Archive for the ‘NIH Director’s New Innovator Award’ Tag

Rapid Advances in Ebola Research

The current Ebola outbreak is by far the largest since this hemorrhagic fever was identified in 1976. Previous outbreaks involved dozens or hundreds of infected people (click here for CDC chronology). Estimates of the current outbreak are 2,473 infections and 1350 deaths thus far. Outbreaks begin by transmission through close contact with infected animals, then rapidly spread through human communities via direct contact with bodily fluids of infected people, or through contact with items contaminated with such fluids. Once infected, case fatality is as high as 90% (click here for WHO fact sheet). There are currently no vaccines, treatments, or cures. Traditionally, outbreaks have been controlled largely by infection control measures (masks, gloves, etc.) and quarantine, and supportive care such as hydration of the infected patient.


Experimental Treatments: A promising drug called ZMAPP was given at Emory University to two missionaries who were infected with Ebola. Both have gotten better. The drug was also given to a Spanish priest who died soon thereafter, though the timing of drug delivery may have played a part in the drug’s efficacy in this case. As of this week, it appears to be helping three Liberian health care workers. The drug is manufactured by Mapp Biopharmaceutical Inc. It is not FDA approved at present, nor can this monoclonal antibody be produced quickly in large quantities. Other drugs are in development but have yet to show as much promise as ZMAPP. Ebola is a rare disease and affects poor countries almost exclusively, so limited funding is provided mostly by government agencies (see $28 million consortium led by Scripps and funded by NIH, and the recent $10.8 million initiative announced by Wellcome Trust and the United Kingdom’s Department of International Development.) I generally distrust .com coverage of anything related to medicine (and so should you), but this recent CNN piece on ZMAPP seems reasonable, if you would like more information.


Cause of the Current Outbreak: NIH announced this morning that researchers funded by NIH have used advanced genomic analysis to determine the single point of infection from an animal that led to the current outbreak, and that since that initial infection the spread has been solely human to human. Importantly, through their genetic analysis, the researchers can see how the virus has mutated since December to outsmart human immune systems. As we know, viruses are little more than tiny pieces of DNA that can mutate with diabolical speed to outsmart the comparatively slow human immune response. By understanding how infection occurs, how disease is spread, and how viruses are mutating to defy immune attack, these researchers have taken a giant step toward improved treatments and a cure. The team was led by Pardis Sabeti, MD, PhD (who not surprisingly won a highly prestigious NIH Director’s New Innovator award in 2009.)


Experimental Vaccines: Next week, NIAID will begin the first of several phase I clinical trials of an Ebola vaccine produced in collaboration with GlaxoSmithKline (for details, click here). They will also test an Ebola vaccine developed by the Public Health Agency of Canada and licensed to NewLink Genetics Corp. NIH will partner with a British-based international consortium to test volunteers in the UK, and in the West African countries of Gambia (with approval of local authorities) and Mali. The CDC is in discussion with Nigerian officials about testing vaccines there.


What Does the NIH FY12 Appropriations Report Actually Say?

Why should we follow the Appropriations process? Aside from the obvious reason—to know how big the pot of extramural money will be next year and to understand the government’s commitment (or lack thereof) to science funding—there is another important reason: If you know the language worked into Appropriations testimony you can strategically design your research and incorporate key language and ideas into your NIH proposal in order to improve your odds of funding. (In these competitive funding times, every little advantage helps.) So without further ado, here are some key concepts from the NIH FY12 Appropriation report:

NIH has requested $31.987B for FY12. In the cover letter for the report from the Office of the Budget, Francis Collins states: “The requested funding will enhance NIH’s ability to support research that prolongs life, reduces disability, and strengthens the economy. NIH-funded research contributes to economic growth, produces well-paying jobs, and helps to keep the United States competitive on the global stage.” He continues: “For the FY 2012 budget request, NIH has identified one major area of extraordinary opportunity and three other themes that are exceptionally ripe for investment and integral to improving the health of the American people.” The one major area of opportunity of course is the proposed highly-controversial National Center For Advancing Translational Science (NCAT), which Collins refers to as “a new paradigm for turning lab discoveries into cures and treatments through targeted investments in translational science and medicine.” The three themes that NIH has deemed “instrumental in paving the way for more rapid scientific advances across all areas of human health and disease, including global applications”:

 1) Technologies to Accelerate DiscoveryThis area focuses on genes and the environment (I guess we will see more of those FOAs), and directly lists advanced technologies such as DNA sequencing, microarray technology, nanotechnology, new imaging modalities, and computational biology.

2) Enhancing the Evidence Base For Health Care Decisions. Language here includes “comparative effectiveness” and “personalized medicine.” He also cites the new HMO Research Network, which “will bring together HMOs caring for more than13 million patients for the purpose of accelerating research in the high priority areas of epidemiological studies, clinical trials, and electronic-health-record-enabled health care delivery.”

3) New Investigators, New Ideas. Here Collins mentions two programs: “the NIH Director’s New Innovator Award, which supports new investigators with potentially high-impact projects, and the Early Independence Award, which enables our most talented young scientists to move directly from a doctoral degree to an independent research career.”

If you write NIH grants, I strongly encourage you to spend some time with the full Appropriations report put out by the NIH Office of the Budget. (click here)

The Administration requested $31.829B for NIH FY12. Here are highlights that the Administration pulled from the NIH report (and therefore deem important):

*The FY12 budget proposes to support a total of 9,158 competing Research Project Grants (RPGs), a reduction of 228 from FY10. In total, NIH projects it will support 36,582 RPGs (competing and non-competing) in FY12, an increase of 43 grants from 2010.

*The budget also proposes a 4 percent increase in stipends under the Ruth L. Kirschstein National Research Service Award (NRSA) program. The goal is to “improve NIH’s ability to attract high-quality research investigators to the field of biomedical research.” This will result in an increase in NRSA funding of $19 million over FY10, for a total of $794 million.

*The Cures Acceleration Network would receive $100 million in FY12; it is included in the budget of the Office of the Director.

*As in previous years, $300 million is transferred out of the budget of the National Institute of Allergy and Infectious Diseases (NIAID) for the Global Fund to Fight HIV/AIDS, Malaria, and TB.

*Although the budget narrative specifically mentions implementation of the National Center for Advancing Translational Sciences (NCATS), the National Center for Research Resources (NCRR) remains a line item in the FY12 budget.

*At a briefing of NIH advocates, NIH Director Francis Collins said that within the next month, the agency expects to file a budget amendment detailing the movement of NCRR programs into NCATS or other NIH institutes and centers.

*The National Children’s Study would receive $194 million, the same level as FY10; the Common Fund would receive $557 million, an increase of $13 million.

*NIH intramural research would increase by $50 million, to a total of $3.382 billion, which is approximately a 1.4 percent increase.

*NIH estimates it will be able to save more than $15 million in administrative costs in FY12. The agency plans to do so through such means as using technology to save study section travel costs by holding virtual peer review sessions.

To illustrate the achievements of NIH, Dr. Collins used two particularly compelling examples at the budget briefing:

*A 21-year-old diagnosed today with HIV/AIDS has a life expectancy of 70 years, thanks to the anti-retroviral         therapy made possible by NIH funding.

*Gains in life expectancy supported by NIH-funded research result in $3.2 trillion in annual savings.

NIH identified in its FY12 budget justification priority areas and initiatives related to the following diseases: autism; cancer; Alzheimer’s disease; type 1 diabetes; and HIV/AIDS.

Some scientific program areas of accomplishment or special emphasis provided by NIH include: bioinformatics and computational biology; National Technology Center for Networks and Pathways programs; epigenomics; genotype-tissue expression; global health; Gulf oil spill long-term follow-up; health economics; high-risk, high-reward investigator initiated research; the HMO research collaboratory; the human microbe project; and nanomedicine.

Posted April 27, 2011 by Meg Bouvier in Biomedical research, medical grant writing, medical policy writing

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