Forging new partnerships  pg. 2

Spiegel: There is cultural change needed at the level of the university and academic medical center in order to foster multi-disciplinary investigations. It is increasingly important to bring in the mathematical and physical sciences, computational biology. The sheer volume of data we are inundated with from advances in genomics and proteomics, for example, mandates that biology take on more of a ‘math’ kind of tone.

Equally important is the need to break down some barriers between universities, and allow investigators to come together so they can apply their talents. The current system of promotion tends to discourage this. If you are part of a collaborative effort, it’s hard to identify the individual contributions upon which, historically, decisions of tenure have been made.

Lens: How important is NIH funding in diabetes research?

Spiegel: Extremely important; relative stability in funding is particularly important. In the early 1990s, the funding of the NIH hit a real low. Under those circumstances, sadly, the success rate of applicants for research grants began to plummet. It had a ripple effect, discouraging individuals from going into science.

In the past three years, NIH-wide funding of diabetes research has increased substantially, from $688 million in the 2000-2001 fiscal year, to an estimated $946 million in the coming fiscal year (2003-2004).

One of the powerful messages that needs to be disseminated is: You can’t go from feast to famine. Investment in medical research is something that pays off, not only in terms of improving quality of life and preventing mortality, but economically. The entire biotechnology industry was built on the fundamental investment of NIH resources.

Lens: How important is it for universities and the government to collaborate with industry? What are the barriers to successful collaboration?

Spiegel: This is a vital partnership. A prime example is recombinant DNA technology, which largely came out of curiosity-driven research about restriction enzymes. Through the private sector, it was converted into an enormously successful enterprise that is delivering new, innovative treatments.

But this partnership with industry has to be assiduously framed and monitored, not only to guarantee appropriateness and safety in clinical trials, but also to ensure the sharing of resources, data and research findings. In recent years, universities have promulgated some very clear guidelines regarding the need to publish and how to address real or perceived conflicts of interest, both as individuals and institutions.

Lens: What are some other challenges to translating research findings into benefits for patients?

Spiegel: One translational block is in the dissemination of information. It’s well established, for example, that certain drugs called ACE inhibitors are unequivocally effective in halting the progression of diabetic kidney disease. Why aren’t we applying this knowledge far and wide?

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