Germany plans for healthy future

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National health-research centres take shape.

The German Centre for Neurodegenerative Disease will be based at a hub (above) to be built in Bonn. Credit: Engel, UKB

After years of wrangling, Germany is finally setting up a national medical-research system, meant to help the country's scientists compete with powerhouses such as Britain and the United States.

German biomedical research has traditionally been done by universities and their clinics (which have direct access to patients), and by research institutes belonging to organizations such as the Max Planck Society and the Helmholtz Society. But they don't always collaborate, limiting the effectiveness of the country's research in this field.

Three years ago, federal research minister Annette Schavan decided to create a series of national health-research centres that would bring together these disparate efforts to make more efficient use of funding, enable multi­disciplinary studies in translational medicine and attract top talent from abroad. The first such centre — the German Centre for Neurodegenerative Disease (DZNE), headquartered in Bonn but with seven partner institutes around the country — opened last year without controversy. But angry protests greeted proposals for a second, for diabetes research. Some university medical faculties claimed that power was being given to research centres lacking appropriate expertise, and the widely publicized row threatened to derail plans for subsequent centres.

Those plans are now firmly back on track. The National Centre for Diabetes Research (DZD) opened officially on 9 November; the day before, the government approved the locations of four other distributed national centres, covering cardiovascular diseases, infectious diseases, lung diseases and cancer. These should begin operation next year.

All the new centres will focus on translational medical research and each will receive around €35 million (US$48 million) a year in federal government funding (the DZNE receives more). To defuse tensions with the universities, the ministry is now letting participating scientists decide how to structure the four new centres — unfamiliar territory for many of them. "We don't yet know how to do this," confesses immunologist Dirk Busch at the Technical University of Munich, a member of the infectious-diseases centre.

To circumvent an existing bar on federal funding for universities, federal money for each centre will be funnelled through a research institute of the Helmholtz Society, which is 90% federally funded. Most of the new centres have been chosen to give equal importance to each of their half a dozen or so bases, which were selected by international expert committees from competing bids. Each bid was required to be a collaboration between local universities and non-university research institutes. Once established, the centres may draw in research groups not based in the winning locations. The winners now have just a couple of months to put together a concept for the centres' organization and research, to be submitted to the same review committees. The ministry wants money to flow before the end of 2011.

After more than a year of uncertainty, the mood is upbeat. "Germany has not been competitive in health research in the past decades," says Oliver Eickelberg of the Comprehensive Pneumology Centre in Munich, a member of the new lung-research centre. Even sceptical universities are coming round to the idea. Clinician-researcher Andreas Zeiher, from the Goethe University in Frankfurt, who is a member of the cardiovascular-research centre, says they now realize "that it is better to have something than nothing".

One project that the lung centre is discussing is the identification of molecular signatures of lung fibrosis in order to develop targeted therapies. A single clinical centre would typically have only some 150 such cases to work with, but by pooling patients from around Germany the lung centre expects to be able to recruit up to 1,000. This number would make analysis — using the sequencing and systems-biology platforms the centre intends to establish — statistically feasible. "The new centres allow us to concentrate our activities with the security of long-term investment and increase our visibility internationally," says Eickelberg. "That's important if we want to attract outside investigators."

"Germany is making a smart move," says David Warburton, a physician-scientist at the Children's Hospital Los Angeles at the University of Southern California, and a member of the expert advisory panel for the lung-disease centre. He believes that synergies between groups involved with the new centres will add value to the "well-funded, well-organized but decentralized research activities in Germany".

Participants agree that the effort will succeed only if it is backed by stable funding, and in a statement to Nature the ministry confirmed that this is its intention. Oncologist Otmar Wiestler, head of the German Cancer Research Centre in Heidelberg, is confident that the government will not allow the centres to fail. "This is a new era for biomedical research in Germany — nothing less."

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Abbott, A. Germany plans for healthy future. Nature 468, 358–359 (2010) doi:10.1038/468358a

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