Nominee Would Take His Seat at a Desk Piled High With Issues

President Bush on Tuesday nominated an Algerian-born radiologist to lead the National Institutes of Health, moving to fill a position that was long vacant even while the ongoing bioterrorism threat added to its importance.

Bush chose Dr. Elias Adam Zerhouni, 50, to lead the NIH, the nation’s premier medical research institution with an annual budget of more than $23 billion. The agency has been without a permanent director for more than two years.

Zerhouni arrived from Algeria at age 24, with $300 in his pocket and little ability to speak English. Now, he is a top administrator at the Johns Hopkins University School of Medicine, chief of its radiology department and co-founder of a 15-person company that aims to create better images of the inner workings of the body.

“Dr. Zerhouni is well prepared to manage this rapidly growing institution during times of great new opportunity and urgent biodefense needs,” Bush said Tuesday in announcing the appointment.

Zerhouni must be approved by the Democratic-led Senate. Although there were few initial signs of opposition, some lawmakers and research groups said they want to learn more about Zerhouni, particularly his views on medical research that uses stem cells from human embryos, a politically charged issue.

Several lawmakers said they were pleased that Bush had finally moved to fill the slot, 14 months into his term.

The NIH has been without a permanent director since the end of 1999, leaving a leadership vacuum at a crucial time. At least five of the agency’s 19 major institutes lack directors, including those devoted to neurological disorders, mental health and drug abuse. Agency insiders say prominent scientists have been hesitant to commit to those jobs until the top NIH slot is filled.

At the same time, the NIH has received an unprecedented boost in funding, as Congress completed a five-year plan to double its research budget and the anthrax attacks last year prompted a major boost in funding for bioterrorism research.

Members of some patient groups and scientific associations have viewed the delay in picking a nominee as a sign of how difficult it has become to fill top government health jobs when abortion, stem cell research, pressure from industry and patient advocacy groups and other divisive issues are topics of debate.

Still vacant after more than a year is the top job at the Food and Drug Administration, an agency responsible for regulating goods that represent 25 cents out of every dollar spent in the U.S. In addition, the director of the Centers for Disease Control and Prevention is leaving next month, with no successor waiting in the wings.

The stem cell issue has been a particularly thorny one for the president. A wide range of scientists, including many of those at the NIH, believe that research using stem cells from human embryos could yield cures for a variety of diseases. Many patient-advocacy groups want the federal government to support the research aggressively.

But Bush’s allies in conservative and antiabortion groups say the research is tantamount to murder because it destroys human embryos.

Bush was able to navigate the issue last year when he faced a decision on whether to approve federal funding for the research. He decided to allow funding for experiments using cells already taken from embryos but not for research that caused any new embryos to be destroyed.

Zerhouni has not spoken directly about Bush’s policy, which he would be charged with carrying out. Also unclear are his views on a related issue: whether to allow scientists to create human embryos through cloning for their stem cells. Bush strongly opposes the cloning work.

At Johns Hopkins, Zerhouni was the driving force behind the new Institute for Cell Engineering, which is dedicated to basic research on stem cells. When the institute was created last year with an anonymous donation of $58.5 million, Zerhouni seemed to take an expansive view of stem cell research. “We wanted this field to progress as unimpeded as possible, because it may have a huge potential for all mankind,” he said.

A Johns Hopkins spokeswoman said Tuesday that studying cells from human embryos “was certainly within the vision of the institute.”

But Bush signaled Tuesday that Zerhouni supports sharp limits on that research. “Dr. Zerhouni shares my view that human life is precious and should not be exploited or destroyed for the benefits of others,” Bush said.

Bush spokesman Ari Fleischer, in a briefing held before the announcements, rejected the suggestion that a “litmus test” on abortion and other issues was being applied to candidates. Still, he said: “You should expect people who are going to be in these positions to support the ideas that the president has, otherwise they might not be comfortable serving in an administration.”

Even without a full understanding of Zerhouni’s views, people on both sides of the stem cell debate endorsed the nomination.

Peter Van Etten, chief executive of the Juvenile Diabetes Research Foundation International, a leader in the fight for federal stem cell funding, declared himself “very pleased” and said Zerhouni would “carry stem cell research forward.”

Deal Hudson, editor and publisher of Crisis, a Catholic magazine, declared himself pleased by Zerhouni’s selection.

“The president was able to make a decision that satisfied more than one group,” said Hudson, who prefers a total ban on funds for embryonic stem cell research but applauded the limits that Bush set.

While any NIH nominee would be expected to support the president’s views on stem cell research, that person could have a big influence on the pace of the research. In addition to setting research priorities, the NIH director could prod companies that own stem cell lines to share them more quickly with scientists, and on more favorable terms.

Zerhouni, one of eight children, was born in Nedroma, a small mountain town on French Algeria’s western border. His father was a math and physics teacher. Zerhouni earned his medical degree in Algiers.

Johns Hopkins, in Baltimore, is one of the nation’s largest research enterprises and wins more grant money from NIH than any other institution. Zerhouni is executive vice dean of the medical school. He also is co-founder of Surgi-Vision Inc., of Gaithersburg, Md., which is trying to pioneer a new generation of magnetic resonance imaging equipment.