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Gallo: Certainly it takes benevolent, good, and yet strong, leadership. I would have everybody in one large institute devoted towards research on AIDS. But that does not mean I would pick on research in other institutes. I would not over-fund every institute on AIDS. But I think having people under one roof is not a bad idea for cross-fertilization and exchange of information. So that is one way.
I would try to get rid of redundancy. No director likes to tell scientists what to do. It is rough, and it is also wounding to the person who is on the receiving end of being told what to do. But there comes a point in a disease like this where some of that direction is necessary, I think, if there is too much redundancy, or if there is too little of something, that you try to fill in the gap.
What if everybody here was working just on the blood test. What if we became insane and we all said, “Let us all just do the assay for the blood test.” You would certainly stop this if you were the director and say, “We have a blood test already. Why are you all working on a blood test?” There comes a time, I think, when the director has to step in. Maybe I would look at the totality of it [the research being conducted] in some retreat. NIH is so big it is hard to grasp that. But maybe everybody working at least 40 percent of their time on AIDS could be organized to present their program at one hearing for three or four days with an NIH group of three to five people looking at it carefully. If you did this, you might get a sense of what is redundant, if something is, and you might get a sense of what you are not doing enough of. Somewhat closer contact between the people who have the money, or control the decision making process and the people who actually are doing the work and most of the thinking would be what I would want to see.
Harden: I get questions from time to time about the justification for funding particular diseases, including AIDS. What is your evaluation of the extramural funding for AIDS and the impact it has had on funding levels for research on other diseases? Is the funding out of balance?
Gallo: I have no way of being able to answer that question because I have never looked at such things. I am not in a position to do much about it, unless I knew that funds for AIDS research were greatly lacking, and then I would be screaming. But it is hard for me to know whether if more money is given here, there is less there. Usually that is not the case. In my experience at NIH, when people argue, either out of jealousy or fear that they are not going to get funded, it ends up that both are hurt in the end. It reminds me, as I mentioned to you once, about when the National Cancer Act was passed and I was called by a famous scientist who said that his son was a good scientist but he could not get funded, and also this and that about the National Cancer Act. I was a relatively beginning person here. I was startled that I was called. I was in the laboratory and I did not know anything about it basically. But I just said, “Why didn't he get funded?” Well, he had applied to the National Institute of General Medical Sciences, and I said, “Why not just apply to the National Cancer Institute. The project could fit with NCI's research program, even though it is on E. coli, its replication, with DNA.” The scientist's son did and he got funded.
I feel it is a mistake for scientists outside to argue against funding anything, because Congress responds to crises and Congress responds to crusades. That is a simplistic statement, I know, but it is generally true. If they put a lot of money in for some crusade, it is a mistake to fight it, I think, because there is obvious spillover and there is obvious justification to fund research in many different areas that are not directly AIDS related. I do not think–from what I have usually seen–that if the money does not go to AIDS it will go to the Heart Institute [National Heart, Lung, and Blood Institute], or something like that.
But putting aside that kind of politics, to evaluate whether AIDS research is over-funded versus another field is not easy. It is simplistic and, frankly, I think it is stupid to use the numbers game, “There is more of this disease than there is of that, and therefore this is more important that that.” That precludes any discussion of is there as much morbidity here as there, is there as much involvement of young people here as there. As you know, my mother died a few weeks ago of a stroke. She was 92. You could argue that many more people die of strokes than almost anything else. We have this problem. Now, which way do you want to die?
Let us say that you got rid of strokes, and everybody died of heart disease. Let us say you got rid of heart disease; everybody will die of cancer. I mean, something is going to happen. That is clear cut. I do not like the idea of hypertension and stroke in somebody of age 30, 40, or 50, but at 92, is it a bad way to die? How do you compare that to an infant born without parents because they died of AIDS at 25 and now the infant is infected too, or something like that? How do you compare it to a 16- or 17-year-old dying of AIDS?
I am not arguing for more AIDS money. I do not know what balance there should be. I only know that you cannot play numbers games, and particularly since the number of people with AIDS continues to grow. The stupidity comes right down to that. With the numbers of AIDS patients there were 10 years ago, you would have said, “AIDS is the least important disease.” Now, all of a sudden, it is very important. But it was important then too; just as important as it is today.
The thing about AIDS that you can argue for is that you have the cause in hand. You have quite a bit of understanding about it. You have a chance to get rid of it and go back to work on the more complex diseases. AIDS sounds complex. The virus is terribly complex. But, on the other hand, it is much less complex than many of the more subtle chronic degenerative disorders, and so it would allow us to get back to them.
This is a sort of strangely chronic emergency situation, and the danger is complacency, because we cannot really predict what is going to happen in the future. So, I do not know. The answer as to whether AIDS has too much money versus something else is yes if there is over-funding, if there is a lot of bad science, if there are no ideas, if there are too high a percentage of the grants being awarded, that kind of thing. If that were the case, then I could answer it better. I think there are also many spinoffs from AIDS research to other areas, to cancer certainly, to basic immunology, and to molecular biology. AIDS is in the forefront in virology now. It will be for antiviral therapy and it is likely to be a leader in vaccine efforts as well, I hope, if everybody does not run out of the profits.
Rodrigues: Recently you announced that you will be leaving the NIH to create a new Institute of Human Virology at the University of Maryland's Medical Biotechnology Center. I wonder if you could tell us about this episode in your career, how you came to the decision, and the context in which you made the decision?
Gallo: Sure. The decision was gradual, over a long period of time. Actually, before AIDS, I started thinking that there should be centers of excellence in virology in the United States, and there were none. In fact, the trend was in the opposite direction. There were medical schools getting rid of microbiology departments because they were not needed anymore; everything was molecular biology. I felt, on the contrary, that certain chronic viral diseases were threatening, potentially on the rise, and that centers of virology should exist in America, as they do in Europe.
Many virology experts, or, let us say, the centers of excellence in Europe were not even focused on human virology; they worked on any kind of viruses. Certainly that was true in the United States. You could argue that Rockefeller [University] was certainly a great place for virology, but the research was mixed. It could be animal viruses, it could be plant viruses, it could be anything. That was fine. That was good basic science. But I also felt that nowhere in the world was there a unique center of human virology. That belief began in the 1980s and certainly was greatly fostered by the AIDS epidemic. So I thought someday, if I left NIH, that would be my dream, to form a center of excellence in human virology. I have thought this since roughly 1982, the year before–or at–the time of our first AIDS experiments. But I remember thinking it even before I knew AIDS existed, maybe in 1981.
But I never got that serious. It was not time to think of leaving. The relationship to NIH was too tight. Like most of you here, I thought I was immortal, that everybody else would get older, but not me, and so there was plenty of time. Then, all of a sudden, time went by and around 1988–I think it was 1987 or 1988–I had the first real push to look around. That was when two sets of individuals came into my life and offered me a large amount of money to leave the NIH to do exactly that, found a center of excellence in virology, and that was because of AIDS. That crystallized my thoughts greatly. Even though some of the offers were quite dramatic, and more than I have right now, I could not quite get myself to do it, thinking I still had plenty of time.
When I got everything I wanted, it was for an institute, on the NIH campus, which was a fusion of government, industry and university. To show I was not doing it for financial reasons, I was to stay. I was ready to accept that, and it got approved by the Scientific Director of the NIH during [Dr. James] Jim Wyngaarden's tenure. But then the person providing the $60 to $75 million went from black to red and then dead, and that was Robert Maxwell. You remember the problems. At the same time, the Blech brothers in New York were offering me large sums of money to do something very similar. I learned a lot in that period, so it was not a waste of time, but the project never really came to fruition.
Time now provides a very big demarcation point because, on 1 July , I will have been 30 years at the NIH. On July 1, I can retire with benefits. Any time I leave after July 1 is, in a sense, a loss of money. Money is not my main purpose for leaving, however, but the timing is appropriate. The thing that stimulates me is that the old idea never left my mind and now there is opportunity to realize my dream. Most important, the last five or six years have been very frustrating to me because I could not go to the clinic very easily and I could not be, shall we say, master of my own destiny. I cannot determine what goes from here, to there, to get to the clinic at NIH. I am in the hands of the pharmaceutical industry's positions and patents and I have CRADAs. If it is the NIH, I am not in the position of saying what goes to the clinical person here, or administrative person there, and it depends on their interest. In my new position this will depend on my interest and my colleagues in the institute we form. A biotechnology company will be part of this new institute too. The purpose of that company will be to feed the institute financially, but also to help develop movement from the laboratory to there, to go to the clinic.
I am not criticizing the NIH for that, because I chose to be in a basic science building and to have a laboratory that was focused on laboratory science rather than clinical applications. I do not think that you can just walk into the Clinical Center one day and say, “I want this ward, or that ward, and I am going to do this or that.” But it has been a frustration for these last few years.
Furthermore, those years of dilemma that I went through certainly make it psychologically easier to leave NIH, if you understand what I mean.
Finally, the move is only up the road [to Baltimore] and therefore, in a way, I do not feel exactly like I am leaving. I will have many memories, lots of nostalgia, and lots of love for this place. As I told you before, I do not believe I could have achieved anywhere else what we have done here, so I owe everything to the NIH. I will still have friends and collaborators here and I will be not moving my home. I will live and stay in Bethesda. I will maintain the collaborations, the friendships, and the dinner meetings here. The way I look at it, I will just have added access, with collaborations throughout the University of Maryland system and, in part, with Johns Hopkins, where I will be an adjunct professor of biology in the graduate school.
Rodrigues: The last time we were talking to you, you mentioned many of the administrative burdens that detract from your ability to focus on science. I imagine that in your new position you will probably try to restructure things so that you can focus on science.
Gallo: In the new position, if I have money, the administrative structure will depend on me. I will determine what administrative help I get. Here, I cannot do that; I am told what it is. Here, at NCI, Dr. [Vincent] DeVita gave us an administrative helper. That is, we could have a scientist who was not doing as well scientifically any more, who could be our scientific administrator. Dr. [Samuel] Broder did not allow that. Where I am going, you can be sure I will have administrative help, and plenty.
Harden: Can you flesh out a little more the organization in your new institute that you anticipate now. What roles will you, Dr. [William] Blattner, and Dr. [Robert] Redfield have?
Gallo: Yes. This institute is novel in two ways. It is novel, according to Governor [Parris] Glendening, in its structure in relationships with the state and the city [Baltimore], and with the University of Maryland. It is not the University of Maryland Medical School, it is not UMBC [University of Maryland Baltimore County]. It is housed in the Biotechnology Center, but it is affiliated closely with the Medical School and the biotechnology part of the University of Maryland and the hospital. There is this partnership with the city and the state. So, this is novel.
It is also novel in that, to my knowledge, it is the first Institute of Human Virology. For certain, it is the first Institute of Human Virology where laboratory science, a large epidemiological program–or a modest program, whatever it turns out to be–and a clinic are together. In part, that will all be under one roof.continued on Page 05
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