President Bush moves to fill NIH and surgeon general positions

Robert Roos

Mar 27, 2002 (CIDRAP News) President George W. Bush yesterday nominated an administrator and radiologist from Johns Hopkins University to head the National Institutes of Health and an Arizona trauma surgeon and public health expert to serve as US surgeon general.

Dr Elias Zerhouni, executive vice dean of the Johns Hopkins University School of Medicine in Baltimore and chair of the radiology department there, was nominated to direct the NIH. The nominee for surgeon general is Dr Richard Carmona, a clinical professor of surgery, public health, and family and community medicine at the University of Arizona in Tucson. He also is a deputy sheriff and SWAT team member and chairs a five-county emergency medical system.

The two nominees, who must gain Senate approval, are described in newspaper reports as little known outside their own fields. The president cited concerns about bioterrorism in announcing both nominations.

"These are distinguished physicians who have worked tirelessly to save lives, and to improve lives," Bush said. "They bring exceptional knowledge and skill to these critical jobs. And they are absolutely dedicated to improving the health and well-being of all Americans."

Bush said Zerhouni and his wife immigrated to the United States from Algeria "with $300 in their pocket, but a dream of opportunity." A White House statement said Zerhouni will bring to the position a strong research background, experience in running a large medical research organization, and "leadership on the cutting edge of medical technology."

In his announcement, Bush noted that the NIH's budget has grown from $2 billion in 1975 to more than $23 billion this year and that he is proposing an increase of nearly $4 billion for fiscal 2003. Observing that medicine is making progress against AIDS, diabetes, heart disease, and cancer, the president added, "The anthrax attacks against American citizens also demonstrated the need to strengthen our defenses against bioterrorism. Medical research will improve our ability to identify and respond and treat infectious diseases, whether they occur naturally or are used as terrorist weapons."

"Dr. Zerhouni is well-prepared to manage this rapidly growing institution during times of great new opportunity and urgent biodefense needs," Bush said. Praising the nominee's skills in teaching, research, patient care, and management, Bush added, "Dr Zerhouni shares my view that human life is precious, and should not be exploited or destroyed for the benefits of others. And he shares my view that the promise of ethically conducted medical research is limitless." The president did not offer any specifics on Zerhouni's views on such issues as human cloning, stem-cell research, and abortion.

In a written statement, Health and Human Services Secretary Tommy Thompson said Zerhouni "has a track record of bringing together the best minds from across the medical spectrum and asking them to think beyond the existing bounds of knowledge." At Johns Hopkins, Zerhouni showed "great skill at building consensus on difficult issues due to a strong understanding of human disease and clinical research," Thompson said.

Carmona has described himself as a "high school dropout and poor Hispanic kid," according to newspaper reports. In introducing him, Bush praised his diverse background and record of risking his life to save others on several occasions. "As an Army Green Beret in Vietnam, a decorated police officer in Pima County, Arizona, a SWAT team member, a nurse and a physician, Dr. Carmona has redefined the term 'hands-on medicine,'" Bush said.

The president said the new surgeon general will "address three particularly urgent issues." The first of these is administering the Public Health Service Commission Corps, consisting of 5,600 health professionals who are on call for emergency duty. With years of experience in law enforcement and community preparedness, "Dr Carmona is an experienced voice to help educate Americans about the best precautions and response to the threat of bioterrorism," Bush said.

A report in the Arizona Daily Star, a Tucson newspaper, said Carmona has been warning at least since 1996 that Tucson and other American cities are ill-prepared for biological attacks and other forms of terrorism. For the past 2 years Carmona has been working on the city's Metropolitan Medical Response System, a federally funded project to improve emergency preparedness, according to the report. The Southern Arizona Emergency Medical System Council, of which Carmona is chair and medical director, supervises the treatment of emergency patients in five counties and their transportation to Tucson hospitals.

For his other two priorities, Bush said he wants Carmona to launch an initiative to promote the benefits of lifelong healthy habits, including a sound diet and regular exercise, and to speak regularly about the toll of alcohol and drug abuse.