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Executive Summary

NIH DIRECTOR SHORT LIST: NIAID's FAUCI, MERCK's VAGELOS, and Washington University (St. Louis) Chancellor William Danforth, MD, are the prime candidates for the top biomedical research post. All three names have reportedly been submitted to HHS Secretary Sullivan. Anthony Fauci, currently director of the the National Institute for Allergy and Infectious Diseases and a 21-year career government employee at the National Institutes of Health, is the clear front-runner for the post. As NIAID director for the past five years, Fauci, 48, has been at the epicenter of AIDS research and treatment. Handling that pressure spot skillfully, he has developed a good public image and positive relationship with the general media. That kind of reputation is a natural plus when considering the strengths of a candidate for the top NIH post. Combined with his home-grown background at NIH, Fauci's public image probably assures him the inside track on the NIH job. It is unclear, however, whether Fauci can be convinced to move up in the NIH heirarchy. One obvious drawback to the top post is that the administrative work would pull Fauci away from his lab. As director of NIAID, he has been able to maintain an active role in research. The luxury of balancing administrative duties with lab research would have to yield to the duties of managing the $ 7.7 bil. NIH annual budget. Merck Chairman Roy Vagelos and Washington University Chancellor Danforth also have the type of high visibility backgrounds in biomedical research that would bring luster to the NIH director's post. Neither Vagelos nor Danforth, however, appear to be actively seeking the position. A Merck spokesperson said definitively that Vagelos will be staying at the company (see related item below). Danforth said he had not been contacted by HHS and does not expect to be a candidate for the post. Fauci has been at NIH since 1968, when he joined NIAID as a clinical associate in the Laboratory of Clinical Investigation. From 1977-1984, he was deputy clinical director of NIAID. Since 1980, he has also held the position of chief of the Laboratory of Immunoregulations. He also holds the titles of associate director of NIH for AIDS research and director of NIH's Office of AIDS Research. An NIH biography of Fauci notes that he has "pioneered the field of human immunoregulation by making a number of basic scientific observations that serve as the basis for current understanding of the regulation of the human immune response." In addition, Fauci "demonstrated the precise nature of the immune defect in AIDS." He has also developed cures for such formerly fatal diseases as polyarteritis nodosa, Wegener's granulomatosis and lymphomatoid granulomatosis. Danforth, 63, joined the Washington University School of Medicine faculty in 1957, was appointed professor of internal medicine in 1967, and has been the university's chancellor since 1971. Prior to joining Merck, Vagelos worked under Danforth for nine years as head of a department in Washington University's school of medicine. Vagelos is currently on the board of the philanthropic Danforth Foundation, which Danforth chairs. Danforth also served as chairman of NIH's Cardiovascular Study Section from 1966-1970, and was on the National Advisory Heart and Lung Council from 1970-1984 and the NIH Director's Advisory Committee from 1980-1984. Danforth has strong ties to political Washington. He is the brother of Sen. John Danforth (R-Mo.), a member of the Finance Committee and the Commerce, Science and Transportation Committee. One of the hurdles to recruiting a top-level outside candidate for the NIH director is the issue of salary. At $ 89,000 plus benefits, the NIH position would involve a drastic cut for most people that have been under consideration. For Vagelos, who made over $ 1.6 mil. in salary in 1988 and has stock and options in Merck totaling over 400,000 shares, the cut in salary, while substantial, probably would not be a major issue. Similarly, Danforth comes from a background with substantial inherited wealth. The Danforth family founded Ralston Purina and still is represented on the company's board. Bernadine Healy, chairman of the Research Institute of the Cleveland Clinic Foundation, reportedly withdrew her name from consideration over the issue of salary. Other names that were rumored for the position included Mt. Sinai's Robert Butler, who was the first director of the National Institute of Aging, and Frederick Goodwin, administrator of the Alcohol, Drug Abuse and Mental Health Administration.

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