The third lecture of the 2004 Milton S. Eisenhower (MSE) Symposium marked the return of Dr. Elias Zerhouni to Johns Hopkins University. Zerhouni opened the evening reminiscing that, "It is a pleasure to be back, because Hopkins is home to me."
Hundreds of undergraduates, professors and members of the community braved a tornado warning to listen to Zerhouni speak.
He joked with the audience about how difficult it was to follow the prior week's symposium guest, Dr. Ruth Westheimer, saying that he "hoped to make this as fun as Dr. Ruth's must have been last week."
Zerhouni is currently the Director of the National Institutes of Health (NIH), a position he has held since his appointment in 2002 by President George W. Bush.
Originally from Algeria, his roots are in the Hopkins medical system where he has served in several different capacities, including as a physician and, most recently, Dean of the Medical School.
He also holds eight patents and has written over 150 articles within his fields of expertise.
The lecture focused on the theme, "Back to the Future: Where Will Today's Research Take Us Tomorrow?"
He drew great attention to the students themselves who will lead the way in the research of the future.
Zerhouni asserted his belief that students need to understand the meaning of health from not only local, but international perspectives. He cited the importance of exposing students to a variety of different complexities within the global health paradigm.
He often directly addressed the many students in the audience, encouraging them: "As undergraduates you need to listen to multiple world views. You need to be able to synthesize information from many different places."
This theme of "multiple world views" framed his speech, as he discussed not only international efforts to eradicate disease, but more fundamental concerns, including how to best train future scientists, as well.
At the level of institutions such as the Hopkins undergraduate programs in science, Zerhouni said he believes that a shift in focus is needed. "At the undergraduate level, training pathways need to change."
He put great emphasis on the fact that where healthcare seemed to be going 30 years ago and where it is today are by no means the same.
He cited many "diseases of the past," such as tuberculosis and malaria, which are re-emerging today, along with new dangers such as HIV/AIDS and those he characterized as based in the upper classes, such as diabetes and obesity.
Zerhouni asked the audience to reflect, "Where did we go wrong? Why the paradox of a world close to public health nirvana, and why now new diseases of the rich?" He blamed much of this on the levels of social distinction now present in the world.
According to Zerhouni, the best way to overcome this is to spread more knowledge about public health policies.
He said, "Finding better ways of educating the world is the best vaccine and best antibiotic out there."
Zerhouni provided startling facts as to the disparity of healthcare and knowledge around the world.
"Currently, 90 percent of research money goes to investigating 10 percent of the diseases that exist worldwide, while 10 percent of the money goes to 90 percent of the diseases."
He claimed the poor classes in the world mainly suffer from those diseases that receive little funding for study.
As members of an increasingly interconnected global community, everyone shares certain risks, said Zerhouni. He cautioned, "We are changing our environment so much that our genetics and natural evolution cannot keep up."
The NIH itself is not limited simply to domestic concerns, Zerhouni said. "We have a global responsibility to healthcare. We step in where there is a resource mismatch."
This global economy of healthcare and resources is where Zerhouni sees the future of medical research having the largest impact.
"This is the greatest challenge and the greatest opportunity for young scientists."
The NIH currently has a budget of over $28 billion per year, which is allocated to different areas of research and technological development within the medical field.
Zerhouni said that in the upcoming years, the amount of money spent on healthcare is going to drastically increase. "Today, 1.6 trillion dollars is spent on healthcare - that is going to double in 10 years."
Even in an election year, Zerhouni strived to avoid political favoritism with regard to the funding of different, potentially controversial health programs and policies.
In his efforts to further educate the country and the world about public health issues, Zerhouni emphasized that, as a larger scientific community, "we need to be factual and not factional. Disease knows no politics."
