White House Keeping Low Profile As Hunt For Healy's Successor At NIH Appears To Be Reaching Final Stage

Judith Rodin of Yale and UC-San Francisco's Harold Varmus are said to be strong contenders for the agency position Author: FRANKLIN HOKE, pp. 1, 3, 4 Sources close to the search for Bernadine Healy's successor as director of the National Institutes of Health say the list of candidates is down to three individuals, with a decision from the White House considered imminent. In the running at press time were Harold Varmus, a Nobel Prize- winning molecular biologist at the University of California, San Francisco, School of Medicine, known for his work on oncogenes, and Judith Rodin, the provost of Yale University, New Haven, Conn. The identity of the third candidate could not be confirmed through sources. Healy, who was not asked to stay on at her post by new President Bill Clinton early this year, announced in February that she would step down as NIH director on June 30. Ruth Kirschstein, director of the National Institute of General Medical Sciences, will act as director until the president declares his choice and that person is approved. Department of Health and Human Services (HHS) officials and members of the search committee HHS convened say that the current search process has been virtually free from obtrusive White House influence. They contrast this with the search that resulted in the appointment of Healy, in which agreement with then-President George Bush's position on the controversial issues of abortion and fetal tissue research was considered a prerequisite for nomination. "When Healy came in, it was generally known that the NIH candidates were put through a political litmus test, in large part coming from the White House," says one HHS official on condition of anonymity. "And that was not the case here." For the most part, White House influence was limited to a request that the search committee include women and members of racial and ethnic minorities in their larger candidate pool, according to committee members. Also, several potential nominees who were suggested directly to the White House by various constituencies were passed on to the committee without particular comment. "We several times asked, `Are you telling us that you want `X' kind of candidate?' " says search committee member Samuel O. Thier, president of Brandeis University, Waltham, Mass., and former president of the Institute of Medicine, "and they just said, `No, we want the best candidate.' " Committee members were left to develop their own criteria for the job, they say, and to choose the candidates they thought best met those criteria. "We weren't given any instructions, except to come up with a person who had the best attributes to lead the NIH to a new level of prominence," says committee member James H. Wyche, associate provost of Brown University, Providence, R.I. "We were left to our own devices, and I appreciate that more now than I did at the outset." Diversity And Credibility To help ensure that the White House request for diversity in the candidate pool would be met, the six-person search committee included two women and an African American. "There is a tendency of bias toward the network which one knows," says D.A. Henderson, HHS deputy assistant secretary and one of the three people responsible for the committee's composition, "and, for the more senior members [of the scientific community], it's often a white, male network. So, you have to be sure that you're not falling into the trap of dealing with a school network in which minorities and women have not been included." According to Henderson, the members of the committee were selected by HHS secretary Donna Shalala, assistant secretary Philip Lee, and himself. Bruce Alberts, the University of California, San Francisco, molecular biologist who took over the presidency of the National Academy of Sciences on July 1, chaired the committee. The other committee members were Elizabeth Neufeld, chairwoman of the department of biological chemistry at the University of California, Los Angeles; William Richardson, president of Johns Hopkins University, Baltimore; Brandeis' Thier; Linda Wilson, president of Radcliffe College, Cambridge, Mass.; and Brown's Wyche. The group identified several characteristics that they hoped their ideal candidate would embody. First and foremost, the individual would be a prominent, respected scientist. The candidate also would have proven administrative abilities, preferably in an organization of significant size, in terms of both budget and personnel. A degree of distance from NIH was also sought in the potential nominee, someone who would have "the objectivity we deemed crucial at this point," as Wyche says. "We first looked at scientific credibility," says Wyche. "That far outdistanced the other criteria. We were concerned about management styles and past administrative experience. And we looked at conflict-of-interest issues: How close was a person to NIH? Were they so close they could not look at the issues that had to be looked at?" The committee also hoped that the person would have a clear and comprehensive view of NIH and where it should be headed. While Healy's specific strategic plan for the agency--which has been controversial among biomedical researchers almost from its inception--was not specifically endorsed by the search group, the idea of continuing with something similar was seen as vital to the institutes. "The sense was that having a strategic plan and view of the institution was important," says Thier. "Whether or not the person was committed to the specific plan, the concept and the process of having one--with perhaps a more open process on the next go-round--would be something that the person would be expected to be able to continue." Implied in this would be the ability to pull the biomedical community closer together, to better unify it under NIH's leadership, say committee members. And an awareness that the NIH director serves as a spokesperson for the institutes--and for biomedicine generally--to the public and Congress also informed the committee's decisions. "Obviously, the hope was that the person would be capable of articulating these positions as the public spokesperson for biomedical research," says Thier. Scientist Or Administrator? Through spokespersons, Varmus and Rodin declined to comment for this article while the nomination process continues. But each brings his or her special strengths to the position, according to their supporters. Emphasis shifts between capability and stature as a scientist and demonstrated leadership and administrative ability, although each candidate is accomplished in both areas. Denis J. Prager, director of the health program for the John D. and Catherine T. MacArthur Foundation in Chicago, and a former deputy science adviser to presidents Jimmy Carter and Ronald Reagan, has worked with Judith Rodin for about a decade. Rodin, who in addition to being Yale's provost is a professor of psychology and of medicine and psychiatry at the university, has chaired the foundation's Network on Health-Promoting and Health- Damaging Behavior since 1984. Prager says that he worked closely with the NIH director in his advisory position with the White House. "It's not primarily a scientific job," Prager says of the directorship. "It is primarily an administrative job and a leadership job, dealing with a budget of [nearly] $11 billion and 10,000 employees." Rodin's position as provost of Yale, Prager says, gives her the administrative experience to manage NIH's budget and personnel, as well as the ability to communicate with and accommodate various constituencies in a larger community. In addition, he says, the breadth of her own scientific work, encompassing psychology, neuroscience, and molecular biology, helps her speak to scientists across discipline boundaries. "I've watched her manage an interdisciplinary group here for us for the last 10 years," Prager says. "She can build consensus. She knows how to pull people together across a broad range of scientific issues. She understands the relationship between basic research, applied research, and clinical outcomes." He adds that Rodin has "an articulateness that knocks you off your feet. [Her] testifying in front of Congress in support of an NIH budget is something I would like to see." Philip Needleman, head of corporate research and development for Monsanto Co., St. Louis, serves on the NAS Board on Biology, which is chaired by Harold Varmus. Needleman notes that Varmus carries a Nobel Prize winner's evident scientific credibility, an important attribute for the NIH director to possess. But he adds that NIH also could benefit from the change in operating style that Varmus would bring to the director's post. "He's a reasonable, gentle soul," says Needleman, "certainly quite a different personality from the [just-departed] occupant of that position." According to Needleman, Healy had "too hostile a relationship with Congress. It didn't serve the National Institutes [of Health] very well." Needleman also notes that Varmus has a "splendid working relationship" with search committee chairman and new NAS president Bruce Alberts, who comes from Varmus's institution. Calling the National Science Foundation, NIH, and NAS "the pillars of a lot of important activities," Needleman says links among the leadership of the organizations can only be helpful. He adds: "This is a decade when there'll be crushing, alternative demands for funds, changing attitudes about science in general, and skepticism and hysteria around biotechnology. The position of biomedical research in the world is really in a state of flux. The next leader of the program is a very important choice." Members of the search committee also kept their choice in perspective against the backdrop of the larger scientific community, the public, and Congress. "We realize that, as scientists, we don't work in a vacuum," says Wyche, "that we work principally for the American public, we're funded by them, and we have to be sensitive to a variety of issues. Scientists have to plead their case like everyone to Capitol Hill, where the battle is either won or lost. We were very cognizant that we wanted someone who had displayed this balance of being scientifically right at the top, but had [strengths on] all of these other issues that we're concerned with." "The research community is rather tender," says Thier. "They need to have the sense that there's somebody in control who has a clear vision and philosophy about the mission of the NIH as the primary biomedical research unit for the country."

White House Keeping Low Profile As Hunt For Healy's Successor At NIH Appears To Be Reaching Final Stage

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