America welcomed Elias Zerhouni — today the door would be closed

The former NIH director warns anti-immigrant policies, assaults on universities make it impossible for others to follow his path

Elias Zerhouni personifies the American dream. He arrived in the U.S. from Algeria as a young man with a couple of hundred dollars in his pocket. Talent, ambition and hard work propelled him into a successful academic career. In 2002, he was nominated and confirmed as NIH director, and later he served in senior positions in the biopharma industry.

That trajectory “would be almost impossible” today, he told The BioCentury Show.

Anti-immigration policies, especially the recently imposed $100,000 fee for an H1B visa, underfunding of basic research that allows some NIH institutes to fund only 4% of grant applications, and attacks on philanthropy have made the U.S. an unattractive destination for anyone hoping to follow his path, Zerhouni said. The young people America needs to power future biomedical innovation are saying “I would rather stay in my country or go to other countries that are more welcoming.”

Zerhouni’s perspective ranges beyond academia. After NIH, he was president of global R&D at Sanofi (Euronext:SAN; NASDAQ:SNY). He’s currently president and vice chair of Opko Health Inc. (NASDAQ:OPK; Tel Aviv:OPK) and co-founder and chair of OPKO company ModeX Therapeutics, Inc.

Beyond the long-term damage caused by shutting the door on immigration, he pointed to problems that are going to cause a slowdown in biomedical progress in the short term. “We have a perfect storm going on right now with funding being attacked, universities being attacked, biopharma because of pricing issues being attacked, and then at the same time philanthropy” under assault. He raised the alarm over the Trump administration’s threats to impose a 30% tax on foundation endowments.

Despite his serious concerns, Zerhouni said he is not completely pessimistic. He cited Congress’ rejection of the Trump administration’s requests to slash NIH’s budget, as well as support from administration officials for maintaining American preeminence in the life sciences. “I talk to people in the administration as well as people who are supportive of President Trump, and they’re telling me, look, we don’t want to destroy the scientific enterprise of the United States, we want to stay number one.”

From Zerhouni’s perspective, two factors are driving the public’s distrust of science that has corroded support for NIH. A struggling healthcare system and continuing fallout from the COVID pandemic.

The hardest problem, he said, is the stark mismatch between global leadership in biomedical research and a healthcare system that is failing to improve the health of the American people. 

Zerhouni described critical failures, especially mistakes made by FDA and CDC, in testing and preparedness, that exacerbated the COVID crisis. He credited NIH’s investment in coronavirus biology for enabling rapid vaccine development and differentiated it from political mismanagement and socioeconomic fallout that fractured public trust.

Zerhouni expressed sympathy for the Trump administration’s attempts to reduce international drug pricing discrepancies and touched on ideas for reforming healthcare, topics he explores in a recently published memoir, “Disease Knows No Politics.”