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Gary Gibbons graduated from, and worked at, very fancy schools and medical facilities, but he understands that some folks in America face different challenges because the places they live in are challenging. It doesn't relieve anyone of personal responsibility, but there are different challenges.

Some folks in the pharmaceutical industry, who have never known poverty, don't like to admit that the business relies on government funding, but one way it does is through research money from the National Institutes of Health. Gibbons runs the National Heart, Lung, and Blood Institute (NHLBI) at NIH. Among the institutes, Gibbons' branch is the third largest with a budget of $3 billion and a staff of 917.

Gibbons grew up in the Germantown section of Philadelphia, before graduating from Princeton and Harvard Medical School. After that, he worked at Harvard-affiliated Brigham and Women's Hospital in Boston, Stanford, Harvard and Morehouse College. After he was named to lead NHLBI in April of 2012, he told Nature magazine in an interview that his mother was his inspiration and a reason he is committed to public health.

"She was an orphan who made it through college and received a master's degree in education, with help from a stranger who paid most of the expenses after hearing her speak at her high school graduation," Gibbons said in the Nature article, which is here. "That gave her an appreciation for what caring people could do for someone in need. She founded a church, a nursery school and a house for unmarried teenage mothers. She took kids who were in trouble into our house while I was growing up in the predominantly African American neighborhood of Germantown, Philadelphia. My mother instilled in me a sense of social responsibility that has stuck. When I was speaking to people about applying for the position at the NHLBI, I realized how much the NIH's mission of giving back to the community resonated with me."

The pharmaceutical industry is going through a tough stretch, at least by its standards. Chief executives might not be effected much, but there have been plenty of layoffs. Faced with the economic challenge, companies have been looking at research and development costs overall, but also the process. The common time line is 10 years to produce a drug. But companies now are making assessments sooner.

The U.S. federal government reflects a similar situation. Sequestration meant budgets were generally cut across the board. Because of the federal budget crisis that preceded sequestration, worries about healthcare costs and concerns about American health, NIH is looking at more studies that help fight chronic disease such as obesity, diabetes and heart disease.

"They know they have a pipeline problem and what they see as opportunity for the government in what we will call this pre-competitive space, where the discovery science starts to identify pathways and targets that weren't even on their radar," Gibbons said of drug companies during a Monday evening discussion with reporters and editors at the Inquirer.

A few minutes earlier, Gibbons had been talking about research around eating, and the discussion turned to vegans and cheeseburgers.

"Even comparing a vegan to somebody who eats too many cheeseburgers, if we start to find the pathway that explains why the vegans are doing better, that becomes a drug target that wasn't on their radar screen," Gibbons said, referring again to drug companies. "That's where they still see - quite frankly - that the taxpayer still pays off for them. They are very interested in a partnership with NIH that promotes that discovery capability. We're funding hundreds of thousands of scientists, who are letting ideas bubble up. And no one engineered that. It didn't come from the CEO saying, 'Go after that." That's the advantage of the NIH-funded community. They are just doing science. They are not looking for drugs. They were just trying to ask, 'What's the difference between the vegans and the meat-eaters and it ends up being a drug with a target."

Gibbons said the mapping of human genes will create a "treasure trove," of information that researchers can build off of in their experiments.

GlaxoSmithKline is among the pharmaceutical companies remaking its scientific research processes to get answers sooner on whether the a compound is worth continued study or greater investment. With sequestration, some of those issues apply to NIH.

"That is part of it - as I've certainly explained to my staff - that this is the new normal and when our funding has been flat for a couple of years," Gibbons said. "We just took a sequester and we don't know what's going to happen with sequesters of the future. We're going to have to be much more strategic and nimble ourselves. We may fund somebody for five years. We have to get more of that go or no-go discussion that says, 'This is an $80 million trial and we might to put in some milestones. If things aren't trending right, we might have to cut our losses here.' Whether it's the hypothesis, the accrual, the way the events are going. Those are conversations we're going to start to have. Absolutely. It would not have come up in the good old days with the budget going up, but now we have to do that."