HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, September 25, 2008

Federal Health Official to Step Down

The New York Times reports that Dr. Elias A. Zerhouni, director of the National Institutes of Health, who shook up the agency when he barred scientists from consulting for drugmakers, announced that he would leave at the end of October.  Gardiner Harris writes,

Zerhouni_wwwnytimescom_chris_kleponDuring his six-year tenure, Dr. Zerhouni pushed scientists to focus more on patient care and less on basic research, and he forced the agency’s independent institutes to cooperate on common projects. But he also faced a stagnant budget that has curtailed research around the country and demoralized scientists.

In a conference call with reporters, Dr. Zerhouni said he planned to write about his time at the health agencies before accepting another job.

“I know there’s speculation that I’m going back to Johns Hopkins,” Dr. Zerhouni said. “That’s not been decided by me at all. I want to finish here, take a few weeks, maybe write a bit and evaluate what I want to do next.”

One of the few prominent Arab-Americans in the Bush administration, Dr. Zerhouni is an Algerian immigrant who came to this country more than 30 years ago with $369 in his pocket and became a multimillionaire after inventing numerous devices as a radiologist at Johns Hopkins University.

Dr. James Thrall, chairman of the radiology department at Massachusetts General Hospital, said that Dr. Zerhouni got the health institutes to focus “on the big problems, big issues and big opportunities.”

“Uniquely among all the recent people to hold that position, he got the battleship to turn in a different direction,” Dr. Thrall said of Dr. Zerhouni.

The most controversial part of Dr. Zerhouni’s tenure was a years-long Congressional investigation of agency scientists who mixed their government research positions with private consulting deals. Dr. Zerhouni decided in 2005 to ban agency scientists from consulting for drug and device companies.

The ban was unpopular among many agency scientists, who said it would make recruiting top scientists difficult. But in the wake of continuing Congressional investigations, a growing number of medical schools and medical groups are now cracking down on the outside consulting relationships of their faculty and staff members.

“I took decisions early relative to conflict of interests that are frankly now proving to be the right ones,” Dr. Zerhouni said.

Dr. Zerhouni said his tenure at the health institutes could be split into three periods. His first two years, he said, were a “euphoric phase” because the agency’s budget was growing rapidly. The second two years were difficult. Besides the conflict of interest controversy, the agency’s stagnant budget during this time forced him to explain “why it was harder getting grants.” His final two years involved “institutionalizing many of the reforms I had been advocating” and hiring many of the agency’s present leaders.

Dr. Ezekiel J. Emanuel, chairman of the agency’s department of clinical bioethics, had criticized Dr. Zerhouni’s handling of the conflict-of-interest scandal but said Wednesday that Dr. Zerhouni “has been a victim of very difficult circumstances that he didn’t create.” Dr. Emanuel praised Dr. Zerhouni’s clinical research initiative.

Dr. Zerhouni was chosen after President Bush announced strict limits on federal financing of stem-cell research, and the White House made clear that Dr. Zerhouni was expected to support this policy. But in 2004 and 2005, Dr. Zerhouni told Congress that the president’s policy was hindering scientific progress.

That he maintained the support of the White House despite this public disagreement is noteworthy. By contrast, Dr. Richard Carmona, whose appointment as surgeon general was announced on the same day as Dr. Zerhouni’s, was forced from his job in 2006 and later told a Congressional panel that he had been muzzled and his initiatives suppressed.

Dr. Zerhouni said he decided to leave the agency before the election “so there is a clear sense that whoever wins the election, N.I.H. has to be a clear priority in their mind.”

Raynard S. Kington, deputy director of N.I.H., is expected to serve as the agency’s interim director for the remainder of the Bush administration.

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This agency consumes 40% of the national medical research budget. These so called scholars do not even teach doctors in training to generate any benefit to the public. The output is quite ordinary, as if from an ordinary research medical school. It does not warrant such great expense. I find it ironic that this Director made his $millions from medical devices. He prohibits outside collaboration with device makers. It is interaction between basic medical scientists and these private companies that generate all big advances in medicine. Ordinary clinicians then generate creative, unforeseen endless uses for drugs and devices that repay the public 10,000% return on investment, guaranteed, year after year to the end of life. The government does nothing well. Once these scholars leave the NIH service, their productivity rockets up like fireworks. This is true of all government workers, including the military (see the effectiveness of Saddam's army before and after leaving Saddam's government).

The idea of government research is absurd on its face. It is a total waste, not just partially wasteful. The government should be defunded to a bare minimum. It is a wholly owned and 99% controlled subsidiary of the criminal cult enterprise that is the lawyer profession. The hierarchy of this cult enterprise must be decapitated before we can end its government incompetence and oppression.

Posted by: Supremacy Claus | Sep 25, 2008 7:22:15 PM

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