National Heart, Lung, and Blood Institute

Gary Gibbons

Fostering Diversity, Heading Off Heart Disease

Jocelyn is a staff writer for Science magazine.

On 13 August, cardiologist Gary Gibbons became director of the $3 billion National Heart, Lung, and Blood Institute (NHLBI). Gibbons, who turns 56 next week, comes to the third largest National Institutes of Health (NIH) component from Morehouse School of Medicine in Atlanta, where he founded a research center that studied cardiovascular disease in minorities. He previously was a faculty member at Stanford University and Harvard Medical School.

Gibbons served this past year on a working group that advised NIH on how to promote diversity. It was formed after a study found that among scientists applying for an NIH research grant, blacks had a success rate 10 percentage points lower than whites. Part of his reason for coming to NHLBI, Gibbons says, was to address this problem. He will maintain a lab at the National Center on Minority Health and Health Disparities.

Gibbons spoke with ScienceInsider last week; his remarks have been edited.

Q: Why were you interested in this job?

G.G.: I think this organization has an inspiring and very noble mission. It's one that resonates with me as a clinical scientist. I've always been motivated to address scientific questions that have implications for patients and patient care and public health. And that's what this institute's all about.

Similarly, a critical part of the NHLBI mission is to train the next generation. And I have a particular passionate commitment to expanding the diversity of the biomedical workforce. This position gives me an opportunity to really pursue that goal.

Q: What motivates you to pursue public service?

G.G.: One of my heroes growing up was my mother, who exemplified this notion of community service, giving back. That's derived from her own personal experience as an orphan growing up in the Great Depression. Her survival was related to the kindness of strangers. She always felt compelled to give back. That value system was instilled in us as children. I'm carrying on in that sort of family tradition.

Q: What was your reaction to the August 2011 report finding a lower success rate for African American scientists applying for NIH research grants?

G.G.: Having lifelong experience in the field, it's not surprising that there are these differences. I think it's also self-evident that although we think that we have a superb peer review system, the results and outcomes are not always driven purely by the hypothesis that was written and the specific aims. There are other factors that come to bear and race happens to be one of them, apparently. But what institution you're at also comes out in the analysis as well.

One of the key points to [the diversity working group] report is that one could hypothesize that part of the reason people at certain institutions, say the top 25, fare better than those at other institutions that have less NIH funding is perhaps they are not as well mentored by people who are successful senior investigators who know the best strategies for receiving funding.

I'm encouraged that it's something that remediable. That mentorship is something that we can make more accessible to applicants and I would hope that that's something that we can look forward to addressing.

Q: How will you balance priorities within a flat NHLBI budget?

G.G.: The success of NHLBI is founded on some enduring principles, including an ongoing priority investment in fundamental basic discovery science. That will be a principal part of our portfolio. Another key element is a balanced portfolio that appreciates the complementary value of basic, translational, clinical, and population science. I think it's critical that we maintain that balance because they all reinforce each other.

Q: Are you having to think more about whether you can fund big clinical trials?

G.G.: It's going to be important to take careful scrutiny in ensuring that in each of our budget lines that we're more strategic, thinking about cost-effectiveness of our approaches. …

I can understand that the costs of clinical trials may attract attention within our overall budget, but I think it's also important to step back and recognize the impact of those trials. Many of these are really transformative in changing how we treat patients.

Q: What are the big challenges ahead?

G.G.: One is: We're in the midst of an obesity epidemic. And we have children who are starting to get the risk factors for cardiovascular disease at earlier and earlier ages. This has an incredible impact on our nation and our public health. And so it will be critically important to work on the preventive measures that may be mediating obesity related cardiovascular disease. …

That will take a multipronged approach. There's certainly basic discovery science that needs to be done that can help refine the effect of obesity on cardiovascular disease. In terms of clinical investigation, there may be opportunities to intervene in pathways like inflammation in a preventative strategy.

To be more provocative, we tend to think of [heart, lung, and blood diseases] as chronic diseases. Hypertension is something you just have forever. You take a pill forever. And yet what we're learning in areas of reparative biology, in terms of epigenomics, these advances suggest ways of intervening that can kind of erase or reboot the memory of the body and change these processes like atherosclerosis that stretch over decades and change the natural history [of these conditions].

We often get jealous of our oncology colleagues [who] talk about the remission of the disease. We're not quite there, but those would be frontiers that we'd be excited to pursue.

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