Progress Pushes Forward
The achievements are more than just political, however. This is a scientific program that is starting to show scientific results.
Diabetes treatment is one area that stands to benefit; a project led by a team at the UK's Imperial College has provided the
first demonstration in humans that the PAS kinase protein plays a key role in insulin secretion. Chronic pain is being explored
in another project, and schizophrenia and depression are being investigated through new experimental models.
New tools are under development to test potential treatments of Alzheimer's disease, bringing together databases of previously
conducted clinical trials and combining the results from blood tests, brain scans, and behavioral tests. Innovative testing
methods to classify asthma patients are expected to play into new drug development, and new assessment techniques are emerging
for chronic obstructive pulmonary disease. Work is under way on proof of concept that early biomarkers can reliably and robustly
predict later cancer development.
The range of supported actions extends beyond specific therapeutic categories to cover the entire research process. The search
is on for sensitive and specific clinical tests to diagnose and monitor drug-induced injury to the kidney, liver, and vascular
systems in man, so as to overcome one of the major current hurdles in drug development. One project provides advanced training
on subjects such as safety, pharmacology, ethics, and non-clinical safety assessment, or predictive cell culture systems.
Another is creating a pan-European platform for education and training across the entire lifecycle of medicines research,
from basic science, through clinical development, to pharmacovigilance. Doctoral-level training in pharmacovigilance and pharmacoepidemiology
for specialists and non-specialists also started in late 2011.
IMI is promoting standardized management methods for clinical and medical research data through an agreement with the Clinical
Data Interchange Standards Consortium (CDISC). As IMI executive director Michel Goldman observed, "Since IMI projects will
be increasingly based on the analysis of large data sets, harmonization and standardization of data made possible through
the collaboration with CDISC will be critical to success." And to promote collaboration, it provides an online partner search
tool for people, organizations, and enterprises interested in participating in its projects.
The evaluation processes that IMI uses for project selection have won approval from independent observers. External monitors
found the latest assessment of expressions of interest was conducted "professionally and fairly," and with "dedication of
all participants to ensuring an impartial and thoughtful evaluation."
Upcoming projects include the creation of a European compound library where the findings of participating pharmaceutical companies
will be pooled, and the establishment of a European screening center with novel tools to improve procedures and pick up molecules
that might otherwise be missed.
But perhaps IMI's biggest challenge in 2012 will be to drive forward a wider EU program in tackling resistance to antibiotics
scheduled to get under way in the coming months. IMI's role in the short term will be to build partnerships that can speed
discovery and development of novel antibiotics to treat the most urgent infections. Over the longer term, IMI could become
the focal point for large-scale collaboration between European health authorities and the pharmaceutical industry, based on
novel partnership arrangements for drug development in antibiotics and, further ahead, across a broad range of therapeutic
There are plenty of other challenges ahead where IMI could prove a valuable resource for Europe. In particular, the known
unknowns—and even more so, the unknown unknowns—of personalized medicine will demand a new capacity for research cooperation in Europe if the potential is to be
exploited. Unprecedented collaboration between therapeutic and diagnostic approaches is just one of many obvious areas that
could benefit. IMI is, in principle, well placed to provide that form of cross-sector support, and it has already set additional
priorities in its scientific agenda for pharmacogenetics and taxonomy of human diseases, and for rare diseases and stratified
Time may not, however, be on IMI's side. Agreement in Europe on the need for a strong base for medicines research is unambiguous.
What is somewhat ambiguous is how this is to be secured. There is, for instance, still no consensus on a further round of funding
once IMI's initial $2 billion is exhausted—and the current economic climate in Europe is hardly propitious for publicly funded
programs, even when industry puts in its own contribution too. IMI still has to come up with satisfactory solutions to the
intellectual property questions attached to innovation, so that future business or research opportunities are not limited
by uncertainty or inequity.
Meanwhile, there are signs that drug development in the U.S.—still Europe's biggest competitor in this field—may be recovering
from its decade-long slowdown. The FDA approved 35 new medicines in 2011—one of the highest totals since the turn of the century.
And these were not just lifestyle-inspired me-too products; around half were for cancer or orphan diseases. Strikingly, two
of the new medicines were linked with a molecular test, making them the first companion drug-diagnostic approvals. IMI's aim
of invigorating European drug research is admirable, and its achievements to date are substantial. But it will have to do
even more, even faster, if it is to win the support it needs in order to be able to give the backing to European drug research
that is also crucially needed.