>>Dr. Harold Varmus:
It's been exactly one year,
fifteen days, and zero hours
since I was sworn
in as the director of the NCI
and this first anniversary is an
opportunity for me
to take stock.
What are my ambitions
and hopefully shared ambitions
of all us for the next
five years?
The first is to think
that we'll have some answers
to some of my favorite
provocative questions
within the next few years.
Some obvious questions I'd
like some answers
to in the next few years are:
first, how does obesity
contribute to the incidents
and mortality of cancer;
why does some commonly used
drugs like aspirin appear
to reduce the risk of cancer,
both incidence and mortality;
how do some neurological
diseases like Parkinson's
disease for example,
confer protection
against cancer.
The second ambition is actually
the most obvious but it has
to be stated
because it is incredibly
important and that is;
I'd like to see
over the next couple
of years a much more substantial
incorporation
of our molecular understanding
of cancer into all phases
of cancer control.
I expect to see a pretty
dramatic revolution
in epidemiology defining cancers
not simply pathologically
under the microscope,
but by genetic subsets.
I expect to see molecular tools
brought more forcefully
into the realm
of cancer diagnosis.
Hopefully in the very near
future, we'll be talking
about ways to discriminate among
early lesions
and precancerous lesions
that may have malignant
potential again
by defining molecular changes
in those lesions.
What I'd like to see happen
over the next couple
of years is an accepted
integration of research
on cancer into the menu
of what constitutes a global
health initiative
for this country.
So this means not simply
treating more people
in poor countries for cancer,
it means improving our
traditional epidemiology
by which we determine
which cancers are most common
in which countries,
broadening the strategies
for prevention
in developing countries,
identifying opportunities
and the means
for affordable treatment.
The fourth general ambition is
the only mention I'm going
to make about money,
but I think we can get better
prepared for the need to adapt
to budget uncertainties.
Now this raises some NIH-wide
issues, perhaps these are U.S.
government-wide issues,
about our contract
with granting institutions;
should we use more so-called
R21 grants?
Some would argue they encourage
exploration
and more innovative proposals.
I think we need
to think a little bit
about the numbers and sizes
and shapes of our
multi-investigator awards.
I strongly believe in the need
to encourage teamwork
between investigators within
and between institutions,
but also some awards
to our most
outstanding investigators.
I mean both new
and more experienced
investigators; grants of seven
to ten years for a few percent
to decrease the burden
on the review system.
I want to be sure
that we're paying attention
to our training program as big
as our training programs are;
one of our best means
for recruiting people
to the Intramural NIH.
I would like to believe
that over the next few years we
can develop a greater sense
of public trust.
That is trust by the public
and the idea
that NCI is making progress
against cancer,
is spending its funds wisely,
and is acting
in the public interest
from many points of view
with respect to the way
in which we conduct science.
I am able to bear witness
and some others of you
in the room can as well
to the remarkable transformation
of cancer research
that has occurred
over the last forty years or so.
We need to get out there
and talk about the depth
of the change that's occurred
in this field
from a time forty years ago
when we didn't have a clue
about how a normal cell became a
cancer cell,
to a time when virtually
everything we do
to understand cancer cells
becomes a topic
for contemplation about new ways
to diagnose, treat,
and prevent cancer.
We have a responsibility to make
that change known to the public.
That is the only way
in which we'll be able
to ensure the public's
commitment to what we at the NIH
and the NCI do.
Thank you very much
for your attention today.
[ Applause ]