NIH Director Says Timing Right to Reengineer Translational Science

Francis Collins, MD, PhD, director of the National Institutes of Health (NIH), says the timing is right to reengineer the process of developing diagnostics, devices and therapeutics to better detect, treat and prevent disease.

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Francis Collins, MD

Francis Collins, MD, PhD

In a commentary published on July 6 in Science Translational Medicine, Collins announced that the NIH intends to establish a new entity, the National Center for Advancing Translational Sciences (NCATS). Collins also describes the bold new action in a podcast on the NIH website.

"The mission of NCATS is to catalyze the generation of innovative methods and technologies that will enhance the development, testing and implementation of diagnostics and therapeutics across a wide range of diseases and conditions."

Importantly, Collins points out, that the NCATS will not compete with but will complement the translational research being carried at at NIH and elsewhere in the public and private sectors.

The idea of reorganizing the NIH has sparked intense debate in scientific circles since Collins first endorsed the concept in December. The plan is based on a recommendation by the NIH's Scientific Management Review Board to create a center aimed at speeding the development of biomedical discoveries into treatments. Part of the controversy stems from the NIH's decision to also disband its National Center for Research Resources (NCRR). NCRR's largest program, the $490 million Clinical and Translational Science Awards, which includes the UCSF Clinical and Translational Science Institute, would move into NCATS. 

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Collins makes the case for establishing NCATS as a way to counter the various bottlenecks in the complex, time-consuming and costly process of translating basic biomedical discoveries into clinical applications that improve human health.

"The medical benefits of the current revolution in biology clearly cannot be achieved without vigorous and effective translation," Collins writes. "Yet the triple frustrations of long timelines, steep costs, and high failure rates bedevil the translational pathway. The average length of time from target discovery to approval of a new drug currently averages 13 years, the failure rate exceeds 95 percent, and the cost per successful drug exceeds $1 billion, after adjusting for all of the failures."

Collins says that be creating a new model of funding research will open up new opportunities that can spur a revolution in therapeutics. He notes that clinical advances have been frustratingly slow to arrive: Therapeutics currently exist for only about 200 of the ~4,000 conditions with defined molecular causes.

Collins concludes his commentary like this: "Through partnerships that capitalize on our respective strengths, NIH, academia, philanthropy, patient advocates and the private sector can take full advantage of the promise of translational science to deliver solutions to the millions of people who await new and better ways to detect, treat and prevent disease. So, let us embark on this new adventure with eyes wide open — recognizing the tremendous scientific challenges and acknowledging the difficulties posed by fiscal constraints, yet fixing our vision on the possibility of profound benefits for humankind."