The NIH Roadmap
Authors: Inder M. Verma
Journal: Molecular Therapy (2004)

On 30 September 2003, NIH Director Dr. Elias Zerhouni announced a five-year plan that laid out a series of far-reaching initiatives known collectively as the NIH “Roadmap for Medical Research.” In anticipation of lawmakers’ concerns over budget accountability and ethical issues, the roadmap was developed with input from more than 300 leaders in academia, industry, and government to provide guidelines for the optimization and prioritization of the NIH research portfolio. To be part of the roadmap, “scientific initiatives had to be deemed of high potential impact, had to enhance the disease- and mission-specific activities of all of NIH's twenty-seven institutes and centers, and had to respond to the needs and concerns of the public, “ according to the NIH press release. The roadmap focuses on the most compelling opportunities in three main areas: new pathways to discovery, future directions of research and the re-engineering of the clinical research enterprise. Implementation of the agenda is forecast to cost $2. 1 billion dollars over the next five years. The financial burden will be borne by existing NIH budgets rather than new sources of funding. According to Zerhouni, the roadmap was designed “to remove some of the biggest road blocks that are keeping research findings from reaching the public as quickly as possible, “ and covers the broad spectrum between basic science and the clinic. The roadmap recognizes that the scale and complexity of today's biomedical research requires scientists to move beyond the confines of their own métier and to cross into other disciplines—perhaps requiring a new organizational model for team science. It is increasingly common for basic biologists to work with structural biologists, imaging experts or bioinformatics gurus. It is becoming difficult for any single laboratory or institutes to sustain the rapid progress and expense of modern medical technology. Clearly, updating access to technology and infrastructure should energize and stimulate the much hallowed hypothesis-driven, “R01 style” of science. However, there is some uneasiness with the concept of the “research team of the future,” new partnerships between “public and private sectors,” and “infrastructure for a multidisciplinary tool box.” Many question whether the funds diverted to the roadmap will cannibalize our traditional source of funding, the R01. The proponents of the roadmap assert that there will be no adverse effects on extramural funding—although this may be overly optimistic. However, an even bigger concern is the concept of changing the culture of science. Scientists cherish individuality and freedom. Most researchers that I know are entrepreneurs, and if solving a biological problem requires crossing disciplines, they readily do so. The concept of relinquishing recognition of independent contributions for the greater good of the team will take time to settle in. The NIH remains a fundamentally important proponent and supporter of basic medical research in the U. S. and in the world. So we should take a serious look when Dr. Zerhouni's motivation for establishing the roadmap is to allow the NIH to “do something that no other entity can or will do.” There will be pressure from Congress, who will judge its success by the number of new drugs discovered or diseases cured. There will also be pressure from the public who are increasingly intolerant of grand technical fixes, even while they hunger for new cures. Unfortunately, the tension between science and society continues to widen, polarized by the extreme views espoused by politicians and religious leaders. The roadmap will not alleviate the uneasy relationship of the scientific community with proponents of traditional beliefs, but its goals aspire to bring science closer to its beneficiaries. Like any experiment, we must give it a chance.