 Okay. So I will move on to the second major presentation, and I just chose to do it back-to-back because I thought that was an appropriate way to do it. But I'm using this council meeting to publicly describe, really for the first time, two interrelated efforts that are important to NHGRI and to our programs. Now both of these reflect my and the broader institute's desire to use this moment in time to thoughtfully examine some key issues that are highly relevant to NHGRI. There are really going to be two parts of the story that I'm about to tell you. The first part involves reflecting on NHGRI as an organization. Who are we? What is our role in the genomics community? And how has that role been shaped and changed over time? In essence, what is NHGRI's current identity? The second part relates to planning for the future and doing something that our institute is particularly good at, strategic planning. In essence, what is our strategic vision for the future of NHGRI's genomics efforts? And for the second part, I will be telling you about the beginning of a journey that will put us in route to a 2020 vision for genomics through the next round of NHGRI's strategic planning. In setting a context for these questions, let me share with you an interesting historic milestone that is rapidly approaching. Many regard the Human Genome Project as the beginning of the field of genomics. The Human Genome Project began on October 1, 1990, making that day the beginning of the beginning. Similarly, since NHGRI was explicitly created to lead the U.S.'s effort in the Human Genome Project, one could readily consider October 1, 1990 to be NHGRI's symbolic birthday of sorts. Well, guess what? This coming Friday will be February 16, 2018, and that day will precisely mark 10,000 days since the start of the Human Genome Project. So in many ways, NHGRI and the field of genomics is about to celebrate its 10,000th day of existence. So it seems reasonable to use this odometer moment as a time for NHGRI to reflect on who we are, what we have accomplished, and where we are heading. Now, obviously, a lot has happened over the last roughly 10,000 days, including the successful completion of the Human Genome Project, now nearly 15 years ago. And while NHGRI has morphed considerably over the last 10,000 or so days, in many ways the Institute and the Human Genome Project will be forever linked, historically and symbolically. And I think we should actually embrace that forever linkage. Ironically, during the week that I actually made this slide, I received something in the mail that actually amplified this NHGRI Human Genome Project identity linkage, at least from the perspective of the general public. A new story. Arriving in the mail was this envelope addressed to me as the director of NHGRI and postmarked in mid-January. It was from a person that's going to remain anonymous, but who happens to live in Utah. This generous soul was clearly impressed with the field of genomics, and in particular the Human Genome Project, because in the envelope was this note saying that this individual would like to donate $10 to the Human Genome Project, and indeed this $10 bill was included as a donation. Now, I wanted to share this story with you, both because it actually came when I was preparing that slide, but I think it really illustrates that even 10,000 days later, NHGRI is explicitly linked to the Human Genome Project in the eyes of many, and I think appropriately so. But, and there is a but. At the same time, all of you realize that there has been substantial changes in the last 10,000 days, and NHGRI finds itself to be an organization well beyond a simple and exclusive linkage to the Human Genome Project. The world around us has just changed in so many ways. For starters, genomics has grown and matured considerably. In fact, genomics is now nearly ubiquitous across the biomedical research landscape throughout the NIH, the private sector, and around the world. Much to NHGRI's credit, genomic medicine is becoming a reality and is expected to grow substantially in the coming decade. And to be honest, NHGRI absolutely deserves considerable credit for its leadership in genomics for the past roughly 10,000 days, but, and there is a but. The simple reality is that NHGRI is no longer the major funder of genomics research in the U.S. or the world. In fact, the collective funding for genomics research around the world, and even just at NIH alone, far exceeds NHGRI's budget. So in short, despite our historic and important linkage to the Human Genome Project, NHGRI finds itself in a very different place now compared to 10,000 days ago. So with that as a backdrop, I would now like to tell you about two efforts that we're tackling that are highly interrelated, one that is nearing completion and one that is just now starting. First I'll tell you about our efforts to look inward at NHGRI's identity and to define the institute's current place in the genomics ecosystem. Second, I will tell you about NHGRI's plans for developing an updated vision for the future of genomics research. Well, with the past roughly 10,000 days and the rearview mirror and the turn of the decade and the year 2020 on the near horizon, we concluded that it was an appropriate time to pause for a moment and endeavor to modernize NHGRI's identity. Such an effort would serve both to preserve our place in history and to define our current place, not just at NIH, but in the broader genomics and scientific ecosystems. So for the past two years, our communications and public liaison branch has led an initiative to clarify NHGRI's mission, value, and role in the scientific community. This discovery process captured input from both internal staff and external stakeholders from NIH and beyond. To help guide this effort, we established a trans-NHGRI steering team to ensure that different stakeholder perspectives were actively considered. Internal input was then gathered by about 40 interviews, including all institute leadership and staff from every division. We also gathered external input from colleagues in academia, industry, education, policy and healthcare settings, and the process also included analysis of how peer organizations and genomics tell their stories. Here is what we learned, or perhaps really said differently, here's what we confirmed about NHGRI's identity. First, shaping genomics. NHGRI has played an integral leadership role in genomics since the inception of the field. Our institute continues to be a leading authority in the field of genomics. We provided critical leadership during the Human Genome Project, we have catalyzed the use of genomics across NIH, and we have expanded genomics across biomedicine. This influence on genomics has included an unrelenting commitment to data sharing, which has led to important cultural changes to not only the field of genomics, but really across all of biomedical research. In short, we have continually helped shape the field of genomics by funding and conducting groundbreaking research and leading efforts to ensure the widespread access to genomic data. Second, accelerating breakthroughs. NHGRI is a model for learning, collaboration and support. Our world-class interdisciplinary research groups are tackling increasingly complex biological challenges, accelerating scientific and clinical breakthroughs in the process. We have a team science approach that has fostered a spirit of collaboration at NIH and led to cultural changes in biomedical research. We fund the critical research efforts of scientists at NHGRI and at institutions across the world, and we help power the field by providing access to shared tools and data that can transform genomic advances into health discoveries. Third, improving patient care. NHGRI is helping to ready front-line healthcare professionals by using genomics and routine patient care. This is being accomplished by enabling healthcare professionals to provide personalized treatments, creating partnerships to study rare and common diseases, and to expand knowledge about the genomic basis of disease, and bringing patients and families hoped by diagnosing and treating previously unnamed diseases. Finally, advancing genomics in society. NHGRI is a trusted resource of up-to-date information expertise for the public, educators and healthcare professionals, and policymakers. Through workshops and community outreach and training, our efforts are helping to build a more informed and diverse workforce and to repair the public for a future in which genomic information is used in everyday life. Our researches are the leading edge of exploring the ethical, legal, and social issues that intersect with genomic advances, and our experts continually inform the development of policies involving human subjects research and the sharing of genomic data, among others, to enable scientific discovery while protecting research participants. So shaping genomics, accelerating breakthroughs, improving patient care, advancing genomics in society. So this is NHGRI's story. So this month, we're introducing a new mantra that we think captures the essence of NHGRI, one that truly reflects our vision, our mission, and our unique commitment to the field of genomics. And rather than me just telling you the new mantra, I think it's best to share it with you through a short video. We are highly complex creatures, astonishingly unique in many ways, and yet there is so much we share. Genomics is giving us a deeper appreciation of our complexity. It's an ever-evolving area of scientific research that is transforming our understanding of human health and disease. At the National Human Genome Research Institute, we are focused on advancing genomics research. Building on our leadership role in the Human Genome Project and other major genomics initiatives, we collaborate with the world's scientific and medical communities to enhance genomic technologies that accelerate breakthroughs and improve lives. By empowering and expanding the field of genomics, we are charting new frontiers and benefiting all of humankind. So in addition to this new mantra, the forefront of genomics, we've also drawn upon our identity research to refine the institute's messages, in particular the vision and mission statements. It's important to articulate that our identity clearly is to all, needs to be well understood to all internal and external stakeholders. So the updated vision statement for NHGRI is, quote, to improve the health of all humans through advances in genomics research. Now, a vision statement is intended to be the outcome of what we would like to achieve when all is said and done. What we do every day to move us towards that vision is our mission. The updated mission statement is as follows, quote, as a leading authority in the field of genomics, our mission is to accelerate scientific and medical breakthroughs that improve human health. We do this by driving cutting edge research, developing new technologies and studying the impact of genomics on society. While having reflected on NHGRI's present circumstance and redefined our identity at the forefront of genomics, we now have a modernized view of the institute and its place in the scientific community, as well as an updated vision and mission statements. With that in mind, I want to now shift gears and discuss the second topic that I mentioned earlier, that is defining an NHGRI vision for the future of genomics research. Specifically, I would like to tell you about how we are now en route to a new 2020 vision for genomics, one that will be developed by a new round of NHGRI strategic planning. Now, in telling you this story, let me remind you of the strong and consistent history of strategic planning that is deep within the essence of the genomics community and of the institute. There were, of course, three successive strategic plans that were developed as part of the Human Genome Project, with NHGRI playing major role in shaping all three of these. And I think the culture of regularly getting the community together was a very important one that we learned during the Human Genome Project. And so using that as sort of as a foundation, it was the reason why a strategic planning process that just involved NHGRI was put forth a couple of years before the Genome Project ended, which would allow our strategic plan to be published, a new strategic plan, literally the day the Human Genome Project ended in 2003. And of course, again, the recognition that these strategic plans, if they're good, are not forever. They need to be updated. We recognize that it was not going to make it forever. And that is why we kicked off in about 2009 or so a new RONDA strategic planning at the institute that led to the 2011 strategic plan, which is the one we currently operate on. And I just want to really emphasize that not only are the strategic plans important for guiding the science and guiding the activity of the institutes, you know, in many ways they define errors for, I think, the field, to some extent, but certainly errors within the institute. There's just no question that during the Genome Project, that was basically the identity of the institute, and in many ways the identity of the field. And I think our strategic plan that we published in 2003 with its iconic structure built on a foundation of the Human Genome Project provided an identity for the institute and in many ways for the field. Recognizing that that identity needed to be updated, I would contend that the current strategic plan very much defines the era, certainly under my leadership at the institute, at the institute level, but I think in many ways what we depicted here, especially aggressive movement towards clinical applications but continued emphasis on fundamental aspects of genomics, I think very much is representative of what the field currently really represents. And so I think they define errors, but they also define sort of a framework for moving forward that are incredibly important. The strategic plans themselves are important, but the process of developing the strategic plan I think is also very important. I think this importance of both the process and the product is really applicable both to the community who gets engaged in the process, the broader genomic community, but also I can tell you internally at NHRI, I think having the staff deeply invested and involved in this, both the process and the product is important. You know, you spend a lot of time getting critical looks under a microscope of everything you're doing and your priorities and your identity. I think as an organization, and I think to some extent as a community, you also look in the mirror. You sort of, you have outside people looking under a microscope, you also take yourself and you look at the field, look in the mirror and say, all right, what do I look like? What does this field look like now? Where does it need to be in the future? So I really think it is a very healthy process to go through and having gone through multiple of these very in belief that this is critically important to do at some frequency. Now, the truth is, it's complicated, it's a lot of work. I just to remind you how much work this is shown here is just a high level timeline of what was involved in the 20, producing the 2011 strategic plan. And you can see it's a multi-year process, it's at least two to three years, it could probably be short a little, but you know, it can't be short in less than two years because you have to kick it off and along the top, or actually along the bottom in green are various meetings that took place and workshops along the top are various ways of engaging and getting public comment. And of course, then at the end, you have to write a paper and you got to submit it to a journal and you got to get it published and all that takes time as well. So it's complicated and it's multi-year in nature. So what's our current situation? Well, think about our current situation. We're in great shape as a field of genomics and to be honest with you, I think our NHRI is in great shape. And I think our 2011 strategic plan is still pretty darn good. It really is. And if you read it, I think so much of what we do at the Institute, what this council considers even what all parts of the Institute maps very nicely to the 2011 strategic plan. But let's face the reality that 27 that 2011 strategic plan was really written in 2010 and that was a long time ago. And if I just told you that it takes two years to produce a new one, that means 2020 is not that far off. And in 2020, it would be a little odd to be operating off of a document written a decade earlier. When I tell you that genomics is incredibly hot, it's fast moving, there's all sorts of things, it's just not defensible. And so I would just say that it's hard to claim or believe that a 2011 strategic plan written in 2010 represents a suitable blueprint for genomics in 2020 and beyond. And yet we're in 2018 now, and I think by 2020, we need to have a new strategic plan in place. And so today I am formally announcing and shown here is the press release that went out probably a half hour ago or something like that, that we are launching a new round of strategic planning as an institute, one that aims to develop a 2020 vision of genomics. Now, I want to tell you more details, of course. And so what I'm going to do is I'm going to tell you about four things that we want to discuss at this time and tell the community about it this time, four areas. I'm going to tell you about our planned timeline, very drafty, planned timeline. I'm going to tell you about the elements of the strategic planning process. I'm going to tell you what we've done internally to get started, ready for today. And then what I'm going to tell you the most detail about, because it's the hardest part, I'm going to talk to you about scope. Because that, as you will see and hear me talk about, is probably going to be the hardest element of all of this. So let me start with timeline. So we've been talking about this internally, recognizing that we needed to get going. And today I'm formally kicking this off, February 2018 at this meeting of council. And you can imagine I told you it's going to take a couple of years to really do this well. So we want this in 2020 and also has a nice catchy name, the 2020 vision. I like that. And so in 2020, we will publish this. So we scanned around 2020. We could publish it anytime we wanted in 2020. We scanned around and said, well, is there a particular nice moment in time to publish this that would just sort of make us all feel good? And we came up with one. Because on October 1 of 2020, it will be the 30th anniversary of the launch of the Human Genome Project. And I think symbolically that would just be awesome to publish it on or about October 1, commemorating the 30th anniversary of the start of the Human Genome Project. Admittedly, by having it a little later in the year, it gives us more time as opposed to really early in 2020. That may prove to be very nice to have it later in October. But I wanted time stamp 2020. So then we just got to back things up, right? So we got to submit that probably over the summer to a journal to be named. And then we probably will have a finale meeting we always do to sort of bring a draft and get lots of input from lots of members of the community. We'll probably do that in the spring. So that just gives us between now and spring-ish of 2020 to do a whole lot of things for strategic planning. That will be the actual process. So what will be the strategic planning elements that will take place between now and the spring or so or summer of 2020? But let me tell you about the elements as we currently see them. And we are very receptive to input. We will broadly engage many individuals, many groups, many communities as part of this process. I am certain we will be reaching far more people and far more different communities this round of strategic planning than previous rounds because of the nature of the field and the complexity of the issues. We will obviously have workshops. You know that. We do lots of workshops. This is not a realistic picture because it has windows. Oftentimes we'll have windowless conference rooms where we will have our workshops. We thought, though, that instead of making everybody always come to Bethesda to be in some hotel or some NIH conference room, maybe there's some value of having town halls as a means and different types of town halls where we would get out a little bit in various ways and capture input from the community. And so we did some of this, but we didn't do much of it. We're gonna do a lot of it, I think, this round of strategic planning. So let me tell you what our current thinking is. Obviously the advantage of such town halls is that you can engage stakeholders to collect ideas and information that informs the strategic planning process. You can do this very generally across the entire swath of topics being covered or you could have certain town halls be very focused. We're just gonna talk about this area or just this area and it could be based on the audience or the area, et cetera, et cetera. I would also say that one other advantage of having different types of town halls is that here at NHGRI even more now than 14 years ago or certainly 20 years ago, we just have a very deep bench of really good seniors, program directors and other scientists that can fan out in various venues. It doesn't always have to just be me going to town. We could send out delegations of really good people, good staff to go out and have town halls and bring information back to us. And so we really wanna use this as an opportunity to have multiple members of the NHGRI senior staff and participate and go out and help us and also reach multiple audiences of different communities of various flavors and types. And so one of the types of town halls, well, we're gonna have some traveling town halls. We're gonna leave and Bethesda and we're gonna go out to various communities. We've already making some decisions about various locations, some ones that are candidate or here, some of these are starting to be organized, some other ones we're gonna organize but we're gonna get out and we're gonna travel to try to have some traveling town halls. We're also gonna take advantage of meetings and have satellite gatherings at major meetings. Just here are just some candidate examples. These are obvious meetings like ASHG and the AGBT meeting, et cetera, Cold Spring Harbing, et cetera, et cetera. We'll also take advantage of making sure to engage our trainees at our annual training meeting, for example. And then we're gonna have some NIH-based meetings. We'll do some meetings within our fence because we wanna reach out to the NIH community, both our intramural researchers but also the extramural and programs of other institutes, many of which are, almost all of which are doing genomics, as well as other individuals in the policy, education and other realms around the NIH. And we've also decided we're probably gonna do some virtual town halls. We recognize that everybody might be in a location we go to or may not go to these meetings and so we're thinking about ways of doing WebEx type or video cast type virtual town halls to allow people to get their input in in various ways. And I really wanna emphasize that through these various means of town halls we wanna engage obviously researchers but obviously trainees but all other communities including the general public communities and other communities that we wish to engage to get their input on as well. So that'll be town halls. We'll obviously have a lot of electronic dimensions to this. We have, and I believe it is now live, we'll have a dedicated webpage. It'll be an easy URL to remember, genome.gov backslash genomics 2020. Remember, genomics 2020 is gonna come up multiple times. This webpage, my goal is to make our strategic planning process as transparent as possible. We will load up this page with lots of materials, lots of summaries, lots of PowerPoint presentations, video stuff and so forth. I think there's been good examples of this lately at NIH on big initiatives where you just put all the material that you possibly can so that everybody feels invested and everybody feels engaged in the process. We will gain that transparency by many means including by what I hope will be a very robust website. But we also wanna consider modern approaches and so we will have a valuable to us with an expanding use of social media through our communications group. So we just created a hashtag for those who are interested. It's up there, again, hashtag genomics 2020. This will be used on Twitter and Facebook and so forth in ways that I don't even fully understand at a personal level but I am told is really important for the younger generation which is great. So we will use all the tools of social media available to us. We will also engage our advisory groups. I'm starting with you but at other groups as well and this will be very important. It will include engagement of our intramural advisory groups. It will also involve engagement of our advisory groups who are associated with individual programs and also you'll see in the next slide the working group, various four working groups I have associated with council. And I fully expect there will be some type of finale meeting. I don't know its location or date or any of those sorts of details. And we will work this out. We've got a couple of years to worry about that but I'm certain there will be at least a finale meeting and I guarantee it will be other workshops leading up to that as well. And so the third thing I wanted to tell you about was internal organization. And this is just simply our attempt to not have this announcement be the start of energy moving forward. We didn't want to say, okay, we're about to launch strategic planning process and we haven't done anything yet except make a bunch of PowerPoint slides. Obviously we wanted to have a little bit of forward momentum. And so I have worked with NHGRI staff to have an organization that'll just internally gets us started so that we can divide up the work and to divide up the thinking about things so that as we engage external people we're not flat footed, but rather we're already moving forward and already have things to react to. All of the strategic planning will be reporting up through the NIH leadership but that I mean me and my division directors but what we did was to create five, what I'm calling focus groups that basically focus on different domains. And the domains are sort of pretty obvious, a more basic one, a more disease oriented one, one related to genomic medicine and precision medicine, a data science one and then society, education and engagement. It is not our intention to allow these groups to all work independently. Obviously there's an immense amount of cross talk between them and in fact the earliest deliberations of these internal focus groups, each of which has, I should point out, two co-chairs from different parts of the institute, we're not just about extramural, it's about the whole institute and each of the groups has four to eight members, six to eight members, again drawn from all across the institute. In their early deliberations, one of the biggest things I struggled is they immediately realized that some of the stuff they were talking about was relevant to another focus group. Makes sense. So there's gonna be lots of attempts to cross fertilize, cross pollinate, but at least it gets them started thinking about the grand challenges, thinking about organizationally what's needed, what are the new ideas, what are the things we need workshops, what are the things we might need, white papers, all those sorts of discussions. I'll also point out that three of the focus groups align very nicely with council working groups. In fact, the far right one has two council working groups nicely aligned to it. And so there's in fact already begun some dialogue between these working groups and these focus groups and some of the, many more things being planned in the weeks or months ahead. So the bottom line is we have a very active, energetic, enthusiastic set of focus groups who already have some draft ideas, very draft ideas typed up. There's things to react to so that starting at lunch, they could talk and we'll start to engage different groups, go to meetings, and begin to sort of scope out the set of events and elements that need to play out over the coming months. So that's the internal organization. And again, as we made more of this with time as we get going in here, I just didn't want to start cold. I wanted a little bit of warm up and so I got some groups going a couple of months ago. So the fourth thing I want to tell you about, and it's the last thing I want to tell you about relates to an important overarching, an actual difficult issue that will naturally arise during the 2020 NHRI strategic planning process. And it has to do with the scope of the effort. Is the strategic planning process about the future of genomics as a field or the future of NHRI supported genomics research? Now, such questions, I've been there every time, such questions have consistently been part of previous rounds of NHRI strategic planning. But in reality, I think the nature of the answer has changed over time as genomics has grown in breadth and depth as a scientific discipline. So let me walk you through my logic in this. So NHRI played an important leadership role in formulating the strategic plans during the Human Genome Project. Of course, the field of genomics was much simpler back then, both in terms of breadth, which I would say was reflected by the width of the depicted wake from the NHRI boat and its depth reflected by the length of that wake. Now, all the areas within these early strategic plans that is the wakes area, which is depicted in blue, were supported by NHRI. They were all part of the Human Genome Project. And meanwhile, other funders in the U.S. and internationally reflected by these additional boats largely pursued work within the same strategic areas of genomics as NHRI. Again, all of this related to the Human Genome Project. Well, the situation got more complicated, it started 15 years ago at the end of the Human Genome Project. Now, genomics was still young, it was not widely disseminated, and in the case of NIH, genomics was really exclusively the domain of one NIH Institute or Center, that is our domain, NHRI. Well, the field has grown quite a bit in both breadth and depth, but the 2003 NHRI Strategic Plan was comfortably able to cover virtually all areas of genomics as it existed at that time. And NHRI then funded work across almost all areas of genomics, and the small gray areas at the fringes of the wake simply reflect the small parts of genomics that NHRI did not completely fund during that time. In some cases, other funders in the U.S. and abroad started supporting these areas represented by those other boats. Well, 2011, by 2011, the world of genomics had changed substantially, and that reality influenced both the development of the 2011 NHRI Strategic Plan and the NHRI's use of that 2011 Strategic Plan up until the present time. Well, compared to, say, a decade ago, genomics is now associated with a much greater breadth of research activities, again, the width of the wake and a greater depth of research activities, again, the length of the wake. The genomics research activities associated with the 2011 Strategic Plan, which is reflected again by the wake's overall area, are simply too large for NHRI to fund by ourselves. Well, the good news is that virtually every NIH Institute and Center funds genomics research to some extent, and a significant amount of genomics research is funded beyond NIH, both in the United States and internationally. So as such, there are significant areas within the 2011 Strategic Plan that NHRI has only been able to partially fund, often in partnership with other funders. Again, these are reflected by the gray areas at the fringes of the wake. Now, and also associated with other boats. So some of these are starting to represent areas of biology and human disease that have matured considerably, evolving into important specialized areas in their own right. And finally, there are even some interesting areas of genomics that are not even part of the 2011 Strategic Plan of NHRI's and are not funded by the Institute, and those are reflected here by these other boats with their own red wakes. Well, looking ahead, right? By 2020, the situation with genomics will be even more complicated. The field will have evolved even greater breadth of depth, and many more funders will be involved in supporting genomics research. That is, there'll just be a lot more boats in the water. So in developing a 2020 vision for genomics, it would really be impractical for NHRI to tackle all things genomics. That would simply be biting off more than we could chew or that we could fund. Well, defining the scope of NHRI's current strategic planning process will be influenced by the Institute's new self-identity, that is at the forefront of genomics. Recognizing that the bulk of genomics research will be funded by others in the US and internationally, NHRI aims to identify, lead, and support areas of genomics that are paradigm setting, that enable novel applications, and that expand the field, that is, at the forefront, all with the focus on applications to human health and disease. In doing so, NHRI will be directly responsible for highly impactful and generalizable progress in genomics that benefits the efforts of others who are most often each working at the forefront of their own areas of interest. Well, keeping with the above focus, areas that are well-established and are being sufficiently funded by others will just practically have to be de-emphasized during NHRI's strategic planning process, not because they are unimportant, but rather because they are not in need of NHRI's unique capabilities and attention. In some cases, these will reflect areas that the Institute once emphasized and funded, but for which progress now allows the Institute to seed leadership strategic planning and funding to others. Okay, so a few concrete examples should help clarify how NHRI will be prioritizing its current strategic planning process and focusing its attention on the forefront of genomics. There are several very important and hot areas of genomics, cancer genomics, microbial genomics, and microbiome research that are now blossoming. Likely other such areas will arise in the near future and at some point in the past, NHRI was involved in helping shape and support research in these areas, but over time, these areas have grown and matured substantially, attracting major other funders. For example, other NIH institutes and centers in addition to other agencies and foundations and non-US funders who now lead and support the associated research. These are thus areas of genomics that are critically important and should continue to expand, but are not being tackled directly as part of NHRI's strategic planning process. In fact, these areas deserve their own dedicated strategic planning that engage individuals with appropriate expertise and in many cases, such planning is actually already underway. In short, these areas will largely be regarded as out of scope for the NHRI strategic planning process. But other areas of genomics reflect different situations in which the research is less advanced, but the opportunities are compelling. Once again, represented by these gray regions within the wake, these areas of genomics include the genomic basis of rare and common diseases and their clinical management and computational genomics and data science as two examples. For both of these areas, NHRI has been heavily involved for many years as have other funders. Some aspects of these areas remain at the forefront of genomics while other aspects have become more routine or heavily domain specific. Other such gray areas will almost certainly emerge during the strategic planning process. NHRI believes that there are continued opportunities to make important contributions in these areas often in collaboration with other funders. And so these areas thus represent intermediary or gray areas in which NHRI will likely share the leadership involvement and funding to support the needed research. And as such, the institute will include such intermediary areas in its current strategic planning process, albeit with the caveat that some of the strategic elements that might ultimately be described cannot be fully supported by NHRI funding alone. Well, finally, there are a number of major areas that have yet to be well-defined and or lack sufficient investment. These areas will get high priority attention during the institute strategic planning process, often agnostic to particular diseases or physiological systems. These, what I will call mainstream elements will be particularly appropriate for NHRI stewardship and funding as has often been the case for the last decade or more. Let me list some prototypic examples of these mainstream areas. They would include genomic technology development, genomic variation in its functional consequences, interactions between the genome and the environment, general and generic aspects of and barriers to uses of genomic medicine in clinical care, research and clinical training in genomics, policy development and implementation to enhance data sharing and the ethical, legal and social implications or LC of genomics. So to emphasize then both of these intermediary or gray areas and these mainstream areas will be considered in scope for the strategic planning process. So in summary, we recognize that this key question related to the scope of the strategic planning process is an important, it's also a complicated one. From what I've just reviewed on the previous slide, I am hoping that you can appreciate that there is an answer, one that I acknowledge will evolve over time as the planning process progresses and the answer is that the scope will largely reflect research at the forefront of genomics as it pertains to human health and disease. So in wrapping up, I would just say that there'll be an immense amount of energy put into the strategic planning process by NHGRI staff, by many of you and by the broader research community. I can tell you that that input and engagement over the next two plus years should be incredibly exciting, incredibly stimulating. What an opportunity, what a great moment in time. I think it has the potential to be incredibly impactful. I think our strategic plans are widely read and are widely cited and are widely respected. They do have impact. And I can tell you personally as an NHGRI director that your input and your engagement will be much appreciated. Critically important for this to be successful. I would just conclude by saying that the aim of the process and the product really is to be the driving force for much of genomics at NIH and around the world. We hope to provide a clear, that is a 2020 vision for using genomics to advance human health. It's gonna help guide NHGRI scientific priorities and shape our research portfolio across the institute. And of course, we hope it fosters partnerships within not only the research community but the healthcare education policy and various general public communities, all of which are important. And finally, I think the strategic planning process will actually put some fine detail that will help us define an NHGRI's position going forward at the forefront of genomics. So with that, let me encourage all of you to stay connected. Here are various ways to stay connected. Website I mentioned. We live now as a dedicated email address shown here. We're gonna take lots of stuff by email, comments, so forth, so feel free to put that out. And then I already introduced you to our hashtag. And with that, I will end and look forward to your questions, your feedback, and any thoughts you have about both the first part of the story with NHGRI's identity as well as our strategic planning process as we go forward. Thank you. Janita. So thank you for that great overview. I'm really excited to see the next round of strategic planning. I had the great fortune to be involved in the strategic planning previously. I didn't wanna make one observation and comment and just it's about the sites where you're planning to do town halls. And I think that's really important. And it seems like you have a lot of places that have really robust infrastructure already for genomic medicine. And it might be worth considering adding places that are building their capacity for it to begin thinking about how some of their issues might be considered as part of the strategic planning process. I think that's an excellent point. And I also, I failed to say one thing about some of these travel town halls that would apply to the places we're already thinking about, would apply to some of the places you're suggesting is when we go to a place and we've traveled there, I think inevitably we're gonna have multiple town halls. We'd probably wanna have one with an open one, probably mostly scientists, but we also wanna have at every venue a dedicated one just for trainees. And then in certain places, there might be ways to engage community more broadly. So when I say we're doing a traveling town hall to such and such a city, it's really think plural because in every case, we're gonna do two to three. Jeff. Yeah, this was very impressive. Thank you. This is my question relates to scope and sort of building on the bench to bedside issues. Seems there's been such enormous success on the bench side, both with the basic knowledge and the tools being developed. Seems to me many of the emerging challenges and barriers are on the bedside end of things in terms of how much the clinicians know about this technology. Can they use it knowledgeably? Insurance coverage issues are a barrier and the whole emerging notion of sort of implementation science. How do we get this actually into the hand of primary care providers? Is there going to be much emphasis on that end of the bench to bedside spectrum as part of the scope? So there's not a single thing you just said that I don't think is in scope. I'll look to Anastasia Wise, who's one of our co-chairs of the genomic precision, not co-chairs of the focus group and, or I can look to Teri, but I know Anastasia, it's absolutely, there was wording I meant to say, if I didn't say it, it's not only the implementation, it's not just the means to get there but the barriers, trying to define all of these barriers to genomic medicine implementation. But Anastasia, you want to add to that? We've been thinking of in the group that's looking at genomic and precision medicine, trying to specifically look at those challenge that are related to more of that clinical setting and how do you take all of this genomic information that might be more focused on developing that knowledge base in some of the other groups and apply that more in that healthcare setting? So all of those challenges to talk about are things that we've started having discussions about in that group. And Jeff, the thing that the wording, even that you use really amplified a point, why I make it frequently is the barriers you just listed are disease agnostic. It's, you know, for the most part. And so if it's not us, I mean, that is at the forefront of drama. It's because if it's not us, it won't be another NIH Institute who will often just want to tackle that problem in a particular disease or a domain specific way. We've got to knock these barriers down because they don't fall nicely along disease categories. Jay? Okay, so think about how best to articulate this. So I think I like the overall framework. I really like the idea of focusing the bullet, so to speak, even if it means jettisoning or partly jettisoning focus on things that were formerly part of the portfolio, because I think that's a necessary thing to get things done given the expanding scope of what genomics is and the limited resources of one institute. I think I just wanted to drill into one specific terminology that you used around what that bullet would be focused on if it was a bullet or car. You said application to health, application to human health and disease, right? And I just, you know, I think what I want to make sure or what I'm hoping isn't missing here is a minimally and equal focus on just the basic biology of the genome. I mean, to me that was lacking a bit and at least what I heard and maybe I just missed it, but I feel like that's always been an important part of the portfolio. We still don't know what most genes do. You know, we still have a pretty rudimentary understanding of how enhancers work. And I think that, you know, to some extent you're right. You know, the science, you could say that the basic science has gone well, but I think it's still a shocking how little we know about how this all works. And I think that something that this institute could or should uniquely bring is a set of tools or a systematic or unbiased set of approaches for agnostically interrogating gene function, enhancer function, so on and so forth. And I think that if that's missing from this as something that's front and center, I feel like it would be a mistake. So there's nothing that I meant to imply that would in any way say that we're not committed to understanding basics of genome structural function. In fact, I listed it as one of the mainstream areas. If it has the word human in it, so especially, now here's where it starts to feather out, right? So with human genome function, we fully appreciate that to understand human genome function, we probably have to study some other genomes along the way. So that's all, but we just need to have those connections, but there's nothing about the strategic planning process that is backing us away from basic understandings of genome structure. I think it should be more front and center and more accelerated. I take an important from. Okay. Aviv. The place I thought I heard it in was in the interpretation of genome variation. And the point that I would make is that I think in the history of NHGRI, in France approaches have taken the primary road, meaning we would analyze a lot of genomes of a lot of people and we would infer from them. And that has been one of the resounding successes of human genetics, the phenotypic consequences of the variants. And that carries you very nicely between genotype and phenotype, except that it is a little weaker when you're trying to infer mechanisms. And mechanisms become very important as a general tool for medical application. It's true that they're also absolutely critical for basic understanding of the processes that I as a basic research scientist care the most about, but they're also an absolute stomping block between the general success of human genetics and the ability to apply that success and really bring new therapies and medicines. And I think that's the recognition that has to add that this is not a place where you have to choose between doing the basic research because it's interesting to understand how an enhancer works, but because if you understand how the BCL11A enhancer works. Exactly. That's sort of set up nicely by the director. And with BCL11A, it's relatively easier because you actually know that it is the enhancer of BCL11A with most of the non-coding variation. We don't even know where it goes, which is just step one. Then we need to figure out what those gene products actually do and how to manipulate and so on. So that calls for the other side of genetics, the side which is actually more engineered. And there there is a really remarkable opportunity which did not exist in 2011 because the tools were not there. And they are. And so that's I think what Jay means by front and center, but I think it's also important to understand that it's not just for basic research. It's also absolutely critical in order to deliver general purpose solutions for medicine. Then you become very specific about the applications and 10 years later every institution will be doing this. I violently agree with you. Sharon. Well, I would just agree with Jay's comment that I don't think someone just hearing the presentation would have gotten a strong basic research theme. So I think perhaps having a slide or two that specifically addresses the importance of basic research is important because I think a lot of people doing very basic research feel like they have to defend themselves. And I just wanna make sure we're acknowledging that importance of presentation. I was gonna comment with regard to the town halls and your comment about cancer and microbiome as being out of scope. I think for the public, that will be a more difficult argument. A lot of what the public is reading about genomic medicine is exactly microbiome and cancer genomics. And so I do think that messaging in the town halls may be complex and you may just wanna think about what's the best way because I can imagine members of the public saying, oh yeah, you should be doing more microbiome research. We think that's really cool. So I think it's something we understand but I think maybe a more difficult kind of message when you go out on the road. Although interesting, yeah, I agree with you. It will be one of the challenges. One could imagine though, I bet that especially a general public town hall, I would imagine that their biggest questions about cancer genomics will look very, they look more like what Jeff was raising some of the barriers, more than the most cutting edge scientific questions being asked by the cancer moonshot efforts, for example. So it actually, you're right. We could use those as examples. Yeah, I just think they're gonna be examples that you're gonna be given. And so the messaging kind of has to be clear. Yeah, just to second that, I went through a similar process when I was watching the slides and of course cancer is a common disease and so basic methods to decipher common disease is right behind your wake. And that was great. As long as the public doesn't miss the fact that if you can develop those basic methods like Jay's alluded to as well, then you can also address cancer, of course. And you know, and you're probably gonna need those to address cancer, in fact. So Eric, it seems to me one of the challenges is comes back to this scope question. I had a mentor decades ago who said that, his view of his science and his lab should be that he should descend on a field, make seminal advances and then leave and let somebody else pick up all the pieces. Fill in the blanks, exactly. And in some ways the forefront of genomics implies exactly that. So the challenge is, at what point do you sort of leave a field and let somebody else fill in the blanks? And I think that the other tension that you may feel, particularly with regard to the public is the tension between basic science for knowledge for knowledge's sake versus knowledge for therapeutics sake or knowledge for patient care sake. And somehow playing into the idea that there is a role for just knowledge for knowledge's sake because we don't know where things will go versus knowledge for knowledge's sake to advance prevention, management of disease, prognosis, new drug development, genome editing, all those things that people are hearing about. So I think the selling job would be sort of how to shed things appropriately and how to make sure that there is a tent that people feel like they're part of in the ways that Trey alluded to as well. So I don't think you get rid of cancer. You say that what we do, we understand what the kinds of things that Jay is talking about will directly affect the way people in the cancer field think about it. So it's what you mean by cancer on that slide, massive amounts of cancer genome sequencing like you've done in the past. Is that basically what you're addressing? Yeah, and major clinical studies. I mean, I just sort of look at a lot of the elements of what NCI is now ably doing and just say, this is great. So maybe instead of saying cancer genomics have some more constrained term that doesn't sort of say we're not gonna do anything with cancer because that's probably not what we want to go. I think what I'm trying to do is to not overwhelm us with too many very complicated areas that need their own strategic plan on their own right. When we start to do strategic planning around varying interpretation around technology development especially single cell analysis, all that is gonna be highly relevant and will inform, nicely inform cancer genomics. But I think by stating cancer genomics, I mean, if that's the lead of something that's probably not well suited for our strategic plan. In fact, we don't even have adequate expertise to do what that field now needs. I think the same with the other areas that I listed, it's not to say there won't be cross talk and certainly things we do might benefit but it's a matter of are we gonna take on the responsibility to do the cutting edge strategic planning in those areas? I think the answer should be no. Wendy? I think one question the public is wondering is what are we, if you're really talking about therapeutics are we gonna be at the forefront of gene therapy and gene editing? I mean, is that gonna be something that we own or exactly is that part of that strategic mission? Those are great question. And I would say that I think those, gene, I mean, we talk about this internally, I mean, and therapeutic genome editing and anything in gene therapy, we're pretty devoid of, at least on the extramural side. I believe that should be part of the discussions for strategic plan. I don't know which way we're gonna go. I think to ignore it would be irresponsible. I think we should try to figure out what do we have to contribute and also we should be very mindful of what else is going on. I mean, as you heard in my director's report, there's a major genome editing common fund program starting up, so there's stuff going on at NIH. What is our role? And I think that's a hard one. So that'll be one of the hard areas. But the overall area of getting from the variants from the genetics to some functionalization of them in a generalized way rather than in a way that's related to one specific disease has to be. No question. Not at the sides in the grade. It has to be at the heart because that's where it needs a catalytic investment that NGRI can make. And if it's done well, later on, yes. Others will take it on. But one of these questions was if you take something like genome editing, you take something like gene therapy, there's a lot of disease agnostic space that one could imagine. A lot of that's been pretty well supported by other institutes. But maybe there's some opportunities of stuff we can contribute. I don't know. I think it should be in the mix for discussion because it's notably absent in our extramural portfolio. But on the other hand, it's pretty hot. A lot of players in there, maybe we're not even needed. I don't know. It's hot as a separable item as let's have capabilities in genome editing or let's apply it in a specific context. But I do not think it's actually handled well at all. He has a general tool applied, for example, for functionalizing all variants. And that's where there is a remarkable opportunity for NGRI. And no one else will do it. Troy, you want to say something about that? Then we're going to go to Steve and Carol. Sure. I think the other related scoping issue here that I was thinking a bit about is the scope overlap with just basic cell biology and upwards from there. If you think about doing what Aviv's talking about and this goal of understanding variants, you're really going to start to get into systematic cell biology in ways that overlap in very interesting ways with other institutes and so on and so forth. So I'm looking forward to those discussions, of course, but I think it's going to be an interesting scope question. Let me have a head down there. I mean, it's one of the reasons why we need to do some town halls within NIH. I mean, there's a lot of things happening in other extramural programs, as an example. And we probably need to synchronize with them and make sure that they may be covering stuff we don't need to or maybe it's just exactly the opposite. We don't do this in isolation. We engage community. We also have to engage the NIH community. Yeah, Steve? So I just want to remark, I mean, there's been tremendous progress, as you mentioned in the last decade, of actually gathering data. And there's a lot to be said for how to measure variation and how to milk out of that the clinical significance. But I also want to bring up this point about addressing the things that we don't know. And to uncover all the regulatory elements, for example, in the genome, to understand how the regulatory elements interact with the environment is still, I mean, it's a very challenging area. And it's relatively ill-defined at this point. So I just, again, want to put in a plug for pushing on the basic science of how genomes function, how they relate to the environment, and how perturbations on those genomes affect evolution or health and disease. And that is fully in scope. And I want to keep emphasizing, the reason it has to be fully in scope is because it's all that activity, if properly, that is disease agnostic. And so if you look across NIAs, they're just not going to be other institutes tackling this on the kind of scale and the kind of expertise that we bring to it. Carol? Yeah, so back to the scope question. So one of the areas that you put in scope needs a boat of its own, and that's the whole computational biology thing. So is the thought that you're going to pull out of that very, very broad area, some specific areas that NHGRI will be uniquely poised to lead? And does that mean changes in bringing on additional expertise in those areas within NHGRI? Probably yes to all of that. I mean, let me just really emphasize the data science, computational biology, bioinformatics, boat, if you will. I mean, it's the full recognition that we have to be all in on this. But we can't even pretend that even if I took my entire institute's budget and put it in that boat, it would be big enough. This is not fair. We have to do this in partnership with other parts of NIH. And as you know, there's a lot of things happening. We are a major driving force of a lot of the stuff happening, and it can't just be NIH. It's a worldwide issue. And so, no, there's just no question. I think, so we're all in on this, and whether we need to invest more to be determined, probably yes, whether we need more expertise internally, probably yes, we can deal with that. But what I would also say, and that you sort of implied it, is I think the strategic planning process, which will actually take place during a time of great, of strategic developments at NIH-wide, will hopefully help define and refine what NHGRI should be doing in this space compared to everybody else. But there's just no question. This is a huge priority. You're right, the boat could be much bigger than it is, but it's a limits to my metaphor. But yes, I completely agree with you. Jeff? Yeah, I guess despite my LC emphasis, I'm quite comfortable with the whole more basic science notion given the size of the genome institute. But I also see the need, and maybe consistent with my last question, sort of rethink how clinical science is funded through the NIH, because genetics is really posing a lot of challenges with rare conditions, lots of variants. You're subdividing your clinical population progressively, and a lot of the outcomes you're interested in learning about are longer term, longer term than your typical three-year grant. So how do we fund these larger longer term studies to really better understand the concrete health outcomes on people based on genetic information? And I think the whole clinical utility barrier is huge for genetics, because we don't have that long term outcome, and we've got a lot of subvariants and behavioral factors that are involved with that. So however the science policy or science initiatives developed out of the institute, we ought to be thinking about how that translates into other institutes in the clinical science that have to be building on, I think, bigger, larger studies than have been typical. No, I agree. I'm sure Terry Minnelli agrees with you as well. I mean, this becomes an issue. We know that. OK, well, this is just the first hour of the strategic planning process. There'll be two more, plus more years for you to give input. I'm sure we will be regularly revisiting this with council for the next two years. And again, in fact, all of it, you will be kept very updated. You will be an integral part of it. You'll probably get invited to more things than you want to participate in, but we're looking forward to it. So I think we're going to break now for lunch. We're a little behind, but we knew we were going to be. And why don't we try to reconvene it a quarter after? Does that sound good? Can we have a working lunch? Probably not realistic in terms of getting people through. Why don't we try to be back at 10 after? How's that? Try to be back at 10 after. I know sometimes the line gets to be long up there and so forth. See you at 10 after.