December 2002 Bulletin

Bone and Joint Decade leaders meet with National Institutes of Health

By Mark W. Wieting

Stuart L. Weinstein, MD, (left) discusses the October 11 meeting agenda with NIAMS director Stephen I. Katz, MD

United States Bone and Joint Decade(USBJD) chairman Stuart L. Weinstein, MD, and 15 others leading their organizations’ efforts met with top leaders of the National Institutes of Health (NIH) on Oct. 11.They explored areas of mutual interest and pledged to work together on specific programs, such as the upcoming Surgeon General’s Report on Osteoporosis and Bone Health.

Organized by Stephen I. Katz, MD, director, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the meeting drew Elias A. Zerhouni, director of the NIH as well as the directors of three other institutes:

A representative of the National Institute of Dental and Craniofacial Research (NIDCR) also expressed a high level of interest in Decade activities.

Spearheading the meeting on behalf of the USBJD were Philip Osdoby, PhD, representing the American Society of Bone and Mineral Research, and Edward Puzas, PhD, from the Orthopaedic Research Society. Joshua J. Jacobs, MD, American Academy of Orthopaedic Surgeons, and Joan McGowan, PhD, chief, Musculoskeletal Diseases Branch, NIAMS, also contributed to the development of the agenda. Dr. McGowan worked with Toby King, USBJD executive director, to coordinate the meeting, which was held at Building 31 on the NIH campus, home of the NIAMS.

Several themes emerged from the discussion including the importance of:

There was agreement that this was the first in a series of meetings likely to take place during the Decade.

NIAMS initiatives

The Surgeon General’s Report on Osteoporosis and Bone Health is in development, according to Dr. McGowan, and expected to be released in the summer of 2004. Dr. Katz invited the USBJD organizations to participate in developing the report. See www.surgeongeneral. gov/topics/bonehealth/

NIH seeks proactive partnerships

Dr. Zerhouni noted the enormous impact musculoskeletal diseases have on American society. He said the groups around the table had a responsibility to communicate with each other and with patients, remarking on the millions of patients the groups and their members come in contact with each year.

Dr. Zerhouni recalled that in testimony before Congress, he’d stated it was necessary not only to look at the current burden of disease but also to look to the future. Dr. Zerhouni pointed to the fact that the President himself has declared a focus on bone and joint disease, which indicates a high-level realization of the importance of issues related to musculoskeletal disease.

He also noted the number of NIH institutes represented around the table, all with a stake in the issues of musculoskeletal health and disease. The impact of stem cell research, tissue engineering and other developments needs to be recognized even beyond the walls of the NIH. He said the NIH wants to see a policy of proactive partnerships—public and private.

Dr. Vivian Pinn, NIH associate director for research on women’s health, said her office has "a real commitment to this area" and works closely with NIAMS and other institutes.

New researchers needed

Dr. Katz led a discussion on the importance of developing new researchers to work on musculoskeletal diseases and basic science issues. All of the groups have an interest in this area, including basic and clinical research. It was noted that there is a "pipeline problem," with not enough emphasis being placed on the musculoskeletal system in medical schools. Moreover, medical school applications are down, the ratio of physicians per 100,000 people in the United States is down, and the number of specialists is down. With the growing burden of disease related to the musculoskeletal system, aggravated by an aging population, the group agreed it is key to try to change the culture in high schools so that more students value a career in medicine or clinical research. Dr. Weinstein added it was also important to communicate effectively that advancing musculoskeletal research is in everyone’s self interest, that basic and clinical research lead to better, longer, more active lives.

Next Steps

Dr. Katz said the next steps are to identify specific projects the groups can work on together, identify milestones toward their goals, and continue their discussions on communication, partnering, attracting resources and training researchers.

"This meeting represents the diversity of the Bone and Joint Decade," said Dr. McGowan. "There are groups here that don’t often sit down together. That’s very positive and we all are working on projects that benefit patients of all ages."

"I really think everyone made a positive contribution to the meeting," Dr. Weinstein said. "I am really excited about the outcome and future initiatives that will develop."

Mark Weiting is Vice President of the education department at the AAOS

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