Eric Green: Well, let me start by giving my own welcome
to all of you.
Thanks for coming.
I agree and want to echo what Howard just had to say, that some of you, we know, traveled
far to get here, in some cases with many other demands on your time.
So, we appreciate you coming and spending two days with us in Bethesda.
Let me also thank Howard McLeod specifically for his willingness to co-chair this meeting,
along with Teri Manolio.
I thought I would just spend a few minutes setting the context for this meeting, which
I think is important to appreciate.
You know, on the one hand, we asked you to come here, and we’re going to sort of take
stock of the NHGRI genomic medicine portfolio.
And in some ways, you may just take that for granted.
But I have to admit that when I opened up the book, when I got here this morning and
actually saw it in print, the NHGRI’s genomic medicine portfolio, I should just point out
that it wasn’t obvious that there was going to be a portfolio, that this wasn’t something
we’ve done from the beginning of the Institute’s existence some, now, you know, 24, 25 years
ago.
And the fact of the matter is, we are here to evaluate and to get input about our portfolio
because of a substantial amount of effort to create such a suite of programs in a -- in
a situation that allows us to now capitalize on these great opportunities in genomics.
So, you know, I’ve been director now for a little over five and a half years.
And certainly, one of the goals I set forth when I applied to be the director was to try
to infuse more clinical applications of genomics into our extramural research program, having
seen early efforts of that bear fruit in the intramural research program, which I had been
a part of for a number of years.
And it wasn’t that it was absent at the Institute.
It was -- there was -- besides the intramural program, there were elements of it starting
to gain some traction within the extramural program and other parts of the Institute.
But we really -- I personally felt that it was a bit -- it was -- the timing was right
to have a more substantive effort in clinical applications of genomics.
Shortly after I became the director, we finished and published a new strategic plan for the
field of genomics, which now is four years old.
It was published in 2011.
The significant feature of that strategic plan, besides doing all the things our previous
strategic plans had done in describing all these grand opportunities across a wide variety
of areas of genomics, was to really signal a commitment to see genomic medicine become
a reality.
And in fact, the phrase “genomic medicine” was put into the title of that paper deliberatively.
Now, what’s transpired since that strategic plan was published in 2011?
Well, the history here was this idea to start now thinking about, what are we going to do
in this new area?
That eventually -- actually, I believe, from input of then-Council member Geoff Ginsburg
was the suggestion to start having workshops to sort of look at what the opportunities
are.
And that resulted in Genomic Medicine I, which took place in 2011.
And in some ways, the rest is history.
Now we’re at GM8.
And what has happened, needless to say, is that we’ve actually put a portfolio together,
and our extramural research program around genomic medicine.
And so, where we are now is essentially in a position, having now been a number of years
into starting to get programs out of the gate; in some cases, they’re starting to mature,
but they’re -- other ones are younger, and other ideas are still brewing -- is, we want
to assess and review where we are.
That’s the purpose of this meeting.
And we have a portfolio.
And I would also point out -- I think it’s particularly exciting to think about the fact
that we actually are having a workshop to evaluate a new set of programs that actually
be called a portfolio, having come out of what arguably has been the worst budgetary
climate for the NIH, certainly in the 20 -- nearly 22 years I’ve been at the NIH.
But I believe it’s probably the worst budgetary circumstance, if you add in the sequester,
and all the question marks we’ve faced, probably for 40 or 50 years.
And yet, I think, to the credit of our advisers, to the credit of our staff, to the credit
of the community, we’ve been able to at least get some things out of the gates and
to have some programs that we’re going to talk about throughout this workshop.
And that’s great, the fact that we’re able to do that.
So, in thinking about what we’re asking you to do for the next couple of days, and
the input I am -- I certainly want, but I know the staff wants as well -- there probably
are other factors just to remind you of.
Now, some of you know this really well, especially some of our Council members who are here.
But I do just want to remind you sort of the broader context that NHGRI is going to operate
in relative to the NIH.
And -- number of things.
Number one, keep in mind, despite having -- and I know the cameras are rolling, but I’m
just going to say it anyway -- we have a very large intellectual footprint.
It’s probably just a lot of pride I have for the field of genomics that many of you
have helped contribute to.
But despite having this immensely large, cutting-edge, exciting intellectual footprint responsibility
around genomics, we are small.
You know, we are only 1.7 percent of the NIH budget.
We are not a big institute.
So, we can’t do everything.
So, that’s number one.
Number two, at the same time, it’s not that we want to stop doing many of the things that
the Institute has led in for a number of years.
We need to be thinking about many aspects of technology development, of basic genomics,
of mechanisms by which the genome operates, and so on -- understanding genomic variation,
understanding the role variation plays in health and disease.
We are now a full sort of spectrum institute, complete from the most basic questions to,
now, the most important clinical applications.
And yet, we remain small.
So, while we have this incredible spread across the landscape of biomedical research, we are
doing so, you know, with a relatively modest budget, which means we have to be incredibly
selective.
We have to be strategic.
We have to partner a lot.
Meanwhile, what has, of course, happened -- number three, meanwhile, is that almost all other
institutes and centers at NIH are doing genomics.
And we have many representatives from around this table already, and others are going to
be joining us throughout these two days.
And that’s a great thing, and we welcome that, and we regard it as part of our success,
that we are seeing genomics become infused across all of NIH.
What that does, of course, is lead to the obvious question -- what should NHGRI do,
relative to other institutes?
When do we do it together?
When do we cede it to them?
And obviously, what gets very challenging in the genomic medicine space for us is deciding,
especially when we’re going to invest in programs or projects that are going to, by
necessity, have to stick their toes into specific disease areas, should that be what NHGRI is
spending its dollars on?
Or should that be left to another institute who focuses exclusively on that disease area?
But of course, we want to sort of help push the cutting edge.
Sometimes that means we have to put some of our skin in the game.
So, what we do a lot now, and we attempt to do even more in the future, is to partner
with other institutes, and -- even if it means we’re putting some money into a -- into
a joint program that involves a specific disease area.
So, those are sort of all the cautions.
We’re small, we’re broad in what we’re doing, and lots of other institutes are doing
it, so why should we be doing?
There’s all those dilemmas.
So, those are all the cautions.
Now, meanwhile, though, I want to leave you with a couple optimistic ideas that I think
will be important for what we’ll be doing the next two days.
First of all -- and I don’t know if -- this isn’t real wood, but knock on wood, you
know, it appears the budget might be approval.
We might be entering a new era that -- where the budgetary circumstance might be very different
than it was the last five years.
Now, there’s lots of question marks.
We can’t take anything to the bank.
But the fact of the matter is, all of the signals are looking better than what it has
been the last few years.
And while that means we have lots of catching up to do because lots of things are really
hurting because of the bad budgetary circumstance, there might be a situation where we can start
to do things we couldn’t think of doing because of a lack of funds.
So, hope -- we want to be prepared in case all the good things happen that we hope will
happen.
And then, the last thing to keep in mind, also, which maybe is intermixed with this
new era, and it -- but it is -- you know, I’m sure it will come up at some point -- not
that we have a lot of certainty of what this is going to look like, but the Precision Medicine
Initiative has created a lot of attention to this general area.
But it’s obviously bigger than genomic medicine.
There will hopefully be new money at a new initiative.
And many of us in this room actually are involved in craft -- well, will be involved in crafting
this and executing it, assuming the money comes in next year.
And so -- but we will similarly have to think about, well, where does any -- where is precision
medicine, and where does that relate to NHGRI and NHGRI’s genomic medicine portfolio?
And of course, I have no idea the answers to that because we still don’t know exactly
what the Precision Medicine Initiative is going to look like.
So, the bottom line is, we need to be nimble, and that we also need incredibly valuable
input so that we can be nimble and be effective at the same time.
So, what we’re asking this workshop to do, in my opinion -- and Teri, I think, is about
to frame the rest of the workshop, and I’m sure she’ll have her own spin on this and
her own way of looking at it, as a person closer to having to execute this -- is, number
one, to help us prioritize.
Look at what we’re doing, and talk about additional opportunities, but importantly,
help us prioritize, since we know we can’t do everything.
Be very valuable to know what the levels of enthusiasm are for various things.
And then, the second thing to do, again, with the hope that we’re entering a new era,
is give us, I guess, what I would call, you know, sort of shovel-ready ideas or at least,
you know, a vision for new things we want to do or ways to mold what we are currently
doing and having them be is -- in a situation that they’re intellectually shovel-ready,
so that if and when things present themselves with new budgetary circumstances, we don’t
want to be on our heels -- not that our institute ever is.
But we really, in this case -- we want to be on our toes.
And the more developed the ideas are, even if it means we have to put them on hold until
the right circumstance comes along, I’d rather have the great ideas on that list,
ready to surge ahead with.
And I know I can speak for members of Council; we just talked about this just a couple weeks
ago, that -- the idea of just being poised -- and just in a what-if scenario, if things
get better, to just jump right in and have a projects or project ideas ready to go would
be extremely beneficial.
So, that’s what I’m looking for, I think a lot of my staff’s looking for.
But you’ll be hearing from others of the staff because they’ll have their own unique
ways of looking at this and what they’re going to need from this workshop as well.
So, that’s what I wanted to say, Howard, and thank you very much.
Looks forward to spending a couple days with you.
Howard McCleod: Thank you.
[end of transcript]