Physician, Once Hesitant, Agrees to Take NIH Post

A Duke University physician, whose concerns about some of the new, more stringent conflict-of-interest rules at the National Institutes of Health had delayed his decision to become an agency director, said Tuesday that he would start his federal position next week.

Dr. David A. Schwartz said he decided to accept the job as director of the National Institute of Environmental Health Sciences after several recent conversations with the NIH’s director, Dr. Elias A. Zerhouni.

In an interview, Schwartz said that he was won over by Zerhouni’s commitment to reevaluate and revise a provision that would require all senior NIH scientists to sell, by Oct. 3, any stock they held in a biomedical company. Schwartz said he would limit his holdings in publicly traded biomedical companies to no more than about $15,000 worth of stock and would place the holdings under the control of an outside money manager.

Zerhouni had announced Schwartz’s appointment in October, before the new policies were adopted. In March, Schwartz told Zerhouni that the rules had caused him to delay accepting the position.

“I strongly believe that investments do not necessarily equate to conflicts of interest,” Schwartz said. “However, there are some investments that clearly do represent conflicts. Those investments need to be avoided or the conflicts need to be managed in a way that allows for full disclosure, review and appropriate supervision.”

Zerhouni has said publicly in recent weeks that he wants to scale back the stock divestiture rule. On Feb. 1, he announced the enactment of the rule and another requirement that called for nonscientific staff, including elevator operators and secretaries, to limit their stock holdings to no more than $15,000 in specific biomedical companies.

“Dr. Zerhouni and I have developed a partnership over the past four to six weeks -- a partnership in terms of addressing the conflict-of-interest issue not only for me but for the other NIH employees,” Schwartz said.

“And I’m confident Dr. Zerhouni will develop a reasonable policy” regarding stock investments, he added.

Schwartz said he would start Monday at the National Institute of Environmental Health Sciences’ 509-acre complex in Research Triangle Park, N.C., not far from Duke’s campus.

Schwartz, 52, who has served for five years as a professor at Duke’s medical school and as the director of Duke University Health System’s division of pulmonary and critical care medicine, has limited his criticisms of the new NIH policies to the stock divestiture provisions. He said he supported the NIH’s across-the-board ban on consulting fees from all pharmaceutical and biotechnology firms.

“The limitations on consulting fees seem to be justified given the conflicts that any consultancy relationship might raise,” Schwartz said.

Schwartz’s stance on consulting fees is at odds with a group of NIH employees, the Assembly of Scientists, who have hired a law firm and lobbyists to try to overturn the conflict-of-interest rules. The government employees want most NIH scientists to be allowed to collect fees from drug companies and to roll back the requirements for divestiture of biomedical stocks, the group’s website says.

Zerhouni said that although the stock divestiture requirements were apt to be softened, he did not intend to revisit the ban on consulting fees.

In a statement Tuesday, Zerhouni praised Schwartz’s decision to join the NIH.

“I am pleased that we have been able to conclude his recruitment and address his concerns regarding the interim rules on stock divestitures,” Zerhouni said. “When I speak of NIH’s need to attract the best and the brightest scientists, David is a prime example.... He is one of the world’s outstanding researchers in environmental health.”

At Duke, Schwartz has focused on the genetic causes and biological consequences of certain lung ailments, including asbestosis and asthma.

As director of the National Institute of Environmental Health Sciences, Schwartz will preside over a budget of about $711 million. The institute’s staff, including about 480 employees assigned to in-house research, conducts experiments aimed at assessing how the interplay of the environment, genetics and aging can cause or affect the course of complex diseases.

Schwartz said he would bring 23 colleagues with him to the government from Duke -- 18 physicians and doctorate researchers and five technicians.

The origins of the institute that Schwartz will lead can be traced to a 1962 bestseller, “Silent Spring,” which forecast the deaths of birds and possibly people from the growing use of chemicals. In 1964, Congress authorized funding for a centralized environmental health research facility; five years later, the Nixon administration elevated the facility to the National Institute of Environmental Health Sciences.

“I’m making this move primarily because I think I can have a bigger impact on the direction of this field,” Schwartz said. “I would like to see environmental sciences have a far greater impact on improving the health and understanding of the distribution of disease in the public.”