The National Eye Institute (NEI) of the US National Institutes of Health (NIH) has initiated an Obamaesque project termed “Audacious goals in vision research.” Of the 478 pre-proposals it received in response, NEI requested about 85 experts from all over the world to study these ‘audacious goal’ proposals and asked each of us to send them what we consider as the best five among these. (I say “us” here since Dr. Gullapalli Rao and I, both of the LV Prasad Eye Institute, were the two from India, out of the 85).
NEI then held an intensive discussion for three days last week with all of us in order to discuss the proposals in depth. In order to do so, 10 representative themes in these audacious goals were chosen and 10 researchers to present them and to give roadmaps of how to achieve the goals.
What is an ‘audacious goal’? It cannot be ridiculous or beyond the reach of science, such as the infamous quest for the “perpetual motion machine,” which was attempted in earlier centuries. (Such a machine is impossible since it breaks the laws of conservation of energy; you cannot get something out of nothing).
Also, it cannot be just incremental such that it can be achieved using the conventional methods within a few years; for example, to make a human cornea in the lab — a laudable and needy goal but limited in its end. It has to be far-reaching and generate new knowledge through its approach. Dr Francis Collins, Director of NIH defined the goal of “putting man on the moon”, set up by John Kennedy as an audacious one, or “ridding the world of polio” as another. Dr Paul Sieving, Director of NEI, further elaborated on this. He pointed out that the goal must be inspirational (become the seed out of which many new, perhaps equally audacious, ideas emerge); far-reaching in its endpoint and affecting the whole of mankind; bold and innovative; compelling such that NEI should pursue it over other opportunities; and the goals should reach beyond vision and ophthalmology, and inform or benefit other areas of sciences.
Thus, each proposal should contain elements of goal development, feasibility and implementation. It should ask what the barriers and challenges (technological / conceptual/ theoretical) are and how to address them; what advances (from related or other disciplines) are critical to reach the goal; how long it would take to achieve the goal; how do we know when the goals are achieved, and how far-reaching and global the achievement would be.
Tough questions indeed! And ten broad themes came out the proposal and discussions. Without going into their intricacies, let me summarise them.
Dr Jeffrey Stern of Rensselaer, NY spoke of “Releasing our Inner Salamander.” The amphibian animal salamander is able to completely repair its eye parts by itself. Is such a mechanism lying dormant in the human eye? How can we awaken it using today’s science and technology, create new knowledge and achieve such self- repair methods?
Dr Julia Richards of Michigan wants to turn back the ageing clock in the eye such that diseases such as glaucoma, retinal disorders and such start 10, 20, or 30 years later than they do now.
Drs. Yingbin Fu of Utah and Steven Pittler of Alabama want to find methods to edit the genes in the body precisely, using molecules that target mutations and scissor them away right in the eye and add the right sequence of the DNA to cure the disease right in the eye.
Drs. Dennis Clegg of Santa Barbara, CA and Rajesh Rao of Missouri want to “reprogramme the retina” using stem cells and similar molecular toolboxes to develop an “off-the-shelf tissue graft” to repair the eye.
Dr. Robert Duvoisin of Oregon wants to restore vision by opto-electronic stimulation, not by using bionic chips, but making nerve cells in the eye sensitive to light so that images captured by a camera can be converted to nerve signals that are sent to the brain.
And Dr. Tonia Rex of Tennessee wants to regenerate the axons (threadlike extensions of a nerve cell which conduct electricity) from the optic nerve so that vision loss due to glaucoma and other disorders is restored. Dr. Russel van Gelder of Seattle wants to reverse blindness of the retina by using photo-switch molecules which become active (or inactive) when light of certain wavelengths hits them.
The tenth was by Dr Janey Wiggs of Harvard who wants to put together a vision BioBank from all over, which collects samples corresponding to both genetic errors for certain types of eye diseases as well as samples of the disease tissues themselves. Using such banks, we can accurately determine a person’s risk for specific eye diseases, as well as their responses to therapies.
Setting up such audacious goals and methods to approach and win them over not only spurs innovation, but brings disciplines to work together, and while winning, the goalpost creates new science and applications of value to humanity at large. Such audacious goals are not new to India. We set them up and won them — be it the green revolution, vaccines for the world, or the proposed Mars project.
Minister Jairam Ramesh wants to solve the sanitation problem of India. Conventional methods do not work here, given the current technology sociology, and personal hygiene habits of the aam admi .
We need innovative solutions, meeting of disciplines including social psychology in order to reach this audacious goal. I believe we have it in us to do so. Let us go for it — for a cleaner, safer and healthier India.
