For information about the grants that the University of Chicago received as part of the ARRA package, click here.

If the scientists you know have an extra spring in their step today, here’s why: over $5 billion in National Institutes of Health funding was announced this week, the scientific portion of the federal stimulus package passed in the spring. In his January inaugural address, President Barack Obama made researchers’ neck hair stand up when he promised to “restore science to its rightful place,” and this was the first installment of that pledge - a much-needed boost of cash after five years of flat NIH budgets put many laboratories in jeopardy.

“We’re announcing that we’ve awarded $5 billion — that’s with a b — in grants, through the Recovery Act, to conduct cutting-edge research all across America, to unlock treatments to diseases that have long plagued humanity, to save and enrich the lives of people all over the world,” Obama said Wednesday at an NIH event announcing the grants.

A $42 million slice of that $5 billion pie was awarded to the University of Chicago, and I’ve spent the day talking to some of the researchers who snagged the biggest awards. They are all, as you might guess, thrilled to have an infusion of money to help finally launch projects that have languished unfunded or undermanned. In all, more than 100 UChicago researchers shared in the $42 million pot, with grants ranging from $10,000 to $5.6 million. After the jump is some information on the day’s big winners and the projects their new grants will fund.

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The question was a welcome one, given the heated, exhausting health care debate that has raged through the summer: On the day after health care reform (whatever form it takes), what are the potential stumbling blocks and opportunities?

That’s how moderator Michele Norris (of NPR’s All Things Considered) thoughtfully began the panel at the University of Chicago-curated “Chicago Contributes” health care forum, held Thursday in Washington, DC less than a day after President Barack Obama’s speech to Congress. Reform supporters might consider that question to be a jinx as Obama and the Democrats struggle to find a consensus plan, but it allowed the forum’s panelists to clear the political fog and put the focus back where it should be - on the challenging questions of access and cost reduction that face modern American medicine.

After a keynote address by Kathleen Sebelius, Obama’s Secretary of Health and Human Services, echoed many of the points the President made himself the night before, the stage was turned over to a national group of university experts that were grappling with these issues long before health care became the season’s political hot potato. The importance of access to health care, not just insurance, was summarized nicely (and immediately) by Gerard Clancy, Dean of the University of Oklahoma-Tulsa College of Medicine: “If we have 40-50 million people now with health care coverage, who’s going to take care of them?”

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University of Chicago molecular geneticist Janet Rowley received her Presidential Medal of Freedom Wednesday along with 15 other honorees, including Stephen Hawking and Sen. Edward Kennedy. Here’s video of the ceremony, courtesy of C-SPAN…President Obama’s warm introduction is at 15:50, and he presents Dr. Rowley with the medal at 35:00:

Here is President Obama’s introduction:

“After graduating from the University of Chicago School of Medicine in 1948, Janet Rowley got married and gave birth to four sons, making medicine a hobby and making family a priority. It was not until she was almost 40 that she took up serious medical research, and not until almost a decade later that she discovered, hunched over her dining room table examining small photos of chromosomes, that leukemia cells are notable for changes in their genetics — a discovery that showed cancer is genetic and transformed how we fight the disease. All of us have been touched in some way by cancer, including my family, so we can all be thankful that what began as a hobby became a life’s work for Janet.”

Two Chicago TV stations have also done profiles of Dr. Rowley since the Presidential Medal honor was announced, which you can watch online:

WTTW, Ch. 11

ABC-7 Chicago

You could say that Janet Rowley is having a pretty good year. In March, the University of Chicago molecular geneticist stood at President Barack Obama’s right arm as he signed an executive order clearing the way for federal funding of embryonic stem-cell research. Earlier this month, she was declared the winner of the 2009 Peter and Patricia Gruber Genetics Prize, which comes with a $500,000 cash award and a gold medal.

Today, another tremendous honor was announced for the still-active 84-year-old: the Presidential Medal of Freedom, the highest award an American civilian can receive from the White House. Among the other 15 recipients are Stephen Hawking, Sen. Edward Kennedy and Desmond Tutu; very prestigious company indeed.

In typical fashion, Rowley downplayed being recognized for her important research in the early days of cancer genetics.

“I felt very humbled, but also as though I didn’t deserve it,” Rowley said yesterday about her initial reaction to the honor. (You can watch the video interview with Dr. Rowley here: Janet Rowley talks about winning the Presidential Medal of Freedom)

With all due respect to Dr. Rowley, she’s wrong. When Rowley began to investigate the mysterious relationship between chromosomal abnormalities and leukemia in the 1960’s the scientific jury was still out on the relationship between genes and cancer. It was known that patients with certain types of leukemia had unusual chromosomes — notably the shortened “Philadelphia Chromosome,” associated with chronic myelogenous leukemia (CML) — but scientists debated whether that was the cause of the cancer or the result.

After starting a laboratory at the University of Chicago with help from legendary hematologist Dr. Leon Jacobson, Rowley used the newest chromosome-staining techniques to discover that the genetic segment missing from the Philadelphia Chromosome had not disappeared, but instead traded places with a segment from another chromosome in a process called translocation. This swap was not merely cosmetic; the gene for a particular protein that promotes cell division was separated from its natural genetic brake, causing the uncontrolled cell proliferation characteristic of cancer.

Rowley’s landmark paper on CML was published in 1973, but only after rejection by at least two scientific journals unconvinced of her findings. Eventually, chromosomal translocations were found to be responsible for several different cancers, and the concept of cancer as a genetic disorder became widely accepted in medicine. Her research also led to the development of the anti-cancer drug imatinib, aka Gleevec, which acts by inhibiting the protein that is excessively activated after the translocation.

For much of the past decade, Rowley served on President George W. Bush’s Council on Bioethics, advising the White House on controversial scientific topics such as embryonic stem-cell research. Having long opposed Bush’s limitations on federal funding for such studies, Rowley celebrated Obama’s loosening of those restrictions, writing for US News & World Report that the decision “has removed a key barrier to research and discovery.”

Rowley continues her research at the University of Chicago, and is an avid swimmer, sailor, cyclist and gardener. When I interviewed her for a Chicago Tribune article on the Gruber prize in late June, she said, in her understated way, that she was flattered to receive such awards and surprised that her work was still being acknowledged.

“It’s a great honor to have one’s colleagues still recognize one’s accomplishments,” Rowley said. “I suppose it’s a great pleasure to be around to be recognized.”

I don’t mean to gush with advance praise for the Pritzker School’s commencement speaker, Dr. Atul Gawande, but he really does seem to be everywhere lately. First he wrote that great New Yorker piece on the deep puzzle of how some communities can spend so much on medical care without improving health outcomes. Then this week the New York Times reported that Gawande’s piece is at the center of White House discussions about health care reform. Veteran health policy reporter Robert Pear writes that the piece has become “required reading” among President Obama’s staff, and that Obama cited it in a recent meeting with two dozen senators, saying, “This is what we’ve got to fix.”

So needless to say, we’re curious about what Gawande will have to say here tomorrow morning. For clues about his address, here’s a Wall Street Journal blog report on his commencement speech earlier this week at the Harvard School of Public Health. If it’s any indication, he should have some interesting thoughts on modern medicine’s central paradox: The more sophisticated and profound our scientific discoveries become, the more difficult it can be to make those cutting-edge treatments widely available.

The news of unusual swine flu cases in Mexico and the American southwest has raised concerns that the outbreaks could herald a new flu pandemic - though the anxiety level in this AP story on today’s news seems just a bit too high at this stage. Something about the tone smacks of that movie “The Andromeda Strain” - “it’s something we’ve never seen before…”

It’s important to be vigilant, but overreaction also can have costs. In 1976, the CDC instituted an emergency immunization program in response to an outbreak of swine flu. The vaccine they used may or may not have been the cause of an uptick that year in cases of Guillain-Barre Syndrome (see this for an account of the 1976 experience by the former directors of the CDC and the immunization program).

President Obama has a history of interest in flu pandemic preparedness. He co-wrote a 2005 op-ed in the New York Times on pandemic measures, and later that year I interviewed him on that subject for the Chicago Tribune. You can see the transcript here. Two passages from that interview may offer clues about how Obama’s administration will handle the latest outbreak: 

Even when the SARS scare struck, the losses were in multiple billions of dollars. And that proved to be a false alarm essentially. If something like this genuinely occurred, you’d see global trade come to a standstill. And in addition to obviously the loss of life, the breakdown of our health systems, the economic consequences would be huge.

…you hate to be Chicken Little on this thing - no pun intended. But this is actually one of those situations where getting people a little scared, and certainly getting our government a little scared is probably a useful thing. And as I said, whatever investments we make are not going to be wasted, because the likelihood of pandemic is so high, even if it isn’t this particular pandemic. 

Perhaps Obama will see the issue differently as president than he did as a senator. But his instincts seem similar to those of the people who ran the 1976 immunization program - “When lives are at stake, it is better to err on the side of overreaction than underreaction.” If this outbreak continues, we may see another test of that idea.

Last Friday the Obama administration published its new guidelines for federal funding of embryonic stem-cell research, ending the Bush-era restrictions on that work.

Except they didn’t end all of the restrictions. The new rules do not allow for work on cells made via research cloning (somatic cell nuclear transfer), and they require an informed consent process that may exclude some cell lines already derived with different consent procedures. Advocates at both antipodes of the stem-cell debate found something to criticize in the Obama rules. Researcher Irv Weissman of Stanford said the rules maintain an “ideological barrier” that will hinder progress, while Douglas Johnson of the National Right to Life Committee said the guidelines herald “an incremental strategy to desensitize the public to the concept of killing human embryos for research purposes.”

For now Obama seems to have struck an ideological balance, and some conservatives are giving him credit for it. Yuval Levin, a former Bush bioethics adviser who recently appeared on this blog, wrote on Friday that the new guidelines “certainly could have been worse” from a conservative’s perspective.

At the same time, the new rules mean that federally funded research can move beyond 2001-era technology. Bush’s guidelines, which restricted funds to lines derived before August 2001, allowed researchers to work with just 21 cell lines. Obama’s rules open the door to hundreds of additional lines created since 2001, many of them with genetic defects that can help scientists understand how diseases develop.

In moral terms this may even be a clearer approach than Bush’s policy, which claimed to protect nascent life but did allow some funding of research that required the destruction of human embryos. Those rules allowed fewer stem-cell lines to qualify for funding, yet the restriction was based on an arbitrary cut-off date. Why was it moral to allow funding of research on stem cells taken before August 8, 2001, but beyond the pale to allow funds for cells taken after that date?

Levin, who also served as executive director of the President’s Council on Bioethics, wrote that by keeping some limits on stem-cell research funding, Obama’s NIH has conceded “that the destruction of embryos for research is not an innocent and unproblematic practice, but must be constrained for ethical reasons.” So far, so good. As the bioethicist Art Caplan once told me in an interview, “A human embryo may not be a legally protected person, but it’s also not just any old stuff.” Levin then goes further: “These rules raise the question of why limits are necessary, and any serious answer to that question would lead us to conclude that these rules are inadequate. ”

That’s not at all clear to me. Under Bush’s old rules, an embryo’s fate might depend solely on the date when it was created. Under Obama’s new rules, the embryo’s fate is governed by something far less arbitrary - the parents’ intentions, informed by all the options available to them. It seems reasonable to trust that whatever parents decide, they will see their embryos as something more than raw material.

[Note: This post originally contained a quotation from a private classroom setting, which has been removed at the speaker's request.]

Suddenly George W. Bush is no longer the easiest target for anyone frustrated at the pace of scientific progress.

He started to occupy that position at 9 p.m. Eastern time on Aug. 9, 2001, when he went on national television to outline restrictions on federal funding for the new field of embryonic stem cell research. It seemed an arbitrary and even arrogant policy. No federal funds could be used for research on cell lines derived after the moment Bush began his speech - exactly 9:00:00 p.m. He portrayed the decision as a compromise - the original intention was to give no funds at all - but many researchers saw it as a fiat that would stifle a promising field and send a message that scientists served at the pleasure of the president. Science-related decisions in subsequent years tended to bear out that early impression.

Now there’s no obvious scapegoat for the obstacles facing researchers and patients eager for new treatments. President Obama has pledged to lift Bush’s restrictions on stem cell research, and to “put science back in its rightful place.” But we still don’t have a good sense of what that means.

This could be a rare opportunity to make a new strategy for American biomedical research. It would be a massive undertaking, centered on the sprawling National Institutes of Health, which currently lacks a permanent director. The $28 billion NIH budget supports 27 centers and institutes, and an army of researchers around the country.

A blog post last week by Stanford researcher Stephen Quake suggested that this is “the time to rethink the basic foundations of how science is funded.”  He proposed more long-term grants to scientists and better incentives to pursue creative projects. The current system has some incentives for researchers to follow the agencies’ institutional priorities, rather than give reign to their best ideas.

My op-ed last Monday in the Chicago Tribune suggested creating a new NIH institute devoted to stem cell research. Yet some of the response to that piece reflected a widespread wariness of doing anything to complicate the federal research bureaucracy. My e-mail friend Yuval Levin, a National Review writer who worked in Bush’s domestic policy office, said that if anything the NIH needs a simpler management structure, not more institutes. He echoed Quake’s point that the current system doesn’t do enough to support younger investigators or new ideas.

In the short run, how Obama handles the NIH may be a better test of his managerial success than the outcome of the stimulus plan. It’s one thing to sign a piece of paper and reverse Bush’s stem-cell policy; it would be a much greater feat to free the awesome creativity of America’s scientists.