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NIH Record  
Vol. LX, No. 2
January 25, 2008
Nobelist Mather Brings ‘Big Bang’ to NIH
‘Operation Smile’ Treats Facial
Deformities in Kids
Efforts Expand to Address Childhood Overweight Epidemic
Students Ask NIDA Scientists About Drugs, Addiction
Virtual Medical Papyrus Unfurls at NLM
Indo-U.S. Group on Vision Research Meets
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Building a ‘Community of Colleagues’
NIH Steering Committee Reaches Milestone as Governance Model

It was late 2002 and NIH’s historic budget doubling was set to end in 2003. Looking ahead, new NIH director Dr. Elias Zerhouni foresaw a time when the agency’s expanded size and complexity could become unwieldy—just when NIH would have to be agile.

“We needed to have more transparency and to share information so that decisions could be made more effectively as a group,” he recalls. “We’re such a large and complex organization. We have to develop more effective mechanisms of interactions and coordination across institutes. It’s understandable, because NIH grew very fast. One of the things people don’t realize is that if you double in size, the complexity of managing the organization doesn’t just double—it quadruples, it grows exponentially. I think over the years NIH grew and grew and grew, but didn’t look at its way of making decisions.”

The English vs. The American Patient
Health Disparity Paper Spurs Debate
  Dr. James Smith
  Dr. James Smith

When JAMA published an article in May 2006 reporting that Americans in late middle age are “sicker” than their English counterparts, there was a swift, intense reaction.

“How could this be?” wrote a columnist in the Washington Post. “The British diet is terrible.” And, “Forget vitamin D: The English rarely see the sun in a dank climate where the national dress is a raincoat.”

But according to Dr. James Smith, a study coauthor and senior economist with the RAND Corp. who shared this quote in a recent presentation here, the findings are true. In fact, even as critics have posed potential issues with the report, further study has only made the case for the article stronger, Smith believes.