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Strengthening Clinical/Translational Research in the U.S.

Posted on by Dr. Francis Collins

At NIH, our job—in a nutshell—is to turn discoveries into health. Even if you’ve only read this blog a few times, you know we conduct and support basic science advances, clinical breakthroughs—and everything between. We call that “between” process, “translation.” And it takes sustained creativity, innovation, attention—and collaboration—to do it well.

Which brings me to today’s Institute of Medicine (IOM) Report on NIH’s Clinical and Translational Science Awards (CTSA) program [1].

First, a bit of background. The CTSA program was established by my predecessor, Elias Zerhouni, in 2006, to enhance translation and improve clinical research [2]. Awards were given to academic centers to improve tools and infrastructure—not just at those centers, but between them and local hospitals, non-profits, community health centers, and other area health organizations, providing a critical mass of expertise around the country. These centers also joined together as a consortium, all to better our translational efforts. Back in 2011, under my leadership, the CTSA program became part of the newly-launched NIH National Center for Advancing Translational Sciences (NCATS). NCATS was designed to identify novel ways of doing translational research. The convergence of missions would serve to amplify translational efforts.

Over the years, the number of CTSA centers has grown. So, too, has the program’s budget. Today, seven years later, the CTSA program extends to 61 centers and is NIH’s largest investment in clinical research. At the same time, biomedical science and technology are advancing at an unprecedented pace, and the need for new and improved diagnostics, treatments, and cures continues to drive our healthcare system. For optimal performance of the network, we need to make sure that it is a well-oiled machine that can be deployed rapidly, especially in these tight financial times. It seemed a good time to re-assess the CTSA program—to identify its strengths; to find ways it might be improved, to ensure its efficacy and efficiency. Think of it as updating the program’s operating system: creating a “CTSA 2.0.”

This is where the IOM Report comes in.

A distinguished IOM panel has just issued recommendations regarding the CTSA program and its goals under the new NCATS mission. This group provided some wonderful insights and recommendations that will make the program even stronger. The panel recommended stronger leadership from NCATS to drive the innovative research that can ultimately lead to the development of new tools and methodologies; it encouraged the establishment of clear goals and milestones.

The panel also recognized that each CTSA is unique. As such, they recommended that NCATS should maintain flexibility in supporting the full spectrum of translation, while allowing these institutions to cultivate further their individual strengths. In essence, the aim is to make the whole greater than the sum of its parts. The panel also urged the creation of an innovation fund and encouraged a more interdisciplinary approach to training, education, and research—all of which is critical if we are to nurture a new generation of clinical researchers.

The U.S. leads the world in translational and clinical research. For this to continue, we need a nimble network of clinical trials infrastructure that can evolve and adapt. It is exciting that this transformative work is happening around the nation and in your very own community. The CTSAs have already provided an excellent foundation. An enhanced CTSA program, as envisioned by the IOM report and led by NCATS, will lead translational and clinical research well into the 21st century—and improve the health of us all.


[1] IOM Report

[2] Translational and clinical science—time for a new vision. Zerhouni EA. N Engl J Med. 2005 Oct 13;353(15):1621-3. Epub 2005 Oct 12.


NCATS statement on IOM Report

NCATS: CTSA website

NIH support: National Center for Advancing Translational Sciences

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