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I very much appreciate this opportunity to communicate on a regular basis with our constituents within the cardiovascular physiology community. The National Heart, Lung, and Blood Institute (NHLBI) comprises not just the people on the Bethesda campus but also the much larger group of scientists and physicians who share a common interest in diseases of the heart, blood vessels, lungs, and blood. Our interdependence must be appreciated and nurtured if we are to achieve our mutual goal of improving the public health.

Thus we welcome this new forum for communication and anticipate that it will be useful for all concerned. This space will be devoted to topics that should be of general interest to cardiovascular physiologists and will cover a range of research, policy, and programmatic issues. We hope to stimulate a continuing dialogue between the community and the Institute; thus the readers' reaction is eagerly anticipated and encouraged. We look forward to receiving comments and suggestions via conventional modes of communication or electronically at NHLBI.listens{at}nih.gov.

As most readers are certainly aware, we are currently enjoying a climate of strong public support for biomedical research and burgeoning scientific opportunities. To make the most of these fortunate circumstances, we need input from the entire community that we serve: researchers, healthcare practitioners, patients, and the general public. Let me mention two recent efforts along these lines.

One year ago the NHLBI convened a working group of the National Heart, Lung, and Blood Advisory Council (NHLBAC) consisting of selected NHLBAC members and other accomplished scientists. Through much of 1998, this SPARK working group (so named because it is expected to kindle a new generation of research ideas for the Institute) assisted the Institute in identifying extraordinary research opportunities that warrant funding in the event of a significant increase in financial resources. During its initial meeting in May 1998 and a subsequent meeting in June of 1998, the group developed a research schema and identified several possible themes for research opportunities.

It then solicited the expertise of three major professional societies, the American Heart Association, the American Thoracic Society, and the American Society of Hematology, at a conference titled "From Genes to Health and Health to Genes." The objective was to focus on broad research themes and identify approaches necessary to engender new research in specific areas. Four areas of opportunity were identified during this conference: tissue genesis and organogenesis, immunobiology, gene-environment and gene-gene interactions, and functional genomics. Recommendations in these areas are being developed for implementation as budget resources permit. The full SPARK conference summary can be accessed through the NHLBI web site at http://www.nhlbi.nih.gov/nhlbi/commdir/sparkweb.htm.

Just as the SPARK group was getting under way, the Institute of Medicine released the report "Scientific Opportunities and Public Needs: Improving Priority Setting and Public Input at the National Institutes of Health." Included in it was a recommendation that each component of the National Institutes of Health (NIH) develop a strategic plan. The Director of NIH, Dr. Harold Varmus, has made that recommendation a requirement, with a draft plan for a 2- to 5-year planning horizon due to him by December 31, 1999.

The Institute has initiated several activities, including the SPARK meetings, which relate directly to the process of developing a strategic plan. However, unlike the SPARK report, which was written for a scientific audience, the NHLBI strategic plan is intended to be understandable to the general public. Thus it is organized around topics that are key areas of concern to patients and their physicians: maintenance of health through prevention of disease, development and progression of disease, diagnosis of disease, treatment of disease, translation of research results into practice, and reduction of health disparities. The plan will also address emerging needs with respect to the research work force and research resources.

We intend to present a proposed plan to the NHLBAC at its September 1999 meeting and then make it available for comment by the scientific and medical communities and the public before its final version is submitted to the NIH director. We very much look forward to the reactions and suggestions of the readership of this Journal. Indeed, the full participation of the physiology community will be vital to the success of this endeavor. We are well aware that many onlookers today view science as drifting inexorably and, perhaps, calamitously toward the subcellular level. There are resultant concerns that the gap between science that looks at the totality of function and science that looks at the molecular forces that drive function is growing ever wider. On the contrary, I believe that we now have a magnificent opportunity to unite these two perspectives in a unique science. That is our hope for the future, and we are counting on the physiology community to help make it happen.

Editor's Reply

Scientific journals function to disseminate knowledge and to archive data, forming the basis for our understanding of normal and abnormal biological function by initiating potential development of therapeutic approaches targeted to treating disease. In most cases, the majority of funding to support the work represented in the AJP: Heart and Circulatory Physiology comes from the NIH. This editorial by Dr. Lenfant begins to open a dialog between one of our principal funding agencies and our Journal readership. In this regard, the Journal serves as a forum to promote discussions with the NIH in establishing priorities for distributions of funds to support the work that appears in the Journal. Dr. Lenfant's invitation to contact the NHLBI through the provided NIH e-mail address is a positive approach to promote these discussions.

Speaking on behalf of the AJP: Heart and Circulatory Physiology Editorial Board, I thank Dr. Lenfant for initiating this dialog. It will be exciting to see what comes of it.