKE THAT PROGRESS, SO
I'M REALLY EXCITED ABOUT THAT.
THAT RAISES A QUESTION WITH
REGARS TO YOUR EARLIER POINT
ABOUT THINKING ABOUT HOW TO MAKE
THESE ADVANCES REALLY HAVE
IMPACT ON OUR ENTIRE POPULATION,
RIGHT IN CERTAINLY WE'VE LEARNED
FROM PAST GENOMIC EFFORTS THAT
IT'S REALLY IMPORTANT FOR PEOPLE
OF DIFFERENT ANCESTRIES TO BE
REPRESENTED WHEN WE'RE MAKING
THESE DORPHYS OF ATLASS WHETHER
IT'S A PART OF CANCER CELLS OR
WHAT HAVE YOU, SO POINT YOU WERE
MAKING ABOUT BRINGING OTHER
POPULATIONS INTO THE SCIENTIFIC
FRAMEWORK, FIGURING OUT HOW TO
ADDRESS CULTURAL BARRIERS THAT
MIGHT PREVENT SOME FROM HAVING
TISSUE SO WE CAN LEARN ABOUT
ANCESTRY DIFFERENCES IN ATLAS
CELL TYPES ARE A REALLY
IMPORTANT PRIORITY GOING FORWARD
TO MAKE SURE THOSE DISCOVERIES
TRANSLATE INTO DIFFERENCES IN
HUMAN HEALTH.
AND THEN FINALLY I'LL HIGHLIGHT
1 THING EVEN BEYOND THE IDEA OF
GETTING HUMAN AND CELL ATLAS,
YESTERDAY THAT RELEASED THE
FIRST MOUSE CELL ATLAS WHICH IS
REALLY THE PRIORITY OF THE BASIC
SCIENCE RESEARCH BECAUSE LOTS OF
THINGS WE'RE TRYING TO
UNDERSTAND WITH REGARD TO HOW
THE BRAIP WORKS TO COME UP WITH
THOSE EARLY INTERVENTIONS AND
THERAPEUTICS THAT APPLY IN THE
HUMAN BRAINS START ABOUT THE
ARCHITECTURE IN THE BASIC
SCIENCE RESEARCH.
SO I'M EXCITED ABOUT ALL THE
PROGRESS BEING MADE ON THIS
INITIATIVE AND LOOK FORWARD TO
DOING GOOD WORK GOING FORWARD.
>> WELL, THANK YOU SO MUCH FOR
THAT AND THE OTHER PHILOSOPHY, I
THINK THAT WE ALL SHARE IS THAT
YOU KNOW WE HAVE FUNDAMENTAL
SCIENCE.
--WE HAVE FUNDMENTAL SCIENCE
ISSUES CLINICAL TRANSLATION AND
THEN WE HAVE DEEP COMMUNITY WORK
FOR THE BEHAVIORIAL WORK TO GET
THINGS TO PEOPLE, BUT WE ALWAYS
HAVE A VIRTUOUS CYCLE BACK.
I DON'T THINK ANYTHING WE EVER
DO, PEOPLE SAY, WELL YOU'RE A
CLINICAL TRIALIST, YOUR A
CLINICAL RESEARCHER MOSTLY ARE
YOU GOING TO--YOU KNOW
EVERYTHING WE DO IS ALSO ABOUT
INFORMING BASIC SCIENCE AND WHAT
EVERYTHING THAT HAPPENS IN BASIC
SCIENCE IS ABOUT INFORMING WHAT
GOES TO THE CLINIC.
SO THESE PILLARS DO NOT STAND
ALONE AND WE CAN'T FORGET THAT
CIRCLE BACK, SO YOU RAISED IT
REALLY LYOU KNOW EVERY
OPPORTUNITY TO ENGAGE WITH A
POPULATION TO RUN A CLINICAL
TRIAL, TO LOOK AT THE
ENVIRONMENTAL INFLUENCES HAS TO
BE LOOKED AT AS AN OPPORTUNITY
TO BRING THE TOOLS IN THAT CAN
ALSO DRIVE FUNDAMENTAL SCIENCE.
>> MARTHA.
>> YEAH, FIRSTLY THANK YOU FOR
EXCELLENT PRESENTATIONS, VERY,
VERY INFORMATIVE FOR ALL OF US.
I HAVE A COMMENT RATHER THAN A
QUESTION, BUT IT'S KIND OF
DISPLAYING THE PANDEMIC EFFORT
IS STUCK OR WHAT THE RIGHT WORD
IS?
IS THAT THE RIGHT WORD?
AND IS THERE LIGHT AT THE END OF
THE TUNNEL THAT THIS WOULD BE
REVIVED?
I MEAN AUTOJUST SAD TO BE IN
THIS SITUATION O QUICKLY AFTER
WHAT WE WENT THROUGH WITH
COVID-19 AND NOT PREPARE FOR THE
NEXT 1 1.
>> THAT MIGHT BE FOR ME, WE'RE
NOT STUCK, WE'RE TO THE
FORGETTING IT, OUR INITIATIVES,
OUR WORK, YOU KNOW THE WORK OF
NIAID AND ALL THE OTHER ICs TO
NOT ONLY CONTINUE TO ADDRESS THE
FALL OUT I WOULD JUST SAY FALL
OUT AND TRAUMA FROM THIS, FROM
THE MOST RECENT TERRIBLE NEW
AGENT ARRIVING, THE INFECTIOUS
AGENT ARRIVING BUT TO PREPARE
FOR THE NEXT.
THERE'S BEEN NO DIMINUTION OF
OUR FOCUS ON THAT, IT'S JUST--
>> I MEANT THE FUNDING.
BUT I DIDN'T MEAN THE
COMMITMENT.
>> I THINK MAKING THE GOOD CASE
FOR OUR WORK IS WHAT WE NEED TO
KEEP DOING.
>> OKAY, THANK YOU.
>> I HAVE BRIAN AND THEN ATULLE
IN.
>> WELL I JUST WANT TO SAY HOW
DELIGHTED I WAS TO SEE THAT OUR
SCIENTIFIC WORK IS NEVER DONE,
AND CONTRIBUTING TO LONG HEALTHY
LIVES.
I SPENT 2 DAYS AT THE NIH
SUPPORTIVE AND IMPLEMENTATION
SCIENCE CONFERENCE WHICH WAS
PACKED AUDIENCES, REALLY YOU
COULD BT GET INTO SO MANY ROOMS,
IT WAS THE LARGEST MEETING YET
OF ITS KIND AND I THINK THERE IS
A LOT OF HUNGER AMONGST OUR
SCIENTIFIC COMMUNITY TO
UNDERSTAND HOW TO TRANSFER THE
KNOWLEDGE THAT COMES OUT OF
THEIR NETWORK IERK H SUPPORTED
WORK CAN TO APPLICATION, INTO
PRACTICE AT THE SAME TIME
DESPITE THE HUGE GROWTH THERE
REALLY IS A VERY SHORT SURVEYS
PLOY OF RESEARCHERS WHO
UNDERSTAND THE SCIENCE, WHO CAN
SUPPORT INVESTIGATORS AND
DISSEMINATING THEIR WORK AND
TRANSLATING IT TO APPLICATION,
AND YOU KNOW, I WOULD SAY, LIKE
MAYBE IT'S ONLY SECOND TO AI IN
MY EXPERIENCE, LIKE EVERYONE'S
LOOKING FOR AI EXPERIENCE AND
EVERYONE'S LOOKING FOR DNA
EXPERTS AS WELL SO I WONDER HOW
WE CAN THINK COLLECTIVELY TO
HELP SUPPORT THE GROWTH IN THIS
AREA, AND TO HELP INVESTIGATORS
THINK ABOUT HOW TO BUILD INTO
THEIR APPLICATIONS, KNOWLEDGE
TRANSFER ACTIVITIES, I THINK
THERE'S A LOT OF QUESTIONS FOR
PEOPLE ABOUT HOW TO DO THAT
ISSUE HOW DOES IT GET REVIEWED
IN WHAT'S A REASONABLE ACTIVITY
AROUND THE EXPERIMENT?
I WOULD LOVE TO DISCUSS THAT IN
THE FUTURE AND I THINK IT TIES
INTO THE LARGER DISCUSSION OF
MISTRUST OF SCIENCE, HOW WOE
DISSEMINATE OUR SCIENCE
CONTRIBUTED TO HOW PEOPLE TRUST
US.
NTHANK YOU.
YOU ILLUSTRATE 2 THINGS
EVERYTHING WE DO ALSO HAS TO
WORRY ABOUT THE WORKFORCE,
EVERYTHING.
BUT THE OTHER SPECIFIC TO THIS
ISSUE, WE NEED WHOLE NEW TYPE OF
RESEARCHER, NEW, YOU KNOW WE
NEED THE ADMINISTRATORS, WE NEED
HEALTH ECONOMISTS, RIGHT?
WE NEED CLINICAL DELIVERY
EFFICIENCY EXPERTS.
THIS IS AN AREA YOU KNOW MORE
THAN I DO, RIGHT IN BUT WE NEED
TO ENGAGE A WHOLE NEW DIFFERENT
TYPE OF RESEARCHER THAT MAYBE
DON'T REALIZE, HEY, WAIT NIH
REEL KEEPSAKESLY DOES WANT TO
HEAR ABOUT MY IDEA.
SO I THINK THIS IS--THAT MEETING
IS A CRITICAL STEP IN GETTING
OUT, PUT OUT THERE WHAT KIND OF
QUESTIONS ARE WE INTERESTED IN
DOING BUT ALSO TO HEAR BACK FROM
THE COMMUNITY WHAT KIND OF
RESEARCH IS GOING TO BE USEFUL
TO YOU AND SO, YEAH, NOT ONLY
GROW THE YOUNG GENERATION BUT
LOOK TO NEW PEOPLE THAT HAVEN'T
BEEN ENGAGED IN THIS YET.
>> OKAY, SO I HAVE ATULLE, THEN
HOWARD THEN LUCILA.
>> EXCELLENT.
THANKS.
TWO COMMENTS.
FIRST IT'S GRIT TO SEE THE
EFFORTS IN ARTIFICIAL
INTELLIGENCE, AI, THE PRIVATE
EFFORTS RIGHT NOW ARE HUGE.
A LOT OF HYPE, BUT THERE ARE
ALSO BUILDING TOWARDS CLOSED
MODELS, SO IT WOULD BE GREAT FOR
NIH'S EFFORT ANDS OTHER
GOVERNMENTAL INVESTMENTS BUILD
TOWARD DEMOCRATIZED FOR OPEN
MODELS.
WE ALSO KNOW OTHER COUNTRIES AND
CONTINENTS ARE INVESTING LIKE
CRAZY AS WELL, IT WOULD BE GREAT
NOT TO BE LEFT BEHIND EMPLOY I
SENSE THAT WE'RE NOT.
THERE'S A LOT OF EXCITEMENT BUT
WE NEED MORE MUCHERS IN THIS
FIELD, THE SLIDE YOU SKIPPED
OVER WAS THE AIM AHEAD PROGRAM
WHICH SUSPECT A PIPELINE
DEVELOPMENT PROGRAM, JUST WANT 1
COMMENT THOUGH IS THAT THE 2019
ACD, AI WORKING GROUP, 2019 WAS
EONS AGO IN AI, THERE MIGHT BE
TIMES TO EVEN REFRESH THAT SO
THAT'S JUST A COMMENT TO THINK
ABOUT AND A QUESTION.
NOKAY, THE QUESTION IS UNRELATED
BUT JUST MORE THINKING, YOU
STARTED YOUR PRESENTATION TODAY
TALKING ABOUT TRUST AND SCIENCE,
HAVING DECLEANED AND YOU ENDED
THE PRESENTATIONOT BUDGET AND I
CAN'T SENSE THAT THESE 2 ARE
ABSOLUTELY CONNEBBED, OBVIOUSLY
AND THE REAL QUESTION IS HAS NIH
EVER ACTUALLY FACED A BUMMINGET
CUT BEFORE IN ITS HISTORY AND
HOW DOES THAT HAPPEN?
>> OH YEAH, THIS IS HOW I MAKE
THE ASSERTION WE KNOW WHO'S
GOING TO GET HURT HERE, YOU KNOW
THE PEOPLE WHO ARE GOING TO GET
HURT ARE THE YOUNG, THE
TRAINEES, THE JUNIOR
INVESTIGATORS, THE POST DOCS,
THE FELLOWS, ET CETERA AND YOU
KNOW THAT'S--THAT IS A TRAGEDY.
YOU KNOW I THINK THE LAST TIME
WE SAW SEQUESTRATION WHEN YOU
LOOK AT THE DATA, THE WORD IS WE
LOST A GENERATION DUE TO
SEQUESTRATION.
AND I DON'T HAVE THE ANSWERS
BECAUSE IT'S NOT IN MY HANDS
NECESSARILY, I MEAN WE WANT TO
DO EVERYTHING WE CAN TO HELP BUT
WE ARE LOOKING TO OUR
INSTITUTIONS TO THINK ABOUT THIS
IMMEDIATELY ABOUT HOW WE CAN
SUPPORT THE NEXT GENERATION.
>> THANK YOU.
HOWARD?
>> THANK YOU FOR ALL THE
OUTSTANDING PROGRESS AT NIH, MY
QUESTION IS ALSO ABOUT AI AND
THINKING ALIKE.
SO AS YOU KNOW THIS WORK IS OF
COURSE REALLY MOVING AT A VERY
FAST PACE AND THIS WORK IS
INCREDIBLY CAPITOL INTENSIVE FOR
THE TALENT POOL NEEDED AND ALSO
FOR THE ACTUAL MACHINES TO DO
THE WORK.
AND YOU ALSO TALKED ABOUT AMP,
SO IS THERE A POSSIBLE OF
ENGAGING SOME SORT OF
PUBLIC-PRIVATE ENTERPRISE
THROUGH FNIH, BUT IT'S VERY
IMPORTANT TO REINFORCE TO THE
POINT THAT THE MODEL STAY
PUBLICLY ACCESSIBLE.
>> OH, YOU ARE SPEAKING
EXACTLY--THIS IS EXACTLY WHAT I
HAD HOPED TO HEAR AND IT IS JUST
WONDERFUL VALIDATION OF A
DIRECTION WE REALLY THINK WE
NEED TO GO PRACTICES ALL.
SO VERY, VERY PLEASED TO HEAR
THAT.
I AGREE THIS IS YET ANOTHER
EXAMPLE WHERE NIH CANNOT DO THIS
ALONE.
NOT ONLY CANNOT, SHOULD NOT DO
THIS ALONE.
THAT WOULD BE VERY LIMITING AND
SO, WE DEFINITELY LOOK FORWARD
TO MOVING THERE AND YOU WILL
HEAR A MORE RIGOROUS PLAN TO DO
EXACTLY WHAT HAVE YOU DESCRIBED
IN THE NOT TOO DISTANT FUTURE.
IT'S 1 OF THE PRIORITIES THAT
WORKING WITH ALL OF THE IC
DIRECTORS, WE'VE ALREADY
DISCUSSED AND ARE IN THE PROCESS
OF GETTING READY TO THEREFORE TO
YOU.
>> OKAY, I HAVE LUCILA, COREY
AND THEN GISELLE.
>> HI, MINE IS ALSO RELATED TO
AI IN 2 ASPECTS OF IT.
I'M DELIGHTED TO HEAR ABOUT THE
EGHTECS AND INTEREST WORTH AI
BEING VERY IMPORTANT FOCUS AREA
AND PRIORITY.
IN TERMS OF THAT, I THINK IN
TERMS OF GETTING DATA FROM
UNDERREPRESENTED POPULATIONS IN
TERMS OF ELECTRONIC HEALTH
RECORDS FOR EXAMPLE, IS
IMPORTANT THAT WE PAY ATTENTIO,
THAT WE DON'T CONTINUE TO FOCUS
ON INSTITUTIONS THAT ALREADY
HAVE THEIR REPRESENTATION AND SO
ON AND GO TO COMMUNITY BASED
ORGANIZATIONS LIKE QHCs AND A
LOT OF OTHER COMMUNITIES.
I THINK TELL BE A GREAT, GREAT
THING TO DO.
IN TERMS OF TRAINING PEOPLE IT'S
SELF-EVIDENT THAT WE NEED TO
PROVIDE IT TO EVERYONE, MAYBE
INCREASE PARTICIPATION IN
COMMUNITY COLLEGES FROM UNDER
SEGMENTS AS WELL.
AND LASTLY REGARDING THE COMPUTE
POWER AND REGARDING THIS
PUBLIC-PARTNER, PUBLIC-PRIVATE
PARTNERSHIP, I THINK IT'S ALSO
EVIDENT TO THE COMPUTE POWER
AVAILABLE TO INVESTIGATORS THAT
MAKES US NOT COMPETITIVE FOR
WHAT INDUSTRY IS, DOING IN THIS
AREA.
SO HOW CAN WE START ADDRESSING
THAT PROBLEM?
>> YES, THANK YOU FOR THAT AS
WELL.
I ALSO COMPLETELY AGREE.
AS YOU HEARD, I THINK THROUGHOUT
THE ENTIRE PRESENTATION, WE WILL
NOT SUCCEED IN OUR EFFORTS
WITHOUT MAKING SURE THAT WE ARE
ENGAGING PEOPLE AT ALL WALKS OF
LIFE INTO THIS ACTIVITY AND 1 OF
THE THINGS THAT WE ARE WORKING
ON DPEAN VERY DILIGENTLY AND I
HOPE YOU WILL SEE SOON IS THAT,
WE PLAN TO DO THIS IN CONCERT
WITH PEOPLE DIRECTLY AND TO
ENGAGE, TO DEVELOP TRUST BECAUSE
THE PEOPLE PARTICIPATING, THE
PEOPLE WHO'S DATA WE ARE USING
CAN DIRECTLY SEE HOW THEY ARE
BENEFITING FROM US BEING ABLE TO
ACQUIRE THIS DATA.
NOW WHY DO I SAY THIS.
INFORMATION TECHNOLOGY IS
RADICALLY DIFFERENT THAN IT WAS
JUST EVEN 1 YEAR AGO.
AND SO, IF WE HAVE THE ABILITY
TO EXCHANGE DATA IN THE
COMMERCIAL ENTERPRISE, JUST
THINK ABOUT THAT EVERY TIME YOU
LOG-IN, IF WE HAVE THAT ABILITY
TO EXCHANGE DATA WITH AN
INDIVIDUAL PERSON AT THAT LEVEL,
PERSONALIZED LEVEL, OH BOY WE
WILL HAVE THE ABILITY TO DO IT
FOR RESEARCH, SO THAT PEOPLE
PARTICIPATING CAN KNOW WHAT'S
HAPPENING.
SO BUILDING AND PILOTING THESE
KINDS OF UNDERSERVED ACTIONS
WILL NUMBER 1 HELP US BUILD
TRUST, NUMBER 2 IT WILL INSURE
THAT THE RESULTS ARE RELEVANT TO
THE PERSON WHO'S ACTUALLY
PARTICIPATING AND FINALLY, THIS
IS NOT GOING TO BE EASY, THIS IS
NOT GOING TO BE WITHOUT GREAT
EXPENSE AND COMMITMENT, YOU
KNOW, I'M NOT POLYANNAISH ABOUT
WHAT IT WILL TAKE BUT I'M ALSO
SENSING FROM THESE DISCUSSIONS
THAT THERE'S BIG COMMUNITY
SUPPORT FOR MAKING THIS A BIG
PRIORITY EMPLOY SO I'M VERY
GRATEFUL FOR YOUR COMMENTS.
>> WE WILL HAVE COREY AND THEN
GISELLE WILL BE THE LAST
QUESTION FOR THIS SEGMENT.
>> I DON'T HAVE A QUESTION BUT A
COMMENT.
SO IN TERMS OF RECOMMENDATIONS
AND NIH'S RESPONSES, THE
RECOMMENDATIONS OF THE SUBGROUP
ON INDIVIDUALS WITH
DISABILITIES, I AM SO EXCITED
AND PLEASED THE WAY THE NIH HAS
RESPONDED.
I THINK IT'S BEEN A STELLAR
RESPONSE TO THE COMMITTEE'S
WORK, SO MANY TIMES I'VE
PARTICIPATED ON COMMITTEES AND
WHERE A LOT OF WORK HAVE BEEN
PUT FORTH BUT NOTHING REALLY
COMES OUT OF IT SUBSTANTIAL AND
I THINK IN TERMS OF THE WAYS
THAT NIH IS RESPONDING REALLY
SPEAKS TO THE VALUE FOR
ENCLOUDING PEOPLE WITH
DISABILITIES AS A MARGINALIZED
POPULATION WITHIN THE NIH BI ONY
MEDICAL AND BEHAVIORIAL SCIENCE
AGENDA.
I THINK IN TERMS OF THE
DESIGNATION, PEOPLE WITH
DISABILITIES HAS A HEALTH
DISPARITIES POPULATION HAS A
PARADIGM SHIFT FOR THE AGENCY
AND WILL HELP TO INCREASE THE
NUMBER OF PARTICIPANTS AS WELL
AS THE NUMBER OF RESEARCH
SCIENTISTS WITH DISABILITIES WHO
PARTICIPATE IN RESEARCH AT NIH,
INTRA MIEWRALLY, AS WELL AS
EXTRA MIEWRALLY.
BUT HAVING SERVED ON--SERVED ON
THIS PARTICULAR SUB COMMITTEE
AGAIN AND IT'S JUST A PLEASURE
TO BE HERE AND TO HEAR FROM THE
DIRECTOR AND FROM THE AGENCY,
THE ACTUAL OUTPUT THAT COME OUT
OF THIS WORK EMPLOY THERE'S
STILL MUCH WORK TO BE DONE.
AND I HOPE THAT NIH IS COMMITTED
TO DOING THAT WORK.
I THINK THE STEERING COMMITTEE
OF THE ACD, WGD, IS WORKING TO
IMPLEMENT SOME OF THE OTHER
RECOMMENDATIONS IN THE REPORT
AND I HOPE THAT WE CAN MONITOR
THE PROGRESS IN TERMS OF HOW
THOSE RECOMMENDATIONS ARE
CARRIED OUT AND HOPEFULLY,
PUSHED--CONTINUE TO PUSH THE
AIENDA TOWARD INCLUDING PEOPLE
WITH DISABILITIES, NOT ONLY AS
RESEARCH PARTICIPANTS BUT AS
CREATORS OF THE RESEARCH BECAUSE
AS REFLECTED IN THIS NEW
DESIGNATION, THEY ARE CONSIDERED
A MARGINALIZED POPULATION THAT
HAVE BEEN HISTORICALLY AND
CURRENTLY MARGINALIZED IN THE
DEVELOPMENT OF SCIENCE.
>> SO COREY THANK YOU SO MUCH
FOR THAT AND I WILL JUDGE UOF
THE SAY AGAIN, THIS IS THE
START.
THIS IS JUST THE BEGINNING
BECAUSE WE WILL NOT BE
SUCCESSFUL UNTIL PEOPLE WITH
DISABILITIES ARE TELLING US
YOU'VE MADE LIFE BETTER FOR US.
AND THOSE VICTORIES IS WHAT
WE'RE FOCUSED ON, THE
DESIGNATION IS JUST THE
FRAMEWORK, NOW WE HAVE TO DO THE
REAL WORK EMPLOY SO I AGREE WIH
YOU.
>> WE WILL HAVE GISELLE, AND
THEN WE WILL GO INTO A BREAK
EMPLOY JUST A HEADS UP, WE WILL
HAVE PHOTOS DURING THE BREAK, SO
DON'T QUICKLY DISAPPEAR.
>> THANK YOU SO MUCH I WANT TO
FOLLOW UP ON LUCILA'S COMMENT,
THE LAST PART OF HER COMMENT
WHICH IS JUST TO UNDERSCORE THE
POTENTIAL DISPARITY THAT CAN
HAPPEN AND WHEN WE'RE THINKING
ABOUT THE COMPUTING POWER AT
DIFFERENT ORGANIZATIONS AND
INSTITUTIONS WHERE MICROSOFT
MIGHT BE MORE LIKELY TO ENGAGE
AS A COLLABORATOR AND PARTNER IN
THESE PUBLIC PRIVATE
PARTNERSHIPS, COMPARED TO OTHER
UNIVERSITIES THAT MAY NOT BE, OR
1 UNIVERSITIES WHERE THEY WILL
BE LESS LIKELY AND TO THINK
ABOUT THE NIH'S RESPONSE THERE
AND THE OPPORTUNITY FETAL
COMPARTMENT CREATE CONSORTIA
THAT LEVERAGE THAT--THAT CAN
MITIGATE THOSE DISPARITIES IN
ACCESS TO THOSE PUBLIC PRIVATE
PARTNERSHIPS, ACCESS TO LARGE
LANGUAGE MODELS THAT MIGHT BE
DEVELOPED ONSITE, IS THERE A WAY
AND CAN YOU THINK ABOUT OR MAYBE
WILL YOU THINK ABOUT A WAY IN
OUR THROUGH THE NIH TO MITIGATE
DISPARITIES BETWEEN INSTITUTIONS
THAT WILL JUST GET PERPETUATED
OVERTIME AS INVESTIGATORS HAVE
MORE OR LESS ACCESS TO
GENERATIVE AI OPPORTUNITIES.
>> AH, YES, THANK YOU FOR
LETTING MOOY ADDRESS THAT
BECAUSE I SKIPPED OVER IT TOO
QUICKLY LAST TIME.
WE HAVE WONDERFUL TALENT AND WE
NEED TALENT FROM EVERYWHERE, WE
HAVE MAJOR BIG TALENT IN OUR
CENTERS ABOUT YOU WE ALSO HAVE
INCREDIBLE TALENT OUT IN SMALL
COMMUNITY COLLEGES CROSS THIS
COUNTRY THROUGHOUT OUR ENTIRE
EDUCATIONAL SYSTEM AND THAT CAN
REALLY MAKE MAIMINGOR
CONTRIBUTIONS AND WE DO, YOU
KNOW, IDEALLY WE FIND A WAY TO
MAKE IT POSSIBLE FOR ANYONE WITH
A REALLY WONDERFUL IDEA AND
THE--YOU KNOW THE WILLINGNESS TO
DO THE WORK TO BE ABLE TO USE
THE RESOURCES, HAVE ACCESS TO
THE NECESSARY RESOURCES.
THIS IS BEING VERY CAREFULLY
CONSIDERED AS WE PUT TOGETHER
THE MODEL THAT WE'RE TALKING
ABOUT, I WILL JUST PUT IT OUT
THERE THAT AN IDEA THAT JUST
GIVE YOU A KERNEL OF THE IDEA,
THE NIH HAS THE NATIONAL LIBRARY
OF MEDICINE.
THE NATIONAL LIBRARY OF MEDICINE
HAS BEEN OUR HUB FOR KNOWLEDGE
AND SHARING AND WE COULD
ENVISION A DRAMATIC, DUE TO THE
ARK MAZING DRAMATIC INCREASE IN
CAPABILITIES PRESENTED BOY THIS,
A DRAMATIC ECPANGZ OF THE
CAPABILITIES OF THE NATIONAL
LIBRARY OF MEDICINE TO
DEMOCRATIZE ACCESS TO THE TOOLS
REQUIRED TO DO RESEARCH.
AND OBVIOUSLY, THIS WOULD TAKE
CONSIDERABLE NEW RESOURCES, BUT
WE ARE GOING--WE ARE WORKING ON
A PLAN AND GOING TO PUT FORWARD,
MAKE THE CASE THAT THIS WOULD
REALLY BRING CONSIDERABLE
PROGRESS, SO THANK YOU.
>> OKAY, WELL, THANK YOU
EVERYBODY.
WE'RE GOING TO TAKE A SHORT
BREAK EMPLOY WE WILL
RECONVENIENCE AT 11:15 BUT I
UNDERSTAND THAT THE PHOTOGRAPHER
WOULD LIKE TO CAPTURE THE MOMENT
SO BEFORE YOU DISAPPEAR--
OKAY, LET'S TRY THAT AGAIN
EMPLOY GOOD TO SEE EVERYBODY
BACK.
WE'RE LETTING A FEW FILL UP
THEIR COFFEE CUPS BUT WHILE WE
DO THAT, I WILL INVITE MA
RIBERNARD AND ALFRED JOHNSON TO
GIVE US AN UPDATE ON UNITE AND I
GUESS WE'RE STARTING WITH MARIE.
THANK YOU.
>> THANK YOU SO MUCH I AM MARIE
BERNARD, NIH OFFICER OF THE
SCIENTIFIC FORCE FORCE COMMITTEE
AND I HAVE THE PRIVILEGE OF CO
LEADING THE NIH UNITE INITIATIVE
WITH DR. TABAK, DR. JOHNSON AND
DR. BERNES AT THE CENTER FOR
SCIENTIFIC REVIEW AND THIS IS AN
UPDATE ON ACTIVITIES WITH UNITE.
FOR THOSE THAT HAVE BEEN
FOLLOWING THIS, WE UNVEILED THIS
AT A SPECIAL MEETING, THE
ADVISORY MEETING TO THE DIRECTOR
FEBRUARY 6 OF 2021, AND WE MADE
THE PLEDGE AT THAT TIME THAT WE
WOULD GIVE PERIODIC UPDATES IN
THIS SETTING.
SO THIS IS APPROACHING THEE
YEARS SINCE THIS INITIATIVE WAS
LAUNCHED AND WE'RE EXCITED TO BE
BE ABLE TO SHARE WITH YOU THE
DEVELOPMENTS IN THE LAST YEAR
PARTICULARLY SENSE WEB CONNECTED
CAME TO THE LEFT ACD.
OKAY, SO UNITE IS REALLY I THINK
TANK TO PROMOTE EQUITY, TO
GENERATE BOLD IDEAS, TO CATALYZE
NEW ACTION ANDS TO COLLECTIVELY
IDENTIFY AND ADDRESS ANY
STRUCTURAL RACISM THAT MAY EXIST
WITHIN THE NIH AND THROUGHOUT
THE BIOMEDICAL AND BEHAVIORIAL
SCIENTIFIC WORKFORCE.
WHEN WE UNVEILED TALKED ABOUT
THE 5 INTERACTING COMMITTEES,
EACH 1 OF THEM REPRESENTING THE
LETTERS OF UNITE, CONCEPTUALLY,
WE'VE EVOLVED TO THINKING OF IT
AS SHOWN IN THIS GRAPHIC HERE.
AT THE HEART OF IT IS PEOPLE,
AND DATA, THAT DRIVEWAYS
EVERYTHING THAT WE'RE LOOKING AT
CONTENT WISE WE'RE LOOKING AT
THINGS RELATED TO HEALTH
DISPARITIES AND MEANERRITY
HEALTH RESEARCH.
NOT AT ALL TO SUPPLANT THE ROLE
OF THE NIMHD, BECAUSE WHEN YOU
RECALL WHEN WE UNVEYED IN THIS
FEBRUARY 2021, WE WERE STILL AT
THE HEIGHT OF COVID WHERE WE HAD
SEEN DISPROPORTIONATE MORBIDITY
AND MORTALITY FOR POPULATIONS
THAT ARE UNDERREPRESENTED ACROSS
THE COUNTRY AND FELT THAT WE
NEEDED TO STOP ADMIRING THE
PROBLEM ANDS START DOING AND
MAKING EFFECTIVE INTERVENTIONS.
WE ALSO HAVE BEEN FOCUSING ON
OUR OWN INTERNAL WORKFORCE,
RECOGNIZING WE NEED THE ROLE
MODEL FOR WHAT WE WILL HOPE AND
EXPECT OF OUTSIDE INSTITUTIONS
AND WE ARE A NUMBER OF THINGS WE
DEVELOPED TO ENHANCE THE
EXTERNAL WORK WORKAT ACADEMIC
AND RESEARCH INSTITUTIONS.
THINKING OF IT OTHER THAN IN THE
CONCEPTUAL FRAMEWORK, WE HAVE
FOCUSED AT THE SAME TIMES FOR
EACH OF THOSE 4 AREAS THAT'S
ASSISTING WITH WORKING GROUP
THAT HAS BEEN NOW ASSEMBLED TO
HELP US TO EVALUATE THE IMPACT
OF UNITE AND THE MIDTERM AND THE
LONG-TERM.
WE ARE A LOT OF PROCESS THINGS
WE BROUGHT TO YOU BUT THE
LONG-TERM CHANGES IN ENVIRONMENT
AND CULTURE WILL TAKE MUCH
LONGER PERIOD OF TIME THAN THE
COLLABORATIVE EFFORT TO MEASURE
AND THOSE FOCUS STATEMENTS ARE
HELPFUL IN GUIDING THAT.
SO LOOKING AT IT, FOCUS AREA BY
FOCUS AREA, THE FIRST 1 IS
ELEVATING HEALTH DISPARITIES AND
MINORITY HEALTH RESEARCH ACROSS
INSTITUTES AND CENTERS, AND AS
DR. BERTAGNOLLI, THE MISSION WAS
INSPIRED BY UNITE.
THAT MARCH OF 2021 RIGHT AFTER
WE PUBLICLY UNVEILED UNITE,
THERE'S ANNOUNCEMENT OF COMMON
FUND COMPETITIONS FOR
TRANSFORMATIVE HEALTH
DISPARITIES RESEARCH AND AT THE
END OF FISCAL YEAR 2111 PROJECTS
WITH A COMMITMENT OF UP TO
58 MILLION-DOLLAR WERE
SUPPORTED.
BUT THE UNITE MEMBERSHIP WAS
VERY CLEAR THAT THAT WAS NICE
BUT NOT SUFFICIENT INVESTMENT
AND THAT THERE NEEDED TO BE
MORE.
SO WITH A LOT OF WORK LED BY
DR. SHANNON ZENK, DIRECTOR OF
THE NATIONAL NURSING RESEARCH
AND DR. KNIGHT, DR. JEANINE,
CLAYTON, OFFICE OF WOMEN'S
HEALTH RESEARCH AND
DR. PEREZ-STABLES, AND OTHERS
THE COMPETITION WAS DEVELOPED
AND SUPPORTED BY THE COMMON FUND
WITH THE INITIAL 5 YEAR
COMMITMENT AS DR. BERTAGNOLLI
MENTIONED, IT'S SUCCESSFUL AND
POTENTIALLY AS MUCH AS
$400 MILLION OVER 10 YORES.
THE COMMUNITY LED TRUCTURAL
INTERVENTIONS IN THE 25
INSTITUTIONS OR 25 COMMUNITIES
THAT DR. BERTAGNOLLI MENTIONED
AND THE COORDINATING CENTER AND
IT'S REALLY NEAT TO LOOK AT THE
MAP OF EXACTLY WHERE THESE
INTERVENTIONS ARE PLANNED EMPLOY
THIS WILL BE A FREIGHT CHANCE
FOR US TO LEARN AT NE H HOW TO
WORK EFFECTIVELY WITH
COMMUNITIES AND WE WILL KEEP YOU
POSTED, COMMON FUND WILL KEEP
YOU MOST OFFICE OF DIVERSITY
OUTCOMES FROM THAT.
ADDITIONALLY AS WE SHOWED YOU
LAST DIAGRAM, WE'RE SEEING
GROWTH IN NOFOs IN MINORITY
AND HEGHT DISPARITIES IN 2015
THERE WERE 23, AND IN FISCAL 23,
WE'RE UP TO 204.
EVERYONE AT THE NIH IS LEANING
IN.
THIS NOT A DIRECT
RESPONSE--RESPONSIBILITY OF
UNITE BUT IT'S REPRESENTATIVE OF
THE ETHOSE THAT WE HAVE AND THE
REAL FOCUS IN THIS AREA EMPLOY
AND THEN OTHER THINGS THAT ARE
DIRECTLY AS A RESULT OF THE
UNITE INITIATIVE, THERE'S A
RESOURCE PORTAL FOR ADVANCING
HEALTH EQUITY AND RESEARCH UNDER
TWEP AM.
THE VISION HERE BEING THAT IT'S
1 STOP SHOP FOR SCIENTISTS TO
GET BEST PRACTICES AND TOOLS FOR
DOING RESEARCH IN THIS AREA, WE
WILL LIKELY BE HOUSED ON THE
NIMHD WEBSITE, WORK TO
FACILITATE EQUITABLE SUPPORT FOR
HEALTH DISPARITY AND MINORITY
HEALTH RESEARCH WILL BE WOUND
INTO THAT, PLANS FOR
ENTERDISCIPLINARY COLLABORATIVE
WORKSHOPS ON INNOVATIVE RESEARCH
APPROACHES TO END STRUCTURAL
RACISM, 1 OF THOSE WORKSHOPS HAS
ALREADY BEEN HELD IN
COLLABORATION WITH THE NATIONAL
EN--STRATEGIESITUTE OF MINORITY
HEALTH AND HEALTH DISPARITIES
AND INTERNAL HEALTH DISPARITIES
WORKING GROUP.
THERE'S ANOTHER WORKSHOP PLANNED
FOR MARCH.
AND THEN A LOT OF WORK THAT'S
BEING DONE TO INSURE NIH WIDE
TRANSPARENCY, HEALTH
ACCOUNTABILITY, DISPARITIES AND
HEALTH RESEARCH TO ARK LOW
ANALYSIS OF GRANT APPLICATION
AND,A WARD DATA AND THAT IS
ONGOING, WE ANTICIPATE THAT
THERE MAY BE FORMAL ARK NOUNS
WANTS ABOUT ADVANCEMENTS WITH
THIS IN THE NEXT FEW MONTHS.
A FOCUS AREA, TOO WHERE WE'RE
LOOKING AT THE EXTERNAL
BIOMEDICAL AND BEHAVIORIAL
RESEARCH ECOSYSTEM, THE FACULTY
INSTITUTIONAL RECRUELTIMENT FOR
SUSTAINABILITY TRANSFORMATION
INITIATIVE IS 1 THAT WE CONSIDER
TO BE UNITE RELATED, IT WAS
RELEASED AS A NOFO BETWEEN OUR
INTERNAL WORK TO GET UNITE
LAUNCHED AND THE EXTERNAL
UNVEILING OF UNITE.
AND AS YOU MAY RECALL THIS IS AN
INITTIA
INITIATIVE TO BRING IN COHORTS
FOR EARLY YORE FACULTY WHO HAVE
AN INTEREST IN AND TRACK RECORD
IN DE IA, IT MAY NOT BE THEIR
AREA OF RESEARCH, MAY BE THEIR
ADVOCATION AND SUPPORT THEM
THROUGH TO BECOMES A 10 IRBED
FACULTY MEMBER.
ADDITIONALLY WITH FOCUS ON
ATTENTION TO THE CLIMATE AND
ENVIRONMENT AT THAT INSTITUTION
TO MAKE SURE THAT IT IS
SUPPORTIVE TO ALL.
THE LAST, THE THIRD AND LAST
COHORT WAS ANNOUNCED THIS PAST
JULY, AND YOU CAN SEE NOW, THAT
WE HAVE 15 COHORTS, SOME
PARTNERSHIPS, SINGLE ACTIVITIES,
MOOREHOUSE COOL OF MEDICINE AND
AN EVILLUATION CENTER, AND THIS
IS A COMBINATION THAT GETS
FUNDED THE FIRST 5 YEARS, IFUC
ASSESSESFUL, CONTINUED FUNDING,
THE FULL 10 YEARS ANTICIPATED
THAT LIKE UP TO $275 MILLION
WILL BE DEVOTED TO THIS.
AND WE'RE REALLY LOOKING FORWARD
AGAIN TO WHAT WE CAN LEARN
TRUSTEES THIS INITIATIVE THAT
MIGHT BE GENERALIZABLE FOR ORGT
NOFOs ARE NIH.
AND THEN THERE ARE SEVERAL
FUNDING OPPORTUNITY
ANNOUNCEMENTS THAT WERE
DEVELOPED SPECIFICALLY OR
ENHANCED SPECIFICALLY FOR UNITE.
THERE'S THE SCIENCE EDUCATION
PART MERSHIP,A WARDS WHICH I
THINK WE MENTIONED LAST YEAR, IT
WAS AGAIN EXPANDED FOR FISCAL
YEAR 23, WITH 19 STUDENT CENTERS
AND OFFICES SIGNED ON, WE THINK
THIS IS A CRITICAL INIT WHYATIVE
BECAUSE IT'S A K-12 FOCUSED R25.
TO HELP MAKE OUTREACH TOO AND
STIMULATE THE INTEREST OF THAT
POPULATION.
WE KNOW THAT SCIENCE IDENTITY IS
OFTEN SOLIDIFIED AS EARLY AS
MIDDLE SCHOOL.
WE ALSO KNOW THERE'S QUOIT A BIT
OF DIVERSITY IN THE K12
POPULATION SO IT'S IMPORTANT TO
MAKE THAT OUTREACH.
WELL IS A NOFO THAT WAS RELEASED
IN FISCAL YEAR 23 RESEARCH WITH
ACTIVITIES RELATED TO DIVERSITY
OR THE REWARD RO-1 OPPORTUNITY
WITH 21 INSTITUTE CENTERS AND
OFFICES SIGNED ON.
THIS IS AN OPPORTUNITY FOR
SCIENTIST WHO IS HAS DONE GREAT
WORK IN DEIA, LOTS OF MENTORING,
LOTS OF OUTREACH, ET CETERA BUT
NOT HAD SIGNIFICANT NIH FUNDING
TO GET NIH FUNDING AND RO-1
GRANT TO SUPPORT THEIR SCIENCE
AND THEIR CONTINUED ACTIVITIES.
IT'S OFTEN SAID THAT WE WORK IN
THIS FIELD, YOU GET--YOU ARE PUT
AT A DISADVANTAGE BECAUSE YOU
DON'T GET THAT OPPORTUNITY TO DO
THAT RO-1.
THIS IS THAT OPPORTUNITY FOR
THOSE INDIVIDUALS.
THERE'S INSTRUMENTATION GRANT
PROGRAM FOR LIMITED INSTITUTIONS
FOR 16 INSTITUTE CENTERS AND
OFFICES SIGNED ON.
THIS IS THE PROGRAM THAT IS
TARGETED AT THOSE ORGANIZATIONS
THAT HAVEN'T HAD A LOT OF NIH
FUNDING.
OFTEN NOT ON THE EAST COAST OR
WEST COAST TO ALLOW THEM TO DO
RESEARCH OR TO USE THE
INSTRUMENTATION IN UPPER LEVEL
EDUCATIONAL PROGRAMS.
AND THEN THERE'S THE
STRENGTHENING RESEARCH
OPPORTUNITIES FOR NIH GRANTS AND
THE STRONG PROGRAM WITH 15 OF
OUR INSTITUTE CENTERS AND
OFFICES SIGNED ON.
THIS IS A PROGRAM THAT WOULD
ALLOW AGAIN, THE LIMITED
RESOURCE INSTITUTIONS,
INSTITUTIONS THAT DON'T HAVE A
LOT IN THE WAY OF NIH FUNDING TO
STEP BACK AND EVALUATE WHAT IT
IS THEY NEED TO MAKE THAT HAPPEN
AND TO DEVELOP A PLAN.
AND JUST LAST WEEK, I'M
DELIGHTED TO SAY THAT THE
ASSESSMENT OF CLIMB @
INSTITUTIONS AWARD WAS RELEASED.
THIS IS AN AWARD THAT WILL ALLOW
ACADEMIC AND INSTITUTIONS TO DO
A CLIMATE ARK ASSESSES EXPMENT
DEVELOP A PLAN TO MAKE THE
CLIMATE SUPPORTIVE TO ALL OF THE
FACULTY.
THE FIRST INITIATIVE REQUIRES
THAT SORT OF ASSESSMENT AND
ACTION AS WELL AS BRING NOTHING
COHORTS.
THIS DOESN'T PAY FOR THE COHORTS
BUT IT ALLOWS THE INSTITUTION TO
LOOK AT THEIR OWN ENVIRONMENT
AND FOR THOSE INSTITUTIONS THAT
HAVE THE FLEXIBILITY OF PRIVATE
FUNDS OR WHATEVER TO BRING THIS
COHORTS THEY BASICALLY HAVE A
FIRST ASH WARD.
UNDER DEVELOPMENT IS A NOFO
RESEARCH CAPACITY BUILDING
WORKFORCE DIVERSITY.
WE CAN SEE IT'S UNDER
DEVELOPMENT BECAUSE IT WAS
APPROVED IN CONCEPT AND
HOPEFULLY IT WILL MAKE IT
THROUGH THE PROCESS.
IN MOST CASES WHEN SOMETHING IS
APPROVED AT A COUNCIL, I THINK
IT WAS NIGMS, IT ENDS UP AS
NOFO, BUT IT'S NOT A NOFO UNTIL
ITS PUBLISHED.
HEREYA A REVIEW ON BIAS AND
TRAINING THAT'S NOW REQUIRED
THAT'S AVAILABLE AT OD-23-156.
AS OF THIS MONTH, WELL IS
TRAINING ONGOING FOR PROGRAM
ROVES AND SCIENTIFIC REVIEW
OFFICERS FOR INCLUSIVE AND
EQUITABLE INTERACTIONS WITH
APPLICANTS AND GRANTEES AND MY
TEAM THE TEAM ON BEHALF OF UNITE
AND NIH HAS LED A DEI, A PRIZE
COMPETITION.
THE TOTAL PURSE IS A MILLION
DOLLARS, 10 INSTITUTIONS WILL
DPET A HUNDRED THOUSAND THERE IS
EACH.
APPLICATIONS ARE IN, WE'RE STILL
SORTING THROUGH THINGS.
WE HOPE TO BE ABLE TO MAKE
ANNOUNCEMENTS BY MIDJANUARY.
ALSO ON BEHALF OF UNITE AND NIH.
MY TEAM IS LEADING SOMETHING
CALLED ENGAGEMENT AND ACCESS FOR
RESEARCH ACTIVE INSTITUTIONS.
THIS IS A NAVIGATION PROGRAM
THAT HAS BEEN DEVELOPED FOR
ACADEMIC AND RESEARCH
INSTITUTIONS THAT HAVE
UNDERSERVED POPPULESES THAT
PROVIDE DEGREES IN STEM AND DO
NOT AGAIN HAVE A LOT IN THE WAY
OF NIH FUNDING.
WE'RE SPECIFICALLY LOOKING FOR
INSTITUTIONS THAT HAVE LESS THAN
$25 MILLION AVERAGE IN THE PRIOR
3 YEARS OF NIH RPG GRANTS AND
THEN TEND TO THIS PROGRAM IS TO
TRY TO HELP MATCH THOSE
INSTITUTIONS WITH RESOURCES THAT
EXIST AT NIH AND HELP THEM
NAVIGATE OUR SYSTEM THAT CAN
SOMETIMES SEEM QUITE OPAQUE.
WE ALL HAVE SOMETHING CALLED THE
MOSAIC PROGRAM, IT'S NOT A
DIRECT PROGRAM FROM UNITE BUT
AGAIN VERY MUCH IN KEEPING WITH
THE SPIRIT OF UNITE THAT WE
THINK IT'S IMPORTANT FOR US ALL
TO BE AWARE OF.
THIS IS LED BY NIERK GMS, IT HAS
17 INSTITUTES AND CENTERS
INVOLVE WIDE IT.
IT'S DESIGNED TO ENHANCE FACULTY
INTENSIVE POSITIONS, IT'S A K99
WITH AN R00, CAN K9 ADDED TO IT.
IT'S BEEN AWARDED WITH A 50%
SUCCESS RATE.
SO IF YOU DON'T HAVE TRAINEES
WHO LOOK AT THIS, THEY SHOULD
LOOK AT IT.
IT'S YIELDED QUITE A BIT OF
DIVERSITY IN THE PEOPLE WHO ARE
SCHOLARS.
ONE OF MY EARLY TRAINEES I'M
HAPPY TO SAY WAS IN THE FIRST
COHORT AND A LOT OF THEM REALLY
STARTED OR ACCEPTED FACULTY
POSITIONS.
PLEASE DO TAKE A ELECTRIC AT
THIS IF YOU WANT TO SEE MORE,
JUST GO TO THE NIGMS WEBPAGE.
THEY HAVE IT HIGHLIGHTED THERE.
I WILL TURN THE PODIUM OVER TO
DR. JOHNSON.
NYEAH, THANKS MARIE, AS SHE
MENTIONED A LOT HAS BEEN FOCUSED
ON THAT SIDE OF THE HOUSE, WE
HAVE ALSO BEEN FOCUSING AS WELL,
AND WE HAVE BEEN WORKING ON
INTERNAL NIH WORKFORCE AND 1 OF
THESE PROGRAMS THAT WORKED WITH
UNITE AND THE OFFICE OF
INTRAMURAL RESEARCH AND
EDUCATION, THE MEDICAL STUDENTS
SOME OPPORTUNITIES TO ADVANCE
RESEARCH PROGRAMS ON M-SOAR, WE
PILOTED IT THIS PAST SUMMER,
THIS WAS A PILOT PROGRAM FOR
MEDICAL STUDENTS IN GOOD STAND
WHOG ARE COMMITTED TO
TRANSLATIONAL AND CLINICAL
APPROACHES IN THEIR CAREER.
OUR POOL IS VERY DIVERSE, WE HAD
88 APPLICANTS, 23 ACCEPTED AND
16 ACCEPTED IN THE PILOT PROGRAM
AGAIN CONFUNDED BY OIR AND WITH
THE UNITE PROGRAM, SO AGAIN, A
GREAT WAY TO GET STUDENT EXPOSED
TO THE NIH ENVIRONMENT AND
HOPEFULLY WE WILL THINK ABOUT
OPPORTUNITIES TO LATER IN THEIR
CAREER HERE AT THE NIH.
ALSO ANOTHER INITIATIVE THAT WE
HAVE WAS TO THE DEVELOPMENT OF A
LIST SERVE FOR FEDERAL AFFINITY
GROUPS FOR NIH VACANCY ANNOUNCE
WANTS, AGAINST THIS WAS A
PROJECT INITIATED BOY OUR
ANTIRACISM TEARING COMMITTEE,
NONSCIENTIFIC SUBCOMMITTEE
WORKING IN PARTNERSHIP WITH THE
OFFICE OF HUMAN RESOURCES.
THE DPOAL HERE WAS TO MAKE SURE
THAT AS WE HAD VACANCIES THAT NO
MATTER WHAT TYPE VACANCIES WE
HAD, WE COULD ANNOUNCE TO A
POPULATION TO THOSE WHO WERE
UNDERREPRESENTED HERE AT THE
NIH, SO PUTTING THIS LISTSERVE,
FOR ALL AFFINITY GROUPS AIDED IN
THAT AND NOW ALL THESE JOB
ANNOUNCEMENTS GOUTE THROUGH THE
LISTSERVE AND HOPEFULLY WE WILL
GET A MUCH MORE DIVERSE
POPULATION ARK PLYING FOR YOBS
HERE AT THE NIH.
ANOTHER DEVELOPMENT THAT WE HAVE
IS CAREER DEVELOPMENT FRAINING
PROGRAM FOR THOSE IN THE GSE LAB
AND 1 THING AS YOU LOOK ACROSS
THE NIESH H AND YOU WE LOOK AT
HIGH REPRESENTATION OF THOSE WHO
ARE UNDERREPRESENTED AND
MINORITY POPULATIONS IS AT THE
LOWER GRADE LEVELS.
SO THIS WAS VERY CLEAR AND AS WE
LOOKED @ OUR TRAINING AND
DEVELOPMENT PROGRAMS THIS WAS AN
AREA WHERE WE ARE LACKING.
WE DID NONAPOPTOTIC THE HAVE
CAREER DEVELOPMENT PROGRAMS AT
THAT LEVEL.
SO THROUGH THE UNITE PROGRAM AND
WORKING WITH THE OFFICE OF HUMAN
RESOURCES WE'VE GONE THROUGH A
PROCESS OF DEVELOPING THIS
PROGRAM FOR THOSE WHO ARE AT THE
GSE 11 AND BELOW LEVELS, AGAIN
HAVING A MORE DIVERSE POOL OF
TALENT THERE, BUT NOW HAVE A WAY
TO OFFER THEM THEIR ABILITY TO
DEVELOP THEIR CAREERS AND MOVE
FORWARD INTO THE HIGHER
GS-LEVELS.
AGAIN STARTING BACK IN
OCTOBER 22, GAINED RESOURCES TO
DO THIS, DEFINED THE PROGRAM
FOCUS AREAS, DEVELOPED THE
PROGRAM AND AS I JUST LOOKED
THIS MORNING, THE ANNOUNCEMENT
WENT OUT TO ALL THE INSTITUTION
CENTERS FOR NOMINATING
INDIVIDUALS FOR THE FIRST PILOT
COHORT WE'RE GOING TO DO.
WE HAVE 2 PILOT COHORTS PLANNED
FOR 2024, THE FIRST AREA FOR
NOMINATION INTO THE MIDDLE OF
JANUARY.
WE WILL DO A HYBRID COHORT AND
THEN THE SECOND 1 WE WILL DO ALL
VIRTUAL COHORT TO SEE HOW IT
GOES AND THEN WE WILL REFINE THE
PROGRAM AS WE MOVE FORWARD
EMPLOY BUT EACH CAN COHORT WOULD
HAVE ABOUT 30 INDIVIDUALS IN IT
AND AS WE LEARN AND EVALUATE, WE
WILL FEBRUARY OUT HOW TO REFINE
THE PROGRAM AND MAKE IT EVEN A
BETTER PROGRAM FOR THOSE WHO
WANT TO FURTHER THEIR CAREERS
FROM THE LOWER GS LEVEL.
YOU CAN DO THAT, BUT IT'S
CERTAINLY WILL BE HELPFUL IF YOU
HAVE A PROGRAM TO MAKE SURE
YOU'RE HITTING ALL THE RIGHT
MARKS AS YOU MOVE THROUGH THE
GRADE LEVELS.
SO AGAIN, WE'RE LOOKING FORWARD
TO HOW THIS WILL WORK IN HELPING
TO ENHANCE NOT ONLY THE
DIVERSITY OF OUR STAFF AT THE
HIGHEST GRADE LEVELS.
WE ALSO LOOKED AT DISPARITIES
FOR THE NIH DIRECTORROR'S AWARD,
THIS IS THE HIGHEST ASHES WARD
AT THE NIH, SO A GROUP GOT
TOGETHER AND WORKED WITH OHR TO
LOCK AT WHAT WE COULD DO IN THIS
AREA, SO THEY REVIEWED THE AWARD
CATEGORIES, LANGUAGE THAT WAS
USED, WORKED ON EXPANDING
DEFINITIONS, CREATED NEW AWARD
CATEGORIES BECAUSE 1 THING WE
NOTICE IMEAN WAS THAT THESE
AWARDS WOULD GIVE FOR THOSE AT
THE HIGHER GRADE LEVELS SO NOW
WE'RE EXPANDING CATEGORIES THAT
WOULD FOCUS ON LIKE CUSTOMER
SERVICE AND SUPPORT AND SO WE
HAVE NEW CATEGORIES NOW THAT WE
HAVE LAUNCHED.
AGAIN, THEY WERE REVIEWED THE
COMMITTEE THAT DOES THE APPROVAL
OF THESE, DECIDED WE NEED A MORE
FORMAL CORING RUBRIC AND AGAIN
TRY TO REDUCE BIAS.
AND AGAIN, ALSO PROVIDE GUIDANCE
TO THOSE WHO NOMINATE
INDIVIDUALS AT THE ICLEVELS AND
WORKING WITH THE IC COORDINATORS
TO MAKE SURE WE GET A MORE
DIVERSE NOMINATION AND A PROCESS
FOR NOMINATING INDIVIDUALS FOR A
MORE DIVERSE BACKGROUND AND
OFFERING OPPORTUNITIES BECAUSE A
LOT OF THESE AWARDS ARE GIVEN TO
THOSE THAT GET THE WORK ON THESE
KEY PROGRAMS THAT ARE
HIGHLIGHTED AND SO YOU HAVE TO
THINK ABOUT WHO'S PARTICIPATING
AT THIS AT THE BEGENERATEDDING
SO THAT IN THE [INDISCERNIBLE]
WILL HAVE THE OPPORTUNITY TO BE
NOMINATED SO WE ARE SEEING AS WE
GO THROUGH THIS, FIRST YEAR,
THAT WE'VE SELECTED THOSE AND
WE'LL LOOK AT DIVERSITY AND SEE
IF THIS, THESE CHANGES MADE IN
ANY DIFFERENCE AND THEN LOOK TO
EVEN REFINE MORE IF WE NEED TO.
AND OUR FOCUS AREA BEFORE WHERE
WE'RE FOCUSED ON ACCURACY AND
TRANSPARENCY OF RACIAL AND
ETHNIC EQUITY DATA THERE'S BEEN
A LOT OF WORK THAT HAS BEEN DONE
BY THE UNITE COMMITTEES
ESPECIALLY THE YOUTH COMMITTEE.
WE FIRST REQUESTED INFORMATION
HERE IN 2022, AND THESE REPORTS
ARE NOW AVAILABLE, AGAIN THIS
RFI, OVER11 HELPED RESPONSES AND
SOME OF THEM WHILE FOCUSING ON
THE INCLUSIVENESS, IMPLEMENTING
DEI INITTIAIVE ITS, LOOKING WHAT
WE CAN DO IN TERMS OF DIVERSITY
METRICS AND ENHANCING AND
EXPANDING OUR DEI TRAINING AND
WE'RE ALSO IN TERMS OF OUR
EXTERNAL LISTENING SESSIONS,
THERE WERE OVER 1300 PARTIC
PAPTS, 14 DIFFERENT SESSIONS, A
VARIETY OF INDIVIDUALS FROM ALL
OVER HEART ATTACK BCUs, FROM
MSIs, FROM TRIBAL COLLEGES AND
UNIVERSITIES, AND STUDENTS AT
ALL DIFFERENT LEVELS TO MAKE
SURE WE WERE GETTING THE RIGHT
INPUT AS TO SOME OF THE THINGS
WE NEEDED TO DO, FROM THIS THERE
WERE A NUMBER OF CROSS CUTTING
THEMES THAT CAME ABOUT, FOCUSING
ON THE STATE OF EQUIT COMPETENT
BIOMEDICAL RESEARCH, CHALLENGES
IN THE CAREER PATHWAY ANDS IN
WORKFORCE.
LOOKING AT BARRIER IN TERMS OF
PRACTICES AND POLICIES,
CHALLENGES WITH DISPARITIES
RESEARCH AND CHALLENGES IN
ADDRESSING HEALTHCARE EREQUESTIT
EXPE HEALTHCARE OUTCOME, AND SO
THIS AGAIN, GAIN A LOT OF
INFORMATION FROM THE EXTERNAL
LISTENING SESSION, WE HAVE A LOT
WE CAN WORK ON AND WILL CONTINUE
TO DO SO.
IN TERMS OF INTERNALLY, THE MIH
LEADERSHIP PULLED TOGETHER A
NUMBER OF SESSIONS WITH
INDIVIDUALS FROM ACROSS THE NIH
WITH OUR DIFFERENT AAFFINNITY
GROUPS TO HEAR FROM THEM EXACTLY
WHAT THEIR EXPERIENCES ARE, WHAT
THEY'RE FACING, WHAT THEY THINK
ARE THE ISSUES THAT WE NEED TO
BE ADDRESSING AND SO AGAIN,
THROUGH THESE LISTENING
SESSIONS, WE'VE GAINED A LOT OF
INFORMATION THAT HAS BEEN VERY
HELPFUL AS WE CONTINUE TO FORM
WHAT UNITE SHOULD BE ABOUT AND
HOW WE CAN BETTER PROVIDE THEA
BAKING AND GUIDANCE TO HELP US
IMPROVE OUR ACTIVITIES BOTH
INTERNALLY AND EXTERNALLY WITHIN
THE BIOMEDICAL RESEARCH
ENTERPRISE.
IN TERMS OF DATA GATHERING THEY
MAY ALSO HAVE RECENTLY GOTTEN
RESULTS FROM OUR NIH WORKPLACE
STABILITY AND EQUITY SURVEY.
WE DID A SURVEY A FEW YEARS AGO,
THAT WAS SLIGHTLY DIFFERENT, SO
THAT WE HAD MORE INPUT, UNITE
WORK WITH OHR, WITH THE EQUITY,
DIVERSITY AND INCLUSION AND
OFFICE AND OTHERS TO FORM THIS
SURVEY AND AS WE NOW TAKE A LOOK
AT THE RESULTS AND HAVE
PROVOIDED RESULTS TO ALL THE
EN--STRATEGIESITUTES AND CENTERS
AND EVEN DOWN TO SOME OFFICE
LEVELS, WE CAN GET AN
UNDERSTANDING OF THE PERCEPTIONS
OF INDIVIDUALS FROM ALL ACROSS
THE NIH, NOT JUST OUR FEDERAL
EMPLOYEES, WE HAVE A SURVEY
THAT'S DONE EVERY YEAR FOR A
FELLOW EMPLOYEES BUT IT DID NOT
INCLUDE CONTRACTORS AND TRAINEES
AND THOSE WHO ARE NOT PART OF
OUR FEDERAL EMPLOYEE WORKFORCE.
SO THIS GIVES US A BROADER
CATEGORY OF INDIVIDUALS
PARTICIPATING IN THEIR FEELING
ABOUT HARASS AM, THEIR FEELING
ABOUT INAPPROPRIATE CONDUCT AND
HOW WE'RE DOING HERE AT THE NIH
AND WE CAN USE DATA OVER TIME AS
WE REPEAT THE SURVEYS ON A 3
YEAR CYCLE TO SEE IF WE'RE
MAKING IMPROVEMENTS WITHIN THE
NIH WORKFORCE SO THAT PEOPLE
FEEL MUCH MORE WELCOME AND ARE
ABLE TO REACH THEIR FULL
POTENTIAL HERE AT THE NIEKS H.
NIH HAS BEEN A TERRIFIC
ORGANIZATION FOR FOCUSING ON
DEIA AND SO WE NEED TO GATHER UP
ALL THE ACTIVITIES WE'RE DOING
NOT JUST FROM THE UNITE LEVEL
BUT ACROSS THE WHOLE ENTERPRISE
BECAUSE THE INSTITUTES AND
CENTERS AND OFFICES ALSO HAVE
ACTIVITIES IN IN SPACE AND
COLLECTING ALL OF THIS AND
SEEING AND MAKING SURE WE ARE
WORKING TOGETHER, ALL FOCUS ON
TRYING TO GET THE SAME TYPE OF
OUTCOME, THIS IS CERTAINLY
SOMETHING THAT WE CERTAINLY HAVE
HAD TO DO AND ARE CONTINUING TO
DO AND WILL GIVE US A BETTER
OPPORTUNITY TO CONTINUE TO
IMPROVE DEIA ACROSS THE AGENCY.
IN TERMS OF FOSTERING
TRANSPARENCY THIS, IS SOMETHING
THAT CAME UP VERY EARLY IN THE
UNITE PROCESS THAT WEB CONNECTED
NEED TO BE VERY CLEAR ABOUT
WHAT'S GOING ON AND MAKING
SHOULDURE THAT OTHERS ARE AWARE.
SO THERE ARE A NUMBER OF EFFORTS
IN THAT REGARD, THE OFFICE OF
EXTRAMURAL RESEARCH, OER, THE
DATA DASHBOARD, MAKING IT
AVAILABLE TO EVERYONE SO THAT
THEY CAN SEE EXACTLY WHAT'S
HAPPENING IN TERMS OF WHO'S
BEING FUNDED AND WHAT'S
HAPPENING IN THE EXTRAMURAL
COMMUNITY.
BUT ALSO WE'RE LOOKING AT WHAT
WE'RE DOING AT UNITE AND HAVING
EVALUATION WORKING GRUP IN PLACE
TO LOOK AT ALL THE WORK THIS'
GOING ON, THEY ARE HELPING US AS
WE MOVE FORWARD THROUGH THEIR
UNITE PROCESS, AND AS WE AS THE
CO CHAIRS ARE LOOKING AT THE
FUTURE OF UNITE, WHAT WE ARE
WILLING TO TERM UNITE 2.0, SO
THAT WE CAN BETTER SUPPORT THE
EFFORTS HERE, THIS EVALUATION
GROUP IS CERTAINLY 1 THAT WILL
BE VERY UPONFUL.
WE HAVE AN ENDING STRUCTURAL
RACISM DATA HUB THAT HAS A LOT
OF INFORMATION THERE THAT ALL
THE NIH INDIVIDUALS CAN GO AND
SEE WHAT'S HAPPENING IN TERMS OF
THAT WE'VE ALSO RECENTLY
LAUNCHED AN UNITE ADVOCATES
PROGRAM FOR COMMUNICATION, IT'S
A GREAT WORK AND I STILL HERE
FROM PARTS OF IT THAT THEY DON'T
KNOW WHAT'S HAPPENING WITH
UNITE.
SO WE WILL ASK FOR AGENCIES
ACROSS THE FRONT TO HELP US AND
MAKE HUR THAT'S HAPPENING.
WE'RE ALSO BRINGING NEW
ONBOARDING FOR PROGRAM FOR THE
NIH EMPLOYEES, TRAINEES AND CONS
TRACTORS, IT'S I BIT CONFUSING
BALL A TYPES OF INDIVIDUALS COME
THROUGH TO WORKA THE NIH BUT
WE'RE TRYING TO TOUCH ON ALL
THIS SO THAT ALL NEW EMPLOYEES,
CONTRACTORS AND TRAINEES ARE
AWARE, AND ALSO OTHER ACTIVITY
WHAT'SY HAVE ONGOING AND
SOMETHING CERTAINLY THAT WILL BE
HELPFUL TO US IN THE LONG RUN.
UNITE AGAIN MARIE MENTIONED AS A
THINK TANK BUT OF COURSE NIA IS
TRYING TO LEFT EVERYONE, IT'S
NOT JUST THOSE, FROM CERTAIN
GROUPS, WE'RE LIFTING THEM
BECAUSE IF WOE CAN IMPROVE THEIR
ENVIRONMENT FOR THOSE WHO MADE
BE DISPROPORTIONATELY AFFECTED
BY SOME OF THESE ISSUES I WE
WILL IMPROVE THE ENVIRONMENT FOR
EVERYONE AND THAT HAS ALWAYS
BEEN A THEME THAT WE'VE HAD AT
UNITE AND WE WILL CONTINUE TO DO
SO AGAIN A RISING BEING A BIG
ALABAMA CRIMSON TIDE FAN HAVE TO
BRING IT IN FROM TIME TO TIME
BUT WE ALSO TO WANT THANK TARA
SCHWETZ, WHO STEPPED IN HER NEW
ROLE AND WE WELCOME BACK
DR. LARRY TABAK AS A CHO-CHAIR
ROLE SO AGAIN PAST COUPLE YEARS
WORKING WITH TARA HAS BEEN
TERRIVE AND I CAN THANK HER FOR
ALL THE SUPPORT SHE'S GIVEN TO
UNITE EVEN HOE THESE HOT A CO
CHAIR, SHE DOES NOT GET TO GO
AWAY.
SHE WILL HELP US AS WE GO ALONG
THE WAY.
BUT NOT ONLY TARA BUT WE HAVE A
TREMENDOUS GROUP OF MEMBER WHO
IS ARE SO DEDICATED AND IF YOU
LOOK AT THE NAMES FROM WHEN WE
TARTED, MANY NAMES HAVE CHANGED,
BUT WE HAVE PEOPLE ALWAYS
WAITING TO JOIN US TO HELP US IN
THE EFFORTS, THEY HAVE GREAT
IDEAS AND WANT TO CONTRIBUTE SO
AGAIN WE REALLY APPRECIATE ALL
OF THOSE, SPECIALLY OUR PROGRAM
MANAGER, TAMMY WHO SUPPORT THIS
WHOLE EFFORT AND WE COULD NOT DO
IT WITHOUT HERE BUT AGAIN, THESE
ARE TREMENDOUS INDIVIDUAL AND I
ENJOY WORKING WITH ALL OF THEM
AND JUST LOOKING FORWARD TO
CONTINUING TO ROLE WITH THEM AS
THE UNITE CONTINUES TO
CONTRIBUTE TO THE NIH
ENVIRONMENT AND THE EXTRAMURAL
COMMUNITY AS WELL.
WE ARE JUST SO GRATEFUL FOR ALL
OF THEM, GREAT TO READ ALL THE
FLAMES BUT WE WOULD BE HERE ALL
DAY.
SO I THINK WITH THAT, THAT WILL
BE THE END OF OUR UPDATE ON
UNITE AND CERTAINLY MARIE AND I
WILL AND LARRY AND AS A CO CHAIR
CAN ALSO TAKE QUESTIONS.
TODAY.
THANK YOU.
>> IMRAIT, THANK YOU SO MUCH.
>> --I AM AT THE UNIVERSITY OF
NORTH CAROLINA AT CHAPEL HILL
AND WE WERE NAMED IN THE STUDENT
[INDISCERNIBLE] ADMISSIONS
LAWSUIT THAT WAS HEARD BY THE
SUPREME COURT.
AND SO WE HAVE A NEW LAW OF THE
LAND THAT WE ARE FEST
EDUCATIONALIOUSLY WORKING TO BE
COMPLIANT WITH HERE AT THE
UNIVERSITY OF NORTH CAROLINA.
THERE ARE MANY QUESTIONS THAT
ARE COMING UP FOR THOSE OF US
THAT HAVE GRANTS THAT ARE
INTENDED TO DIVERSIFY THE
WORKFORCE, PARTICULARLY OUR CTSA
AWARDS THAT WE'RE WORKING
THROUGH NOW.
HOW IS THE NIH BALANCING THIS
NEW LAW?
WITH THE UNITE EFFORTS, WHAT
ADVICE ARE YOU GIVING
INVESTIGATORS LIKE MYSELF THAT
ARE IN STATES AND AT
INSTITUTIONS THAT WERE NAMED IN
THIS LAWSUIT AND IN STATES WHERE
THERE'S BEG YOUR PARDON A
TREMENDOUS PENDULUM SWING AROUND
DIVERSITY, EQUITY, INCLUSION AND
ACCESSIBILITY EFFORTS?
>> THANK YOU FOR THAT QUESTION.
IT'S NOT THE FIRST TIME IT'S
BEEN ASKED.
>> I IMAGINE YOU'RE WELL VERSED
IN IT.
>> PLEASE HELP US.
NI --NI CAN SAY THAT WE AT NIH E
THINK OF DIVERSITY AT LARGE, SO
IT'S DIVERSITY OF IMOGRAPHY,
DISCIPLINE, YES DIVERSITY IN
KEEPING WITH DEMOGRAPHIC
CHARACTERISTICS,
DIVERSITY--BECAUSE YOU'RE A
PERSON WITH A DISABILITY OR YOU
HAVE COME FROM A LOW
SOCIOECONOMIC BACKGROUND, VERY
MUCH IS OUTLINED IN OUR NOTICE
OF SPECIAL INTEREST IN DIVERSITY
AND WE DO NOT FUND BASED UPON
DEMOGRAPHIC CHARACTERISTICS.
WE WILL FOCUS ON INSTITUTIONS
THAT MAY BE IN AREAS WHERE
THERE'S NOT BEEN A LOT IN THE
WAY OF NIH FUNDING IN KEEPING
WITH THE ERA INITIATIVE I
MENTIONED AND YES, WE HAVE
INITTIAIVE ITS LIKE THE FACULTY
AND RECRUITMENT FOR SUSTAINABLE
TRANSFORMATION PROGRAM WHERE AS
I MENTIONED, WE'RE LOOKING FOR
PEOPLE WHO HAVE INTEREST IN AND
A TRACK RECORD IN DEIA BUT IT'S
NOT NECESSARILY THE AREA OF
FOCUS AND WHEN YOU LOOK THROUGH
THOSE FACULTY ARE ISSUES IT'S A
VARIETY OF INDIVIDUALS JUST AS
IS THE CASE FOR THE
DISTINGUISHED SCHOLARS PROGRAM
HERE AT NIH WHICH IS THE BASIS
UPON WHICH IT WAS FIRST
DEVELOPED.
SO WE RECOGNIZE THAT IT GETS TO
BE CHALLENGING AND WE'VE HAD
MANY INSTITUTIONS SAY, WELL CAN
I APPLY FOR THIS INITIATIVE AND
AS WE'RE GIVING OUT FUNDS LIKE
THIS LAST COHORT OF FIRST
GRNTEES, AT LEAST 3 OF THE 5
INSTITUTIONS THAT GOT FUNDED
WERE IN THE STATE OF TEXAS.
AND TEXAS HAS SOME LAWS ABOUT
DEI THESE DAYS.
SO THE RECOMMENDATION WAS FOR
THOSE INSTITUTIONS AND
LEADERSHIP OF THOSE INSTITUTIONS
TO WORK WITH THEIR IN-HOUSE
COUNCIL TO MAKE SURE THEY'RE
ABLE TO MEET THE TERMS OF THE
GRANT.
BUT FORTUNATELY ALL 3 OF THOSE
INSTITUTIONS WERE ABLE TO
RECEIVE THEIR GRANTS AND THEY'RE
MOVING FORWARD IN THEIR FESTER
INITIATIVE AND WE WILL CONTINUE
IN THAT FASHION.
Y SEE DR. MIKE LOWRY IS THE
OFFICE OF EXTRAMURAL RESEARCH,
DO YOU WANT TO ADD ANYTHING,
MIKE?
>> HE'S NODDING HIS HEAD IN
AGREEMENT.
>> THE OTHER THING WE'RE DOING
HERE JUST LIKE YOU ARE ENGAGING
WITH YOUR COUNCILS AND TRYING TO
MAKE SURE THAT WHAT YOU'RE DOING
IS MEETING THE SPIRIT OF THE
LAWS, WE DO THAT HERE AS WELL,
WE JUST RECENTLY THIS PAST WEEK
HAD A MEETING WITH OUR OFFICE OF
GENERAL COUNCIL TO TALK ABOUT
OUR PROGRAMS AND SOME OF THE
THINGS THAT ARE GOING ON TO MAKE
SURE THEY UNDERSTAND THE
PROGRAMS AND TO SEE IF THAT--IF
WE HAVE ANY ISSUES THAT WE NEED
TO BE DOLING WITH IN TERMS OF
THESE NEW RULINGS, SO WE'LL
CONTINUE TO DO THAT AS WE LOOK
AT OUR CURRENT PROGRAM ANDS
DEVELOP ANY NEW PROGRAMS TO MAKE
SURE THAT WE ARE NOT DOING
SOMETHING OUTSIDE OF SOME OF THE
NEW RULES THAT ARE IN PLACE;
>> THANK YOU SO MUCH.
>> THANK YOU DR. BERNARD AND
JOHNSON, I APPRECIATE THE GREAT
WORK YOU ARE ARE DOING WITH
THESE INITIATIVES TO DIVERSIFY
THE BIOMEDICAL SCIENTIFIC WOR
WORKFORCE, I THINK THAT THEY ARE
VERY HONORS EMPLOYEESARRABLE
EFFORT THAT YOU ARE ALL ARE
MAKING.
I HAVE 1 QUESTION IN TERMS OF
ALL OF THE COMPONENTS THAT
REFLECT UNITE, DO YOU HAVE ANY
PLANS
PLANS FOR ASSESSING UNITE IN
TERMS OF THE BENEFITS AS IT
RELATES TO CERTAIN MEASURES THAT
MIGHT COME TO MIND THAT IMPROVE
THE CAPACITY OF MINORITY
INVESTIGATORS WHO PARTICIPATE IN
SOME OF THE NIH COMPETITIONS AND
GRANTS THAT YOU TALKED ABOUT IN
I THINK IT MAY BE IMPORTANT IN
TERMS OF ASSESSING THESE SORTS
OF PROGRAMS AND THAT INFORMATION
GARNERED OR THINGS THAT HAVE
BEEN LEARNED FROM THESE
PROGRAMS, MIGHT BE APPLIED TO
OTHER EFFORTS IN NIH IN TERMS OF
ADDRESSING MARGINALIZATION FOR
INSTANCE PEOPLE WITH
DISABILITIES AND THEY'RE
ADDRESSING ABLEISM, AS UNITE
FOCUSES ON RACISM, ABLEISM, IS
IN FACT AN ISSUE ACROSS THE
NHIER AND OTHER FEDERAL AGENCIES
AS WELL.
SO I WANT TO POSE THAT QUESTION.
>> THANK YOU IF ARE THAT
QUESTION AND YES, WE ARE
THINKING LONG AND HARD ABOUT HOW
WE GET OUR ARMS AROUND ALL THESE
THINGS THAT HAVE SPRING FROM
UNITE.
IT WAS KIND OF LIKE WE PUT OUT A
LOT OF SEEDS AND A LOT OF THINGS
HAVE FLOWERED AND WE HAVE A LOT
OF PROCESS MEASURES BUT TRUE
OUTCOME MEASURES, CHANGES IN
CULTURE AND ENVIRONMENT ARE
GOING TO TAKE LONGER TO MEASURE.
AND THAT'S THE REASON WE HAVE
THIS WORKING GROUP THAT'S
LOOKING AT THESE FOCUS AREA ANDS
STATEMENTS AS WRITTEN.
IT'S UNITE MEMBERS, IT'S
PLANNING AND EVALUATION MEMBERS
AND HOW DO WE HARNESS AND LOOK
AT THOSE THINGS.
I WILL ALSO MENTION THAT YES,
UNITE AND LOOKING AT THINGS WITH
A RACIAL EQUITY LENS BUT IT
DOESN'T LIMIT THINGS TO JUST
RACE AND ETHNICITY.
FOR INSTANCE THE DEIA PRIZE
COMPETITION, ANY INSTITUTION
THAT COULD TALK ABOUT DIVERSITY
EQUITY, INCLOWGZ, ACCESSIBILITY
WAS ELIGIBLE FOR THAT.
SO GO AHEAD.
>> THANK YOU FOR THAT RESPONSE.
I THINK THAT PERHAPS IN TERMS OF
THE ULTIMATE, IT MAY BE VERY
AMBITIOUS AND NOT PRAGMATIC, BUT
IN TERMS OF THE OVERALL ISSUE
THAT THIS UNITE AND UNITE AND
OTHER INITIATIVES ARE ADDRESSING
ULTIMATELY AS HEALTH DISPARITIES
AMONG THESE INDIVIDUALS FOR
THESE UNDERREPRESENTED
POPULATIONS SO IT WOULD BE
INTERESTING TO SEE IF OVERALL,
LIKE YOU SAID FROM THE LONG-TERM
ARE INTERMEDIATE PERSPECTIVE ARE
THERE ANY IMPACTS ON THESE
HEALTH OUTCOMES OR THESE
INDIVIDUALS FROM THESE
MARGINALIZED POPULATIONS BUT AS
YOU NOTED, THERE MAY BE PROCESS
SORTS OF MEASURES AND OUTCOMES,
IT SHOW THE BENEFITS OF THESE
INITIATIVES MIGHT BE IMPORTANT
FOR REPORTING, OR ARK DITIONAL
FUNDING OR TARGETING FUNDING AT
NIH THROUGH THE AREAS WHERE YOU
FEEL LIKE THE COMPONENT AREAS
THAT ARE MOST BENEFICIAL AND
MOST ADVANTAGEOUS FOR ENHANCING
THESE OUTCOMES.
THANK YOU FOR YOUR THOUGHTS.
>> YEAH, WE APPRECIATE THAT.
>> THANK YOU FOR THE UPDATE ON
THE REALLY IMPORTANT WORK, I
BELIEVE IT WAS THE 2019 NIH
WORKPLACE SURVEY, I WAS REALLY
ALARMED BY THE REALLY HIGH
LEVELS OF HARASSMENT AND CLIMATE
ISSUES FOR--THE NIH DATA FROM
2019 WAS A KEY PIECE OF DATA,
LARGE SURVEY OF SCIENTISTS IN
THE WORKFORCE, I GUESS THAT
LEADS TO 2 QUESTIONS, DO YOU
PLAN ON RELEASING THIS DATA, THE
MORE RECENT SURVEY DATA IS IT
GOING TO BE PUBLICLY RELEASED BY
CATEGORY SO WE CAN SEE THAT
AGAIN AND THEN ALSO ARE THINGS
LOOKING BETTER FROM THE LAST
TIME YOU DID THE SURVEY?
ARE THINGS IMPROVING AT NIH?
>> SO YES, THE DATA THAT'S
CIRCULATING WITHIN THE INSTITUTE
ANDS CENTERS, ULTIMATELY THERE
WILL BE AN OVERALL REPORT THAT
WILL BE RELEASED AND AVAILABLE
JUST LIKE DAY 1 FROM 2019, THE
QUESTION ABOUT THOSE OTHER
THINGS ARE IMPROVING OR NOT IS A
BIT MORE CHALLENGING TO,A
ASSESSES BECAUSE THE SURVEYS
WERE SLIGHTLY DIFFERENT ENOUGH
THAT WE COULDN'T HAVE
CORRELATIONS CORRELATING FROM
2019-2023.
THERE ARE SOME QUESTIONS THAT
WERE VERY MUCH THE SAME AND
WE'RE LOOKING AT THOSE TO SEE IF
WE CAN SEE IMPROVEMENTS BUT
CERTAINLY WE SHOULD BE ABLE TO
GET RESULTS THAT WILL TELL US A
BIT MORE BECAUSE THE LGBTQ, YOU
KNOW HIGH PREVALENCE WAS
CERTAINLY THERE.
I CAN'T RECALL THE DATA BECAUSE
I DID SEE IT, I DON'T--WE
HAVEN'T GOTTEN THAT LEVEL OF
REPORT AS YET, BUT WE WILL
BEGINNING THAT AND THAT DATA
WILL BE AVAILABLE SO WE SHOULD
BE ABLE TO SEE IF THERE'S BEEN
IMPROVEMENT OR NOT BUT THE OF
THE REPORTS WE HAVE THE HIGHER
LEVEL PORTS BUT NOT THE DETAILED
DEMOGRAPHIC REPORTS WOY NEED BUT
ONCE WE HAVE THAT, THAT WILL BE
SHARED AS WELL.
NALL RIGHT, KARL?
>> THANK YOU SO MUCH FOR THIS
PHENOMENAL, PHENOMENAL WORK YOU
HAVE DONE.
I WAS LOOKING AT THE SLIDE THAT
FLASHED BOO I QUICKLY, THERE ARE
ANY IDEAITATES THAT HAVE GOTTEN
FIRST PROGRAMS AND THEN IF THERE
ARE OPPORTUNITIES THROUGHOUT THE
UNITE PORTFOLIO THORS THINK
ABOUT WHETHER IT'S THE MOSAIC
ARK WARDS OR FIRST PROGRAMS, THE
IMPACT OF THOSE IN THE IDEA
STATES AND WHAT MAY BE HAPPENING
IN TERMS OF JOB CREATION OR IN
THESE STATES AS WELL?
>> I WOULD HAVE TO PULL THE MAP
BACK UP BUT TO MY RECOLLECTION
WE HAVE A LOT IN THE STATE IDEA
STATES AND A LOT THAT WERE IN
THE SOUTHERN REALM ON THAT MAP
XI WILL SAY THAT OUR COLLEAGUESA
THE NATIONAL INSTITUTE OF
GENERAL MEDICAL SCIENCES HAVE
BEEN PARTICULARLY FOCUSED ON
IDEA STATES AND MAKING ON
OUTREACH TO IDEAITATES.
SO IT'S DEFINITELY ON OUR RADAR.
AS WE TALK ABOUT THIS ERA
INITIATIVE, MANY OF THE TARGET
INSTITUTIONS ARE GOING TO BE AN
IDEAITATE, SO WE'RE NOT IGNORING
THAT ISSUE, BUT WE WERE GOING TO
TRY TO PULL UP THE MAP FOR ME.
I HAVE TO REMEMBER THE
IDEAITATES ARE AS WELL.
BUT I THINK THERE ARE A LOT IN
THE SOUTH AND THE SLIDE SHOULD
BE AVAILABLE LATER TODAY AND
THERE COULD BE A DIRECT
COMPARISON.
>> YEAH, THE POINT IS, I THINK
IT'S REALLY IMPORTANT TO
HIGHLIGHT IN OF THAT IMPORTANT
WORK IN THOSE INVESTMENTS AS
WELL, AS WE'RE THINKING ABOUT
THE PORTFOLIO.
>> OKAY, YEAH, THANK YOU.
YEAH, I'M LOOKING.
>> THERE ARE SOME NMEXICO IN.
>> THERE ARE PLENTY OF
ADDITIONAL 1S THAT WE WOULD WANT
TO EPIGAUGE WITH IN--ENGAGE WITH
IN THE FUTURE.
I HAVE ALEXIA NEXT.
>> I WANT TO GIVE AN ENORMOUS
COMPLEMENT TO THE WORK THAT YOU
HAVE, WE WERE REFLECTING AT THE
BREAK, ABOUT THE INITIAL
PRESENTATION WHICH IS JUST AS I
STARTED ON THIS ROLE ON AND I
THINK THIS IS PROVE OF THEAXIOM
THAT LESS HAPPENS IN 2 YEARS BUT
MORE THAN CAN YOU IMAGINE IN 5,
WITH PROGRESS LIKE THIS HERE WE
ARE AT YEAR 3 AND WHAT IS
AMAZING TO ME IS THE BREDTH, THE
DEPTH, THE COMPREHENSIVENESS AND
THE INTEGRATION OF ALL OF THESE
AREAS THAT EVERYONE I THINK WHO
WORKS IN THIS SPACE DEEMS AS SO
IMPORTANT TO WORK ON IN CONCERT
IN ORDER TO DO IT.
AND I ALSO THINK THE WONDERFUL
THING IS THE WAY THE
ARCHITECTURE IS SET UP, IT
ALLOWS FOR CONTINUED INCLUSION
OF OTHER PRIORITIES AS WE LEARN
MORE ABOUT AREAS THAT WE NEED TO
WORK AND THEN LAST, I THINK
WE'RE ALL COMMITTED TO WHAT HAS
KIND OF BEEN RAISED WHICH IS WE
NEED TO FIGURE OUT WHAT OF THESE
PROGRAMS IS WORKING WELL, WHERE
THE IMPACT IS, WHERE THE VALUE
IS TO CONTINUE TO BOTH
DISSEMINATE, TRY NEW THINGS AND
REALLY CONTINUE TO BRING THIS TO
THE NEXT LEVEL WHERE THE
SUSTAINABILITY IS THERE ALSO, SO
JUST AGAIN A HUGE COMPLEMENT FOR
THE WORK OVER THE PAST 3 YEARS.
I'M SO PLEASED TO BE IN THE MIX
A LITTLE BIT MORE ON THE WORKING
GROUP AS WELL.
>> YEAH. AGAIN, EVERYBODY HAS
BEEN THANKING YOU FOR THIS
AMAZING WORK. ACTUALLY, OFTEN
IN MY OWN OTHER WORK OFTEN HAVE
POINTED TO THIS INITIATIVE AS A
RATHER REMARKABLE COMPREHENSIVE
INITIATIVE THAT OTHER
INSTITUTIONS CAN LEARN FROM AND
DO THINK THIS IS ALSO POTENTIAL
FOR ALL THIS WORK TO INFORM
OTHERS AND OTHER INSTITUTIONS IN
THE COUNTRY IS QUITE ENORMOUS
AND ONE OTHER COMMENT IS AT THE
BEGINNING YOU MENTIONED ONE
INTERESTING PROGRAM INITIATIVE
THAT IS K-12 THAT IS REALLY
FASCINATED TO REFLECT ON THIS.
HOPEFULLY THESE INITIATIVES WILL
LEAD TO THE TRUST ISSUE
IMPROVING TRUST IN SCIENCE AND
NIH AND SO ON.
THIS IS THE RIGHT FOCUS AND HOW
WE THINK ABOUT SCIENCE AND
IMPORTANCE OF SCIENCE. THANK
YOU.
>> ADDITIONAL QUESTIONS OR
COMMENTS FROM ANYBODY?
>> I WOULD JUST SAY MARIE AND
ALFRED AND TARA HAVE DONE A
GREAT JOB.
THE THANKS GO TO ALL OUR STAFF.
>> YEAH.
>> THE SLIDE THAT ALFRED PUT UP
WITH THE MANY, MANY NAMES, THEY
VOLUNTEER THEIR TIME BASICALLY.
IT IS REALLY REMARKABLE HOW MUCH
PASSION AND WE ARE NOW AT A
POINT WHERE THERE HAS BEEN
TURNOVER. THIS IS THE SECOND
AND MAYBE THE THIRD WAVE OF
PEOPLE THAT HAVE ENGAGED AND
THERE IS ANOTHER COMMITTEE, THE
ANTIRACISM STEERING COMMITTEE
THAT IS OVER 100 PEOPLE WHO
DEVOTE THEIR TIME AND ENERGY.
THEY COME UP WITH REALLY
IMPORTANT IDEAS WHICH, YOU KNOW,
WE HAVE BEEN FORTUNATE TO
NAVIGATE AND FIGURE OUT WAYS OF
IMPLEMENTING.
SO, THE CREDIT REALLY, YOU KNOW,
GOES THERE.
AND -- AND I GUESS THAT ONE
OTHER POINT THAT HAS BEEN ELUDED
TO, EVERYTHING IN THIS SPACE IS
NOT HAPPENING THROUGH UNITE.
THE INSTITUTES AND CENTERS PLAY
AN ENORMOUS ROLE HERE AND
SPECIAL SHOUTOUT TO NMGS AND
NIMHD THERE IS A PUSH AND PULL.
WE LEARN FROM THEM. IT IS A
TREMENDOUS PARTNERSHIP AND
ULTIMATELY IS ALL INSTITUTES AND
CENTERS NEEDING TO IMPLEMENT
WHEN WE PARTICULARLY GO
EXTRAMURAL AND MARIE SHOWED YOU
THE SIGN ON FOR THE MANY, MANY
DIFFERENT OPPORTUNITY
ANNOUNCEMENTS THAT HAS BEEN
QUITE BROAD.
SO, LOTS AND LOTS OF CREDIT
ACROSS THE AGENTS.
I THINK PEOPLE ARE HUNGRY
BECAUSE THERE IS A SILENCE HERE.
SO, WE WILL BREAK UNTIL 1:15.
WE ARE NOT GOING TO SPEED AHEAD
BECAUSE IT BEING -- THE FEDERAL
REGISTER, THERE MIGHT BE PEOPLE
THAT WANT TO COME IN FOR THE
NEXT PRESENTATION AND SO FORTH.
WE WILL COME BACK AT 1:15 P.M.
ALL RIGHT? THANKS, EVERYBODY!
HER OPENING REMARKS TALKED ABOUT
TAKING SCIENCES ADVANCES AND
THOUGHT I WOULD START WITH
PEOPLE AND PREVENTABLE TRAGEDY
OF MATERNAL MORBIDITY AND
MORTALITY AND YOU SEE THREE
ATHLETES THAT HAPPEN TO BE BLACK
WOMEN IN THEIR 30S AND SERENA
WILLIAMS YOU HAVE READ SHE
EXPERIENCED SERIOUS PULMONARY
EMBOWLI DURING HER FIRST
PREGNANCY AND SAD THING ABOUT
THAT IS SHE PREVIOUSLY HAD
EMBOWLIED AND KNEW WHAT IT FELT
LIKE. HER DOCTORS WEREN'T
LISTENING TO HER AND SHE
RECOVERED AND HAD A HEALTHY
PREGNANCY THAT IS GREAT AND ALEX
FELIX HAD AN EMERGENCY SES AARI.
FORT NOTELY SHE RECOVERED. SHE
IS A CHAMPION FOR MATERNAL
HEALTHTORY BEAUY WAS NOT
FORTUNATE AND WENT INTO LABOR AT
HOME AT 8 MONTHS OF GESTATION
AND APPARENTLY HAD ACLAMP SEA OR
A LIFE-THREATENING EVENT AND
DIED IN HER HOME IN THE PROCESS
OF CHILD BIRTH. WE CAN'T LET
THAT HAPPEN IN OUR COUNTRY. WE
WOULD LIKE TO HAVE A -- NEXT
SLIDE, PLEASE.
IN THE NEXT HALF HOUR OR SO I
WILL TALK ABOUT THE MATERNAL
MORTALITY CRISIS AND KNOW WE
HAVE DERMATOLOGISTS HERE AND
NEUROSCIENTISTS AND MAYBE YOU
ARE NOT THINKING ABOUT MATERNAL
MORTALITY AND WILL PRESENT OUR
HIGHLIGHTED PROGRAM AND
SIGNATURE PROGRAM AT NIH THAT IS
THE IMPROVE INITIATIVE THAT IS
NOT ALL THAT THE NIH IS DOING
WITH REGARD TO MATERNAL HEALTH.
I WILL JUST SPOTLIGHT A FEW
INITIATIVES FROM MULTIPLE
INSTITUTES AND CENTERS AND THEN
I WILL TALK ABOUT SOMETHING THAT
I KNOW IS NEAR AND DEAR TO DR.
BER CONTINUE OELI'S HEART HOW
YOU USE EXISTING NETWORKS AND
INFRASTRUCTURE AND USE THAT
INFRASTRUCTURE THAT HAS BEEN
ALREADY CREATED FOR MULTIPLE
USES.
LASTLY, WE WILL END WITH
PREVENTION. COULD I HAVE THE
NEXT SLIDE, SOMEBODY?
THIS DOESN'T SEEM TO BE -- THERE
WE GO. WE HAVE A PROBLEM IN THE
UNITED STATES. NUMBERS ARE
GETTING WORSE.
LAST STATISTICS WE HAVE ARE FROM
2021. OVER 1200 WOMEN DIED IN
THE P PROCESS OF PREGNANCY AND
LABOR AND DELIVERY POSTPARTUM
AND LOOKING AT GRAPHS WOMEN ON
THE LEFT THAT ARE WOMEN THAT ARE
NON-HISPANIC BLACKS HAVE BY FAR
THE WORST STATISTICS.
WHAT IS NOT SHOWN HERE IS
AMERICAN INDIANS AND ALASKA
NATIVES THAT ARE NOT QUITE AS
BAD BUT BAD AND ALL OF THE
RACIAL AND ETHNIC BACKGROUNDS
ARE INCREASING AND SOME IS
RELATED TO THE PANDEMIC.
THE TREND WAS BEGINNING TO BE
THERE BEFORE THE PANDEMIC AND
YOU MIGHT NOTICE ON THE RIGHT TO
LOOK AT DIFFERENCES OF A
FUNCTION OF MATERNAL AGE AND
WHAT IS GOING ON WITH WOMEN THAT
ARE OVER 40 AND ARE MORE LIKELY
TO HAVE A LIFE THREATENING
HEMORRHAGE OR SERIOUS
CARDIOVASCULAR DISEASE THAT IS
UNMASKED BY PREGNANCY AND ARE AT
HIGHER RISK FOR PULMONARY
EMBOWLI AND AGE IS ALSO A FACTOR
THAT IS PROBABLY THE BIGGEST
RISK FACTOR OF ALL.
NEXT SLIDE, PLEASE.
AS A PEDIATRICIAN AND SOMEONE
WORKING IN NEO-NATOLOGY I HAVE
BEEN IN LOTS OF DELIVERY ROOMS
AND NEVER REALIZED HOW MANY
WOMEN CAN DIE IN THE FIRST YEAR
AFTER THEY DELIVER.
SO, SOME WOMEN, ABOUT 1/5 OF THE
WOMEN ARE DYING WHILE THEY ARE
PREGNANT RELATIVELY FEWER ARE
DYING ON THE DAY OF DELIVERY AND
65% OF WOMEN ARE DYING BETWEEN
DAY 1 AND A YEAR AFTER DELIVERY
AND PART OF THE REASON WHY THERE
HAS BEEN A GREAT EFFORT TO
EXTEND MEDICAID COVERAGE SO
WOMEN CAN CONTINUE TO BE SEEN BY
HEALTHCARE PROVIDERS TO LOOK FOR
PROBLEMS SUCH AS HYPERTENSION OR
CARDIO MYOPATHY.
NEXT SLIDE.
THIS IS A VERY IMPORTANT SLIDE
AND PROBABLY THE MOST IMPORTANT
SLIDE I WILL SHOW YOU.
THE LACK OF ACCESS TO OBSTETRIC
CARE IN OUR COUNTRY IS A MAJOR
AND SERIOUS PROBLEM.
IF YOU LOOK AT THE RED COUNTIES
THERE, THOSE ARE COUNTIES THAT
ARE SO-CALLED MATERNITY CARE
DESERTS WHERE THERE IS NOT A
QUALIFIED OBSTETRIC PROVIDER IN
THAT COUNTY.
SO, WE HAVE A MAJOR WORKFORCE
ISSUE.
THIS ISSUE IS CONTINUING TO GET
WORST OVER TIME.
SO, MORE THAN 2.2 WOMEN LIVE IN
THESE MATERNITY CARE DESERTS.
AN ADDITIONAL 6 MILLION WOMEN
LIVE IN LOW CARE DESERTS.
NOW, WHY IS THIS HAPPENING?
FIRST OF ALL, FEWER MEDICAL
SCHOOL GRADUATES ARE GOING INTO
OBSTETRICS AND GYNECOLOGY AND
LAST YEAR THERE WERE 10% FEWER
RESIDENTS IN OBGYN AROUND THE
COUNTRY AND SECOND REASON IS
THAT HOSPITALS ARE CLOSING
OBSTETRIC SERVICES BECAUSE THEY
COST MORE THAN THEY PRODUCE.
YOU NEED TO HAVE SERVICES
AVAILABLE 24/7 AND NEVER KNOW
WHEN A BABY WILL BE DELIVERED.
THEY ARE EXPENSIVE TO MAINTAIN
SERVICES SO HOSPITALS CUT THEM
OUT AND THIRD THING IS EFFECT OF
THE DOBS DECISION AND MIGHT HAVE
READ IN NEW YORK TIMES, FOR
EXAMPLE, IN IDAHO, THERE WERE
FIVE OR NINE MATERNAL FETAL
MEDICAL SPECIALISTS THAT ALL
MOVED OUT OF THE STATE OF IDAHO.
THEY WANTED TO PRACTICE IN A
DIFFERENT SETTING THAT IS
HAPPENING IN MULTIPLE PLACES
AROUND THE COUNTRY.
THIS IS A PROBLEM THAT IS NOT
SOLVABLE.
WE CAN'T CREATE MORE
OBSTETRICIANS.
WE CAN PROVIDE HELP WITH OTHER
MEMBERS OF THE WORKFORCE AND CAN
PROVIDE TECHNOLOGY AND WHAT I
WILL TELL YOU ABOUT.
NEXT SLIDE.
SO, THE IMPROVE INITIATIVE
STARTED AT BLACK MATERNAL HEALTH
CAUCUS EVENT IN DECEMBER OF
2019.
EXACTLY FOUR YEARS AGO WHEN WE
MET WITH -- ACTUALLY, 90 MEMBERS
OF CONGRESS WERE PRESENT AT THAT
MEETING AND MEETING IS CONVENED
BY REPRESENTATIVE A--LE MA ADAMS
IN RED AND LAURA UNDERWOOD WHO
IS IN BLACK ON THE RIGHT AND SEE
DR. COLLINS, MYSELF, DR. PARRIS
STABILAY AND DR. GIBBINS WERE
THERE. WE WERE EFFECTIVELY
SHAMED AND TOLD WE HAVE TO DO
MORE TO ADDRESS PROBLEMS OF
MATERNAL MORBIDITY AND MORTALITY
AND FROM THAT CAME THE
INITIATIVE. NEXT SLIDE, PLEASE.
IMPROVE LIKE EVERY GOOD NIH
PROGRAM IS AN ACRONYM FOR
IMPLEMENTING MATERNAL HEALTH AND
PREGNANCY OUTCOMES VISION FOR
EVERYONE WHICH IS A NIH-WIDE
INITIATIVE CO-LED BY NICHD
NATIONAL INSTITUTE OF NURSING
RESEARCH AND NATIONAL OFFICE OF
RESEARCH ON WOMEN'S HEALTH. WE
ARE TAKING A DIFFERENT APPROACH
AND NOT BASIC SCIENCE
INITIATIVE. WE ARE FOCUSED
REDUCING PREVENTABLE CAUSES OF
MATERNAL MORBIDITY AND MORTALITY
AND IS A DISTINCT FOCUS ON
COMMUNITY AND IMPLEMENTATION
RESEARCH AND HOW WE IMPLEMENT
INTERVENTIONS THAT WILL CHANGE
THE NUMBERS IS WHAT WE HEAR FROM
CONGRESS ALL THE TIME. HOW WILL
YOU CHANGE NUMBERS OF WOMEN
DYING, WHICH, BY THE WAY, THOSE
NUMBERS ARE EQUIVALENT TO A
THIRD WORLD COUNTRY AND WE ARE
WORST IN TERMS OF DEVELOPED
COUNTRIES IN TERMS OF WOMEN
DYING.
ALSO, VERY IMPORTANT, WE NEED TO
ADDRESS HEALTH DISPARITIES AS
PART OF THIS.
IN THE BEGINNING, WE DID NOT
HAVE A SPECIFIC APROPRIATION.
CONGRESS VERY NICELY DID GIVE US
FUNDS IN '22 AND '23 AND WITH
THAT COMES BIG PROGRAMS AND
IMPROVEMENT.
NEXT SLIDE, PLEASE.
I WOULD LIKE TO THINK OF THIS AS
A PUZZLE. THERE IS SIX PARTS TO
THE PUZZLE.
I DON'T HAVE TIME TOED TO GO
INTO CONNECT-A-THON AND
DISSEMINATION IMPLEMENTATION
SPECIAL NOTICE BUT WILL TELL YOU
ABOUT ALL OF THE OTHER FOUR.
ALL OF THEM INTERSECT WITH EACH
OTHER.
TECHNOLOGIES THAT WE ARE
DEVELOPING THROUGH RAD X TECH
PART OF IMPROVE WILL BE
IMPLEMENTED IN CENTERS OF
EXCELLENCE AS A EXAMPLE.
THE GOAL THERE IS TO -- WE HAVE
FUNDED 10 RESEARCH CENTERS IN
AUGUST OF THIS YEAR.
THERE IS ALSO A COMMON DATA AND
INNOVATION HUB AND
IMPLEMENTATION SCIENCE HUB.
PART OF THE IMPLEMENTATION
SCIENCE HUB'S MANDATE IS TO
INCREASE THE SCIENTIFIC
WORKFORCE, FOR EXAMPLE, DATA
INNOVATION HUB IS AN OPPORTUNITY
TO INPUT AND SHARE DATA AMONGST
MANY CENTERS AND WITH CENTERS OF
EXCELLENCE WE ARE GETTING
ENGAGEMENT OF COMMUNITIES FROM
THE VERY BEGINNING.
THERE IS A ROBUST TRAINING
COMPONENT. NEXT SLIDE, PLEASE.
NO SIMPLE SOLUTION TO REDUCING
MATERNAL MORTALITY. IT IS A
COMPLEX PROBLEM AND MULTIPLE
CONDITIONS AND WE ARE ADDRESSING
PRETTY MUCH ALL OF THEM IN ONE
IMPROVED PROGRAM OR NIH PROGRAM.
AGAIN, IT IS VERY IMPORTANT TO
LOOK AT THE DIFFERENT TIME
POINTS.
WE CAN LOOK AT PRENATAL OR
DURING PREGNANCY AND DURING
LABOR AND DELIVERY OR YEAR AFTER
DELIVERY.
WE HAVE A FOCUS ON
UNDER-REPRESENTED POPULATIONS.
WE ARE LOOKING AT SOCIAL
DETERMINANTS OF HEALTH AND ARE
LOOKING AT NOVEL APPROACHES.
AGAIN, WITH IMPLEMENTATION.
WE HAVE A BIG FOCUS ON COMMUNITY
HEALTH WORKERS WHO DON'T REPLACE
THE OBSTETRICIAN AND IN FACT
MIGHT BE PROVIDING AN EQUALLY
IMPORTANT SERVICE BY GOING INTO
THE PATIENT'S HOME.
WE ARE ALSO USING ARTIFICIAL
INTELLIGENCE AND WE DIDN'T COME
UP ON THE LIST OF AI.
WE ARE USING ARTIFICIAL
INTELLIGENCE AND MACHINE
LEARNING WITH ELECTRONIC HEALTH
RECORDS IN CONNECT-A-THON TO
LOOK FOR PREDICTORS OF RISK
FACTORS.
AND WE ARE ADDRESSING IMPLICIT
PROVIDER BIASES AND LACK OF
RESPECT FOR CERTAIN POPULATIONS
AND CREATING PREDICTIVE MODELS.
NEXT SLIDE, PLEASE IT IS A
SUCCESS STORY BASED ON RAD X
TECH CHALLENGE FOR COVID
DIAGNOSTICS THAT WORKED SO WELL
AND IS LIKE A SHARK TANK
APPROACH AND WORKED SO WELL AND
SAID WHY CAN'T WE APPLY THIS TO
MATERNAL HEALTH THAT IS A WAY TO
ADDRESS MATERNITY CARE DESERTS.
IF SOMEWHERE IN A RED COUNTY
WHERE YOU DON'T HAVE ACCESS TO A
QUALIFIED PHYSICIAN NEXT BEST
THING IS TO HAVE A WEARABLE OR
POINT OF CARE DIAGNOSTIC THAT
CAN BE THEN COMMUNICATED WITH
SOMEONE WHO IS IN A CITY WHERE
THERE ARE QUALIFIED PEOPLE.
SO, THESE ARE ALL BASED ON
REMOTE SENSING TECHNOLOGIES.
WE FOR FDA APPROVAL REASONS
DECIDED TO FOCUS ON POSTPARTUM
CARE AND IS EASIER TO GET THINGS
APPROVED IN A NONPREGNANT PERSON
THAN PREGNANT PERSON AND THOUGHT
WITH 65% OF DEATHS OCCURRING
POSTPARTUM IF WE CAN HAVE A
WEARABLE DETECTING WOMEN AT RISK
FOR HEMORRHAGE OR HYPERTENSION
OR CARDIO MYOPATHY THAT IS A
SUCCESS THAT WE DEDICATED $8
MILLION IN PRIZE MONEY FROM
APPROVED APROPRIATION.
WE HAVE THE TEAMS THAT ARE GOING
THROUGH PHASES AND NOW ARE DOWN
AT 10 FINALISTS AND ARE IN THE
FINAL TECHNOLOGY ASSESSMENT
PHASE.
THEY ARE HAVING DEVICES TESTED
AND VALIDATED AND 10 FINALISTS
ARE ADDRESSING THE PROBLEMS THAT
ARE SO COMMON IN PREGNANT PEOPLE
AND HYPERTENSION AGAIN IS MENTAL
HEALTH HEMORRHAGE AND URINARY
TRACT INFECTIONS AND ANEMIA AND
WILL HAVE WINTER IN THE SPRING.
TEAMS HAVE BEEN GETTING PRIZE
MONEY ALL ALONG AND WINNER WILL
GET THE MOST.
EVERYBODY HAS GOTTEN A LITTLE
BIT.
NEXT SLIDE, PLEASE.
I WANTED TO GIVE YOU ONE EXAMPLE
WHAT DOES THIS LOOK LIKE?
IF YOU LOOK AT THE IMAGE, IT
LOOKS LIKE -- DID ANYBODY HAVE
AN IPOD BACK IN THE DAY?
YOU KNOW?
LOOKS LIKE AN IPOD ON THE
BRACELET AND IS CALLED A VITAL
STREAM AND DEVELOPED FOR ADULT
ICU INDICATIONS AND NOTHING TO
DO WITH PREGNANCY THAT ARE
ADOPTING IT FOR POSTPARTUM USE
AND BEAUTY IS IT IS FDA CLEARED
AND CONTINUES HEART RATE BLOOD
PRESSURE RESIDENT PRATION AND IT
CAN BE USED IN THE HOSPITAL OR
AT HOME REMOTELY.
SO, THE WHOLE ADAPTATION FOR
PREGNANT AND POSTPARTUM THAT IS
PART OF THE CHALLENGE THAT THEY
ARE DEVELOPING AI FRAMEWORKS TO
LOOK AT VITAL SIGN PATTERNS TO
PREDICT WHO IS AT RISK FOR
HEMMING WRATH OR SEPSIS OR TACKY
CARDIC FOR UNKNOWN REASONS AND
VERY EXCITING AND WHAT IS
EXCITING IS THIS DEVICE WILL BE
USED IN ANOTHER PART OF THE
IMPROVE INITIATIVE THAT I WILL
GET TO IN A MINUTE.
NEXT SLIDE.
ANOTHER CHALLENGE IS THE
CHALLENGE HOW DO WE INVOLVE
LOCAL COMMUNITIES THAT REALLY
STRUCK HOME WITH ME HAVING A
TRIBAL CONSULTATION WITH NUMBER
OF TRIBAL NATIONS AROUND THE
COUNTRY AND PEOPLE FROM THE
NAVAJO NATION AND ASKING WHAT
ARE YOUR BIGGEST CHALLENGES.
WHAT DO I KNOW? I'M SITTING IN
BETHESDA AND PEOPLE IN NAVAJO
TOLD US THEIR BIGGEST CHALLENGE
WAS GETTING ADEQUATE NUTRITION
AND TO A STORE TO GET FRESH
FRUITS AND VEGETABLES.
NAVAJO TERRITORY IS SO ENORMOUS
AND PEOPLE DON'T HAVE
TRANSPORTATION AND IS A EXAMPLE
OF SOMETHING THAT A COMMUNITY
CAN PROVIDE THAT WE SITTING IN
BETHESDA WOULDN'T NECESSARILY BE
PRIORITIZING AND THIS CHALLENGE
WAS REALLY MEANT TO BUILD
CAPACITY IN THE COMMUNITY AND
EMPOWER COMMUNITY-BASED
ORGANIZATIONS WITH HOW TO WRITE
A GRANT APPLICATION.
SO, THIS WAS NOT ONLY A MATTER
OF GIVING THE MONEY AND GIVING
THEM PRIZE MONEY AND ALSO GIVING
THEM NON-MONETARY INCENTIVES
SUCH AS MENTORING AND PROPOSAL
WRITING SO THAT THEY COULD GO ON
AND COMPETE FOR OTHER POTENTIAL
RESEARCH FUNDING.
WE HAVE NOW 9 FINALISTS IN THAT
CHALLENGE AND WINNERS WILL BE
ANNOUNCED IN SEPTEMBER.
THEY HAVE A YEAR TO IMPLEMENT
THEIR PROPOSED PLANS AND DO A
LITTLE PILOT STUDY FOR THEIR
PROPOSED RESEARCH AND WILL
REPORT BACK.
THEIR PROJECTS INCLUDE MENTAL
HEALTH INTERVENTIONS THAT IS
HEAVILY EMPHASIZED BY COMMUNITY
ORGANIZATIONS THAT ARE
CULTURALLY CONGRUENT DUAL CARE
AND HYPERTENSION, MONITORING AND
NUTRITION.
NEXT SLIDE, PLEASE.
EXAMPLE OF ONE OF THE FINALISTS
OF THE COMMUNITY CHALLENGE IS
ABUNDANCE PROJECT THAT IS IN
COLORADO THAT IS EVALUATING
INTERVENTION IS POSTPARTUM DOULA
CARE AND HOW HAVING A DUALA
VISIT SIX TIMES FOR FOUR HOURS
IN THE HOME IF IT REDUCES
HYPERTENSION, REDUCES
DEPRESSION, AND REDUCES ANXIETY
AMONG BLACK INDIGENOUS AND
PEOPLE OF COLOR WHO ARE
POSTPARTUM.
THE, AS I SAID, THE INTERVENTION
IS THE DUALA'S VISITS AND THE
TEAMS ARE ASSESSING FEASIBILITY
AND ACCEPTABILITY OF POSTPARTUM
DOULA CARE AND PEOPLE ARE
GETTING VITAL STREAM DEVICE AND
WON'T BE JUST SUBJECTIVE BUT
OBJECTIVE EVIDENCE FROM THE
VITAL SYSTEMS THAT ARE BEING
ASSESSED.
AND, YOU KNOW, THEY WILL BE ABLE
TO LOOK IS THERE STATISTICALLY
SIGNIFICANT DIFFERENCE IN WOMEN
WITH DOULA VISITS.
NEXT SLIDE, PLEASE.
WE HAVE ANOTHER PIECE OF THE
PUZZLE IS A DIFFERENT COMMUNITY
IMPLEMENTATION PROGRAM THAT THIS
ONE WAS BUILT ON SUCCESSFUL
COMMUNITY IMPLEMENTATION PROGRAM
THAT HAD NOTHING TO DO WITH
PREGNANCY AND IS WELL
ESTABLISHED BETWEEN
COMMUNITY-BASED IMPLEMENTATION
STRATEGIES AND IMPLEMENTING
STRATEGIES IN UNDERSERVED
COMMUNITIES TO ADDRESS MATERNAL
HEALTH EQUITY.
THIS IS A PROGRAM THAT WAS
INITIATED BY NHLBI AND NOW
MATERNAL ASPECT OF IT IS FUNDED
BY IMPROVE.
THEY ARE ALSO LOOKING AT DOULAS
TO IMPROVE OUTCOMES INCLUDING
MENTAL HEALTH AND REDUCING
SUBSTANCE USE.
THEY ALSO HAVE A NUMBER OF
TRIBAL GROUPS THAT ARE LOOKING
AT INVOLVEMENT OF KINSHIP TO
IMPROVE MATERNAL HEALTH
OUTCOMES.
SO, SPECIFICALLY MATERNAL HEALTH
TO REDUCE DEPRESSION, FOR
EXAMPLE.
THEY ARE ALSO LOOKING AT
REDUCTION OF HYPERTENSION.
NEXT SLIDE, PLEASE.
WE WERE VERY THOUGHTFUL AND
INTENTIONAL AND WE USE
INTEGRATED APPROACH TO FUNDING.
WE REALLY WANTED TO SPREAD MONEY
OUT AS MUCH AS POSSIBLE.
WE HAVE A NATIONAL PROBLEM.
SO, MORE THAN SOME OTHER
PROGRAMS AT NIH, WE TRIED TO
REALLY SPREAD IT OUT.
THERE ARE THREE STATES HAVING
BOTH A CENTER OF EXCELLENCE AND
COMMUNITY PROGRAM.
OTHERWISE, THEY ARE SPREAD OUT
AND DISAPPOINTINGLY, SOME STATES
ARE IN GRAY AND NEVER SUBMITTED
ANY APPLICATIONS AND WE WOULD
HAVE WANTED TO PERHAPS FUND MORE
INSTITUTIONS PARTICULARLY IN THE
SOUTHEAST WHERE THERE ARE
SERIOUS PROBLEMS.
WE DIDN'T GET ANY APPLICATIONS .
NEXT SLIDE
IMPROVE IS LIKE OUR MARQUEE
PROGRAM NOW AND WE ARE DOING A
LOT IN TERMS OF REDUCING
PREGNANCY RELATED DEATHS.
NEXT SLIDE, PLEASE.
I ELUDED TO THIS. HERE ARE
NUMBERS THAT LEADING CAUSES OF
PREGNANCY-RELATED DEATHS INCLUDE
MEN TALE HEALTH CONDITIONS THAT
ARE BOTH SUICIDE AND SUBSTANCE
USE DISORDERS.
HEMORRHAGE, CORONARY ARTERY AND
CARDIAC CONDITIONS AND
INFECTION, THROMBBOTIC EMBOLISM
AND CARDIO MYOPATHY AND
HYPERTENSIVE DISORDERS AND THERE
IS CARDIAC IN THERE AND NEXT
SLIDE, PLEASE.
ADDRESSING INFECTION, YOU HEARD
IN ONE OF THE OTHER
PRESENTATIONS THIS MORNING ABOUT
INFECTION AND TREATMENT OF
INFECTION AND THIS IS A + STUDY
CO-FUNDED BY NICHD'S GLOBAL
NETWORK FOR WOMENS AND
CHILDREN'S HEALTH AND BILL AND
MELINDA GATES FOUNDATION AND
HYPOTHESIS WHETHER A SINGLE 2
GRAM DOSE OF RELATIVELY CHEAP
ANTIBIOTIC COULD REDUCE
POSTPARTUM SEPSIS AND DEATH AND
WERE 29,000 WOMEN ENROLLED IN
SEVEN LOW AND MIDDLE INCOME
COUNTRIES THAT STOPPED IT EARLY.
THERE WAS A CLEAR MATERNAL
BENEFIT AND WAS A THIRD FEWER
DEATHS IN THE MOTHERS WHO GOT A
SDIJ ROW MYOSIN AND DIDN'T DO
ANYTHING FOR BABIES THAT WAS
DISAPPOINTING AND EXPOSURE WAS
SO BRIEF THAT THERE ARE
SECONDARY ANALYSIS GOING ON AND
QUESTION IS WHETHER THIS WOULD
BE APPLICABLE IN THE UNITED
STATES OR NOT.
IT WAS A GREAT SUCCESS IN THESE
LOW AND MIDDLE INCOME COUNTRIES.
NEXT SLIDE.
SO, WE TALKED ABOUT CARDIAC
CONDITIONS AND NHLBI FUNDED A
STUDY.
THEY WANTED TO KNOW SHOULD BLOOD
PRESSURE BE HELD TO A LOWER
STANDARD THAN WAS PREVIOUSLY
RECOGNIZED AND WANTED TO GET
PREGNANT PEOPLE DOWN TO BLOOD
PRESSURE 140 OVER 90 AND SHOWED
IF YOU TREATED MILD CHRONIC
HYPERTENSION DURING PREGNANCY
THERE WAS STATISTICALLY
SIGNIFICANT REDUCTION IN ADVERSE
PREGNANCY OUTCOMES SEVERE
PREECOLLAPSIA AND PRETERM BIRTH
AND NEONATAL DEATH AND NUMBER OF
BABIES INTERESTINGLY THAT WERE
LOW BIRTH WEIGHT WAS SAME
WHETHER OR NOT HIGHER LIMIT OF
BLOOD PRESSURE CONTROL OR LOWER.
INTERESTING THING ABOUT THIS IS
THIS IS HOW DATA EFFECTED HEALTH
AND LONGEVITY OF HUMANS THAT
CHANGED ALREADY CLINICAL
PRACTICE AND PREVIOUS STUDY
MENTIONED AND THIS STUDY WERE
PUBLISHED IN NEW ENGLAND JOURNAL
OF MEDICINE.
NEXT SLIDE.
THIS IS PART OF IMPROVE AND IS
SPECIFICALLY ADDRESSING
DISPARITIES IN POSTPARTUM
HEMORRHAGE THAT IS LEADING CAUSE
OF DEATH IN WOMEN OF ASIAN
ANCESTRY AND IS INCREASED IN
PEOPLE OF LATINX AND BLACK
ORI
ORIGIN.
REASONS WHY YOU CAN DEVELOP
HEMORRHAGE CRESSARIAN BIRTH OR
COMPLICATIONS RELATED TO THAT
AND START OUT WITH IRON
DEFICIENCY AND ANEMIA AND THAT
IS ADDRESSING HEMORRHAGE.
NEXT SLIDE.
SUBSTANCE USE DISORDERS AND
THERE HAS BEEN AN INCREASE IN
PREGNANT PEOPLE DYING OF
OVERDOSED MORTALITY THAT IS OVER
A PERIOD BEFORE AND DURING THE
PANDEMIC.
NATIONAL INSTITUTE OF DRUG ABUSE
AND HEAL INITIATIVE ARE
SUPPORTING THIS RESEARCH THAT IS
PUBLISHED IN JAMMA PSYCHIATRY
SHOWING TRENDS AND IN RESPONSE
TO THAT THEY HAVE WRITTEN A
NOTICE OF SPECIAL INTEREST
SUPPORTING RECOVERY ORIENTED
CARE ACROSS SECTORS FOR PREGNANT
AND POSTPARTUM PEOPLE.
NEXT SLIDE.
MATERNAL HEALTH, THIS IS A HUGE
ISSUE THAT IS EXACERBATED BY THE
PANDEMIC AND NATIONAL INSTITUTE
OF MENTAL HEALTH SUPPORTED
AWARDS BEGINNING LAST YEAR IN
PREVENTING PERINATAL DEPRESSION.
THEY ARE LOOKING AT SCALE-UP OF
INTERVENTIONS THAT WILL PREVENT
THIS AND ARE USING TAX-BASED
MESSAGE SCREENING LOOKING AT
DIFFERENCES BETWEEN A VIRTUAL
AND IN-PERSON PREVENTIVE
INTERVENTION AND ARE USING ALSO
AN ALGORITHM TO IDENTIFY PEOPLE
AT RISK THROUGH ELECTRONIC
HEALTH RECORDS AND ARE ALSO
DEVELOPING INTERVENTION FOR
INDIVIDUALS WITH ADVERSE
CHILDHOOD EXPERIENCES.
NEXT SLIDE.
FOR THIS CURRENT FUNDING YEAR WE
ARE FOCUSING ON HELP WITH OBSSR
AND LOOKING AT INTIMATE PARTNER
VILE THAENS IS AN
UNDERCATEGORIZED REASON FOR
MATERNAL DEATHS THAT IS A REAL
PROBLEM.
NATIONAL INSTITUTE OF MINORITY
HEALTH AND HEALTH DISPARITIES IS
LOOKING AT DINSES AND HEALTHCARE
ACCESS AND QUALITY THAT IS
HUGELY IMPORTANT IN ADDRESSING
DISPARITIES AND NIADA IS
ADDRESSING OVERDOSE MORTALITY.
NEXT SLIDE.
THIS, AGAIN, IS SOMETHING THAT
IS EXTREMELY IMPORTANT
LEVERAGING EXISTING NETWORKS AND
INFRASTRUCTURE.
NEXT SLIDE.
IF WE HAVE AN INFRASTRUCTURE AND
LESSON WE LEARNED AT NICHD
DURING THE PANDEMIC WE HAD
INFRASTRUCTURE TO STUDY PREGNANT
WOMEN THAT WAS EXTREMELY
IMPORTANT AND WE RAPIDLY COULD
ASSESS EFFECT OF COVID-19 ON
PEOPLE AT THE BEGINNING OF THE
PANDEMIC AND COMPARE THEM TO
HISTORICAL CONTROLLED DATA THAT
LED TO THE WIDESPREAD
RECOGNITION THAT PREGNANT PEOPLE
HAD A MUCH HIGHER RISK OF BEING
HOSPITALIZED AND VENTILATED AND
DYING DURING PREGNANCY COMPARED
TO NONPREGNANT PEOPLE OF THE
SAME AGE.
THERE IS MULTIPLE ICS SUPPORTING
CLINICAL TRIAL NETWORKS AND
OTHER RESOURCES THAT COULD BE
SCALED UP.
FOR EXAMPLE, NICHD HAS DATA AND
SPECIMEN HUB OR DASH THAT HAS
CLINICALLY IDENTIFIED DATA SETS
AVAILABLE RIGHT NOW WITH LINKED
BIOSPECIMENS.
IMPORT IS NAIED AND WE NEED TO
TAKE ADVANTAGE OF THESE AND NEXT
SLIDE, PLEASE.
GOOD EXAMPLE HOW WE CAN REUSE A
NETWORK STUDY AND 2010NICHD
FUNDED A STUDY CALLED
[INDISCERNIBLE] PREGNANCY
OUTCOME STUDY MONITORING NEW
MOMS TO BE AND ENROLLED MORE
THAN 10,000 PREGNANT PEOPLE THAT
WERE WOMEN IN FIRST PREGNANCIES
AND WANTED TO UNDERSTAND WHAT
ARE PREDICTORS OF ADVERSE
PREGNANCY OUTCOMES COLLECTING A
TON OF DATA AND IN FACT
COLLECTED SO MUCH DATA THEY RAN
OUT OF MONEY AND HAD DATA ON
MATERNAL CHARACTERISTICS AND
BIOMARKERS AND ENVIRONMENTAL
FACTORS AND LOOKED AT PLACENTA
AND GENETIC ISSUES DEVELOPMENTAL
PARAMETERS OF THE FETUS AND DID
SECONDARY ANALYSIS LOOKING AT
GESTATIONAL WEIGHT GAIN AND
ACULL TURATION AND THEY RAN OUT
OF MONEY AS I SAID. THEY HAD
DATA ON 10,000 PREGNANT PEOPLE.
NEXT SLIDE.
THEY DID PUBLISH ON RESULTS.
THEY ALSO WERE ABLE TO LEVERAGE
INITIAL COHORT AND HAND OWE
EVERY TO NHLBI WHO WERE VERY
INTERESTED IN SEEING HOW DO
ADVERSE PREGNANCY OUTCOMES THAT
THEY ASSOCIATE WITH LONG-TERM
CARDIOVASCULAR MORBIDITY AND
ABLE TO RERECRUIT AND REENROLL
6,000 OF 10,000 ORIGINAL --
UNMASTERING PREGNANCY THAT DO
DAMAGE LATER IN LIFE OR IS IT
ADVERSE PREGNANCY OUTCOME THAT
IS CAUSING MATERNAL
CARDIOVASCULAR DISEASE.
THEY FOUND THAT WOMEN WITH
ADVERSE PREGNANCY OUTCOMES WERE
HIGHER AT RISK FOR HYPERTENSION
2 TO SEVEN YEARS AFTER DELIVERY
AND SIGNIFICANT ASSOCIATION OF
MATERNAL OBESITY WITH ADVERSE
PREGNANCY OUTCOMES AND
CARDIOVASCULAR HEALTH AND
ADVERSE PREGNANCY OUTCOMES WERE
MORE LIKELY TO BE MARKER OF
PREPREGNANCY CARDIOVASCULAR
DISEASE RISK AND HAVING THE
NETWORK ALLOWED THEM TO MAKE
CONCLUSIONS THAT, AGAIN, ALERTS
US TO THE FACT THAT PREPREGNANCY
HEALTH AND REDUCING BLOOD
PRESSURE BEFORE CONCEPTION
REALLY WILL DO A LOT TO REDUCE
ADVERSE OUTCOMES FOR THE MOTHER
AND BABY.
NEXT SLIDE.
I DIDN'T GET A CHANCE TO MENTION
WE ARE VERY FOCUSED ON
PREVENTION.
ACCORDING TO CDC, APPROXIMATELY
4 AND 5 OR 84% -- ENRICH IS A
ACRONYM FOR EARLY INTERVENTION
TO PROMOTE CARDIOVASCULAR HEALTH
FOR MOTHERS AND CHILDREN
ADDRESSING SOCIAL DETERMINANCE.
THIS IS LOOKING AT A HOME
VISITING PROGRAM AND COMMUNITY
ENGAGED RESOURCES TO REDUCE
BLOOD PRESSURE AND MAINTAIN
CARDIOVASCULAR HEALTH.
NIDDK IS DOING GO MOMS WHICH IS
GLYCEMIC MEDICATION METABOLIC --
IN MOTHERS AND OFFSPRING LOOKING
AT GESTATIONAL DIABETES EARLY IN
PREGNANCY PROMOTING BETTER
OUTCOMES FOR MOTHER AND BABY AND
NICHD IS IMPROVING HUB MATERNAL
PEDIATRIC PRECISION -- PREGNANT
PEOPLE AND LACTATING PEOPLE AND
LASTLY SUPPORTING CUDDLE STUDY
THAT IS LOOKING AT DRUGS AND HOW
THEY PASS INTO THE BLOODSTREAM
OF THE INFANT TO TRY TO REASSURE
PREGNANT WOMEN IT IS SAFE TO
TAKE A PARTICULAR DRUG.
PREGNANT PEOPLE AND LACTATING
PEOPLE HAVE THIS DILEMMA ALWAYS
SHOULD I TAKE A DRUG WHEN
CONVENTIONAL WISDOM SAYS DON'T
TAKE ANYTHING SAFER FOR BABY.
THAT IS NOT TRUE. IF A MOTHER
HAS ASTHMA SHE HAS TO TAKE
ASTHMA MEDICATION AND IS A
LINGERING GUILT AM I HARMING
FETUS OR BABY AND CUDDLE STUDY
IS ADDRESSING THAT ISSUE.
NEXT SLIDE.
A YEAR AGO IN NOVEMBER, A NUMBER
OF INSTITUTES AND CENTERS
SPONSORED A PATHWAYS TO
PREVENTION WORKSHOP IDENTIFYING
RISKS AND INTERVENTIONS TO
OPTIMIZE POSTPARTUM HEALTH AND
WILL BE A REPORT COMING OUT
ABOUT THIS WORKSHOP VERY SOON.
IT WAS MEANT TO IDENTIFY
RESEARCH GAPS AND WAYS THAT WE
CAN PREVENT SOME COMPLICATIONS.
YOU SEE MULTIPLE OFFICES SPONSOR
THIS PROGRAM AND NEXT SLIDE.
I COULDN'T POSSIBLY LIST
EVERYTHING THAT IS GOING ON.
WE HAVE A BROAD MATERNAL HEALTH
RESEARCH PORTFOLIO SPONSORS BY
MULT INSTITUTES AND OFFICES AND
ADVANCING INTEGRATIVE MODELS OF
CARE TO ACCESS QUALITY AND
TOGETHER WITH SOCIAL INEQUITIES
TO PREVENT ADVERSE PREGNANCY
OUTCOMES AMONG RACIAL/ETHNIC
MINORITY WOMEN SPONSORED BY
NURSING RESEARCH INSTITUTE AND
TESTING EFFICACY AND/OR
EFFECTIVENESS OF INTERVENTIONS
TO REDUCE RACIAL DISPARITIES AND
NUMBER OF INSTITUTES ARE LOOKING
AT CORRECTORS OF EXCELLENCE ON
ENVIRONMENTAL HEALTH DISPARITIES
RESEARCH AND HIGH TEMPERATURES
FOR EXAMPLE HAVE A VERY NEGATIVE
EFFECT ON PREGNANT PEOPLE.
THEN ORWH PROVIDES A PORTAL OF
ALL FUNDING OPPORTUNITIES FROM
NIH AND FEDERAL AGENCIES ALONG
WITH OTHER INFORMATION.
SO, IF YOU GO TO THAT SITE YOU
WILL GET A COMPREHENSIVE LIST
WHAT IS AVAILABLE.
NEXT SLIDE.
SO, IN SUMMARY MATERNAL
MORTALITY RATES CONTINUE TO RISE
IN THE UNITED STATES.
THIS IS FOR A VARIETY OF
REASONS. WE CAN DO SOMETHING.
THIS IS A CRISIS WE HAVE TO
ADDRESS AND PREGNANCY RELATED
DEATHS ARE PREVENTABLE.
I HOPE WE HAVE SHOWN YOU WE HAVE
A BROAD MATERNAL HEALTH RESEARCH
PORTFOLIO SUPPORTED BY MANY
INSTITUTE CENTERS AND OFFICES
AND WE ARE ADDRESSING ALL MAJOR
CAUSES OF MATERNAL MORBIDITY AND
MORTALITY AND WE TOOK A VERY
INTENTIONAL APPROACH TO WHAT WE
WANTED TO FUND AND IMPROVE BY
FOCUSING ON COMMUNITY
INVOLVEMENT THAT WE FELT HAD
BEEN PAID LESS ATTENTION IN THE
PAST AND WANTED TO MAKE A
DIFFERENCE AND TURN NUMBERS
AROUND THAT LED US TO
IMPLEMENTATION RESEARCH AND
CLEARLY ADDRESSING DISPARITIES
IS ESSENTIAL.
SO, WITH THAT, IF I COULD HAVE
THE NEXT SLIDE, I'M HAPPY TO
TAKE YOUR QUESTIONS.
THANK YOU.
>> OKAY.
>> THANK YOU FOR THAT WONDERFUL
WONDERFUL PRESENTATION THAT I
FOUND DATA QUITE ENLIGHTENING
AND I'M A PSYCHIATRIST AS YOU
MENTIONED AND SOME THINGS STUCK
OUT TO ME AND PARTICULARLY HIGH
DRIVERS THAT ARE 23% BEING DUE
TO SUICIDE OR SUBSTANCE USE.
I'M THINKING A LOT ABOUT THAT AS
A PARTICULAR INTERVENTION AND
I'M SURE YOU HAVE SEEN DATA
LOOKING AT TEENAGE GIRLS AND
RATE OF ANXIETY AND PERSISTENT
FEELINGS OF SADNESS CROSSING THE
58% LINE AND THINKING A LOT
ABOUT OPPORTUNITIES TO INTERVENE
EVEN BEFORE PREGNANCY AS A WAY
OF SORT OF MITIGATING CHALLENGES
THAT YOU MIGHT FEEL ON THE OTHER
SIDE AND FIRST HALF OF COMMENT
AND SECOND HALF SUPERVISUAL
PERSON AND THINKING ABOUT GRAPHS
YOU PUT UP WHERE OBGYNS ARE
LEAVING THE COMMUNITY AND
THINKING OF GRAPH WHERE FUNDING
WAS TO THE PROGRAM AND WONDER IF
YOU OVERLAY THAT WITH A GRAPH OF
WHERE MATERNAL DEATH WAS, HOW
WELL WOULD THAT GRAPH OVERLAP
WITH ONE OR THE OTHER?
>> SO, THERE ARE STATES THAT ARE
MUCH WORSE THAN OTHERS.
I WILL GIVE YOU TWO CONTRASTS.
ARKANSAS IS ONE OF THE WORST.
CALIFORNIA IS ONE OF THE BEST.
REASONS FOR THAT HAVE TO DO WITH
STATE PERINATAL QUALITY
COLLABORATIVES.
NOT EVERY STATE FOR EXAMPLE HAS
REVIEW OF THE MATERNAL MORTALITY
CASES.
CDC IS TRYING TO FUND ALL OF THE
STATES BUT NOT ALL STATES WANT
TO REALLY LOOK AT THAT.
CALIFORNIA HAS A NUMBER OF
STATE-BASED INTERVENTIONS AND
MAYBE A- TOOL CAN COMMENT ON
THIS BETTER THAN I CAN.
THEY HAVE EVIDENCE-BASED
INITIATIVE WHERE'S THEY -- FOR
EXAMPLE, HEMORRHAGE, WE
PARTIALLY FUNDED THEM FOR SOME
STUDIES.
THEY HAVE SHOWN THEY CAN
SIGNIFICANTLY REDUCE HEMORRHAGE
WITH SPECIFIC PROTOCOLS.
ARKANSAS IS A LITTLE MORE OF THE
WILD WEST.
ARKANSAS HAS PROBLEM OF
MATERNITY CARE DESERTS GAL OR.
I JUST FOUND OUT RECENTLY AND
MET WITH SENATOR BOZEMAN OF
ARKANSAS WHO IS GENERALLY
INTERESTED IN TRYING TO REDUCE
NUMBERS THAT I THINK THEY DID
NOT GET A VERY GOOD SCORE FROM
THE MARCH OF DIMES.
HE POINTED OUT ANOTHER PROBLEM
THEY HAVE THAT I DIDN'T REALLY
THINK ABOUT THAT IS LACK OF
AMBULANCE ACCESS.
IF WE HAVE THE BEST REMOTE
WEARABLE AND SAY THAT WOMAN IS
AT RISK AND SHE IS AN EX-COUNTY
THEY CAN'T GET AN AMBULANCE TO
HER.
THERE ARE DIFFERENT ISSUES IN
DIFFERENT STATES THAT IT IS
REALLY A STATE-BY-STATE
APPROACH.
APPROXIMATELY 50% OF PREGNANCIES
ARE SUPPORTED BY STATE MEDICAID
PROGRAMS.
THERE ARE DIFFERENT CRITERIA IN
EACH STATE HOW YOU QUALIFY FOR
THAT.
IT IS ENORMOUS WILL I COMPLEX
AND WOULD BE MUCH SIMPLER IF WE
HAD UNIVERSAL HEALTHCARE AND
CLEARCUT DELIVERABLES IN TERMS
WHAT PROTOCOLS ARE THAT WE WILL
USE.
WE ARE WORKING WITH A NUMBER OF
OTHER FEDERAL AGENCIES TO BOTH
RECOGNIZE WHERE THE BIGGER
PROBLEMS ARE AND ALSO TO
CONTRIBUTE TO PROTOCOLS THAT
WILL HAVE CHANGE AND FIRST PART
OF YOUR QUESTION WAS.
>> I WAS ASKING ABOUT MENTAL
HEALTH.
>> RIGHT.
>> AND THINKING OF INTERVENING
ON MENTAL HEALTH IN YOUNG AND
EMERGING YOUNG ADULTS.
>> YES.
>> AS A WAY OF MITIGATING ANY
FUTURE RISKS.
>> THAT IS EXTREMELY IMPORTANT.
THANK YOU FOR THAT QUESTION.
THERE HAS BEEN HISTORICALLY A
GAP ON ADOLESCENT-BASED
RESEARCH. WE HAVE TRANS NIH
PEDIATRIC RESEARCH CONSORTIUM
CONSISTING OF SENIOR
REPRESENTATIVES DOING CHILD
HEALTH RESEARCH ACROSS THE NIH.
WE AND THEY HAVE IDENTIFIED THAT
THE ADOLESCENT PERIOD IS SUCH AN
IMPORTANT PERIOD TO ADDRESS
BURGEONING PROBLEMS THAT IS
BEFORE THE PANDEMIC THAT
EVERYTHING WAS WORSENED BY THE
PANDEMIC.
WE DEFINITELY HAVE A MATERNAL
HEALTH CRISIS.
I MEAN, WE HAVE A MENTAL HEALTH
CRISIS OF PEOPLE OF ALL AGES.
>> MY FINAL COMMENT WAS WE HEARD
EARLIER ABOUT THE PRESENTATION
FROM THOSE WORKING ON UNITE.
THIS IS WHAT I THINK A
REMARKABLE OPPORTUNITY IS
THINKING ABOUT DISPARITIES TO
MAKE SURE THAT SCIENTISTS
HELPING LEAD THE WORK AND
CREATING NEW INTERVENTIONS TO
COMPETITIONS ALSO REPRESENTED
COMMUNITIES THAT ARE SO DEEPLY
IMPACTED.
>> I TOTALLY AGREE.
THANK YOU FOR THAT COMMENT.
THAT IS SO IMPORTANT.
I MEAN, ONE OF THE CENTERS FOR
THE CORRECTORS FOR EXCELLENCE
THAT WE ARE FUNDING IMPROVE IS
IN SOUTH DAKOTA.
WE FUNDED THEM BECAUSE THEY HAVE
A LONG HISTORY OF TRIBAL
RELATIONS WHICH YOU KNOW YOU
CAN'T JUST WALK INTO A COMMUNITY
AND SAY WE WILL HELP YOU.
YOU KNOW, THEY HAVE A LONG
HISTORY OF BUILDING
RELATIONSHIPS AND DEVELOPING
TRUST, WHICH HAS TO PROCEED ANY
RESEARCH.
I MEAN, I'M -- I FEEL I HAVE
LEARNED AN ENORMOUS AMOUNT IN
THE LAST FEW YEARS ABOUT HOW
COMPLEX A PROBLEM THIS IS AND
YET THERE ARE WAYS WE CAN BREAK
IT DOWN AND HELP TO SOLVE IT.
>> OKAY. THANK YOU. WE WILL
HAVE WAFA AND GARTH. THAT WILL
BE THE LAST QUESTION OF THE
SESSION.
>> THANK YOU AGAIN. VERY, VERY
IMPORTANT AND INTERESTING WORK
AND COMPREHENSIVE WORK.
I HAD A -- I THINK THAT THE
INTERESTING ISSUE IS THAT THE
VAST MAJORITY OF THESE ADVERSE
EFFECTS ARE POSTPARTUM THAT IS
KIND OF DIFFERENT IN MOST
PEOPLES PERCEPTIONS OUT THERE
TALKING ABOUT MATERNAL MORBIDITY
THEY THINK OF PREGNANCY AND
LABOR AND DELIVERY AND WONDER IF
THERE IS VALUE IN ALMOST HAVING
LIKE A CAMPAIGN OF SORTS THAT
GOES IN AND RECENTLY DELIVERED
AND FAMILIES, OF COURSE, AND THE
COMMUNITY AND THINK THAT MOST
PEOPLE DON'T THINK OF THAT
PERIOD AS BEING AN AT RISK
PERIOD AND MAJORITY OF PEOPLE
FOCUS ON PREGNANCY RISK AND
LABOR.
>> RIGHT.
>> THAT IS ONE.
SOMEHOW SHOWCASING WHY THIS IS
IMPORTANT IS VARIABLE AND OTHER
IS MOST WOMEN REALLY ARE GETTING
THEIR CARE NOT THROUGH
OBSTETRICIANS AND ARE BEGINNING
CARE IN HOPEFULLY IN PRIMARY
CARE AND I'M ALSO THINKING THAT
THEY ALMOST -- YOU HAVE TWO
PROVIDER TYPES THAT IS PROVIDERS
WITH OBSTETRICIANS IN LABOR AND
DELIVERY AND YOU HAVE TO SOMEHOW
REACH PEOPLE WHO ARE SUPPOSED TO
HOPEFULLY PROVIDE THE PRIMARY
CA
CARE.
ASKING THE QUESTION HAVE YOU
RECENTLY DELIVERED IS A KIND OF
INTERESTING ISSUE I'M A
CLINICIAN.
IT RAISES QUESTIONS IN MY OWN
MIND AS TO HOW MUCH WORK WE HAVE
TO DO WITH THE PUBLIC AND
COMMUNITY OF PROVIDERS OVERALL.
>> THANK YOU FOR THAT COMMENT.
I THINK IT IS VERY IMPORTANT
THAT THERE HAS BEEN A DISCONNECT
THAT IT MIGHT BE A LITTLE BETTER
ALONG WITH ELECTRONIC MEDICAL
RECORDS ASSUMING YOU DELIVERED
IN THE SAME HOSPITAL WHERE YOU
GET YOUR PRIMARY CARE BUT MAYBE
NOT. IT IS TRUE THAT INTERNISTS
DON'T ASK, YOU KNOW, HAVE YOU
HAD A PREGNANCY?
WHAT HAVE YOU BEEN DOING THE
LAST YEAR?
IT IS REALLY IMPORTANT.
THAT WOULD LEAD YOU TO LOOK AT
DIFFERENT THINGS WITH MILD
ELEVATION OF BLOOD PRESSURE YOU
MIGHT TREAT OR CONSIDER IT
DIFFERENTLY.
WE ARE TRYING TO EMPHASIZE THOSE
CONNECTIONS.
>> GARTH, LAST QUESTION, PLEASE.
>> THANK YOU. FIRST, THIS IS
AMAZING PRESENTATION AND YOU
TOUCHED ON ISSUES OF BIAS AND
WANT TO ACKNOWLEDGE MY THANKS
FOR DOING THAT KIND OF WORK THAT
RECOGNIZES SENSITIVITY TO THE
DYNAMIC.
THERE IS SO MUCH OF THIS THAT IS
OUTSIDE OF NIH'S CONTROL AND
INCLUDING ACCESS ISSUES BROADER
IN TERMS OF CMS AND POTENTIALLY
HRSA AND BROADER HHS VISION YOU
ARE TAPPING INTO AND ABILITY TO
INFLUENCE OTHER AGENCIES?
I FEEL IF I GRADE THIS I WOULD
BE LIKE YOU ARE KILLING IT ON
NIH SIDE AND IN TERMS OF
DIVISION HOW WE EXPAND THAT TO
OTHER PARTS THAT ARE DRIVING IT.
MAKE SENSE?
>> YEAH. THANK YOU FOR THAT
COMMENT.
OFFICE OF THE VICE PRESIDENT IS
VERY CONCERNED ABOUT MATERNAL
HEALTH AND AS IS SECRETARY
BACERA WHOSE WIFE IS AN OBGYN.
HE HAS A LITTLE BIT MORE
APPRECIATION OF SOME OF THE
ISSUES THAT I WOULD SAY THAN
PERHAPS OTHER PEOPLE IN MOST
POSITIONS.
WE ARE DOING RESEARCH.
A LOT OF THIS IS REALLY
RECOMMENDATIONS AT THE CARE
LEVEL AND ACCESS TO CARE.
WHAT I CAN TELL YOU IS WE HAVE
FREQUENT CONVERSATIONS WITH
FEDERAL AGENCIES LIKE CMS AND
HRSA AND EVERYBODY KNOWS WHAT
THE PROBLEM IS. IT IS A MATTER
OF MAKING CHANGES THAT WILL
REDUCE COMPLICATIONS AND WITH
REGARD TO BIAS AND LACK OF
RESPECT, I KNOW THAT THE CDC,
FOR EXAMPLE, HAS A CAMPAIGN
CALLED HEAR HER.
BECAUSE JUST LIKE SERENA WILL &S
EXPERIENCED, WOMEN KNOW THEIR
OWN BODIES BUT ARE NOT
NECESSARILY HEARD WHEN THEY ARE
DESCRIBING SYMPTOMS.
SO, THERE IS CERTAINLY AN EFFORT
TO COORDINATE EFFORTS ACROSS
FEDERAL AGENCIES.
IT IS A COMPLEX PROBLEM.
YOU THROW IN THE 50 STATES AS
WELL WHO ALL HAVE THEIR OWN
STATE-BASED PROGRAMS.
SO I THINK, YOU KNOW, PEOPLE
SAY, HOW DO YOU EAT AN ELEPHANT?
TAKE A LITTLE BITE AT A TIME.
NOT THAT YOU WOULD REALLY EAT AN
ELEPHANT BUT WE WANT TO PROVIDE
THE EVIDENCE THAT WILL INFORM
PROVIDERS ABOUT THE BEST WAY TO
PROVIDE CARE.
AND ALSO EMPOWERING THE
COMMUNITY ORGANIZATIONS, I
THINK, WILL HELP BECAUSE IF THEY
CAN GET MORE FUNDING AS WELL,
THEY CAN MAKE LOCAL CHANGE THAT
WILL BE AN IMPORTANT PART OF
THIS PICTURE.
>> WELL, THANK YOU ALL FOR A
GREAT DISCUSSION.
DIANA, THANK YOU VERY MUCH FOR
YOUR PRESENTATION.
WE WILL GO RIGHT AHEAD TO THE
NEXT PRESENTATION BY DR. MATT
GILLMAN ON THE ECHO PROGRAM. HE
WILL DEFINE THAT ACRONYM FOR
YOU.
>> WELL, THANK YOU VERY MUCH FOR
THE OPPORTUNITY TO TALK TO YOU
TODAY.
I SEE THIS DOES WORK.
CAN WE GO BACK TO THE TITLE
SLIDE, PLEASE?
GREAT. THANKS.
I'M HERE TO TELL YOU ABOUT THE
VALUE OF PRESENT AND MORE WITH
THE FUTURE OF THE ENVIRONMENTAL
INFLUENCES ON CHILD HEALTH
OUTCOMES OR ECHO PROGRAM THAT IS
A DEFINED RESEARCH PROGRAM
WITHIN THE OFFICE OF THE
DIRECTOR.
I HOPE THAT MY COMMENTS WILL BE
VERY COMPLEMENTARY TO WHAT DIANA
JUST SAID TALKING SIMILAR POINTS
IN THE LIFE COURSE.
I'M FOCUSING MORE ON KIDS AND
WANT TO TALK TO YOU ABOUT ECHO'S
FIRST 7 YEARS NOW AND FOCUS ON
CONTRIBUTIONS TO ENHANCING CHILD
HEALTH IN CONTEXT TO
CROSS-CUTTING THEMES AND LOOK TO
FUTURE AND HIGHLIGHT A NUMBER OF
THINGS WE ARE DOING INCLUDING
ECHO AS A NATIONWIDE RESEARCH
RESOURCE AND WILL LEAVE TIME FOR
A DISCUSSION.
I WOULD LIKE YOU TO TAKE AWAY
THESE THREE BOTTOM LINES AND
FIRST IS THAT ECHO IS A UNIQUE
LARGE NIH CHILD HEALTH PROGRAM
THAT HAS MATURED FROM STANDING
START IN 2016 WHEN COMING FROM
NIH TO BE INAUGURAL DIRECTOR AND
THIS COMMITTEE HAS BEEN VALUABLE
SINCE THE VERY BEGINNING TO GET
IT OFF THE GROUND AND SECOND IS
THAT ECHO RESEARCH IS NOW
STARTING TO ENHANCE HEALTH OF
CHILDREN ACROSS THE UNITED
STATES AND IN LARGE PART BECAUSE
WE LOOK AT LONG-TERM
IMPLICATIONS OF INFLUENCES OF
EARLIEST STAGES OF HUMAN
DEVELOPMENT AND DO IT THROUGH
COMBINATION OF INFORMATIONAL
INTERVENTION RESEARCH AND IS
POISED TO MAKE STRIDES AND
LARGER IMPACTS GOING FORWARD.
STARTING BY WETTING YOUR
APPETITE WITH A FEW OF MANY
QUESTIONS THAT INVESTIGATORS
HAVE BEEN ASKING.
ONE IS ABOUT THE NATIONWIDE
OPIOID CRISIS THAT YOU HEARD
FROM DR. BER CONTINUE OELI THIS
MORNING ABOUT THE ADVERSE
STATISTICS AND DIANA MENTIONED
THIS AS WELL IN HER TALK.
ONE OF THE ISSUES IS ABOUT
BABIES BORN EXPOSED TO OPIOIDS
IN UTEROCOMING OUT SUFFERING
FROM NEONATIVE OPIOID WITHDRAWAL
SYNDROME A DISTRESSING SYNDROME
THAT IS PREVALENT AND
RECALCITRANT AND COSTLY AND WHAT
WE CAN DO TO LOWER ITS BURDEN
AND WHAT ABOUT ASTHMA THAT IS
ONE OF THE MOST COMMON CHRONIC
CONDITIONS OF CHILDHOOD THAT IS
MORBID FOR THE CHILD AND LOSS OF
SCHOOL DAYS AND LOSS OF WORK
DAYS FOR THE PARENTS AND WE KNOW
THAT RACIAL/ETHNIC DISPARITIES
EXIST AND PERSIST.
QUESTION IS WHEN DO THEY START
AND HOW CAN WE PREVENT THEM?
A THIRD EPIDEMIC WE ARE VERY
CONCERNED ABOUT IS OBESITY
EPIDEMIC IN CHILDHOOD AND KNOW
IT IS RESISTENT TO INDIVIDUAL
INTERVENTIONS AND WHAT ARE
SOLUTIONS AND HOW WELL POLICY
SOLUTIONS WORK AND WHEN MIGHT BE
THE COMMUNITY INTERVENTIONS THAT
ARE INVOLVED WITH AND WHEN MIGHT
THEY BE MOST EFFECTIVE?
SO, BEFORE I GET TO THE ANSWERS
TO THE QUESTIONS I WILL TELL YOU
ABOUT WHAT IS COMMON TO SOME
QUESTIONS IN THE CONTEXT OF
ECHO.
ONE IS THAT WE ARE INTERESTED IN
QUESTIONS THAT HAVE A SOLUTION
ORIENTATION AND WILL ANSWERS TO
QUESTIONS INFORM POLICY PRACTICE
PROGRAMS?
WE FIND THAT SOLUTION ORIENTED
QUESTIONS ARE AT THE SORT OF
GOLDEN INTERSECTION OF THREE
FEATURES AND ONE IS THEY ARE
IMPORTANT TO END USERS AND
POLICYMAKERS AND PEOPLE THAT ARE
DEVELOPING PRACTICE GUIDELINES
AND CLINICAL TRIALISTS AND WHAT
THEY ARE INTERESTED IN AND WHAT
GAPS THEY WILL FILL TO INFORM
ACTION OF STAKEHOLDERS AND
SECOND IS THEY ARE DRIVEN BY
INVESTIGATIVE PASSION AND THIRD
IS THEY ARE FEASIBLE AND THERE
IS AVAILABLE DATA AND WHAT ELSE
IS COMMON TO QUESTIONS?
THEY TAKE ADVANTAGE OF
INNOVATIVE IDEAS AND APPROACHES
AND INCLUDING IMPORTANTLY
ENTHUSIASM OF TRAINEES OF EARLY
STAGE INVESTIGATORS AND IN THE
BOX YOU WILL SEE FOUR
INITIATIVES THAT ARE SUPPORTING
NEXT GENERATION OF RESEARCHERS.
THE THIRD IS THAT THESE TYPE OF
QUESTIONS REQUIRE A LARGE
DIVERSE COHORT FOR MULTICENTER
INTERVENTION TRIAL AND WE FIND
THAT MOST EFFECTIVE RESULTS ARE
FROM THE PRODUCT OF EFFECTIVE
COLLABORATION ACROSS MULTIPLE
DISCIPLINES.
WE ARE VERY INTERESTED IN
APPLYING THE SCIENCE OF TEAM
SCIENCE SO THE HO WHOLE IS GREAR
THAN SUM OF THE PARTS AND MANY
QUESTIONS ADDRESS HEALTH
DISPARITIES AND INEQUITIES NOT
ONLY CHARACTERIZING DISPARITIES
BUT TRYING TO EXPLAIN THEM SO
ACTIONS CAN PREVENT THE
DISPARITIES THAT OFTEN START
EARLY IN LIFE AND ENLARGE AS
KIDS GROW INTO ADULTS .
HOW HAS ECHO BEEN ADDRESSING
SCIENTIFIC QUESTIONS?
FIRST IS THAT WE ALWAYS COME
BACK TO THE TOUCHPOINT THAT IS
THE MISSION TO ENHANCE THE
HEALTH OF CHILDREN FOR
GENERATIONS TO COME.
WE DO WORK WITH NOTION THAT A
GOOD START TO LIFE CAN LAST A
LIFETIME AND OVER GENERATIONS
AND WE LOOK AT FIVE KEY
PEDIATRIC OUTCOMES WITH HEALTH
IMPACT AND PERINATAL CONDITIONS
SUCH AS PRETERM BIRTH AND OPEN
AIRWAYS AND OBESITY AND FACETS
OF NEURODEVELOPMENT AUTISM
SPECTRUM DISORDER AND ATTENTION
DEFICIT DISORDER AND ADDED A
FIFTH OUTCOME POSITIVE HEALTH
AND WELLBEING THAT IS ABOUT THE
WHOLE PERSON AND OUR
INVESTIGATORS LOOK AT OUTCOMES
NO THE ONLY ONE AT A TIME BUT
ALSO IN COMBINATION FROM BIRTH
THROUGH ADOLESCENCE.
WE DO WORK THROUGH AS I SAID
OBSERVATIONAL AND INTERVENTION
RESEARCH AND OBSERVATIONAL
RESEARCH IN ECHO COHORT AND
INTERVENTION RESEARCH THROUGH
IDEA STATES PEDIATRIC CLINICAL
TRIALS NETWORK WHERE I WILL
START COMMENTS AND
AFFECTIONATELY KNOWN AS ISPCTN
AND IMBEDDED IN INSTITUTIONAL
DEVELOPMENTAL ORDER IDEA STATES
23 STATES IN PUERTO RICO WITH
HISTORICALLY LOW LEVELS OF NIH
FUNDING AND ISPCTN COMPRISES 18
STATES WITHIN THE IDEA STATES
NETWORK.
IT IS OVERALL GOALS TO PROVIDE
ACCESS TO STATE OF THE ART
CLINICAL TRIALS AMONG RURAL OR
UNDERSERVED CHILDREN IN THESE
STATES AND TO CONDUCT TRIALS TO
BUILD CAPACITY IN THE WORKFORCE
TO BE ABLE TO CONDUCT TRIALS AND
COMPETE FOR FUTURE FUNDING.
WE HAVE A SPECIAL INTEREST IN
RURALITY.
TO DATE, MORE THAN A QUARTER OF
PARTICIPANTS IN ISBCTN TRIALS
LIVE IN RURAL AREAS ACTUALLY.
WE ARE ALSO INTERESTED IN
QUESTIONS THAT ARE ESPECIALLY
ATTUNED TO ISSUES OF RURAL
COMMUNITIES.
SO, THREE EXAMPLES ARE WE HAVE A
TRIAL ONGOING THAT LOOKS AT
INDOOR AIR QUALITY.
WILDFIRES THAT EFFECT INDOOR AIR
QUALITY OF RURAL PARTICIPANTS
TREATMENT OF OBESITY FAR FROM
SPECIALISTS AND PRIMARY CARE AND
VERY IMPORTANT OVERALL AND
OPIOID CRISIS THAT I MENTIONED
AN ALTERNATIVE TO NEXT.
ONE OF THE ANSWERS TO THE
QUESTIONS THAT I STARTED OUT WAS
RESEARCH THAT IS LOOKING AT
MITIGATING THE NEAR OPIOID
WITHDRAWAL SYNDROME AND WANT TO
TELL YOU ABOUT A STORY THE
COMMITTEE HEARD BRIEFLY LAST
YEAR THAT WE HAVE MORE DATA ON
NOW.
SUPPORTED BY HEAL INITIATIVE,
ACCELERATING CLINICAL TRIALS FOR
NANOOPIOID WITHDRAWAL SYNDROME
PARTNERSHIP AND ACT NOW COMBINES
A NETWORK FROM NICHD AND ECHO
PROGRAM TO GO FROM NO STANDARD
OF CARE TO INFORMING BEST
PRACTICES TO THESE BABIES AND
THESE BABIES ARE BORN AND THEY
ARE JITTERY AND FUSSY AND ARE
TREMULOUS AND VERY HARD TO
CONSOLE AND THEY DON'T SLEEP OR
EAT WELL.
THEY -- THEY ENDURE LONG
HOSPITAL STAYS AND MAY HAVE
ADVERSE NEURODEVELOPMENT.
SO THE AD HOC PARTNERSHIP IS A
PARTNERSHIP OF NEONATAL RESEARCH
NETWORK OF NICHD WITH A LONG
HISTORY OF DOING TRIALS AND
NEWER ISBCTN WITH ADVANTAGE OF
SITES THAT ARE HIGH OF OVERLAP
AND AREAS OF HIGH PREVALENCE OF
NOWS.
IN THIS VERY EFFECTIVE
PARTNERSHIP, OUR INVESTIGATORS
MOUNTED A TRIAL CALLED EAT,
SLEEP AND CONSOLE THAT IS AMONG
26 HOSPITALS IN 18 STATES THAT
IS RECOGNIZED AS I SAID THAT
NEONATAL OPIOID WITHDRAWAL
SYNDROME AND WITH THE OPIOID
EPIDEMIC THERE IS VERY HIGH
INCIDENCE OF NOWS.
TYPICALLY IF SYMPTOMATIC ENOUGH
CLINICIANS TREAT WITH
REPLACEMENT OF OPIOIDS.
IT IS COMPLEX ENOUGH IT IS
IMPLEMENTED IN MANY WAYS AND
THERE IS VERY HIGH SUBSTANTIAL
VARIATION AND MANAGEMENT OF
NOWS.
WITH NO EVIDENCE-BASE FOR
STANDARD OF CARE.
SO, THE IDEA WAS A SIMPLER
ASSESSMENT AND CARE METHOD FOR
BABIES AND PAY ATTENTION TO THE
ACTUAL BEHAVIORS: EATING,
SLEEPING AND CONSOLING AND
PRIORITIZE NONPHARMACOLOGIC CARE
SUCH AS HOLDING SWADDLING AND
[INDISCERNIBLE] AND NOT ONLY BY
NURSES BUT EMPOWERING CARETAKING
NURSES AS WELL AND -- LEAD BY
THREE EARLY STAGE INVESTIGATORS
IN BEGINNING OF TRIAL HAD NOT
LED MAJOR RESEARCH PROJECTS AND
BY NOW ARE WELL RECOGNIZED
ACROSS THE COUNTRY AND BY OWN
INSTITUTIONS AS REALLY EFFECTIVE
CLINICAL TRIALISTS.
IN FACT, THIS WAS A WHOLE
PRACTICE CHANGE THAT IS TOUR DE
FORCE EFFECTIVENESS
IMPLEMENTATION TRIAL THAT
INVESTIGATORS AND TRAINERS TRAIN
ACTUALLY 5,000 NURSES ACROSS THE
COUNTRY AND CUTTING TO THE
CHASE, THE RESULTS WERE
PUBLISHED IN NEW ENGLAND JOURNAL
EARLIER THIS YEAR SHOWING FAIRLY
DRAMATIC RESULTS AND UNDER USUAL
CARE BABIES ARE READY TO BE
DISCHARGED UNDER TWO WEEKS OF
AGE AND EAT, SLEEP AND CONSOLE
AND WILL INGRESTH OF HOSPITAL
STAY WAS ALMOST A HALF OF THE 8
DAYS AND PERCENT THAT RECEIVE
PHARMACOLOGIC THERAPY WAS
REDUCED FROM OVER 50% TO FEWER
THAN 20% OF BABIES AND
IMPORTANTLY SAW NO SIGNAL FOR
SAFETY OUTCOMES TO THREE MONTHS
OF AGE AND IN ADDITION THERE IS
NOT A TWO YEAR FOLLOW UP TO
FURTHER INFORM SAFETY OF EAT
SLEEP AND CONSOLE APPROACH
LOOKING AT INFANT AND FAMILY
WELLBEING AND NEURODEVELOPMENT
AND LOOKING FOR RESULTS SOON IN
THE SUMMER OF 2024.
MOST IMPORTANTLY, I THINK, THIS
TRIAL HAS EFFECTIVE POLICY AND
PRACTICE AND FOR EXAMPLE FOR THE
STATE OF WASHINGTON IS REQUIRE
IMPLEMENTATION OF EAT SLEEP AND
CONSOLE PROJECT BY JANUARY OF
2025.
EAT, SLEEP, CONSOLE TRIAL IS
EXAMPLE HOW THE ECHO MISSION IS
ACHIEVED THROUGH INFORMING
POLICY AND CLINICAL PRACTICE AND
COMING BACK TO THE NETWORK WHERE
IS IT AND WHERE IS IT GOING AND
LIKE TO POINT OUT IT IS THE ONLY
NIH MULTICENTER TRIAL NETWORK
FOCUSED ON RURAL UNDERSERVED
CHILDREN AND ADVISORY COUNCIL IS
CONCEPT OF APPROVED THIRD 5-YEAR
CYCLE AND SHOWN THAT STUDIES IN
ICBTN AND OUTSIDE AND OUTSIDE
FUNDING AS WELL AS OUTSIDE OF
THE NETWORK ARE REFLECTING
CAPACITY BUILDING IN IDEA STATES
AND WE HAVE HEARD ABOUT THE
ECOSYSTEM OF CLINICAL TRIALS AT
NIH AND ISPCTN IS PART OF THE
ECOSYSTEM OF CLINICAL TRIAL
NETWORKS INFORMING POLICY
PROGRAM AND PRACTICE AND TURNING
A FEW MINUTES TO COHORT AND
OBSERVATIONAL SIDE OF ECHO AND
COHORT AND IDEA STATE NETWORK
COVERS ALL IFFIST STATES IN DC
AND PUERTO RICO AND SCIENTIFIC
GOAL OF ECHO COHORT IS ANSWERING
SOLUTION ORIENTATIONS OF EFFECTS
OF BROAD RANGE OF ENVIRONMENTAL
INFLUENCES EXPOSURES ON CHILD
HEALTH AND DEVELOPMENT AND BROAD
RANGE OF EARLY ENVIRONMENTAL
EXPOSURES WE MEAN EVERYTHING
FROM SOCIETY TO BIOLOGY AND SOME
THINK ENVIRONMENTAL EXPOSURES AS
JUST PHYSICAL AND CHEMICAL AND
THINK OF SOCIETAL MEDICAL
PSYCHOSOCIAL BEHAVIORS AND WHAT
IS UNDER THE SKIN IN BIOLOGY AND
NECK OWE HE WE FOCUS ON PERIOD
FROM PRECONCONSIDER EPGS TO AGE
5. WHY IS THAT?
IT IS PERTURBATIONS AND EVENTS
THAT HAPPEN AT EARLY
DEVELOPMENTAL PLASTIC PERIODS
CAN HAVE LONG TERM AND LIFE LONG
INFLUENCES ON HEALTH
TRAJECTORIES.
WE HAVE DEVELOPED THE ECHO
COHORT AS A NATIONWIDE COHORT OF
MOTHERS AND CHILDREN THAT
REFLECTS DIVERSITY IN TERMS OF
AGE AND SEX AND SOCIOECONOMIC
STATUS IN RACE AND ETHNICITY AND
INVOLVES HARMONIZED DATA ON
100,000 PARTICIPANTS FROM WHAT
IS ORTHFALLY 70 EXISTING
MATERNAL HEALTH STUDIES
INCORPORATING DATA ON 65,000
CHILDREN WITH WHOM 30,000 ARE
FOLLOWUP AND ACTIVE USE OF
BIOSPECIMENS THAT ARE NEWER
ASSAY AND NEWER ASSAYS OF 55,000
OR BIOREPOSITORY GOING FORWARD
AND HUNDREDS OF INVESTIGATORS
PRODUCED 1400 PUBLICATIONS AND
EXCITED ABOUT MULTICOLLABORATIVE
AWARD PUBLICATIONS WOULDN'T BE
POSSIBLE WITHOUT FUNDING OF
COLLABORATIVE PROJECT OF ECHO
GROWING RAPIDLY AND 140 + OF
THEM AND ACTUALLY IS EARLY SENSE
THEY ARE HAVING IMPACT LOOKING
AT RELATIVE CITATION RATIO AND
MEDIAN IS NOT ABOUT 85TH
PERCENTILE AND I WILL TELL YOU
ABOUT A COUPLE STORIES AND
STARTED WITH QUESTIONS ABOUT
ASTHMA AND OBESITY AND WHAT
ABOUT ASTHMA INCIDENTS AND
DISPARITIES AND LIKE TALKING
ABOUT THE STUDY HAS A SIMPLE
PREM CIS AND ANALYSIS NUMBER 001
IN ECHO COMPENDIUM FIRST
ANALYSIS COMING THROUGH AND
RESEARCH FREQUENCY OF ASTHMA
FOCUSES ON PREVALENCE. WHO HAS
ASTHMA AND INCIDENCE DATA CAN
TELL US MORE ABOUT EATOLOGY AND
THEREFORE PREVENTION AND IN THIS
STUDY YOU CAN SEE ON THE
LEFT-HAND SIDE THAT THESE WERE
KIDS WITH NO FAMILY HISTORY OF
ASTHMA OR RIGHT-HAND SIDE KIDS
WITH FAMILY OF ASTHMA AND BLACK
CHILDREN HAD HIGHER INCIDENCE
THAN WHITE CHILDREN AND THIS
INCIDENCE WAS OCCURRING RIGHT
AFTER BIRTH AND IS PREVALENT
ONLY IN THE FIRST FEW YEARS OF
LIFE.
FACT THERE IS HIGHER RISK OF
ASTHMA IN BLACK CHILDREN AND
EARLY CHILDHOOD SUGGESTS
PRENATAL DETERMINANTS OF
DISPARITIES RISK AND
INVESTIGATORS INTERESTED IN
POTENTIAL IMPACT OF AIR
POLLUTION AS ONE SUCH POTENTIAL
DETERMINANT THAT IS EXCELLING
AND SOCIALLY PATTERNED AND THIS
ANALYSIS TAKES ADVANTAGE OF GEO
SPATIAL RESEARCH THAT IS PART
AND PARCEL OF ECHOANALYSIS AND
COLLECTING DATA ON PARTICIPANTS
CONSTRUCTING INDIVIDUAL
RESIDENTIAL TIMELINES AND
GEOCODE THEIR ADDRESSES AND
OVERLAY THEIR DATA BASES AND
WITH AIR POLLUTION IT IS
POSSIBLE WITH SATELLITE AND
GROUND MONITORING TO GET
ESTIMATES OF PM2.5 AND
POLLUTANTS EVERY DAY THROUGHOUT
PREGNANCY FROM PERIOD OF 2,000
TO THE PRESENT THAT ALLOWS US TO
ASK QUESTIONS LIKE IS THERE A
CRITICAL PERIOD OF EXPOSURE TO
AIR POLLUTION THAT IS ESPECIALLY
DELETERIOUS FOR DEVELOPMENT OF
ASTHMA?
MIGHT THINK IT IS IN LATE
PREGNANCY AND DIFFERENTIATION --
THAT IS WHEN PARTICLES GET INTO
SMALLWAYS -- SMALL AIRWAYS AND
ECHO STUDIES SUGGEST THAT MID TO
LATE PREGNANCY EXPOSURE TO PM
2.5 IN FIRST STARTY AND
ULTRAFINE PARTICLES LESS THAN A
MICRON IN DIAMETER ARE
ASSOCIATED WITH CHILDHOOD WHEEZE
AND ASTHMA CHILDHOOD ASTHMA --
SO-CALLED CRITICAL PERIOD FOR
THIS DEVELOPMENT AND ARE NO
REGULATIONS OF EPA ON VERY
SMALLEST PARTICLES. THIS
EVIDENCE COULD LEAD TO NEW
REGULATIONS THAT IS PART OF
POLICY IMPACT THAT MIGHT HELP TO
EXPLAIN EARLY CHILDHOOD RACIAL
DIFFERENCES IN ASTHMA INCIDENCE.
SECOND SET OF EXAMPLES FROM ECHO
COHORT IS ABOUT REDUCING
CHILDHOOD OBESITY. THEY TAKE
ADVANTAGE LOOKING AT GEO SPATIAL
APPROACHES.
WITH SAME APPROACH WE CAN LOOK
AT DIFFERENT DATA BASES SUCH AS
OPPORTUNITY AND SOCIAL
VULNERABILITY ABOUT I LOOKING AT
CENSUS DATA.
ONE INDICES THAT INVESTIGATORS
HAVE LOOKED AT THAT IS IN AN
EARLY STAGE INVESTIGATOR IS
CALLED CHILDHOOD OPPORTUNITY
INDEX THAT IS 29 INDICATORS IN
NEIGHBORHOOD CONDITIONS
IMPORTANT FOR CHILDREN'S HEALTH
IN THREE DOMAINS EDUCATION,
HEALTH ENVINEMENT AND SOCIAL AND
ECONOMIC.
WHAT THEY SHOWED IN THIS
ANALYSIS LOOKING AT BMI AND
CHILDHOOD OBESITY TRAJECTORIES
HIGHER COI CHILDHOOD OPPORTUNITY
INDEX PROJECTED LOWER
TRAJECTORIES OF BMI AND OBESITY
ACROSS CHILD ADLESSENCE YOU SEE
UP TO 20 YEARS OF AGE AND HIGH
COI CATEGORY WITH LOWEST
INCIDENCE AND LOW COI CATEGORY
WITH HIGHEST INCIDENCE AND ONE
OF THE INTERESTING THINGS ABOUT
THIS ANALYSIS IS THAT INDEX AT
BIRTH PREDICTED OUTCOMES BETTER
THAN DID INDEX LATER IN
CHILDHOOD EITHER IN INFANCY OR
EARLY CHILDHOOD OR MID
CHILDHOOD.
TAKEAWAY MESSAGES ARE
NEIGHBORHOOD FACTORS PREDICT BMI
TRAJECTORY AND OBESITY RISK AND
ASSOCIATIONS STRONGER WITH
EXPOSURE AT BIRTH SUGGESTS AGAIN
A SENSITIVE PERIOD AROUND TIME
OF BIRTH OR BEFORE THAT COULD BE
PARTICULARLY AMENABLE TO
COMMUNITY INTERVENTIONS STARTING
EARLY IN THE LIFE COURSE.
SECOND EXAMPLE IN OBESITY IS
ABOUT EVALUATING A POLICY CHANGE
THAT IS SO-CALLED NATURAL
EXPERIMENT AND ECHO CAN DO THIS
RECRUITMENT TO ECHO COHORTS
START DECADES AGO. WE HAVE
INFORMATION ACROSS SECULAR TIME
IN THESE ECHO COHORTS.
2010 CONGRESS PASSED HEALTHY
HUNGER FREE KIDS ACT AND SET
NUTRITION STANDARDS FOR SCHOOL
LUNCH STANDARDS THAT EFFECTS
TENS OF MILLIONS OF CHILDREN
ACROSS US AND TONS OF THIS ACT
SUGGESTED ASSOCIATED WITH BETTER
DIETARY QUALITY AND EVIDENCE IS
SLIM ON EFFECT AND OBESITY
RATES.
SO, EARLIER THIS YEAR OUR
INVESTIGATORS PUBLISHED THIS
PAPER SHOWING THAT AFTER MAXIMUM
INTAKE THAT MAXIMUM UPTAKE OF
IMPLEMENTATION OF THIS ACT IN
2016 AND 17 THAT THERE WAS A
REDUCTION IN BMI RATES YOU CAN
SEE IN THE DOWNWARD LINE
COMPARED TO INCREASING RATES OF
BMI BEFORE THAT.
SO, INDEED, THERE IS DECREASE IN
BMI IN FIRST FEW YEARS FOLLOWING
FULL [INDISCERNIBLE] OF THAT ACT
THAT IS REVERSAL OF THE TREND
DURING DECADE BEFORE
IMPLEMENTATION OF THE PROGRAM
SHOWING NATIONAL POLICIES LIKE
HEALTHY HUNGER FREE KIDS ACT CAN
HAVE LIKELY BENEFICIAL EFFECTS
ESPECIALLY ON CHILDREN AND LOWER
INCOME FAMILIES AND LAST PART OF
MY TALK I WILL TELL YOU ABOUT
THE FUTURE OF THE ECHO COHORT.
WE STARTED SECOND SEVEN YEARS A
FEW MONTHS AGO.
GOAL IS TO EXTEND AND EXPAND
ECHO COHORT TO FURTHER
INVESTIGATE INFLUENCES OF BROAD
RANGE OF EARLY EXPOSURES FROM
SOCIETY TO BIOLOGY AND NOW
INCLUDING PRECONCEPTION PERIOD
ON CHILD HEALTH.
AND WE ARE ESPECIALLY EXCITED
ABOUT PRECONCEPTION PERIOD AND
HEARD A COUPLE COMMENTS ON IT IN
PREVIOUS TALK AND SOMETIMES
SEEMS THAT PREGNANCY IS TOO LATE
AND FOR EXAMPLE LATE STATUS OF A
WOMAN COMING INTO PREGNANCY IS
HIGHLY ASSOCIATED WITH CHILDHOOD
OUTCOMES AND MAYBE TOO EARLY TO
INTERVENE DURING PREGNANCY AND
NEED TO KNOW WHAT DETERMINANTS
OF CHILD HEALTH ARE STARTING
BEFORE PREGNANCY AND IN SECOND
SET WE AIM TO CREATE LARGE
DIVERSE COHORT FROM
PRECONCEPTION TO ADLESSIENTS AND
ONE OF LARGEST LONGITUDINAL
STUDIES IN THE WORLD AND
FOLLOWING UP TO KIDS TALKING
ABOUT -- RECRUITING 30,000 NEW
PREGNANCIES AND WAY THAT WE ARE
CREATING POST -- THE
PRECONCEPTION PHASE IS FROM POST
MODERN PERIOD OF THESE INITIAL
PREGNANCIES.
WE ARE EXCITED ABOUT DOING THIS
AND INVESTIGATORS WILL TRY TO
RECRUIT WITHIN A FEW WEEKS UNDER
NEW STANDARDIZED DATA AND
BIOSPECIMEN COLLECTION PROTOCAL
AND SEEING NEW PHASE OF ECHO
COHORT WE HAVE EXPANDED AND
SCIENTIFIC OPPORTUNITIES AND
TOLD YOU ABOUT WORK AND HEALTH
DISPARITIES AND EQUITY AND
HEALTH TRAJECTORIES AND TALKED
ABOUT NATURAL EXPERIMENT AND
WORK LOOKING AT COVID-19
PANDEMIC AND WHAT EFFECTS ARE ON
KIDS AND PARENTS AND EXPOSURES
TO CHEMICALS AND IN CRITICAL
PERIODS AND LEGACY CHEMICALS
REGRETTABLE REPLACEMENTS AND
NOVEL CHEMICALS WE DON'T KNOW
CHARACTERISTICS OF IT AND
INTERESTED IN BIOLOGIC PATHWAYS
EPIGENETICS AND APPLICATIONS OF
ARTIFICIAL INTELLIGENCE TO
REALLY GET A HOLD OF BIG DATA.
SOCIAL DETERMINANTS OF HEALTH.
AS KIDS AGE WE CAN LOOK AT
RESILIENCE AND USABILITY AND
MEDIA USE HAS COME TO THE FORE.
PRECONCEPTION EXPOSURES WHETHER
SOCIAL FACTORS BEHAVIORS WEIGHT
CHANGE AND CHEMICALS AND OTHERS.
AND FINALLY ECHO IS EMERGING AS
NATIONWIDE RESOURCE AND DIANA
TOLD YOU ABOUT DATA SPECIMEN
HUB.
DATA FROM COHORT AND
INTERVENTION TRIALS ARE NOW
HOUSED ON THE DATA AND SPECIMEN
HUB AT NICHD THROUGH CONTROLLED
ACCESS PUBLIC USE DATA BASE
THROUGH BROADER SCIENTIFIC
COMMUNITY. ACCESS REQUESTS
UNDERGO A FAIRLY SIMPLE
ADMINISTRATIVE REVIEW AND WE
RELEASED FUNDING OPPORTUNITIES
TO INCENTIVIZE THEIR USE AND
DATA FROM THE COHORT INVOLVES
60,000 PARTICIPANTS IN EXPOSURE
DOMAINS AND HAPPY TO SAY IN
EARLY PHASES OF THIS WE HAVE 40
USER REQUESTS THAT ARE EXPANDING
RAPIDLY AND IN OVERALL SUMMARY
AND CONCLUSIONS, ECHO IS MAJOR
INVESTMENT UNDERSTANDING EARLY
ENVIRONMENTAL INFLUENCES ON
CHILD HEALTH RELATING TO FIVE
KEY PEDIATRIC OUTCOMES I
OUTLINED AND EVIDENCE GAPS ON
LONG TERM INFLUENCES PRENATAL
CHILDHOOD FACTORS INVESTIGATORS
TAKING ADVANTAGE OF SAMPLE SIZE
AND DIVERSITY TO ASSIST WITH
GENERALIZABILITY.
AS I MENTIONED WE HAVE NOVEL
PRECONCEPTION PHASE IN THE
SECOND CYCLE AND ADDITION IDEA
STATES PEDIATRIC CLINICAL TRIALS
NETWORK ADDRESSING PRACTICE AND
PROGRAMS FOR RURAL AND
UNDERSERVED KIDS AND BOTH SIDE
OF THE PROGRAM WE DEVELOPED
NATIONWIDE RESEARCH RESOURCE FOR
BROADER SCIENTIFIC COMMUNITY.
THANK YOU.
>> THANK YOU VERY MUCH, MATT.
SO, WE WILL BEGIN WITH COREY.
>> >> THANK YOU SO MUCH.
INFORMING THE PRESENTATION AND I
HAVE A TWO-PART QUESTION.
IN TERMS OF THE TARGET
DEMOGRAPHICS ON SLIDE 32,
REFLECTING DIVERSE SEX, AGE,
SOCIOECONOMIC STATUS AND RACE
AND ETHNICITY.
MY QUESTION IS KIND OF CHILDREN
WITH DISABILITIES HAS THAT BEEN
IDENTIFIED AS A TARGET
DEMOGRAPHIC AND SECOND PART OF
THE QUESTION IN TERMS OF
INTERSECTIONALITY IN TERMS OF
DEMOGRAPHIC VARIABLES TO DIG
DEEP NEAR WHERE PROBLEMS IN
TERMS OF OBESITY AND OPIOID
EPIDEMIC AND HAS THERE BEEN
EFFORT IN TERMS OF LOOKING AT
INDIVIDUALS WITH MULTIPLE SOCIAL
IDENTITIES IN TERMS OF
INTERSECTIONALITY INCLUDING
DISABILITY?
>> THANK YOU VERY MUCH FOR THAT
QUESTION.
AS A PARENT OF NEURODIVERGENT
KIDS MYSELF I'M VERY INTERESTED
IN DISABILITIES AND ORIGINS AND
A GROUP OF OUR INVESTIGATORS HAS
PUT THAT IN THE FORE RECENTLY IN
ECHO AND SECOND CYCLE THERE WILL
BE QUESTIONS ON DISABILITIES NOT
ONLY AS PART OF NEURODEVELOPMENT
OUTCOMES BUT WIDER DISABILITIES
AS WELL AND WE HAVE AN ACTIVE
DEIA WORKING GROUP WITHIN THE
ECHO COHORT AS WELL AS ISB
INSIGHT AND EXTREMELY INTERESTED
IN ISSUES OF INTERSECTIONALITY
AND WITH VERY A SPECIALIZED
GROUP OF PEOPLE INTERESTED IN
PSYCHOSOCIAL EXPOSURES IN WHICH
THAT IS BEING IMBEDDED.
THANK YOU FOR THAT QUESTION.
>> OKAY. NOW, I HAVE BRIAN,
ATOOL, HOWARD AND
[INDISCERNIBLE].
>> THANK YOU. THAT IS REALLY
IMPRESSIVE SCIENCE THAT COMES
OUT OF THE COHORTS SO FAR AND
DIVERSITY AND REPRESENTATION OF
THE PARTICIPANTS AND ONE THING I
WONDER ABOUT IS SOMEBODY THAT
DOES PRAGMATIC AND
IMPLEMENTATION TRIALS HOW YOU
APPROACH SITE SELECTION FOR
ENROLLMENT INTO THE COHORT OR
MORE PARTICULARLY TO THE
CLINICAL TRIALS AND ONLY REASON
I ASK IS YOU KNOW IN WORKING
WITH COMMUNITY-BASED
ORGANIZATIONS AND DIFFERENT
KINDS OF ORGANIZATIONS, YOU
KNOW, THE CLINICS THAT HAVE TIME
AND CAPACITY TO APPLY TO AN RFP
TO IMBED RESEARCH WITHIN THEIR
OPERATIONS WHEN OFTEN TIMES IF
IT IS A LOW RESOURCE OR OVERHEAD
ORGANIZATION IT CAN REALLY BE A
CHALLENGE TO PARTICIPATE IN
CLINICAL TRIALS AND AT THE SAME
TIME ARE CLINICS THAT ARE MOST
INTERESTED IN STUDYING IN TERMS
OF IMPLEMENTATION AND SERVICE TO
MINORITIES IN UNDERSERVED
COMMUNI
COMMUNITIES AND ANYTHING YOU
CAN SAY ABOUT SELECTION TO
INSIGHTS AND WOULD BE EXCELLENT
TO HEAR.
>> THANKS FOR THE QUESTION AND
ADDRESSING THAT ON TRIAL
NETWORK SLIDE.
>> KEY ASPECT TO INCREASE
CAPACITY DOING TRIALS AND RURAL
FOR UNDERSERVED KIDS.
MANY OF OUR -- WELL, I WILL
START BY SAYING THAT SOME SITES
ARE NOT MEDICAL SITES.
WE HAVE A SITE AT HEALTHCARE
ORGANIZATION AND SITE AT PUBLIC
HEALTH SCHOOL AND SITE AT
ALASKAN TRIBAL HEALTH
CONSORTIUM. THESE ARE OUTSIDE
OF THE USUAL TERTIARY CENTERS IN
SETTINGS IN ISBCTN THESE ARE
UNDERRESOURCED EVEN IF THEY ARE
UNIVERSITIES IN A MAJOR CITY
THEY TEND TO BE UNDERRESOURCED
COMPARED TO MORE PRIVILEGED
SITES WE THINK ABOUT.
THAT IS ONE THING AND SECOND
THING IS TO A COMMUNITY ADVISORY
BOARD AND OTHER OUTREACH AND
OUTREACH TO ACTUALLY CLINICAL
SITES THAT ARE FAR FROM THE
CENTERS THAT WERE ABLE TO
RECRUIT PARTICIPANTS NO THE ONLY
FROM RURAL MEDICAL PRACTICES BUT
ALSO FROM OUTSIDE RURAL MEDICAL
PRACTICES AND EXAMPLE OF THAT IS
BREATHE STUDY THAT IS GOING ON
RIGHT NOW.
THIS IS A STUDY TO LOOK AT
EFFECTIVENESS OF HELPI FILTERS
TO REDUCE INDOOR AIR POLLUTION
AND THEREBY REDUCE RESPIRATORY
SYMPTOMS IN INFANTS SUFFERING
FROM BRON KEY OELITIS IN FIRST
YEAR OF LIFE AND THAT STUDY
FINISHED RECRUITMENT THREE
MONTHS AHEAD OF SCHEDULE THAT IS
TAKEN UP BY FAMILIES MOST
EFFECTED BY THESE AND WE ARE
BEING SUCCESSFUL IN ISBCTN IN
RECRUITING UNDERREPRESENTATIVE
AND UNDERSERVED POPULATIONS AND
SOMETHING WE TALK ABOUT ALL THE
TIME. I CAN TELL YOU WE TALK
ABOUT IT NOT ONLY IN PRINCIPLES
BUT DOWN TO WHAT IS FWA AND HOW
YOU GET A CONTRACT DOWN TO THE
RURAL CLINIC AND THINGS LIKE
THAT AND IMPLEMENTATION IS WHERE
RUBBER MEETS THE ROAD AND HOW
YOU DO AN IRB AND THOSE
QUESTIONS.
I WILL LEAVE IT AT THAT AND GO
TO THE NEXT QUESTION.
>> SO, GREAT WORK AND
PRESENTATION.
FOR THE RECORD, I'M SLIGHTLY
BIASED I WAS ON YOUR ADVISORY
BOARD FOR TWO MEETINGS, I GUESS.
GIVING YOU MORE CREDIT, YOU SAID
IN 2016 IF I REMEMBER THAT IS
COMING OUT OF THE ASHES OF THE
NATIONAL CHILDREN'S STUDY
CANCELLED IN 2014 MAKING 7 YEARS
OF PROGRESS AND BASED ON THAT
STARTING POINT THAT IS
REMARKABLE.
MY CURIOSITY IS ABOUT RETENTION
RATE OF PATIENTS AND FAMILIES
AND HOW LONG THEY STICK AROUND
IN THE STUDY AND HOW DO YOU KEEP
THEM STICKY WITH THE PROGRAM?
WE WILL HEAR ABOUT ALL OF US
RESEARCH PROGRAM TOMORROW. I
SEE SIMILARITIES AND CURIOUS HOW
YOU MAINTAIN RETENTION.
>> YEAH. THANK YOU FOR THE
QUESTION.
YOU JUST MENTIONED A STUDY THAT
WON'T BE NAMED AND WON'T HAVE
MORE QUESTIONS ON IT.
[LAUGHING].
YEAH.
UM, SO I WILL FIRST START BY
TALKING ABOUT OUR NETWORK THAT
IS SHORT-TERM RETENTIONS AND
WANT TO SAY I HAVE BEEN REALLY
IMPRESSED BY THE ABILITY THAT
INVESTIGATORS NOT ONLY
INVESTIGATORS BUT RESEARCH
COORDINATORS THAT ARE REALLY
PEOPLE WHERE RUBBER MEETS THE
ROAD TO MAINTAIN PARTICIPANTS
AND FIRST STUDY WAS A
PHARMACOKINETIC STUDY OF VITAMIN
D SUPPLEMENTATION AND THOUGHT NO
ONE WILL COME BACK SIX BLOOD
DRAWS AND 99% RETENTION ON
NETWORK SIDE.
COHORT SIDE WE HAVE CENTRALIZED
AND ALSO WE HAVE VERY
EXPERIENCED INVESTIGATORS FOR
USING ALL OF THEIR WHILES TO
IMPROVE RETENTION AND THINKING
ABOUT COHORT STUDIES, I THINK
THAT ONE OF THE UNKNOWNS OF GOOD
COHORT STUDIES RETENTION AND
ACCURATE AND COMPLETE DATA
COLLECTION.
IN FACT, RETENTION IS WE HAVE
GOALS, OBJECTIVES INDICATORS AND
TARGETS EVERY YEAR AND ONE GOAL
IS ABOUT RETENTION AND UNDER
THAT ONE GOAL IS RETENTION OF
UNDERSERVED AND MINORITY
POPULATION AND I'M REALLY HAPPY
TO SAY WE MAINTAINED RETENTION
OF OUR HISPANIC AND NON --
NON-HISPANIC WHITE POPULATIONS
AT VIRTUALLY SAME RATES AS ALL
OF THE OTHERS.
>> DR. GILLMAN THANKS FOR THE
PRESENTATION. YOU HAVE SHOWN
NOTABLE SUCCESS FOR ANY AND
RESOURCE WHICH IS LONGITUDINAL
TRACKING THAT MIGHT THEN ALLOW
YOU TO LOOK AT IMPACT OF
CHILDHOOD HEALTH ON ADOLESCENT
OR ADULT HEALTH. IS THAT IN
YOUR SCOPE AND HAVE YOU THOUGHT
ABOUT HOW YOU MIGHT GO IN THAT
DIRECTION POSSIBLY?
>> THE ORIGINS OF ADLESSIENT
HEALTH AT EARLIEST STAGES OF
HUMAN DEVELOPMENT AND IN
CHILDHOOD IS IN THE PURVIEW OF
ECHO.
PERSONALLY, I CAME FROM A
PARADIGM OF LIFE-LONG HEALTH AND
FETAL ORIGINS OF ADULT DISEASE
AND MANY OF OUR FUNDED
INVESTIGATORS ARE GETTING
ADDITIONAL FUNDING TO FOLLOW
CHILDREN AFTER THEY TURN 21 AND
THEY ECHO PROGRAM ITSELF STOPS
AT AGE OF 21.
>> OKAY.
>> I WAS ALSO THINKING ABOUT
SYNERGY AND FOR EXAMPLE ECHO
STUDY MIGHT LEAD INTO ABCD STUDY
AND ADOLESCENT COGNITIVE
DEVELOPMENT AND THINKING ABOUT
OPPORTUNITIES TO IMPROVE IT UPON
TOTALLY INTENDED AND IN IMPROVE
SESSION WE WERE HEARING ABOUT
HIGH RISKS OF MATERNAL MORTALITY
DUE TO MENTAL HEALTH AND
SUBSTANCE USE AND DURING
PRESENTATION PRESENTED DATA OF
NEONATAL OPIATE WITHDRAWAL
SYNDROME AND -- I'M THINKING IF
WAYS TO GET TOGETHER AND SAW
PRESENTATION EARLIER AROUND
SUBSTANCE USE DISORDERS AND IS
THERE A FORUM WHERE EVERYBODY
GETS IN THE ROOM FOR A DAY AND
SAY WE ARE STUDYING THE SAME
PROBLEM FROM A DIFFERENT ANGLE
AND NEED SOME GRANT PROPOSAL TO
GO OUT AND SOMEBODY TAKES AND
POOLS DATA AND MINES IT AND
FIGURES OUT HOW TO CREATE DATA
STRUCTURES OR OPPORTUNITIES OF
SUBJECT GROUPS TO PROBE HOW YOU
LOOK AT THIS TOGETHER AND HAVE
COMMON INTERVENTIONS AND
WONDERING IF THERE IS A
MECHANISM FOR INTEGRATION OF ALL
THESE THEMES THAT WE KEEP SEEING
SHOW UP.
>> THANK YOU FOR THAT QUESTION.
I HAVE MANY ANSWERS TO YOUR
QUESTION AND I WILL GIVE YOU A
COUPLE THAT ONE IS TOPICALLY
THAT ALTHOUGH ECHO HAS CHILD
HEALTH IN ITS NAME WE SEE
MATERNAL HEALTH IS ALONG THAT
SAME SPECTRUM AND NOW THAT WE
WILL HAVE A PRECONCEPTION PHASE
WE HAVE AN OPPORTUNITY TO LOOK
AT MATERNAL OUTCOMES ESPECIALLY
DURING PREGNANCY THAT IS A
LINKAGE RIGHT THERE.
SECOND THING, WE SHARE PROTOCOLS
BACK AND FORTH AMONG DIFFERENT
STUDIES AND WHETHER IT BE ALL OF
US CHILD STUDY OR ABCD OR HBCD
OR OTHER STUDIES LOOKING AT SAME
PART OF THE LIFE COURSE AND WE
SHARE PROTOCOLS BACK AND FORTH
AND THIRD THING IS WE HAVE TRANS
NIH GROUPS AND DIANA MENTIONED
NPERC AND WE HAVE ADULTHOOD
COLLOQUIUM AND NUMBER OF AREAS
WE REDUCE SHARE AND SO WE CAN
SYNERGIES AND BE COMPLEMENTARY
AND LEVERAGE EACH OTHER'S
PROGRAMS.
>> I WOULD SAY THAT ONE OF THE
BIGGEST CHANGES OVER THE LAST 20
YEARS AS I KIND OF -- THERE IS
JUST MORE OPENNESS TO DOING
THAT.
I THINK YOU HAVE SEEN, YOU KNOW,
A FEW REALLY GOOD EXAMPLES OF IT
TODAY.
MORE IMPORTANTLY, THEY OPENNESS
TO CONTINUE TO DO MORE GOING
FORWARD.
I THINK THAT IS WHAT GREAT
LEADERSHIP IS ABOUT AND IT IS
NOT, YOU KNOW, IT IS NOT MINE
AND LET'S ALL WORK AS ONE GROUP.
YEAH. PLEASE.
>> YEAH. THAT IS ANOTHER PLACE
WHERE I THINK THAT THE
OPPORTUNITY FOR DATA SCIENCE AND
MACHINE LEARNING COME INTO PLAY
WHEN DATA SETS ARE COLLECTED AND
BEING ABLE TO POOL THEM TOGETHER
TO MAKE OBSERVATIONS AND FIND
PATTERNS YOU WOULDN'T OTHERWISE
FIND LOOKING AT ONE OF THE
SECTIONS SO.
>> THANKS FOR THE COMMENT.
>> GREAT.
>> YEAH. ALONG THE SAME LINES,
THANK YOU FOR THE PRESENTATION.
VERY IMPORTANT WORK THAT IS
RELATED EXACTLY TO THE LINKAGE
OF DATA SETS THAT WILL IMAGINE
MIGHT HAVE COMMON POOL OF
PARTICIPANTS.
JUST WANTING TO DRAW ATTENTION
TO THAT.
THAT IS BETTER THAN HAVING
PARTICIPANTS ENROLL LATER ON.
BUT I'M HEARING THAT THERE IS A
LOT OF SYNERGY.
IT IS -- THERE IS A PLAN OF
CONVERGENCE.
>> YEAH. THANK YOU A LOT FOR
POINTING THAT OUT. I REALLY
APPRECIATE YOUR COMMENT.
>> YES, PLEASE.
>> I'M SITTING HERE OF COURSE
THINKING OF THE PRIOR
PRESENTATION.
SORRY.
THE PRIOR PRESENTATION AND THIS
PRESENTATION AND IN SOME OF THE
CONTEXT PARTICULARLY IN GLOBAL
WORK, YOU OFTEN RECRUIT FAMILIES
RATHER THAN STUDYING MOTHERS OR
CHILD'S. YOU KNOW?
I'M CURIOUS WHETHER EITHER GROUP
HAS CONSIDERED THE IDEA OF KIND
OF RECRUITMENT OF FAMILIES WHICH
I THINK WOULD BE OR OFFER
ENORMOUS OPPORTUNITIES TO LOOK
AT SIBLINGS OR OTHER KINDS OF
QUESTIONS.
>> THANK YOU A LOT FOR THAT
QUESTION.
WE ARE VERY INTERESTED IN FAMINE
FLUNSS AND WE DO ASK ABOUT THOSE
AND WAY WE ARE INCLUDING
FAMILIES IN SECOND PHASE OF ECHO
IS IN PRECONCEPTION PHASE WE ARE
RECRUITING THE CONCEIVING
PARTNER AND NOT ONLY IS THE
PERSON WHO HAD BEEN PREGNANT BUT
IS ALSO THE CONCEIVING PARTNER.
WE ARE THINKING ABOUT THAT
MOSTLY IN TERMS OF BIOLOGY AND
ALSO SOCIAL FACTORS.
>> OKAY. WE ARE JUST ABOUT AT
TIME.
WE WILL GIVE YOU A 17 OR 18
MINUTE BREAK.
WE WILL RECONVENE AT 3 O'CLOCK
SHARP.
OKAY?
SO, WE WILL SEE EVERYBODY AT 3.
THANK YOU. THANK YOU VERY MUCH, MATT.
[BREAK] WE HAVE AS YOU KNOW
SEVERAL WORKING GROUPS BEING
REPORTED OUT AT THIS ACD MEETING
AND FIRST THIEVES WILL NOW BE
PRESENTED. THIS IS THE WORKING
GROUP ON CATALYZING THE
DEVELOPMENT AND USE OF NOVEL
ALTERNATIVE METHODS TO ADVANCE
BIOMEDICAL RESEARCH. IT WAS
CO-LED BY ACD MEMBER HOWARD
CHANG AND LYRIC JORGENSON YOU
HEARD TODAY WHO IS NOW ASSOCIATE
DIRECTOR NO LONGER ACTING OF
SCIENCE POLICY AT NIH. ARE YOU
TAKING OFF LYRIC OR HOWARD?
HOWARD, GREAT.
>> GREAT. THANK YOU FOR THE
OPPORTUNITY ON BEHALF OF THE
WORKING GROUP AND TODAY MY
CO-CHAIR LYRIC JORGENSON WILL
PRESENT WORKING GROUP
RECOMMENDATIONS TO HELP WITH NIH
INVESTMENT IN NOVEL ALTERNATIVE
METHODS OR NAMS AND DEVELOPMENT
OF BIOMEDICAL RESEARCH. NEXT
SLIDE, PLEASE.
IN THE NEXT HOUR WE WILL TALK TO
BUT THE MOTIVATION AND FORMATION
OF THIS WORKING GROUP AND THE
APPROACH THAT OUR WORKING GROUP
TOOK TO COME UP WITH
RECOMMENDATIONS AND SPECIFIC
RECOMMENDATIONS AND SOME
EXAMPLES OF TRANSFORMATIVE
PROJECTS THAT MIGHT BE POSSIBLE
WITH THESE NEW TECHNOLOGIES.
NEXT SLIDE, PLEASE.
ALL RIGHT. THE IMPETUS FOR THIS
EFFORT IS THE IDEA REALLY THAT
TECHNOLOGY DRIVES OPPORTUNITY.
SCIENCE IS MADE POSSIBLE BY NEW
TOOLS AND EXAMPLES THAT INCLUDE
TRANSFORMATIVE TECHNOLOGIES LIKE
CRISPR AND WE HEARD ABOUT AI
TODAY AND ALSO FOR EXAMPLE ABOUT
STUDYING NOISE SUCH AS
[INDISCERNIBLE] IN THE DISH.
BY INVESTING IN ADDITIONAL AND
FIBROUS TOOLS, WE MAY BE ABLE TO
ENABLE RESEARCHERS TO USE MOST
EFFECTIVE AND SUITABLE TOOLS
ANSWERING RESEARCH QUESTIONS.
SO, ANIMAL MODELS WILL CONTINUE
TO HAVE VITAL RESEARCH AND
ALTERNATIVE METHODS AND GREAT
OPPORTUNITIES IN SOME AREAS.
THERE IS GREAT INTEREST THAT IS
EVIDENT ACROSS THE NIH AND
FEDERAL GOVERNMENTS AND
BIOMEDICAL RESEARCH ENTERPRISES
THAT MANY GROUPS ARE TAKING ON
ASPECTS ON SYNERGISTIC EFFORTS
AND GIVING YOU AN EXAMPLE AT THE
FDA, THERE ARE ALTERNATIVE
METHODS GROUP AND FDA
MODERNIZATION ACT 2.0 DECLARED
THEY NO LONGER REQUIRED NEW
DRUGS OR ANIMAL TESTING BEFORE
TESTING IN HUMAN CLINICAL TRIALS
AND FROM NATIONAL ACADEMIES,
THEIR REPORT AND NASM REPORT ON
NON-HUMAN FINDING MODELS IN
BIOMEDICAL RESEARCH SELECT NEW
ALTERNATIVE METHODS CAN BE USED
FOR NEW BIOLOGICAL FUNCTIONS OF
WORK THAT IS NEEDED.
NEXT SLIDE, PLEASE.
AT THE NIH SPECIFICALLY, NIH OF
COURSE STRATEGICALLY APPROACHES
INVESTING AREAS THAT ARE WIPED
WITH PROMISED CATALYZED RESEARCH
AND AMOUNT INVESTMENT FROM NIH
ALTERNATIVES OF FACULTY INCREASE
AND EXPLOSION OF WORK BEING DONE
USING ALTERNATIVE METHODS IS
IMPORTANT TO UNDERSTAND WHERE
THE BIOMEDICAL COMMUNITY IS AT
THIS MOMENT AND CHALLENGES AND
OPPORTUNITIES MAY EXIST AND WHAT
KEY INVESTMENTS ARE NEEDED TO
MAXIMIZE POTENTIAL USING
TECHNOLOGIES TO ENHANCE HUMAN
HEALTH.
NEXT, PLEASE.
OKAY. SO, OUR WORKING GROUP WAS
[INDISCERNIBLE] AND FORMATION
WAS IN PART FROM RECOMMENDATION
FROM PRIOR ACD WORKING GROUP ON
ENHANCING RIGOR, TRANSPARENCY
AND TRANSLATABILITY OF ANIMAL
RESEARCH THAT ALSO INDICATED A
RECOMMENDED EXPLORING NON-ANIMAL
MODELS TO REALLY IMPROVE SAME
IMPORTANT METRICS THAT IS RIGOR
TRANSPARENCY AND TRANSLATABILITY
AND AFTER BEING FIRST DISCUSSED
IN NOVEMBER AND DECEMBER 2022ACD
MEETINGS DR. TABEK FORMED THE
WORKING GROUP IN JANUARY EARLIER
THIS YEAR AND CHARGES ARE TO
IDENTIFY TYPES OF ALTERNATIVE
METHODS THAT ASSESS GENERAL
STRENGTHS AND WEAKNESSES FOR
HUMAN BIOLOGY AND CIRCUIT
SYSTEMS IN THESE STATES TO
CHARACTERIZE TYPES OF RESEARCH
CONDITIONS AND DISEASES FOR
WHICH NAMS ARE SUITABLE AND
BENEFICIAL AND TO ARTICULATE
HIGH PRIORITY AREAS FOR NIH
INVESTMENT IN USE AND
DEVELOPMENT WITH HUMAN
APPLICABILITY AND FOCUSING ON
ADVANCING SPECIFIC BIOLOGICAL
PROCESSES AND STATES AUGMENTING
IN CAPABILITIES AND
COMPLEMENTINGABILITIES TO
REPLACE TRADITIONAL MODELS.
NEXT, PLEASE.
OKAY.
SO, TO ACCOMPLISH OUR GOAL, WE
RECRUITED A WORKING GROUP FULL
OF EXPERTS ACROSS SECTORS AND
DISCIPLINES AND INCLUDING
MEMBERS FROM ACADEMIA INDUSTRY
AND FEDERAL AGENCY ENGAGED IN
SIMILAR ACTIVITIES.
I WANT TO TAKE OPPORTUNITY TO
THANK MEMBERS PROVIDING EXPERT
INPUT AND HARD WORK AND
DEDICATION IN THE PAST YEAR TO
PUT TOGETHER A THOUGHTFUL REPORT
AND RECOMMENDATIONS.
NEXT, PLEASE.
OKAY. SO, TO ACCOMPLISH GOALS,
WE AT THE WORKING GROUP TOOK A
TWO-PRONGED APPROACH TO ASSESS
THE LANDSCAPE THAT MEETS
CHALLENGES AND OPPORTUNITIES FOR
NAMS AND TO IDENTIFY WHAT IS
NEEDED AND TO ADVANCE PROGRESS.
AND AS NAMS ACROSS MANY FIELDS
THAT INVOLVE MANY PEOPLE FROM
DEVELOPERS TO USERS AND
PIPELINES AND OUR WORKING GROUP
ALSO CONSIDERED IT BENEFICIAL TO
CONSULT EXTENSIVELY WITH EXPERTS
IN THE COMMUNITY TO INFORM
RECOMMENDATIONS.
NEXT, PLEASE.
THESE ARE DETAILS ABOUT OUR
PROCESS AND TIMELINE AND OUR
WORKING GROUP MET MONTHLY SINCE
JANUARY TO IDENTIFY THE NEEDS
AND CHALLENGES AND OPPORTUNITIES
FOR NAMS. WE UPDATED ACD ON
PROGRESS IN JUNE OF 2023.
IN ADDITION, WE THOUGHT IT WAS
VERY IMPORTANT TO GET INPUT FROM
EXPERTS THAT WERE IN THE PUBLIC
AND PUT REQUEST FOR PUBLIC INPUT
RFI AND HELD TWO WORKSHOPS.
INCLUDE WUNG INTERNAL AND ONE
PUBLIC TO HEAR FROM ADDITIONAL
COMMUNITY AND USER AND
DEVELOPERS WITH DIFFERENT
TECHNOLOGIES.
AND NO LONGER HAVE A YEAR AND
WORKING GROUP USED INPUTS
RECEIVING DETERMINING KEY NEEDS
AND SYNTHESIZING RECOMMENDATIONS
TO IMPRESS THESE NEEDS LEADING
TO THE REPORT TODAY.
NEXT SLIDE, PLEASE.
OKAY. ONE KEY TASK THAT IS
DEFINING NAMS AND WHAT ARE NAMS
AND SCOPE AND MAY KNOW THERE IS
A BROAD AND DIVERSE SET OF
TECHNIQUES TO CONCEIVABLY BE
CONSIDERED ALTERNATIVE METHODS
AND PURPOSE OF THE WORKING GROUP
WE NARROWED SCOPE AND FOCUS ON
AREAS THAT ARE RAPIDLY CHANGING
TECHNOLOGIES AND COMPLEMENTARY
AND TRADITIONAL ANIMAL METHODS
AND WHILE METHODS LIKE
EVERTEBRATE MODELS AND CLINICAL
TRIALS ARE VALUABLE AND
CONSIDERED OUT OF SCOPE AND
FOCUS OF ASSESSMENT IS ON SUBSET
OF NAMS THAT COULD TAKE
ADVANTAGE OF NEW TECHNOLOGIES
MORE FAITHFULLY REPRESENTING
HUMAN PATHOPHYSIOLOGY AND
SERVING AS MODELS OF ORGAN
TISSUE ENTRY REGENERATION AND
DISEASE OR TREATMENT AND IN
PARTICULAR WE FOCUS ON THREE
AREAS: TECHNOLOGY AND INCLUDING
ECHEMICAL THAT ARE METHODS IN
VITRO METHODS AND CELL CULTURE
METHODS AND COMPUTATIONAL
INSILICO METHODS MAP MODELS AND
MACHINE LEARNING AND BASED ON
EXPERTISE AND COMMUNITY INPUT,
WE FOUND THAT THESE -- THERE ARE
MULTIPLE AREAS THAT NAMS ARE
POTENTIALLY QUITE USEFUL AND
INCLUDING CONDUCTING BASIC
RESEARCH AND UNDERSTANDING BASIC
BIOLOGICAL MECHANISMS ISOLATING
SYSTEMS SUCH AS [INDISCERNIBLE]
FUNCTION AND ARE POTENTIALLY
USEFUL IN UNCOVERING HUMAN
PATHOPHYSIOLOGY MECHANISMS THAT
IS HOW CELLS INTERACT WITH EACH
OTHER AND ARE BEING USED FOR
TRANSLATING KNOWLEDGE TO
PRODUCTS AND PRACTICE SUCH AS
TOX LOGICAL TESTING AND DRUG
SCREENING.
THERE ARE AREAS ALSO WHERE NAMS
APPEAR TO BE LESS USEFUL THAT
MAY BE FOR THINGS CONSTRUCTING
COMPLEX BIOLOGICAL SYSTEMS SUCH
AS STUDYING BEHAVIOR AND/OR
PREDICTING WHOLE BODY RESPONSES
UNDER PATHOLOGICAL CONDITIONS
OVER TIME SUCH AS AGING AND
ENVIRONMENTAL FACTORS THAT ARE
DIFFICULT TO REPLICATE IN
CURRENT MODELS AND NOTING THAT
WHILE THERE ARE HUGE
OPPORTUNITIES FOR NANAMS THEY HE
CHALLENGE AND MODELS AND THESE
INCLUDE RIGOR REPRODUCIBILITY
AND TRANSLATABILITY THAT ARE
EXISTING WITH NAMS.
NEXT SLIDE, PLEASE.
BEFORE WE GET TO SPECIFIC
RECOMMENDATIONS, I WANT TO MAYBE
HELP AND SUGGEST WHAT WOULD BE
POSSIBLE IF WE HAD A NEXT
GENERATION OF ALTERNATIVE
METHODS AND A PROBLEM THAT IS
VERY IMPORTANT THAT I STUDY THAT
IS INCLUDING CANCER METACY AFT
ACYST ANIMAL MODELS THAT IS
STUDYING THIS PROCESS THAT IS
HAPPENING AND COMING UP WITH
INTERVENTIONS TO ACTUALLY STUDY
AT SCALE.
THIS IS BECAUSE WE ARE TALKING
ABOUT CANCER CELLS AND IMMUNE
CELLS AND MULTIPLE DIFFERENT
ORGANS AND VISION WITH MODELS
REPLICATING THEM AND STUDY AND
OBSERVE THEM AND PERTURB THEM
WITH HIGH FIDELITY AND
INFORMATION CONTENT WOULD BE FOR
EXAMPLE A VERY TRANSFORMATIVE
SORT OF TECHNOLOGY THAT COULD
HELP BENCHMARKING FOR CLINICAL
DATA SETS AND INTERVENTIONS AND
THINKING ALSO ABOUT TECHNOLOGIES
THAT YOU CAN IMAGINE WOULD BE
VERY COMPLICATED TOOLS AND WHAT
IT WOULD TAKE TO MAKE THESE
EXPERIMENTS REPRODUCIBLE ACROSS
DIFFERENT GROUPS AND TECHNOLOGY
MIGHT INVOLVE MULTIPLE KINDS OF
SPECIALIZED TRAINING AND
TRAINING PEOPLE TO UNDERSTAND
AND USE TOOLS IN EFFECTIVE
FASHION.
THEY ARE ALL NONTRIVIAL
CHALLENGES.
NEXT SLIDE, PLEASE.
SO, FROM WHAT WE HEARD FROM BOTH
OF OUR WORKING GROUPS AND
MEMBERS OF THE COMMUNITY, IT IS
CLEAR THAT NAMS ARE QUITE
VALUABLE FOR RESEARCHING MANY
APPLICATION AND FIELDS AND WHILE
WORK IS BEING DONE A KEY THEME
THAT HAS MERGED THAT IS CURRENT
OPPORTUNITY FOR INTEGRATION AND
INTERDISCIPLINARY WORK BRINGING
TOGETHER DIFFERENT DISCIPLINES,
SECTORS AND TECHNOLOGIES THAT IS
A PLACE THAT CREATIVITY
INNOVATION COULD REALLY HAPPEN
AND THERE MIGHT BE SOLUTIONS
EXISTING AT INTERSECTION OF
DIFFERENT DISCIPLINES WHERE
SOLUTION IS NOT OBVIOUS TO THOSE
THAT ARE WORKING IN ONE AREA
ONLY AND MIGHT NOT BE OTHERWISE
IMAGINED.
BY INTEGRATING THESE
PERSPECTIVES AND EARLY
TECHNOLOGY CONCEPTION AND
RESEARCHERS DEVELOP NAMSS THAT
HAVE HIGHER QUALITY AND
REPRODUCIBLE FINDINGS WITH
HUMANS AND HUMAN BIOLOGY AND
WORKING GROUP DEVELOPED 7 THEME
ATTIC AREAS IN HIGH PRIORITY
NEEDS TO ADDRESS AND ACCELERATE
NAMS THAT I WILL TURN OVER TO
DR. JORGENSON TO GO ISSUES AND
RECOMMENDATIONS IN DEPTH.
>> THANK SO YOU MUCH, HOWARD,
FOR WALKING US THROUGH THE
BEGINNING OF OUR TASK HERE. WE
ARE REALLY, REALLY EXCITED ABOUT
TALKING ABOUT RECOMMENDATIONS.
NEXT SLIDE, PLEASE.
HOWARD OUTLINED THAT MANY OF YOU
AND THOSE LISTENING TODAY ARE
WORKING ON SUCCESSFUL CREATION
AND DEPLOYMENT OF NAMS AND
OPPORTUNITY HERE ADVANCING NIH'S
MISSION IS HOW TECHNOLOGIES
INTEGRATE WITH EACH OTHER AND
ACROSS TRADITIONAL RESEARCH
APPROACHES AND WHAT WE HAVE WITH
EXPERTS ACROSS SECTORS AND
FIELDS AND EYE TOWARDS
ADDRESSING HIGH PRIORITY NEEDS
THAT HOWARD OUTLINES SEVERAL
RECOMMENDATIONS IMPLEMENTED
COULD BE TRANSFORMATIVE FOR
DEVELOPMENT END USE OF NAMSS.
YOU HEAR US SAY DEVELOPMENT AND
USE AND THINK BOTH OF THOSE IN
TANDEM MOVING FORWARD AND LIST
OF REJS ON SCREEN AND NUMERICAL
ORDER ARE NOT PRIORITY ORDER AND
BE CONSIDERED IN TOTAL TO
ACHIEVE VISION WE ARE DISCUSSING
TODAY AND WALKING THROUGH EACH
OF THE 7 INDIVIDUALLY NOW AND GO
INTO DETAIL NOW ABOUT SPECIFIC
IMPLEMENTATION RECOMMENDATIONS.
NEXT SLIDE, PLEASE.
SO, AS I THINK THAT MANY KNOW,
ANSWERING A COMPLEX BIOLOGICAL
QUESTION OFTEN RELIES ON
MULTIPLE METHODS AND APPROACHES
TO ADDRESS PHYSIOLOGICAL METHODS
UNDERLYING A SYSTEM BEHAVIOR AND
MAKES SENSE INSILICO CHEMOCO IN
VITRO MODELS COULD BE DRIVER OF
NEW OPPORTUNITIES AND EQUIP
RESEARCHERS WITH NEW TOOLS
ANSWERING PREVIOUSLY
UNANSWERABLE QUESTIONS HOWARD
TALKED TO YOU ABOUT CANCER THAT
COULD BE ACHIEVED HERE AND
THINKING ABOUT STRATEGICALLY
COMBINING NAMS TO LEAD TO
OPPORTUNITIES AND NIH FIND WAYS
TO PRIORITIZE DEVELOPMENT USE
AND COMBIN ATORIAL NAMS
INSTITUTES ARE WORKING THROUGH
THEM INDIVIDUAL AND WE WANT TO
SEE INTEGRATED APPROACH AND
ACTIVITIES FOR RECOMMENDATION 1
AGENCY SHOULD CONSIDER
STANDARDIZING NA MANY. S AND
BENCHMARKING METHODS TO
DETERMINE STRENGTHS AND
SUITABILITY OF INDIVIDUAL AND
COMBIN ATORIAL APPROACH.
WE RECOMMEND ALSO THAT WE
DETERMINE HOW NAMS AND COMBIN
ATORIAL NAMS COMPARE AGAINST
EACH OTHER AND MODELS TO
DETERMINE AND BUILD TRUST IN
RELIABLE AND REPRODUCIBILITY AND
IDENTIFY STRENGTH AND WEAKNESSES
FOR HYPOTHESES SO RESEARCHERS
CAN CHOOSE BEST MODEL FOR
ANSWERING QUESTIONS AND PILOT
STUDIES ON TECHNOLOGIES
SUPPORTING THREE RS OF
REPLACEMENT REDUCTION REFINEMENT
AND COMPLEMENT CURRENTLY USED
BOTH STANDARD MODELS AND
IMPORTANTLY IN 1.4 WE SEE THAT
NIH SHOULD CONTINUE EFFORTS
TRACKING INVESTMENTS IN NAMS TO
MONITOR AND ASSESS GAPS AND
CRITICAL FEATURE OF EMERGING
TECHNOLOGY TO SHAPE ULTIMATE
UTILITY AND RESEARCH.
NEXT SLIDE, PLEASE.
HIGH PRIORITY NEEDS 2 I AM SURE
RESONATES WITH MANY AND NOT ALL
OF US HERE TODAY IS NEED NOT
ONLY FOR RELIABLE TECHNOLOGY AND
NEED FOR HIGH-QUALITY DATA YOU
THAT IS INTEROPERABLE FOR USE
AND DEVELOPMENT.
TO VALIDATE NAMS WE NEED ACCESS
TO INTEROPERABLE HIGH QUALITY
DATA SETS AND INCLUDING
ASSOCIATED METADATA THAT IS AN
IMPORTANT THING THAT GROUPS
DISCUSSED IN DETAIL AND DATA
SETS WE BEGIN TO IMPROVE
COMPARISONS BETWEEN
METHODOLOGIES TO UNDERSTAND
STRENGTHS AND LIMITATIONS AND
NEXT SLIDE, PLEASE.
SPECIFICALLY RECOMMENDATION 2
WORKING GROUP RECOMMENDS NIH
WORKS ACROSS COMMUNITIES AND
SECTORS ESTABLISHING RESEARCH
AND COLLABORATIONS TO PROMOTE
INTEROPERABLE AND HIGHLY CURATED
HIGH QUALITY DATA SETS AND BIG
ITEM THAT NIH CAN'T DO THIS
ALONE AND WORKING GROUP
RECOGNIZED THIS IMPORTANT NEED
FOR THE CATALYST TO CONVENE.
HOWEVER, NIH COULD PLAY A
LEADING ROLE IN SETTING THE TONE
HERE DETERMINING AND ADDRESSING
WHAT BARRIERS ARE TO SHARING AND
REUSING DATA ESPECIALLY AROUND
DIFFERENT FORMATS AND STANDARDS
DIFFERENT DATA SETS POOR
CURATION AND MORE AND
OPPORTUNITY TO DEVELOP AND
DISSEMINATE METHODS ASSESSING
QUALITY AND LEVERAGING EXISTING
DATA QUALITY METRICS WE LEARN
FROM OTHER DISCIPLINES AND
OPPORTUNITY TO ESTABLISH
POLICIES AND INFRASTRUCTURE
HELPING WITH -- GNOMEN
COLLATETURE AND MORE AND NOTING
NEW DATA MANAGEMENT INSURANCE
POLICIES ARE GOOD FIRST STEP FOR
INFRASTRUCTURE FOR NAM DATA SETS
INCLUDING ALGORITHMS THAT COULD
BE IMPORTANT FOR INSILICO
MODELS.
NEXT SLIDE, PLEASE.
CONSISTENT WITH PRIOR
IMPLEMENTATION, EFFORTS ARE
NEEDED FOR FAIR DATA
INTEROPERABLE ACCESSIBLE AND
REUSABLE AND COULD DEFINE AND IF
NOT FIND ONE CREATE A DESIGNATED
REPOSITORY FOR SHARING NAMS DATA
PROMOTING EQUITABLE SHARING USE
OF HIGH QUALITY DATA AND
RECOMMENDED COULDN'T BE ACHIEVED
THROUGH NIH ALONE.
BADLY NEEDED TO INCENTIVIZE FOR
COLLECTION SHARING AND MANAGING
SHARING DATA THAT IS IMPORTANT
TO HELP RESEARCHERS HARD TO
ACCESS DATA MIGHT BE VALUABLE
FOR RESEARCH SUCH AS UNPUBLISHED
AND PRE-COMPETITIVE DATA THAT
ISSIN DUSTRY'S HANDS AND UNDER
RECOMMENDATION WORKING GROUP
FELT THAT FOR PEOPLE TO TRUST
NAMSS DATA AND ADOPT WHAT WE
FIND FROM NEW TECHNOLOGIES
GENERATE NEW WAYS FOR PEOPLE TO
ACCESS DATA IMPROVE
CHARACTERIZATION AND ULTIMATE
QUALITY.
NEXT SLIDE, PLEASE.
RECOMMENDATION 3, WORKING GROUP
SPENT CONSIDERING TIME TO THINK
ABOUT ENSURING BENEFITS OF NA
MANY. SS AND HOW THEY COULD
WIDELY BENEFIT ALL AND THIS IS
NOT ONLY DEVELOPMENT OF
TECHNOLOGY AND USE OF GETTING IT
INTO HANDS OF OTHER RESEARCHERS
AND BELIEVE THAT HOWARD
MENTIONED CRISPR IN THE
BEGINNING AND EXAMPLE HOW GENE
EDITING TECHNOLOGIES AROUND FOR
DECADES AND CRISPR MADE IT MUCH
MORE USEFUL TOOL FOR RESEARCH
AROUND THE GLOBE NOT DONE BY
ACCIDENT AND DEDICATED EFFORTS
HOW RESEARCH COULD BE USED AND
TO MAKE QUALITATIVE SCIENTIFIC
ADVANCES.
NEXT SLIDE, PLEASE.
REGARDING RECOMMENDATION,
WORKING GROUP RECOMMENDS
APPROACHES IN SPIRIT PROMOTING
ADOPTION OF INTERCONNECTED
NANOTECHNOLOGIES NIH SHOULD
CREATE MECHANISMS SUPPORTING
TESTING VALIDATION QUALIFICATION
AND BENCHMARKING OF COMBIN
ATORIAL SYSTEMS TO UNDERSTAND
WHICH NAMS ARE MOST EFFECTIVE
AND USEFUL AND RECOMMEND HELPING
RESEARCHERS ACCESS VALIDATED
NAMS DUE TO CREATION OF
REPOSITORIES AND SOURCES FOR
MATERIALS NEEDED TO USE NAMS AND
FOR INSTANCE DONOR CELLS AND
ALGORITHMS AND FIND WAYS TO
INCENTIVIZE MAKING NAMS SIMPLER
TO USE AND RESEARCH TOOL
ACCESSIBLE AND CHEAPER TO USE
AND FINALLY UNDER THE
RECOMMENDATION TO WORK WITH A
COMMUNITY TO SET CLEAR
EXPECTATION FOR NAM STUDIES TO
USE ESTABLISHED REPORTING
GUIDELINES THAT WE SEE IN MANY
OTHER SORTS WORKING WITH
JOURNALS AND COMMUNITIES AND
NEXT SLIDE, PLEASE.
RECOMMENDATION 4 IS SOMETHING WE
TALK ABOUT WITH EVERY EFFORT WE
DO HERE AND SELF-EVIDENT AND
NAMS AND EFFECTIVE STRATEGIES
DISSEMINATING TOOLS AND ALSO HOW
TO USE THEM.
IT WILL BE IMPERATIVE TO DO SO
FOR INTERDISCIPLINARY TEAMS AND
HOW TO DEPLOY NEW AND EFFECTIVE
TECHNOLOGIES.
NEXT SLIDE, PLEASE.
RECOMMENDATION 4, THE WORKING
GROUP RECOMMENDED FOR SPECIFIC
INVESTMENT AND COMPREHENSIVE
TRAINING TO BOLSTER CONTINUOUS
ADVANCES IN NAM'S DEVELOPMENT
AND USE AND AC WORKED TO ADDRESS
CHALLENGE MORE AS MORE AREAS OF
ABOUT I- MEDICAL RESEARCH ARE
RELYING ON CONVERGENCE ACROSS
FIELDS AND NIH TAKES LESSONS WE
HAVE DONE HERE TO AUGMENT THIS
WORK AND REGARDING APPROACHES
WORKING GROUP RECOMMENDED
INCENTIVIZED CROSS-TRAININGS
ACROSS SECTORS AND DISCIPLINES
COULD BE OPPORTUNITIES FOR
CROSS-TRAINING THAT NIH HAS
EXPLORED IN TERMS OF WORKING
ACROSS DIFFERENT SORTS OF
ORGANIZATIONS OR SECTORS AND
IMPORTANTLY AND INTERESTING
RECOMMENDATION FOR GROUP TO
CONSIDER WAS THEIR CONCERN THAT
EMERGING TECHNOLOGIES DON'T
SCORE AS FAVORABLY DURING PEER
REVIEW PROCESS BECAUSE OF LACK
OF FAMILIARITY AND EVIDENCE-BASE
TO ADOPT TO PEER REVIEW
PROCESSES AND MORE EVIDENCE TO
BE DONE TO HELP PEER REVIEW
TECHNOLOGY AS THEY EMERGE AND
GROUP RECOMMENDED NEW
OPPORTUNITIES BE CREATED TO
TRAIN DEVELOPERS TO UNDERSTAND
HOW NAMS WILL BE USED AND CENTER
ANGLE NOT ONLY ON CREATION OF
TECHNOLOGY FOR TECHNOLOGY'S SAKE
BUT UTILITY AND APPLICABILITY.
NEXT SLIDE, PLEASE.
CONTINUING IN LINE OF
COMPREHENSIVE TRAINING WE TALKED
ABOUT OPPORTUNITIES FOR
ACADEMICS TO INTEGRATE INTO
REGULATORY PROCESSES OR INDUSTRY
SECTORS TO LEARN HOW TO WORK TO
APPROACH OR USE NAMS
TECHNOLOGIES AND EMPHASIZE
TRAINING INCLUDES BROADER
RESOURCES TO PROMOTE AWARENESS
WHEN SCIENTIFIC APPROPRIATE
METHOD FOR NAM AND WHETHER BE
EFFECTIVE AND REPLACING LESS
EFFECTIVE TRADITIONAL MODEL AND
IN TANDEM COULD BE COMPLIMENTARY
TO GIVE ROBUST RESULTS NEXT
SLIDE, PLEASE.
RECOMMENDATION 5.7 INCLUDES
THINKING ABOUT
MULTI-DISCIPLINARY TEAMS AND
THEME HAS BEEN AROUND
INTEGRATION THAT IS SUCCESSFUL
BRINGING EXPERTS ACROSS
DIFFERENT TEAMS, SECTORS
DISCIPLINES AND MORE TO WORK
TOGETHER.
IT REALLY REQUIRES A SHIFT IN
THINKING ABOUT BIOLOGICAL
RESEARCH AND HOW RESEARCHERS
COMMUNICATE WITH EACH OTHER AND
USE OF LANGUAGE LIKE VALIDATION
AND REPLICATION CAN SLIGHTLY
VARY ACROSS ENGINEERING DATA
SCIENCE AND BIOLOGICAL
DISCIPLINES NECESSARY TO MAKE
THIS WORK WELL AND LACK OF
STANDARD GNOMEN CHICANO/CHICANA
LATINO/LATINATURE CAN EXACERBATE
CHALLENGES FOR COLLABORATION AND
THINKING OF NIH FACILITATING
MULTI-DISCIPLINARY TEAMS WE SAID
MORE COULD BE DONE THINKING
ABOUT ENTIRETY OF LIFE CYCLE AND
NOT NIH'S CHALLENGE ALONE AND
MORE FUNDING OPPORTUNITIES TO
SUPPORT INTERDISCIPLINARY TEAMS
AND THINKING ABOUT MULTILAB
COORDINATION AND MIGHT BE
OPPORTUNITY TO CREATE NEW
INCENTIVES THINKING CREATIVELY
ABOUT APPROACHES LIKE CHALLENGE
OR PRIZE COMPETITIONS AND WILL
BE NEEDS OF VENUES TO FOSTER
CONNECTIONS ACROSS AREAS AND NOW
IS A SMALL COMMUNITY GROWING
THAT NIH CAN DO MORE TO HELP
SUPPORT THAT WORK AND FINALLY
WORKING GROUP STATED THERE WAS
VALUE IN MAKING SURE TEAMS WORK
TOGETHER TO UNDERSTAND VALIDITY
OF MODELS BEFORE THEY MOVE INTO
THE REGULATORY SPACE TO REALLY
DETERMINE HOW TO USE
TECHNOLOGIES TO INFORM POLICY
DEVELOPMENT.
NEXT SLIDE, PLEASE.
FOR RECOMMENDATION 6, WORKING
GROUP BUILT ON SOME OF THE WORDS
WE HEARD FROM DR. BER CONTINUE
OELI THIS MORNING REGARDING
IMPORTANCE OF SCIENCE WORKING
FOR PEOPLE WE AIM TO SERVE
BUILDING TRUST IN RESEARCH WE DO
HERE THEY THOUGHT ABOUT
RESPONSIBLE USE OF TECHNOLOGY
AND ALSO IN MAKING SURE THAT
EMPLOYED TECHNOLOGIES MET
ETHICAL EXPECTATIONS OF PUBLIC
AND TRANSLATED INTO BENEFITS IN
AN EQUITABLE FASHION THAT WAS
CLEAR FOR DISCUSSIONS THAT
ETHICAL CONSIDERATIONS ASSOCIATE
WITH NAMS SIMILAR TO EMERGING
TECHNOLOGY AT SOME LEVEL MUST BE
CONSIDERED EARLY AND OFTEN AND
PROMISE AND OPPORTUNITY TO
DISCUSS OPENLY AND
RESPONSIBILITY WITHOUT HYPE TO
GAIN TRUST IN THE WORK WE DO.
NEXT SLIDE, PLEASE.
SO, FOR RECOMMENDATION 6, GROUP
RECOMMENDED THAT WE NEED TO WORK
TO PROMOTE SOCIAL RESPONSIBILITY
IN THE CREATION AND DEPLOYMENT
OF NAMS ACROSS RESEARCH LIFE
CYCLE AND DEVELOPING NAMS NIH
COULD TAKE A LEADING ROLE IN
EMPHASIZING RESPONSIBLE
DEVELOPMENT OF TECHNOLOGY
SETTING GOLD STANDARD FOR
CONCEPT BIAS REDUCTION ETHICAL
STANDARDS MATERIALS AND MORE AND
WORKING WITH PARTNERS TO PROMOTE
CONSISTENT APPROACH TO
TECHNOLOGY IN SAFE AND
RESPONSIBLE MANNER REDUCING
ADMINISTRATIVE BURDEN FOR
RESEARCH COMMUNITY.
NEXT SLIDE, PLEASE.
OF COURSE, IT IS OUR
RESPONSIBILITY AS SCIENTISTS TO
MAKE SURE TECHNOLOGIES WE DO
BEAR FRUIT AND WORKING GROUP
RECOMMENDED WE CAN BEST PROVIDE
PUBLIC WITH MAXIMUM RETURN ON
INVESTMENT SUPPORTING ANALYSIS
ON COST EFFECTIVE ASSESSMENT ON
EXISTING MODELS DETERMINING
WHICH MODEL PROVIDES MOST
UTILITY SOLVING QUESTION AT HAND
AND RECOMMEND THAT WHILE ETHICAL
ISSUES WITH EMERGING TECHNOLOGY
MIGHT BE UNIQUE ISSUES
ASSOCIATED WITH NAMS INCLUDING
RESPONSIBLE DEPLOYMENT AND
THINKING AROUND CONSIDERATIONS
FOR BIAS AND ALGORITHMIC CODE
AND COLLECTION AND ANALYSIS
INTERPRETATION AND RETURN TO
VALUE RESEARCH PARTICIPANTS
THINKING ABOUT MASS DATA
COLLECTION AND WHO BENEFITS FROM
WHAT WE LEARN FROM THAT AND
WHOSE SALES MIGHT BE ACQUIRED
FOR RESEARCH AND THINKING ABOUT
POTENTIAL FOR STIGMATIZATION IN
COMMUNITIES JUST TO NAME A FEW.
WORKING TO LEARN FROM PATIENTS
IN THE PUBLIC TO PROMOTE
MEASURED REALISTIC AWARENESS AND
ADOPTION OF NEW TECHNOLOGIES.
NEXT SLIDE.
FINALLY, FOR HIGH PRIORITY NEEDS
7, ALL THIS WILL REQUIRE
COORDINATED INFRASTRUCTURE THAT
BY THAT WE MEAN PHYSICALLY AND
INTELLECTUALLY AND WILL BE
INVESTMENTS AND PRIORITIZED
VENUES STRENGTHENING DIALOGUED
IN TERMS AND SECTORS AND ACROSS
GEOGRAPHICAL BOUNDARIES AND
DEVELOPING TECHNOLOGY
INFRASTRUCTURE IS NEEDED TO
MINIMIZE DUPLICATION OF EFFORT
MAXIMIZING TAXPAYER FUNDING AND
EQUITY OF PRIORITY.
RECOMMENDATION 7 FOCUSES ON
SUPPORTING AND MAINTAINING
COORDINATED INFRASTRUCTURE FOR
NAMS AND -- TECHNOLOGIES AND
EXPERTISE.
BOTH EFFECTIVELY AND RELIABLY
ACROSS RESEARCHERS AND
INSTITUTIONS AND EXAMPLES HERE
COULD INCLUDE PROTOCOLS FOR
TECHNOLOGY DEVELOPMENT AND USE
AND QUALIFICATION OF REAGENTS
AND EQUIPMENT TRACKING AND
MATERIALS AND EXPERIMENTAL
DETAILS AND STANDARD OPERATING
PROCEDURES FOR TEAMS AND COULD
CONSIDER CLEARING HOUSES AND
REPOSITORIES FOR EASY AND
RELIABLE INEXPENSIVE ACCESS TO
REAGENTS AND CUSTOM SYNTHESIS
AND TRACKING NAMS HOW THEY ARE
USED WHAT PURPOSE AND IN HOW
COMBINATION AND GROUPS ARE
WORKING TO CREATE RESOURCES
LOWERING BARRIER TO ENTRY TO
INCREASE COLLABORATION AND NOT
SAYING TO REINVENT THE WHEEL BUT
FIND AND LOCATE AND IDENTIFY HOW
TO DO IT IN A SEAMLESS FASHION
FOR RESEARCHERS.
PART OF THE INFRASTRUCTURE WE
HAVE TO THINK OF LAB
INFRASTRUCTURE TO BRING
EXPERTISE TOGETHER.
THERE WERE CONSIDERATIONS TO BE
DATA BASES AND FINDINGS WITH
BIOLOGICAL EXPERTISE ALONG WITH
DEVELOPMENT AND TECHNOLOGY
COMPONENTS FOCUS ON BUILDING
CAPACITY IN SMALL AND MID-SIZED
LABS WITH EQUITY AND DEPLOYMENT
AND DEVELOP AND RUN ASSAYS AT
SCALE AND FACILITIES CAN BE HUBS
TO TRAIN RESEARCHERS TECHNIQUES
TO TAKE BACK TO OWN LABS.
HOWARD BEGAN WITH VISION FOR OUR
WORKING GROUP WHEN WE TRIED TO
DEPICT HERE FOR YOU ALL AND WE
THOUGHT ABOUT ITERATIVE CYCLE
ADVANCING DEVELOPMENT AND USE OF
NAMS THAT ARE UNGURDED BY KEY
COMPONENTS NECESSARY FOR SUCCESS
AND SUCCESSFUL INTEGRATION
ACROSS APPROACHES NEED FOR
MULTI-DISCIPLINARY TEAMS WITH
ACCESS TO HIGH QUALITY
INTEROPERABLE DATA SETS PART OF
INTEGRATION IS ENGAGEMENT WITH
END USERS APPROACH IS FIT FOR
PURPOSE EASILY ADOPTABLE AND
SCALEABLE AND AVENUES TO PASS ON
KNOWLEDGE AND METHODS HOW TO USE
TECHNOLOGIES WHERE PEOPLE CAN GO
TO LEARN AND SYNTHESIS ACROSS
MODELS AND FIELDS IS GOAL TO
MAKE CYCLE WHEREBY RESEARCH
CONDUCTED INFORMS WORK IN OTHER
MODELS INFORMS HUMAN HEALTH AND
BIOMEDICAL DATA FOR FURTHER
NEEDS TO R CONTINUING THIS
CYCLE.
NEXT SLIDE, PLEASE.
BEFORE WE CONCLUDE, NEXT SLIDE,
PLEASE.
WE DID WANT TO MAKE SURE THAT
ACD WAS AWARE TO AGAIN THINK
ABOUT PUTTING RECOMMENDATIONS TO
ACTION AND WHAT CHALLENGES WE
COULD SOLVE AND END OF THE
REPORT YOU WILL SEE IDEAS FOR
TRANSFORMATIVE PROJECTS AND WAYS
TO HAVE CASE STUDIES OF
DEMONSTRATING OPPORTUNITY TO BE
INVASIVE RESEARCH AND
UNDERSERVED AREAS OF DISEASE AND
TRANSLATION AND MORE AND SEE
SEVERAL CASE STUDIES HERE
LEVERAGING IN VITRO AND
TECHNIQUES FOR INSIGHTS INTO
COMPLEX BIOLOGICAL MODELS AND
ANOTHER UNCOVERING NEW
UNDERSTANDING AND
NEUROPSYCHIATRIC DISORDERS AND
THIRD COMBINING IN VITRO AND IN
VIVO -- DEPENDENCE ON
PRECLINICAL MODELS COMBIN
ATORIAL APPROACHES AND FINAL IS
DATA INTEGRATION ACROSS NAMS
TRADITIONAL MODELS AND CLINIC TO
EMULATE PATIENT-SPECIFIC
TUMOR-IMMUNE ENVIRONMENTS AND
GOAL IS HOW HUMAN CONDITION WAS
NEEDING ADDITIONAL RESEARCH
MODELS TO MAKE ADVANCES AND
INTEGRATION OF RECOMMENDATIONS
COULD BRING THAT TO FRUITION.
NEXT SLIDE, PLEASE.
BEFORE WE MOVE TO DISCUSSION,
AND HOPEFULLY ENDORSEMENT OF THE
RECOMMENDATIONS OF THE WORKING
GROUP TODAY I WANT TO TAKE A
MOMENT ON BEHALF OF THE WORKING
GROUP TO THANK DOCTORS BRITTNEY
AND JESSICA WHO HAVE DONE AN
AMAZING LEVEL OF WORK AS
EXECUTIVE SECRETARIES OF THE
GROUP THAT SUPPORTED US
LOGISTICALLY AND INTELLECTUALLY
BRINGING THIS GROUP TO FRUITION.
TURNING TO HOWARD IF I MISSED
ANYTHING HE WOULD LIKE TO SHARE
AND TURNING TO ACDE.
>> THANK YOU FOR YOUR
RECOMMENDATIONS AND LET'S GO TO
OPEN IT UP FOR DISCUSSION.
>> WHO WOULD LIKE TO START?
>> SOMEBODY HAS TO START.
>> ATOOL.
>> THIS IS A LOT OF WORK AND I
KNOW I TALKED TO HOWARD HOW MANY
MEETINGS AND FOLKS WERE INVOLVED
FROM ALL OVER THE COUNTRY.
HOW FAR AWAY ARE WE FROM
REGULATORY BODIES STARTING TO BE
WILLING TO SEE DATA FROM -- FROM
THESE MODELS?
FDA IN PARTICULAR, I THINK THAT
IS PROBABLY A BIG DIRECTION FOR
TRANSLATIONAL RESEARCH AND
CHOICE OF MODELS THAT IS DRIVEN
BY THAT I WOULD IMAGINE.
>> SO, STARTING AND MAYBE WE CAN
JOIN.
YEAH. WE HAD ACTUALLY INPUT
FROM COLLEAGUES AT THE FDA WHO
WERE ACTUALLY ALSO THINKING
ABOUT TOPICS AND MCATS AND
HEARING FROM FDA MONITORIZATION
2.0 THEY ARE THINKING ABOUT
ACTUALLY [INDISCERNIBLE] AND
ACTUALLY DRUGS TO BE APPROVED OR
GO TO CLINICAL TRIALS WITHOUT
GOING THROUGH ANIMALS FIRST;
RIGHT?
THIS IS SOMETHING THAT PEOPLE
ARE ACTIVELY THINKING ABOUT AND
INCLUDING FROM REGULATORY
AGENCIES.
>> I'M NOT GOING TO SPEAK ON
BEHALF OF FDA AND CAN TELL YOU
IT IS PART OF FDA AND CHIEF
SCIENTIST THAT WAS ON OUR
WORKING GROUP THAT IS NOW DEPUTY
COMMISSIONER FDA SIGNALING
HIGHEST PRIORITY FOR AGENCY AS
WELL THINKING ABOUT THE FUTURE.
>> THERE IS STAR ALIGNMENT HERE
THAT HOPEFULLY WE WILL TAKE AS
MUCH ADVANTAGE OF AS POSSIBLE.
OTHER QUESTIONS OR COMMENTS,
PLEASE.
>> AMAZING WORK AGAIN.
THANK YOU VERY MUCH. IT IS
REALLY GROUNDBREAKING IN MANY
WAYS.
IT SEEMS TO ME THIS IS TRULY --
I MEAN, WE HAVE USED THE TERM
CROSS-DISCIPLINARY A LOT. SEEMS
TO ME [INDISCERNIBLE].
I'M WONDERING HOW -- HOW AT NIH
YOU ENABLE THAT TO HAPPEN ACROSS
INSTITUTES.
I MEAN, THERE IS BASIC AND
COMPUTATIONAL SCIENCE AND JUST
IS A VAST ARRAY OF EXPERTISE AND
SKILLS NEEDED TO MOVE THIS
FORWARD.
HOW DO YOU DO THAT?
HOW DO YOU INCENTIVIZE IT?
I GUESS OTHER THOUGHT █I HAD JUT
BEFORE YOU TRIED TO ANSWER THIS
IS IT SEEMS TO ME TO GET A NEW
GENERATION OF YOUNG
INVESTIGATORS THAT ARE
INTERESTED IN THIS SPACE, YOU
HAVE TO KIND OF MOTIVATE A
TRAINING GRANT OR SOMETHING
ALONG THOSE LINES TO MAKE IT
HAPPEN.
I DON'T KNOW WHAT YOUR THOUGHTS
ARE. THANK YOU.
>> I WILL START WITH THE FIRST
PART OF IT.
LY ASK MY COLLEAGUES TO SPEAK TO
THE SECOND PORTION THAT IS
RELATED TO TRAINING.
SO, AGAIN, I -- THE ONLY
ADVANTAGE OF GETTING TO THIS
POINT OF MY CAREER IS I HAVE
SEEN A TIMELINE, YOU KNOW?
WHEN I FIRST CAME TO NIH, EVERY
MULTI-DISCIPLINARY APPLICATION
STARTED REVIEW AND WITH THIS IS
OVERLY AMBITIOUS AND UNFOCUSED
APPLICATION.
I THINK WE HAVE GOTTEN WAY
BEYOND THAT NOW.
I WOULD HOPE THAT YOU WOULD
AGREE THAT EVEN AT THIS MEETING
THAT YOU HAVE SEEN SOME TANGIBLE
EXAMPLES OF REAL PROJECTS AND
PROGRAMS THAT ARE CERTAINLY IF
NOT INTERDISCIPLINARY, THEY ARE
CERTAINLY MULTI-DISCIPLINARY.
THEY INVOLVE MANY INSTITUTES AND
CENTERS AND OFFICES ACROSS NOT
ONLY OUR AGENCY BUT ALSO OTHER
AGENCIES WITHIN HHS.
INDEED, YOU KNOW, BEYOND.
IT IS STILL CHALLENGING BECAUSE
WE USE PEER REVIEW.
YOU KNOW, AS A VERY FAMOUS
PHILOSOPHER SAID, THE ENEMY RS.
WE HAVE TO NOT ONLY TRAIN
INVESTIGATORS BUT ALSO REVIEWERS
TO THINK IN A SOMEWHAT MORE
EXPANSIVE, YOU KNOW, MANNER.
I DO THINK IT IS IMPROVING AND
WE HAVE PARTS OF NIH THAT PA
KIPSY IS A GOOD EXAMPLE.
THAT IS THEIR SORT OF BUSINESS
MODEL THAT IS WORKING ACROSS
MULTIPLE DISCIPLINES AND OFFICES
AND INSTITUTES AND CENTERS.
I THINK THAT DIANA IS THE ONLY
IC DIRECTOR HERE AT THE MOMENT.
WE HAD OTHERS HERE EARLIER.
I WOULD -- I WOULD HOPE THAT
ANYONE WOULD AGREE THAT THE IC
DIRECTORS TODAY HAVE A MUCH MORE
OPTIMISTIC VIEW OF THIS APPROACH
THAN PERHAPS THEY DID WHEN YOU
FIRST ARRIVED, YOU KNOW, AT NIH.
SO, YOU KNOW, IT -- I WISH I HAD
A MORE CONCRETE ANSWER.
I DON'T KNOW.
AS TIME GOES ON, PERHAPS PA
KIPSY WILL CONTINUE TO FORMULATE
SPECIFIC RESEARCH OPPORTUNITIES
SO IT SAYS THAT WE WANT, YOU
KNOW, ONE OF THESE AND ONE OF
THOSE AND SO FORTH.
THIS FIELD, IT IS GOING TO
CATALYZE THAT IN A BIG WAY.
ALTHOUGH, OBVIOUSLY,
MULTI-DISCIPLINARY APPROACHES
SHOULDN'T BE TO THIS FIELD ONLY
HOWEVER IMPORTANT AND THERE IS A
TRAINING THAT I WILL TURN BACK
TO THE TWO CO-CHAIRS.
>> I CAN START.
YOU ARE ABSOLUTELY RIGHT.
WE HEARD A LOT ABOUT PEOPLE WHO
WOULD HAVE OR CONSIDER
NON-TRADITIONAL BACKGROUND DOING
THIS WORK COMING TO NIH'S
PORTFOLIO INCLUDING BOTH
ENGINEERS AND PEOPLE THAT ARE IN
LET'S SAY COMPUTATIONAL
SCIENTISTS.
THERE IS A -- THEY SPEAK THEIR
LANGUAGE AND HAVE DIFFERENT
EXPECTATIONS.
SO, THIS -- I THINK THIS
EDUCATION AND TRAINING GOES BOTH
WAYS.
RIGHT?
BUT WE JUST NEED TO SORT OF KNOW
THE VALUE OF THEIR INVOLVEMENT
AND CONTRIBUTION.
>> THANK YOU. THE BREADTH OF
THIS IS REALLY ASTOUNDING AND
AMAZING.
HOW DID THE GROUP THINK ABOUT,
FOR EXAMPLE, INTERACTIONS WITH
INDUSTRY?
CLEARLY WITH THE FDA ON BOARD
AND VALUE OF IS SOME OF THIS IS
TREMENDOUS TO THEM FROM DRUG
DISCOVERY AND EVALUATION AND
ISSUES AROUND PROPRIETARY AND
INTELLECTUAL PROPERTY AND A
BUNCH OF OTHER THINGS AND
CURIOUS WHAT YOURS OR THE
GROUP'S THOUGHTS ARE.
>> WE HAVE SOME REPRESENTATIVES
FROM INDUSTRY INCLUDING PHARMA
AND HEARD ABOUT ASPECTS WHERE
ALTERNATIVE METHODS ARE BEING
USED EXTENSIVELY TOXICOLOGY AND
AREAS THAT PEOPLE BASICALLY HAVE
QUITE A BIT OF CONFIDENCE AND
THINK THAT NEW TECHNOLOGY
DEVELOPMENT COULD HAPPEN IN A
PRE-COMPETITIVE SPACE AND WHAT
LYRIC TALKED ABOUT IN TERMS OF
KINDS OF STANDARDIZED DATA SETS
ARE VALIDATED THAT PEOPLE CAN
BENCHMARK ON AND PEOPLE THOUGHT
IT WAS IMPORTANT AND BUILD ON
TOP OF THAT.
AND SO -- SO I THINK THAT
RECOMMENDATIONS ARE CATALYZED
BOTH ACADEMICICALLY AND
APPLICATIONS OF NAMS IN INDUSTRY
AS WELL.
>> ADDING INTERESTING
CONVERSATION I HEARD AND
CONVERSATIONS STARTING OFF WE
HAVE EPA AT TABLE AND MAKING
THESE DECISIONS THAT WAS SKEWED
IN THE BEGINNING A LITTLE BIT
AROUND TOXICOLOGY AND HAVE
PEOPLE COMING AND SAYING LISTEN
THAT ALTERNATIVES ARE AMAZING
FOR BASIC RESEARCH AS WELL AND
ATTENTION WHERE SCOPE DOES MAKE
SENSE HERE AND COME DOWN TO
HOWARD TALKING ABOUT HUMAN
TRANSLATABILITY FOR SCOPE WE ARE
DEALING WITH. SO MANY WAYS TO
TACKLE THIS.
>> IN MY HEAD THERE IS
TOXICOLOGY ON ONE SIDE AND
ADVANCEMENT HOW EVERYTHING FITS
TOGETHER AND THEY MIGHT TAKE
DIFFERENT PATHWAYS BUT THEY
[INDISCERNIBLE] EACH OTHER.
I WILL MAKE A CALLOUT APROPOS
PRESENTATIONS WE HAVE EARLIER
FOR WOMEN THAT ARE CONCEIVING
AND PREGNANT OR BREASTFEEDING
HAVING BETTER DATA FOR
TOXICOLOGY FOR THAT GROUP ARE
HIGH IMPERATIVE AND WE MIGHT BE
UNDERTREATING AND MISTREATING
INADVERTIENTLY AND MORE DATA AND
MAKING SURE IT IS CALLED OUT
WOULD BE GREAT.
>> I CAN HEAR LINDA GRIFFITH
FORMER AC MEMBER ON SCREEN
WANTING TO JUMP IN WITH PLUS 1
TIMES 10 AND PART OF THINKING
THAT SOME NAMS COULD DO THINGS
YOU CAN'T DO IN HUMANS BUT ARE A
HUMAN CONDITION YOU NEED TO TEST
OR ACCESS AREAS FOR HUMANS AND
IS SAYING NOT ONLY IMPORTANT FOR
RESEARCH BUT CAN OPEN NEW DOORS
OF INQUIRY THAT ARE PREVIOUSLY
UNDERSERVED.
>> ULTIMATELY YOU WOULD HOPE IT
SAVES TIME IN THE LONG RUN;
RIGHT?
TOXICOLOGY PROFILE THAT IS
INOPPORTUNE.
>> YEAH.
>> YOU DON'T WANT TO FIND OUT ON
PAGE 3.
>> OR LARGE ANIMAL.
>> YEAH. YEAH. ABSOLUTELY.
>> YEAH. SO, OKAY.
>> YEAH. SO, FANTASTIC WORK.
SORT OF GOING THROUGH THERE SOME
APPLICATIONS, MA'AM, AND
ENGINEERING MICE AND LOVE THE
IDEA AND FRAMEWORK OF MET AFT
ASEIZE AND COMBINING DIFFERENT
COMPONENTS TOGETHER THAT WILL
GIVE YOU A SYSTEM OTHERWISE
WOULDN'T HAVE IF LOOKING AT A
SINGLE CELL AND EVERYTHING ELSE
AND THINK ABOUT WITH INVITATION
AND UTILITY YOU HAVE SUDDENLY
ABILITY TO DO SOMETHING YOU
COULDN'T DO; RIGHT?
YOU CAN DO SOMETHING YOU COULD
DO AND SORT OF COULD DO IT
BETTER; RIGHT?
TOXICOLOGY BEING A GREAT EXAMPLE
OF THAT AND TEST IT IN HUMAN
CELLS AND ENTIRE SYSTEMS AND
TAXOLOGY IN HUMANS AND YOU CAN
DO IT FASTER; RIGHT?
I LOVE IDEA OF INSILICO MODEL
AND EXAMPLE OF [INDISCERNIBLE]
WHERE YOU CAN NOW LOOK AT ALL
KINDS OF PROTEIN FOLDING AND
PROTEIN INTERACTIONS IN WAY THAT
WE SUSPEND LOTS OF TIME AND
MONEY GENERATING CRYSTAL
STRUCTURES AND WHAT IS IMPORTANT
ABOUT THIS IS IT IS QUICK AND
EVERYBODY CAN ACCESS IT; RIGHT?
THINKING ABOUT UTILITY OF MODELS
WONDERING EVEN BEYOND TRAINING
HOW YOU MAKE THIS ACCESSIBLE AT
SCALE AND EASY IN WAY YOU WILL
IMPLEMENT IT AND CREATE
INCENTIVE FOR STRUCTURE FOR
PEOPLE TO MOVE AWAY FROM OTHER
APPROA
APPROACHES.
>> EASY. IT IS ACTUALLY THE
PART WE ARE TALKING ABOUT IN
LEVEL AND YOU CREATE GREAT STUFF
AND HOW DO YOU GET IT OUT THERE
AND OUT THERE IN A WAY THAT
PEOPLE CAN USE BECAUSE YOU PUT A
CAR ON THE ROAD DOESN'T MEAN
PEOPLE KNOW HOW TO DRIVE IT.
PART OF THE EFFORT WE THOUGHT
THAT NIH COULD THINK ABOUT IS
ACTUALLY SOME MEASURES PUTTING
THEM IN TANDEM WHEN THEY RELEASE
SO WE EQUIP AND INCENTIVIZE YOU
WITH THIS NEW AND EXCITING
TECHNOLOGY TO GIVE YOU
INCENTIVES TO TRAIN PEOPLE AND
IS HARD YOU ARE LIMITED IN YOUR
TIME AND HOW WE HAVE MECHANISMS
TO REWARD YOU FOR TIME FOR
DEMOCRATIZING TECHNOLOGIES AND
DOING THAT AND IS A COMPLICATED
QUESTION AND SOMETHING THAT THE
WORKING GROUP THOUGHT A LOT
ABOUT NOT CONCENTRATING NEW
TECHNOLOGIES IN AREAS BUT TO
MAKE THEM ACCESSIBLE.
>> LOTS COULD BE LEARNED FROM
BRAIN INITIATIVE AT THE TIME
TECHNOLOGY CREATION ENGINE
FUNDING GRANTS TO TRAIN PEOPLE
IN TECHNOLOGIES FIGURING OUT HOW
TO SPREAD THEM AROUND.
>> YEAH. YOU MENTIONED BRINGING
INITIATIVES AND SITE VISIT WAS
ACTUALLY TO THE LAB OF STANFORD
COLLEAGUE WHO WORKS ON HUMAN
BRAIN ORGANOIDS AND TAKING
MODELS LAY TERM BRAIN
DEVELOPMENT THAT LINKS TO WHAT
WE HEARD EARLIER ABOUT MATERNAL
FETAL HEALTH THAT IS THERE IS A
PARTICULAR TRANSITION THAT
HAPPENS IN GENE INSTRUCTION
STATE THAT BASICALLY IS AROUND
9TH OR 10TH MONTH OF GESTATION
AND IMPORTANCE OF DELIVERY AND
DOING THAT ON THEIR OWN IN
ADDITION AT THE SAME TIME AND
THERE IS A REALLY AMAZING
BIOLOGY THAT SOMEHOW COULD
RECAPITULATE AND HE ALSO SHOWED
THAT HE RUNS ACTUALLY A COURSE
TO ACTUALLY HELP PEOPLE TO USE
THAT TECHNOLOGY AND COME AT HIS
OWN COST AND THEY ARE TRAINED
HOW TO USE TECHNOLOGIES AND
THINK THAT LOTS OF DEVELOPERS
HAVE AN INTEREST IN
DISSEMINATING TECHNOLOGY AND
CHALLENGES HAVE TO BE RIGHT AT
SCALE.
>> AND TO FURTHER ANALOGY TO THE
BRAIN INITIATIVE A LITTLE BIT
MORE, I THINK THAT ONE OF THE
WINS OF THE BRAIN INITIATIVE WAS
TO ATTRACT THROUGH NIH PEOPLE
WHO CARED FOR AND NEVER KNEW
WHAT NIH WAS.
ALL OF THE DIFFERENT TYPES OF
SCIENTISTS, MANY, MANY NEW
INVESTIGATORS.
IT REALLY INCREASED THE -- THE
DIVERSITY OF THOUGHT IN THAT,
YOU KNOW, IN THAT WAY.
I SUSPECT THIS WILL BE THE SAME
THING.
BECAUSE WHILE IT WILL BE A
LITTLE OVERLAPPED WITH TYPES OF
THINGS THAT PEOPLE ARE
INTERESTED IN WITH ASPECTS OF
INITIATIVE NEW CADRE OF PEOPLE
NEVER THOUGHT OF NIH AS A
POTENTIAL PLACE TO LOOK FOR
SUPPORT AND SO FORTH.
SO, I -- I CAN SEE THAT AS A --
YOU KNOW, AS AN IMPORTANT, YOU
KNOW, SECONDARY BENEFIT FOR
SURE.
THAT IS CERTAINLY -- YOU KNOW,
IT WAS PREDICTED FROM THE BRAIN
INITIATIVE AND I'M NOT SURE AND
THINK THAT PEOPLE THAT PREDICTED
IT WEREN'T AS READY FOR THE
TREMENDOUS INFLUX OF MANY
DIFFERENT TYPES OF TALENTS.
SO, THE SAME THING COULD
POTENTIALLY HAPPEN HERE.
SO, OTHER COMMENTS OR QUESTIONS?
>> TARA? SORRY I DON'T HEAR
YOU.
>> I WAS GOING TO TAKE A MINUTE
TO MENTION SOME COMMON WORK
GOING ON ACTUALLY IN PARALLEL
AND COORDINATION WITH WORK THAT
THIS WORKING GROUP HAS DONE.
COMMON FUND, IT ACTUALLY IS
GOING TO -- THE FOLKS AND
PROGRAM STAFF WILL ACTUALLY
SHARE A CONCEPT CLEARANCE AT THE
COUNCIL OF COUNCILS IN JANUARY
FOR A PROGRAM CALLED
COMPLEMENTARY AND I WILL READ
THE NAMES I ALWAYS FOR GET
COMPLEMENTARY ANIMAL -- I FORGET
IT AND THAT IS SIMPLE AND WILL
FOCUS ON DEVELOPING
STANDARDIZING AND VALIDATING USE
OF NOVEL APPROACHES THAT WILL
ACCURATELY MODEL HUMAN BIOLOGY.
THEY HAVE SEVERAL GOALS
INCLUDING TO MODEL AND
UNDERSTAND HUMAN HEALTH AND
DISEASE OUTCOMES ACROSS DIVERSE
POPULATIONS AND DEVELOP NAMS
PROVIDING INSIGHT INTO DISEASE
AND BIOLOGICAL PROCESSES.
AS I SAID, VALIDATE AND
STANDARDIZE THEM AND WITH THE --
I THINK RELATED TO A QUESTION
EARLIER, WITH THE LENS OF OR
THROUGH THE LENS OF SORT OF
THINKING ABOUT THE REGULATORY
ACCEPTANCE AND TO COMPLEMENT OR
REPLACE SORT OF TRADITIONAL AND
EXISTING MODELS THAT IS SOME
WORK THAT THEY ARE DOING AND I
WANT TO ALSO MENTION THAT WE
HAVE HAD AN INTERAGENCY RETREAT,
I GUESS, I WOULD CALL IT BACK IN
OCTOBER TO GAIN ADDITIONAL
INFORMATION TO HELP INFORM
DEVELOPMENT OF COMPLEMENTARY AND
ENCOURAGE PARTICIPATION FROM
OTHER FEDERAL PARTNERS AND HELD
SEVERAL LISTENING SESSIONS THAT
WERE PUBLIC TO GAIN INSIGHT ON
GAPS AND OPPORTUNITIES AND
LIMITATIONS AROUND DEVELOPING
THIS INITIATIVE.
AND EXCITINGLY, WE LAUNCHED ALSO
A CHALLENGE FOR A MILLION
DOLLARS THAT WENT OUT A LITTLE
BIT EARLIER THIS YEAR A COUPLE
MONTHS AGO.
IT IS SPECIFICALLY FOCUSED ON
SEEKING INSILICO AND IN VIVO AND
CHEMMICO APPROACHES WITH A
PARTICULAR FOCUS ON THAT
INTEGRATION ISSUE THAT LYRIC WAS
TALKING ABOUT EARLIER.
MILLION DOLLAR CHALLENGE WITH UP
TO 20 AWARDS AND APPLICATIONS
ARE DUE JANUARY 11TH.
WE HOPE TO SELECT WINNERS IN
FEBRUARY.
IT WILL BE EXCITING.
>> THANK YOU FOR THAT UPDATE.
SO, IT JUST UNDERSCORES THAT NIH
IS ALREADY THINKING ABOUT
TANGIBLE WAYS TO BENEFIT FROM
THE WORK OF THE COMMITTEE.
SOME OF THIS IS IN PARALLEL AND
SOME DONE IN CONSULTATION WITH
AND SO I THINK THAT WE ARE ON
OUR WAY TO ACTUALIZING AT LEAST
SOME OF THIS.
IT IS THE BEGINNING.
AND SO OTHER QUESTIONS OR
COMMENTS THAT THE COMMITTEE MAY
HAVE FOR US? OKAY. SOON I WILL
START TO TELL STORIES.
I'M DESPERATELY WAITING FOR
MONICA TO RETURN.
WHEN SHE RETURNS, YOU WILL
UNDERSTAND WHY SHE HAD TO LEAVE.
IT IS OKAY.
ALL WILL BE FORGIVEN WHEN SHE
TELLS YOU WHERE SHE WAS AND WHAT
SHE WAS DOING.
OKAY.
SO, I GUESS WHAT I CAN DO IS ARE
THERE NO OTHER -- YOU ARE REALLY
HANGING ME OUT TO DRY HERE. NO
QUESTIONS AND COMMENTS AND THANK
YOU FOR BEAUTIFUL WORK FOR THE
WHOLE COMMITTEE AND PRESENTATION
AND WILL VERY DELIBERATELY NOW
WE GO THROUGH A TWO-STEP
PROCESS.
FIRST PROCESS THAT I FEEL
COMPLETELY COMFORTABLE GOING
THROUGH IS TO ASK ACD IF THEY
WISH TO ACCEPT THE REPORT AS
PREPA
PREPARED.
WE WILL ASK BY VOTE WHETHER OR
NOT PEOPLE ARE WILL TO ENDORSE
RECOMMENDATIONS THROUGH THE
WORKING GROUP. OKAY?
>> SHOULD WE MAKE A MOTION FOR
THAT?
>> NEED TO MAKE A LONGER MOTION
THOUGH.
>> I MAKE A MOTION WE ACCEPT THE
REPORT AS THE MOST AMAZING
REPORT PRESENTED AND DISCUSSED.
>> THANK YOU. DO WE HAVE A
SECOND.
>> SECOND.
>> NOW, WE HAVE TO PAUSE AND SEE
IF THERE IS ANY DISCUSSION.
OKAY. GUESS NOT. OKAY. ALL
THOSE -- I KNOW I'M NOT ALLOWED
TO DO THE GAVEL NOW.
ALL THOSE IN FAVOR OF THIS SAY
A
AYE.
>> AYE.
>> I NEED -- I HAVE GISELLE,
LUCILA, MARK, YES.
GREAT. THANK YOU.
LET THE RECORD SHOW IN LIMINE
THAT THE ACD HAS ACCEPTED THE
RECOMMENDATIONS.
NOW, IT GETS A LITTLE STICKIER.
I WOULD RATHER HAVE MONICA COME
BEFORE YOU.
WE WILL TAKE A BRIEF BREAK FOR A
FEW MOMENTS TO SEE HOW IT SORT
OF HAPPENS.
I'M NOT -- BY NOW, SHE SHOULD BE
ABOUT READY TO BE COMING BACK.
WE WILL SEE.
WE WILL JUST HANG OUT FOR A
LITTLE WHILE.
AND BUT SO WILL THE COUNCIL LIKE
ANY -- ANY OTHER TOPICS FOR
FUTURE DISCUSSION OR THINGS OF
THAT NATURE THAT YOU WOULD LIKE
TO RAISE SO WE ARE USING YOUR
TIME PRODUCTIVELY?
YEAH. PLEASE.
>> MY INSTITUTION FOR EXAMPLE I
WORK WITH ENGINEERS AND PEOPLE
FROM THE ENGINEERING SCHOOL.
>> RIGHT.
>> I DON'T THINK THEY THINK OF
NIH AS FUNDING. IT IS FUNNY.
THEY GO TO NSF. IT IS
INTERESTING HOW DIFFERENT. BOTH
NIHS YOU ARE TRYING TO REACH OUT
TO DIFFERENT CONSTITUENCIES.
>> YEAH.
>> THEY ARE ALSO VERY MUCH KIND
OF A -- IT IS TOUGH. NEEDS TO
BE APPRECIATION ON OTHER SIDE OF
THE OPPORTUNITY.
IT IS A FUNNY.
>> INTERESTING DYNAMIC AND WE
INSTITUTE AND NIDIP THAT
ENCOMPASSES ASPECTS OF
ENGINEERING.
>> RIGHT.
>> NOT AS BROAD AS A FULL SCHOOL
OF ENGINEERING.
WE HAVE THAT INSTITUTE.
THEY -- YOU KNOW, THEY HAVE DONE
PRETTY REMARKABLE THINGS DURING
THEIR LIFETIME.
YEAH. I THINK THAT YOU ARE
RIGHT AND THAT IN GENERAL THEY
TEND TO GO TO NSF OR DOE OR, YOU
KNOW, DARPA. YEAH. YEAH. HOW
YOU -- HOW YOU -- MAYBE THINGS
LIKE THIS WOULD ENKRENTIVIZE.
YEAH. THIS MIGHT HELP
INCENTIVIZE.
OTHER THINGS PEOPLE WOULD LIKE
TO RAISE? WOULD YOU LIKE TO BE
LEFT ALONE OR CHECK E-MAILS?
>> QUESTION.
>> YEAH.
>> WE HAD AN OPPORTUNITY EARLIER
TO HEAR FROM DIRECTOR OF ARPA-H.
THEY ARE A SEPARATE AGENCY AND
WILL WE HEAR MORE ABOUT WHAT
THEY ARE DOING OR WHAT IS THE
EXPECTATION?
>> WE CAN CERTAINLY ASK.
AS YOU KNOW, IT IS A SEPARATE
AGENCY THAT IS PART OF THE NIH
ORGANIZATIONALLY.
THEY MAKE USE OF SOME OF OUR
EQUITIES AND SOME OF OUR
ADMINISTRATIVE SYSTEMS AND THINK
THERE IS SOME CROSS-TALK AMONG
ARPA-H ACROSS SOME INSTITUTES
AND CENTERS AND DIRECTOR OF
ARPA-H ATTENDS DIRECTOR
INCENTIVE MEETINGS WE HAVE AND
CERTAINLY IS AN OPPORTUNITY FOR
MORE ONE ON ONE ENGAGEMENT. WE
WILL CERTAINLY RAISE WITH MONICA
THE POSSIBILITY OF INVITING RENÉ
BACK AT OUR FUTURE MEETING AND
WISH YOU WERE HERE NOW.
I WOULD HAVE HER SIT DOWN AND
GIVE A BRIEF UPDATE. THAT WOULD
BE GREAT. OKAY. ANY OTHER
POINTS YOU WOULD LIKE TO RAISE?
OKAY. I -- LET'S TAKE A BRIEF
BREAK.
WE WILL REVISIT THINGS AT 4
O'CLOCK TO SEE IF ANYTHING.
WHAT -- WE HAVE -- WE HAVE A
SHUTTLE OF SOME SORT.
>> YES.
>> [OFF MIC].
>> THEN THE SHUTTLE WILL COME UP
AGAIN. FOR THOSE THAT JOIN US
THIS EVENING, CERTAINLY CASUAL
IS FINE.
I WILL CERTAINLY NOT LOOK LIKE
THIS.
AND THE -- THE -- I THINK SOME
OF YOU KNOW THIS. THE HOTEL IS
LITERALLY TWO MINUTES FROM MY
HOUSE.
IT IS NOT A VERY LONG COMMUTE.
IT IS A LITTLE CHILLY OUT
OTHERWISE WOULD SAY YOU CAN
PROBABLY WALK IT.
IT IS CHILLY SO. IT IS FINE.
I'M SORRY.
>> DO WE HAVE A DATE?
>> I'M SURE WE DO. I'M SURE WE
DO. DO YOU KNOW THOSE OFFHAND,
CINDY?
>> I -- OKAY. YEAH. THEY ARE
USUALLY DONE QUITE -- WHAT IS
THAT? IT IS A SUNDAY?
IT IS PROBABLY NOT JUNE 9TH THEN
BUT YOU ARE WITH US IN FACT.
THANK YOU.
I APPRECIATE YOUR DEDICATION AND
WE WILL FIND IT OUT FOR YOU.
OKAY. WE ARE -- I AM REMINDED
WE ARE STILL LIVE.