NIH initiatives will transform medicine in 21st century

May 2 - Fort Lauderdale, FL - The National Institutes of Health (NIH) is taking an active role in transforming medicine in the 21st century because the burden of public health is changing from an acute to a chronic disease pattern and the population is rapidly aging, explained Elias Zerhouni, MD, who delivered the first of two keynote addresses at the Association for Research in Vision and Ophthalmology annual meeting.

Healthcare costs as a percent of gross domestic product (GDP) continue to climb. This year, healthcare costs per American are estimated to be $5,500 or 15% to 16% of GDP. In the next 10 years, healthcare costs are expected to be 18% to 20% of GDP, noted Dr. Zerhouni, who was appointed director of NIH in 2002.

"In the 21st century, we have to intervene before symptoms appear and preserve normal function for as long as possible," he said. "That is a realistic goal because our understanding of preclinical molecular events and our ability to detect patients at risk is increasing. This would be effective in terms of public health and cost."

This can be accomplished by multiple initiatives:

• Accelerate the pace of discoveries in life sciences;

• Enable deeper understanding of pathobiology of disease prior to irreversible damage;

• Translate research more rapidly from laboratories to patients and back;

• Explore new biomedical strategies that need to be orders of magnitude more effective than current ones.

NIH's latest initiative is the Neuroscience Blueprint, which involves the National Eye Institute (NEI) and all the other neuroscience institutes. "This initiative was undertaken because of the impact of diseases of the nervous system-mental health, neurological diseases, and eye disease-accounts for 6 of the top 10 causes of death," Dr. Zerhouni said. "In terms of the economic cost, it is about five times that of diabetes or $500 billion per year. And it is the number 1 cost of disability in patients age 25 to 44 years.

"This area of investment has a clear rationale, both scientifically as well as from the standpoint of policy," he said. "You will see a tremendous amount of coordination across the 15 institutes, but clearly NEI is going to benefit in a great way because NEI is participating in every component of the Neuroscience Blueprint."