Can Texas Maintain its Leadership in Health Relatd Research?

Dr. Carson: Good morning, all. I don't need really to tell you - but I will this morning - who Kay Bailey Hutchison is. She's from here, and I mean literally here. She grew up in La Marque and went to U.T. and graduated from the law school there as well. She was twice elected to the House of Representatives in Texas, and in 1990 was elected as Texas State Treasurer.

Then in 1993 she was elected as the first woman to represent Texas in the U.S. Senate. Seven years later more than 4 million Texans reelected her to a second full term - at that time the largest number of votes ever garnered in the state. She's the fifth highest ranking Republican senator.

Her many areas of specialty include defense and foreign policy ‑‑ and here she's a leading voice on national security issues and serves as a U.S. delegate to the Helsinki Commission. She played a major role in drafting the landmark security bill in the wake of the September 11 terrorist attacks.

She chairs the Science and Space Subcommittee whose chief responsibility is to oversee NASA. The historic education reform bill signed into law in early 2002 includes important provisions written by the Senator.

We welcome you, Senator, to speak on Can Texas Maintain Its Leadership in Health-related Research.

Senator Hutchison: You said earlier that I was from Galveston.  Not only is that true, but I was born literally right across the street.  This is my home, and it is a wonderful place.  I want to thank our hosts from Galveston for a terrific program; I wish that I could stay here the whole day.  I am so pleased that I was asked to speak to you today about medical research in Texas.  Texas is on the map already in this arena, and I think we have the building blocks in place to stay right on top with the very best in our country and in the world.

Let me first say that I came in from Washington, a city where it can be hard to find your way around.  It was laid out by the French architect Pierre L’Enfant.  The location of Washington is thought to have been decided on during an intense negotiation between Alexander Hamilton and Thomas Jefferson.  Although they probably possessed the best mind from the North and the best mind from the South, they may not have managed to incorporate the best of both regions in the city.  Washington seems to me to be a city that combines southern efficiency with northern hospitality.

In the area of medical research, I am really excited about the opportunities in Texas;  what we have done and what we are doing.  Many of you know that I am on the Appropriations Committee.  When I first went on the committee, I started looking very closely at what was happening in scientific research.  At that time, we were working to double the budget of National Institutes of Health, and I wondered where Texas stood in terms of federal research dollars.  So I asked, and the answer was disappointing.  Texas was fifth in the nation in federal research dollars going to our institutions of higher education, and by some measurements we were sixth.  I could understand that California would come in number one—they are a whole third bigger than we are, and they have more institutions of higher education.  I could even understand that New York was number two because they’ve been at this longer.  But fifth or sixth for Texas, I could not understand.

I began to look at what I could do to help increase our federal research funding.  I brought the heads of our research universities and medicals schools together in Washington to meet with department heads from the federal agencies that were doing the most research.  I knew that these department heads would be able to give us the spark we needed because they knew what their research priorities were.  We had these summits for five straight years, rotating the people with whom we met.  We met with the Department of Defense, the National Science Foundation, the Department of Energy, the National Institutes of Health, the National Cancer Institute, NASA, and others.

Over those five years we started to develop a strategy that would target the centers of excellence at our institutions of higher education.  I did not want everybody to try to be the University of Texas or Rice University or Texas A&M.  I wanted to build specific centers of excellence, encouraging one of our universities to become better than UT in a particular field or better than Rice in another field.  I wanted to bring the different centers of excellence together.  I asked our institutions of higher education to stop thinking of themselves as being in competition with each other.  The University of Texas and A&M should not be competitors, but collaborators.  MD Anderson and UT Southwestern should be collaborators.  We needed our centers of excellence to come together and think of themselves as representing Texas, not individual institutions—we needed to think of ourselves as Team Texas.

Once we focused on our centers of excellence, then we started to build them up.  No university in America receives more federal agriculture research dollars than Texas A&M because they are the best at what they do.  NASA’s biomedical research facility is located at Baylor College of Medicine.  We had the two Nobel laureates who pioneered the area of nanotechnology right there at Rice University, and Rice adopted the team concept immediately.  I asked Dr. Malcolm Gillis, then the president of Rice University, if he would lend the credibility of those Nobel prize winners to other Texas universities and help us build a nanotech research consortium.  He said, “Absolutely,” and Dr. Richard Smalley, whom we tragically lost to cancer just this year, and Dr. Robert Curl became the heads of two major consortia.

SPRING, which focuses on the materials aspect of nanotechnology, has received over $20 million from the Department of Defense.  This consortium of the University of Texas at Austin, Rice University, the University of Texas at Dallas, and the University of Texas at Arlington has been a great coalition; it is in the forefront of nanotech materials research.  Later, we also brought UT Pan American, UT Brownsville, and Texas Tech into the program.  This groundbreaking nanotech work is helping us support our soldiers, creating body armor that is stronger and lighter.  This is invaluable in places like Iraq when it is 110 degrees in the summer.  It can also create lighter and stronger materials for airplane construction.

The Alliance for Nanohealth, in Houston, is the biomedical aspect of the nanotechnology initiative.  It utilizes small particles in the blood to detect and help cure disease.  There are so many new things that can be done now and a lot of what we are putting together in Houston will keep us in the forefront.  This is how we build on our centers of excellence.  For instance, Texas A&M Veterinary School does a lot of research on animals, so they have teamed with Dr. Michael DeBakey at Baylor College of Medicine to use dogs to test the heart machine that keeps patients alive while they are waiting for their transplants.  Baylor and Texas A&M came together with their two centers of excellence to build something even better.

Another national player is right here -- in Galveston -- where you are sitting.  Thanks to the vision of Dr. John Stobo, Galveston is the only city in America that has one of the two national Level 4 Biocontainment Labs and also has one of the regional biodefense research centers.  No other city has both.  The UT Medical Branch is a leader in America in bioterrorism research.  Dr. Stobo is already talking about avian flu and early detection efforts, so again he is ahead of the pack.

Recognizing our potential, we went on a mission to get more federal research dollars for Texas.  I didn’t want to say, “Hey, we’re Texas, we’re the second-largest state in America and we deserve more.”  No, I wanted to do it on the merits; I wanted to get our great minds to hear what the federal research priorities were because I knew we could do more.  I knew that if we could just get that information to our institutions of higher education then we would have a natural advantage.  In fact, UT Southwestern in Dallas has more Nobel laureates than any other medical school in America.  They have four—four at one medical school in Texas.  MD Anderson gets more federal money from the National Cancer Institute than any other institution in the United States.  Dr. Julio Palmaz at the University of Texas at San Antonio medical school invented the heart stent used to treat coronary artery disease.

We were already doing a lot to support research in Texas, but I just knew that if we focused on the federal priorities as they opened up that we could do better; and we have.  We are now third behind only California and New York, and we are not far behind New York.  I think with Dr. Stobo leading the way on these biocontainment labs that we have a chance to go into second place, which is where we should be.  California does have more tier one institutions, but that’s a different subject for a different day.

One of the offshoots of this research effort was suggested by Neil Lane of Rice University at one of our summits.  I asked the group if there was anything else that we ought to be doing, and Neil told me that the best researchers in Texas don’t really know each other.  The people at MD Anderson, Baylor, and UT Houston did not know what UT Southwestern was doing; they did not know what UT San Antonio was doing.  Our researchers need to know what's going on at other institutions.  Dr. Lane suggested that we have a meeting with all of the members of the national academies in Texas.  I thought it was a great idea.  We set up an advisory committee that was headed by two of our Texas Nobel laureates, Dr. Michael Brown and Dr. Richard Smalley.  They are the founding co-chairs of The Academy of Medicine, Engineering, and Science of Texas, or TAMEST.

To be a member of TAMEST, you have to be a member of the national academy in your field because the academies elect members based on rigorous peer assessment.  The academy’s third annual meeting will be in Houston this January.  Each of the 236 members of the academy may bring one protégé, a young researcher who is doing good research.  The members, including Texas’s eleven Nobel laureates, hear presentations on research currently ongoing in the state.  This has already created more alliances and more collaboration because we have a central place for the best minds in our state to meet.

The academy’s numbers are growing because more scientists have been elected to the national academies and we are showing researchers that Texas is the place to be.  It is a place that supports research, supports academics, and supports our science base.  Going to one of those meetings is energizing for me.  I understand about half of it, and I just love the enthusiasm of the members.  Of course, they understand all of it.

Can Texas maintain its leadership in medical research?  Yes it can, and here’s how:  A lot goes into it, but the basic concept is teamwork.  Other places may be somewhat ahead of us in putting all of these pieces together, but we are making swift progress.  Across the United States, universities are performing research in partnership with private industry that brings in more money, fueling more research.  American universities have taken in more than $1 billion in revenue from licensing the products they helped create.  New drugs, new agricultural products, and high-tech components can all become moneymakers for a university.

Across the country, 425 new startup companies have formed from university research.  Many universities negotiated equity in these companies, and they have since sold that equity for a profit with all of the money going back to research.  The model for the future is partnerships with private industry.

Such partnerships return to their academic institutions a percentage of the profits from the products they create.  This money can be used as a recruiting tool.  When researchers do work in Texas, they will be able to gain financially from it.  In general, people who are doing this research could make a lot more money in the private sector–the doctors in our medical schools especially.  Financial incentives can be very helpful in recruiting top notch researchers, and we want to bring in the best people.

Stanford and Harvard are now pursuing these partnerships, and they have created university research parks that are hotbeds for intellectual curiosity.  In Harvard’s case, the pharmaceutical giant, Merck, is 50 feet away from Harvard Medical School's newest 400,000-square-foot research facility.  At Stanford they focus on a lot of cutting-edge research because they are well-placed geographically within the high-tech industry.  Hewlett Packard, Cisco, and Yahoo are all at Stanford’s research park, and they were all founded by Stanford graduates and professors.

We are in the beginning stages of this model as well.  Two examples of success are the University of Texas Southwestern Medical Center and UT Medical Branch.  UT Southwestern formed a licensing agreement that provides them with royalties from a calcium supplement called Citracal.  Most women know that Citracal is an excellent calcium supplement, and it is good for men, too.  Citracal is also contributing to UT Southwestern’s next research project.  UT Southwestern has now negotiated over 350 licensing agreements in the U.S. and abroad, generating over $91 million in licensing revenue.

UT Medical Branch is entering this market as well.  They’ve formed 10 partnerships, including one with Dowpharma and one with Hewlett-Packard.  They are forming partnerships to develop new vaccines, and they will set up a rotating fund to help build their research power.  By leveraging corporate capabilities, we can do a lot to enhance the strength of our institutions.  We can also do a lot to enhance the capability of our institutions to attract more research dollars through philanthropy.

MD Anderson is now in the process of building a research park.  I got involved because John Mendelson came to me about the importance of finding a sanctuary for research.  There happened to be a military reserve base between MD Anderson and Old Spanish Trail, a total of 116 acres, and John asked me to find out if MD Anderson could buy it from the federal government.  I looked into the matter and created what I think is a win-win situation.  The location of the base no longer made sense.  When it was built, I am sure it was way outside of town, but now it is right in the middle of economic development.  Ellington Air Force Base is several miles away and was in danger of being closed during the base-realignment process.  We needed to be sure to save Ellington for a number of reasons.  It is a good base for security for the Houston Ship Channel chemical complex.  I thought if we could put the Navy, Marine, and Army reserve units at Ellington and turn it into a joint base with the Air Force, it would be good for Ellington, and it would be great for Houston and MD Anderson.

As chairman of Military Construction Appropriation Subcommittee, I knew that the Department of Defense could sell excess property if they agreed to a move of a base.  Since the Department already had land at Ellington, and added space for training, it was very appealing to move the facilities and put the money to better use.  I was also able to get the money from the Military Construction Appropriations Subcommittee to start the program at Ellington for the reserve units right away.  Now, MD Anderson has 116 new acres to construct a research park that will attract private industry partnerships.

Philanthropy comes into play here as well because the Red McCombs Foundation has generously donated $30 million for a cancer research facility that will attract private partnerships as well as great researchers.  The Kleberg Foundation has created another center for molecular markers that will be housed in the research park.  We are really beginning to build on the university research-park model, and I think it is going to make a huge difference in our progress into the next phase of our research initiative.  Boston’s academic institutions generate $1.6 billion per year in biomedical funding—that’s about sixty percent more than what comes into Houston.  At present, they produce ten times as many companies from those efforts as we do in Houston.  But soon, we will have the same capacity as Harvard.

We are also doing some great research on Gulf War Syndrome.  We are the best in the country in this field.  One in seven soldiers who were deployed during the first Gulf War came back with conditions that were hard to pinpoint but very debilitating.  For a long time, the Department of Defense wrote it off as psychosomatic symptoms or post-traumatic stress disorder, but the medical signs suggested it was more than psychosomatic.  It was afflicting people the same way as Lou Gehrig’s disease.  Ross Perot funded a $5 million project at UT Southwestern to equip Dr. Robert Haley as he searched for a cause for these conditions.  In a study of these veterans, Dr. Haley found brain damage in some of the veterans that was similar to damage caused by exposure to sarin gas and other chemical weapons.  Others had no symptoms.  Many of the unaffected veterans turned out to have a certain enzyme in their blood that the affected veterans did not.  If this enzyme is indeed the difference, now we might be able to find treatments or even a cure.

We have made great progress, but we can do more.  The next step will require the teamwork of our universities to attract researchers and private industry.  We need to greatly expand our research parks and licensing agreements.  Clearly, the way to attract researchers is to give them the best labs and equipment to do their research, and we can do that in a lot of ways.  Philanthropy is one way, and we have very generous people in Texas.  The federal government is another, and I have certainly jumped in to help on the Gulf War Syndrome project, the nanotechnology consortia, and other projects.  I am also working with the Department of Energy to make sure we have the medical imaging equipment that we need to keep our researchers in the forefront.

Commitment from the state government should be another resource.  The state of New York and the city of New York are very aggressive.  The California state government is also aggressive, and we need to match it.  We need to show that there is a state commitment as well as a federal, local, and philanthropic commitment to our research institutions.

Let me just close by saying that there are also opportunities for us to bring more of our universities into top tier status, especially with the centers of excellence concept.  Texas State University in San Marcos has the very best geography program in America.  I learned this from the chairman emeritus of National Geographic as he was establishing the Gilbert Grosvenor Center for Geography Education.

We can build on this success with centers of excellence at other Texas universities.  If we develop an expertise and keep nourishing it, then success will breed success.  I think we have a lot of opportunities, and we must have more top tier universities in Texas if we are going to remain in the forefront.  I think our medical schools are gems.  They are top tier, and I am going to keep working to build on that status.

Can Texas maintain its leadership in medical research?  Yes.  With Texas teamwork—which is what we do well—we can do it.  Thank you.

Question and Answer:

Judith Zaffirini: Senator Hutchison, my question is related to your topic.  Can Texas maintain or expand its leadership role in stem cell research?

Senator Hutchison: This is such a new and growing field.  I would say that the field is wide open.  And I believe that it is essential that we be in this field.

Now, once again, California is out front.  The people of California held a referendum, and they voted for $3 billion specifically to fund stem cell research in the state of California.  That's a commitment that no other state has matched, so they're going to be in the forefront.

Many of our key people have told me that we could have a brain drain in Texas if we don't have some outlet for stem cell research.  It can be accomplished in several different ways.  It can be done with all private money.  That would allow our researchers to go forward with private money with people who want to support it, and that's where philanthropy would come in.  However, it is important for us to keep our best researchers connected to our universities.  That is an issue to be addressed by the state legislature.

I think that there are ways that we can keep high ethical standards–which we must do–and also keep our best minds looking at stem cell research.  As of today, the research community believes that the embryonic stem cell has the best capability to form itself into healthy bones, blood, pancreas, or whatever is the ailing organ.  The embryonic stem cell has so far shown that it is more adaptable than an adult stem cell.

This is probably a better question for the experts to address, and I would hope that they would.  From what I've learned the research is very new and they don't have 10- and 15-year progress reports, so I don't think we know for sure yet all of the components here.

I think that you could keep high ethical standard by maintaining what we have in place today—not encouraging people to create embryos to destroy them, which I think would be a terrible, horrible, ethical lapse.  If there's no encouragement for an industry that would create embryos to destroy them, you would have 100,000 to 200,000 stem cells from which you could do a lot of experimentation, and there would not be any incentive for the destruction of those embryos.  That is one way that we could try to address this ethical issue, which is very real and very valid to address, as we look at the different components and perhaps even come up with a way in the embryonic stage to take from an embryo without destroying it.  That is something that is very much a possibility.  If that could be the case, then there wouldn't be an ethical issue because there would then be no incentive for destroying an embryo.

This is a new field, and I appreciate State Senator Judith Zaffirini bringing that out because it will be very important for the state legislature to make some of these decisions.  I do hope that we can find the right ethical path that would keep our researchers' capabilities to pursue the very best use of these embryonic stem cells to try to save lives, because we know that they have a huge potential.

Audience:  I just wanted to let you know that the Texas Academy, in collaboration with the University of Texas, will for the first time next year have a mid-year conference located here in Galveston, April 5 and 6.  And, not surprisingly, the chair of the planning committee is Jack Stobo.  And Stan Lemon, who we'll hear from, is helping with this.

It's a very important statewide activity looking at the development of new agents to deal with microbes and vaccines.  The attempt will be to not only look at the science but to look at the connection between the research and what the private sector would like to do in terms of making investments.

Tom Cassidy has been very supportive of this, and we're hoping that this will be an annual mid-year event.  We've already talked to Baylor.  If it's successful in 2006 they will sponsor it with the Academy in 2007.  I wanted you to know that some of the work that you've done on the Academy is now bearing fruit beyond the annual meeting.

Senator Hutchison:  I'm very happy to hear that because I think the more we can have all of our best researchers come together and learn what's going on, I think you'll have more collaboration, more ideas, and more opportunity to get research grants from either the private sector or the federal government.  I'm really very happy and look forward to our January meeting very much.

Thomas Barrow:  Senator, first I want to introduce myself to some of the people here.  I'm Dr. Thomas Barrow.  I am not a medical doctor.  I'm a geologist, petroleum engineer, and member of the National Academy of Engineering.

I've also been for 20 years on the board of Baylor College of Medicine.  I've been vice chairman of that board.  I've been on the Texas Medical Center's board and on the executive committee, so I'm very familiar with what goes on in some of these areas.  I would like to thank you for all the help you have been to the medical profession and to the medical schools and centers in this state.  I think you've done a marvelous job.

In having been a former trustee at Stanford and knowing what they did, eliminating the Department of Geography over my objection, I'm glad that you found out where the center is.  I would urge all of you, as I have for many years, to support our senator.  She's doing a great job and I'm very appreciative that she's here with us today.  Thank you.

Senator Hutchison:  Thank you.

Jim George: I'm Jim George from Austin, Senator.  What percentage of the federal expenditure is the medical research proportion?  And how has that changed over your tenure in the Senate, if it has?

Senator Hutchison:  I can't tell you the percentage, but I can tell you that we doubled the National Institutes of Health (NIH) budget over five years from 1999 to 2003.  Now we're in the $28 billion range.  We have made significant increases in the medical research portion of the federal budget.

We are in the process of doing the same thing right now with the National Science Foundation.  We've gone from $2 billion to almost $6 billion this last year.

The place that we are really lagging in America—not Texas, but in America—is our science and engineering base.  We are focusing on how to get better math and science teachers in our high schools so that students have the prerequisites to earn science and engineering degrees from our universities.

The place where America has its biggest problem and where we are behind the rest of the world in every test is our K-12 education.  We are not preparing our young people to get the college degrees that are necessary for the jobs for the future.  This is something that I think Congress and the President must address.  I think we are making great strides in the medical area, and that's why I think Texas needs to be jumping in now to be competitive, because the money and the emphasis are there.

For those of you in academia, we must strengthen our K-12 programs, which necessitates more qualified teachers.  We're looking at giving competitive scholarships to students who will get degrees in science and engineering and give five years to teach in high schools.  We need to give scholarships to try to encourage our best people to go into teaching in high school so that these young people will be prepared for college.

If you rated our institutions of higher education in America against the rest of the world, we're the best.  People still come here to get their higher education degrees because we're the best.  The problem is a number of the people getting the degrees are discouraged from staying here, and they go home to countries like India and China.  They're using their skills, learned here, at home instead of staying here and increasing our overall productivity, and we're not preparing our students to be competitive.  The bottom line is, in the medical area I think we're in pretty good shape, and that will continue.

Shrub Kempner: Senator, Shrub Kempner from Galveston.  I was struck by the logic of your bringing the institutional heads to Washington to talk to the various research centers and find out what their new research emphasis would be.  I wonder if you are continuing that cycle around a second time, and, if so, whether they had changed their priorities—to the extent you know—whether they had actually changed their priorities from the first time around and what's next.

Senator Hutchison:  We have not had a summit for two years.  We had it for five years and we covered the major areas, and we have not had one for the last two years.  The TAMEST/Texas Academy meetings have given us more of an opportunity to cross-fertilize our academics.  I did a survey of our heads of institutions to see if they thought that it was time for another one, and so far they have not.  If there ever is an impetus to have another one I will.

In fact, I think the next one really should be going back to the Science Foundation, DARPA and the Department of Defense and delving into their newest things.  They have a huge research arm in the Department of Defense that's very successful.  It, too, could be very lucrative for us.  We have a lot of defense research, but we could do even more.

One other thing that I think is significant is that Dr. Andrew von Eschenbach—the head of NCI, the National Cancer Institute—has just gone over to be the acting director of the FDA.  Dr. von Eschenbach is from MD Anderson.  His concept is to stretch our research dollars by doing more public-private partnerships in the National Cancer Institute as well, to make the private research dollars go farther.

Frankly, the private companies are doing less research than they used to because their litigation expenses are overwhelming some of their research capabilities.  The head of a major pharmaceutical company told me that his research dollars and his litigation dollars were about even.  That makes me sad because we ought to be spending more on what can produce for the future.

So they're cutting back, and now the federal government is stepping up.  I think public-private partnerships can be very helpful in maintaining research, because frankly, in the national sense, we have more competition from foreign countries due to our restrictions.

For example, Michael DeBakey told me that he can't test his heart pumps on humans because of FDA restrictions.  He does his testing in France.  They are doing a lot of innovation in France, Germany, other European countries, and China because we have such severe restrictions and high litigation costs.

We need to be looking at that as well as one of the ways that we can pursue more innovations so that we get the licenses to make the products.  We want those products to be made in America because that means jobs for America.  Stem cell research is another area where we could lose a lot to foreign research because it's more open there.  We've got to always be aware of where we can do better.

Dr. Carson:  This has been, I know you will agree, very informative.  Senator, we thank you for your fine work on behalf of the state and the nation.  The future looks bright for research in Texas.

Senator Hutchison:  It does.  Thank you.