Zerhouni seeks balance between science, politics

Elias Zerhouni has been director of the National Institutes of Health (NIH) since May 2003. During his four years in the position, the Algeria-born physician has contended with stagnant budgets, ethics controversies, political tension over embryonic stem cell research and the first reauthorization of his agency in more than a decade. Zerhouni oversees the 27 institutes and centers on the NIH’s sprawling Bethesda, Md., campus, each with its own mission and priorities.

Q: After undergoing a two-fold increase from 1998 to 2003, the NIH budget has remained practically flat at about $28 billion a year. What are the biggest challenges this presents to you as director?

A: Well, as you know, one of the greatest challenges is to manage the transition between a really rapid escalation of the budget and then a rapid deceleration to a level that is flat, abruptly, for programs that really are multiyear programs. … It affects all large organizations, whether it be NIH or any other organization or large corporation [or] large universities, and that is the balance between the need to have decentralized units that focus on their missions specifically versus the need to coordinate the activities of these institutes.

Q: How difficult is it to balance your position as a representative of President Bush, who requested these flat budgets, with your responsibility to carry out the NIH’s research goals?

A: You have to make tough choices. This is not an easy discussion to have, both internal through the administration and with Congress. But my view is that I think you need to both be an advocate for what your agency does but you also have the discipline of implementing rigorous policies that truly prioritize what you can afford. … That, to me, is leadership. You can’t just say, “Well, I’ll deal with what I have,” or, “I need more, no matter what.” You really have to, I think, communicate a clear vision.

Q: The Bush administration has been the target of criticism that it subverts scientific evidence in support of its political agenda. Have you or your subordinates ever felt political pressure from the White House?

A: I’ve never felt that way. I mean, we have a very open peer-review process here, which is probably one of the cornerstones of success of American science as compared to other countries, where scientific investments are in fact politically motivated and influenced. … We’re pretty immune to that sort of political influence, if you will. I have to say that the issues that you refer to have occurred in the context of global warming, and I haven’t heard those come in the context of NIH activities.
Plus, let me just tell you that I would be completely opposed to any of that. I’ve always said what I believe, and that is that NIH has to be above politics. My job is to be factual, not factional. … The day the NIH director is politicized is the day we lose our preeminence in science. … My view is very respected within the administration and encouraged.

Q: What prompted you in March to take a stronger public stand against Bush’s restrictions on embryonic stem cell research so soon before the Senate was to vote on the issue?

A: The president has his policy based on moral and ethical considerations. But from my standpoint as a scientist … it’s clear that more cell lines would help understand the fundamentals of the field. … It’s important for me to also recognize that I’m not the one who sets policy — the president does. …

We were in neutral in 2001 [when Bush established a policy permitting limited research funding]. I think the president’s policy got us into first gear. After three years, [it was] clear that we’ve revved up the engine, science is advancing, and we can’t get stuck in first gear forever. … As the NIH director, I’m the scientific adviser to the president but also the country, and I say things the way they are, without political influence.

Q: NIH employees have expressed misgivings about ethics and conflicts-of-interest rules you’ve put in place. Do you perceive there to be problems with employee morale or with the retention and recruitment of scientists?

A: A lot of people criticized me for having been a little too stringent [and] predicted that there would be a disaster, essentially,  [that] NIH is going to fall apart, that people would leave in droves, so on and so forth. Well, none of that has happened. None.

Q: What do you hope will be the legacy you leave behind when your time at the NIH is finished?

A: Life sciences in this century are going to be the equivalent of physical sciences in the 20th century. … The country that is powerful in life sciences in the 21st century will be as successful as we have been in the 20th century and, by golly, I hope that it is going to be our country.

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