Combining a basic science institute and infrastucturewith an academic health centerThe Berlin Institute of Health

The common goals of basic biomedicalresearch and academic medicine

• Generate fundamental knowledge about the basis andconditions for health and disease

• Application of knowledge to increase health on a population based level

• Train the next generations of scientific and medicalworkforce

• Develop new technologies and therapeutic strategies

Background : Economy 2014

• Biomedical science and healthcare so far are the only growing sectors

• They are an important pillar of economy (regional and national)

• Funding and governance of these pillars are fragmented :

• Ministry of Science• Ministry of Health• Ministry of Economics• Insurance companies• Industry• Society

Health Research: Deficits and Roadblocks

5

III. Employment Market

• Legal restrictions relating to flexible workingconditions (no fixed employment terms)

• Lack of opportunities for securing basic wages forresearch projects

• Limited career prospects for researchers in theemployment market

IV. Medical Research

• Disciplinary segmentation (Natural Sciences -Medicine; Dominance of traditional speciality orientatedstructures, separation of basic and clinical research)

• Research based on medical indications e.g. organs

• Lack of understanding of the complexity and variabilityof biological systems in disease orientated models

I. Scientific System• Lack of financing in German university medicine

compared with other top international medicaluniversities

• Untapped complementary strengths between university, non-university and private research anddevelopment partners

• Lack of visibility in university rankings due todiversification of biomedical research institutions

• Constraints on research due to diversity of tasks (physicians faced with burden of juggling multiple responsibilities e.g. teaching, clinical obligations, research, administration)

• Heavy dependance on hierarchical structures

• Young students want a clinical leg to stand on

II. University Medicine

Challenges

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Compartmentalization (“Versäulung”) between

university and non-university system

Academic System

Gaps and balance between education,

research and patient care

University Medicine

Slow application to public health

Health System

Quality & validity of (pre)clinical research

Medical Research

Towards a Novel and Unique Translational Platform in Germany

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• Bridging an academic health center with a specialized center for bio-medicine

• Highly attractive for excellent scientists

• Increased visibility

• Overcome barriers from bedside to bench & from bench to bedside

• Better career opportunities for translational junior scientists

• Establish “Systems Medicine”

• Validation of approaches of personalized medicine

• Increase quality of (pre-)clinical investigator-initiated trials

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• Need for new technologies (omics, imaging, stem cells, bioinformatics etc.)

• Translation into better prevention, diagnosis and treatment of disease

Gaps in translational research

Charité is the Medical Faculty of  two Universities

Joint Medical Faculty

• Structure and development planning

• Appointments of professors

• Collaborative research projects

• FU and HU are members of the board of trustees

• Joint professorships

• Collaborative research projects

DepartmentsBedsCases (inpatient)Cases (outpatient)Employees (FTE)TurnoverThird Party Funding (spending)Funding by State of BerlinERC GrantsStudentsPublications (IF>10)

Collaborative Research Centers (SFB), DFGClusters of Excellence, Excellence InitiativeGraduate Schools, Excellence Initiative (coordination)Research Units (Forschergruppen), DFGClinical Research Units (Klinische Forschergruppen), DFG Competence Networks (Kompetenznetze), BMBF“Integriertes Forschungs- u. Behandlungszentrum”, BMBF

1033,213

140,706615,694

8,566€1,160M

€154M€190M

117,000

3,559 (183)

16226421

Charité – Basic Facts

10

Figu

res

Larg

e-Sc

ale

Initi

ativ

es

Research at the Charité

German Centers for HealthResearch

Excellenceinitiative with

leadership role

Excellenceinitiative withparticipation

role

Major clusterprojects by

federalgovernment

CoordinatedProjects (DFG) with leadership

roleCollaborative Research Centers (SFB): 10

Research Units:  (FG): 6

Clinical Research Units (KFG): 4

Neurosciences

Oncology

Immuno-sciences

MolecularMedicine / Genetics

Cardiovascular / Metabolismresearch

Regenerativetherapies / Muscoloskeletalresearch

11

Charité – national scientific benchmarking

12

Result:Charité is the number oneuniversity hospital in Germany.

Source:Performance Indicatorsfrom DFG‐Förderatlas

Core budget € 71MThird party funding € 25M

Staff (incl. guests) 1,553

Research groups 59

Post‐Docs 225

PhD students 334

Publications  369(55 with

impact >10)Patents 263

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MDC – basic facts (2011)

MDC – scientific benchmarking

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• Rated best German research institution by SCImago Research Group (2011) with regard to quality of published papers

• 2nd highest DFG funding of all German non‐university research centers (2008‐2010)

#

#

#

# = European institutions

#

DFG Research map 2012

The promises of a partnership

Shared risks:Investment in research infrastructureRecruitment of scientific leadershipDevelopment of workforce

Shared opportunities:Safe return on investments in the growing health sectorSynergy in research projectsAvoidance of redundancies

International Examples of Translation • NCATS (National Centers for Advancing Translational Science, NIH, USA)• Broad Institute (Boston, USA)• TMAT Programme(Translational Medicine and Therapeutics, WellcomeTrust, UK)• ITMAT (Institute for Translational Medicine and Therapeutics, Philadelphia, USA)

German Centers for Translational Research• German Centers of Health Research• Helmholtz Translational Research Centres

17

The International Landscape of Translation

London-wide inter-institutional collaboration

• The Francis Crick Institute

• Imanova

• Social Enterprise for Health Improvement

Berlin Institute of Health ‐a novel, integrated translational

research structure

Page 19

Objectives of the Berlin Institute of Health

Systems Medicine researchNew career paths & attracting excellent scientists

Building on excellent research at Charité, MDC & partners

Creating a culture of translation

Cutting‐edge experimental and clinical infrastructure

Overcoming disciplinary borders & structural differences

20

3

20

Research at the BIH

Systems MedicineCycle

3

21

• Study the human body as a complex system of dynamic, interconnected networks of molecules, cells and tissues.

• Move beyond single organs and disease entities.

• Systems Medicine deciphers molecular signatures of diseases.

• One disease - Several mechanisms. One mechanism -Several diseases.

• Categorize diseases according to molecular causes in addition to phenotypic description.

Systems Medicine3

22

• Ubiquitous

• Action in combination

• Organ-/cell type-transcending function

• Contribution to multiple disease

• Mouse models human disease

Systems Medicine ExampleSignaling Modules Are Involved in Human Physiology

3

23

3

24

Systems Medicine at the BIH:From Organs to Systems

Objectives of the Berlin Institute of Health

Systems Medicine researchNew career paths & attracting excellent scientists

Building on excellent research at Charité, MDC & partners

Creating a culture of translation

Cutting‐edge experimental and clinical infrastructure

Overcoming disciplinary borders & structural differences

25

3

25

Core Facilities & Infrastructures

Omics Facility• Genomics• Proteomics• Metabolomics

Stem Cell Facility

Small MoleculeScreening Facility(with FMP)

Clinical Infrastructures

Experimental Infrastructures

IT InfrastructureExperimental & Clinical

Clinical Research Units at all sites

Biobanking Facility

Imaging Facility

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3

Clinical Research Unit CRU

Structured approach tp clinical research

Standardized pheotyping Standardized materials State-of-the art Infrastructure

(GCP, Biobanken, IT etc) Regulatory affairs

Objectives of the Berlin Institute of Health

Systems Medicine researchNew career paths & attracting excellent scientists

Building on excellent research at Charité, MDC & partners

Creating a culture of translation

Cutting‐edge experimental and clinical infrastructure

Overcoming disciplinary borders & structural differences

28

3

28

Clinical Scientist Program• Combine research & training for clinical specialization• Protected time, space & positions• Expand clinical education programs (KAPs):

• 2-year funding for clinicians in basic research labs• Dual affiliation with clinical and basic groups

Translational Postdocs• 2-year funding for translat. projects in systems medicine• Dual affiliation with clinical and basic research groups

Translational Collaborative Projects & Groups• Jointly designed projects or research groups of

excellent basic & clinical scientists

Career Development with Industry Partners• Internship program for young scientists• Annual career fair with pharma & biotech industry

Career OpportunitiesCreatin

g a cultu

re of translatio

nal research

Educational concepts

Career Opportunities

Recruitment

Internal communication

Physician Scientists = an „endangered species“

Basic Scientists = different focus and language

The Solution: Physician Scientists @ BIH

& Translational Postdocs @ BIH

Step I• Selection of qualified candidates, mentors and departments

Step II• Interview of host departments, mentors and 90 candidates

Step III• Work out individual curricula (3 years) with at least

40% protected time for research in Systems Medicine

START • Evaluation

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The Physician Scientist @ BIH

Recruitment• Joint recruitment and appointment by

Charité and MDC • BIH chair positions (comparable to the

Howard Hughes chairs in the US) for outstanding scientists

• Long-term tandem professorships of clinical and basic researchers

• Visiting professor - and fellowships

Innovative conditions for leadingscientists• Competitive salaries• Guaranteed research sabbaticals• Flexible teaching responsibility

Creating a Culture ofTranslational Research

Creatin

g a cultu

re of translatio

nal research

Educational concepts

Career Opportunities

Recruitment

Internal communication

Organizational Structure 

Opportunities for a Charité partnership

• A unique patient pool• Collaboration between basic and clinical scientists withcollaborative funds for projects and teams

• Education and support of a critical mass of clinicalscientists

• Early transfer of talents and ideas to industry

Major challenge:Managing the conflict of interests of individuals andinstitutions

Size matters? 

Institution Annualturnover( Mio €)

Empoloyees (n)

Erasmus Medical Center

1.100.000 11.000

Cambridge 700 7.000

Imperial College 1.000.000 10.000

Charité 1.200.000 13.000

München (TU+LMU)

1.400.000 13.800

Turnover include in‐and outpatient care as well as funds for preclinical andclinical institutes, graduate and postgraduate education

Marketing profiles of large institutions

Weaknesses: Operational excellence Corporate identity Patient and employees intimacy

Strengths Leadership in innovation Large scale performance benefits Subspecialization

BIH 2020

Moving from a single center to a system approach:

The BIH biomedical research network (umbrella structure):• Charité Institutionalized partnership with MDC and DHZB• New inter‐university centers (IRI Nord, Focus area Dahlem, 

School of Public Health)• Partnerships with other research organisations

(WGL,DRFZ/DIFE, MPI Infection biology, MPI Moleculargenetics,)

• New partnerships with industry• Clinical and care provison research platform Charité/Vivantes

Outlook & Future Perspectives

• Establish sustainable structures for translational research & validate Systems Medicine paradigm -> Regular external evaluations

• Long-term: towards public health -> biomarkers, epidemiology etc.

• Establish BIH as strategic umbrella for translational research in Germany &as international hub for translational research through strategic partnerships.

Short‐ to mid‐term perspective Long‐term perspective

1 2

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BIH Network of International Partnerships

Russia   

2nd Tashkent State Med. 

Institute, 

• University ofMontreal, Montreal

Imperial CollegeLondon

• Berlin-Paris Center in Public Health (Charité & MDC)

• MyoGrad PhD Program, Univ. Pierre et Marie Curie in Paris (Charité & MDC)

• Université René Descartes (Sorbonne Paris Cité) Paris

• MDC-INSERM Research Group, Centre d'Immunologiede Marseille

• Johns Hopkins University School of Medicine, Baltimore

• MDC-NYU PhD Program in Medical Systems Biology

• TransCard - International Helmholtz Research School with University of Arizona

• University of Sao PauloSao Paulo

Kyoto University Graduate School ofMedicine, Kyoto

• Beijing Union Medical College & Hospital & Chinese Academy of Medical Sciences, Beijing

NUS Yong Loo Lin School of MedicineSingapore 

Monash UniversityMelbourne/Australia

• Russian Academy of Medical Sciences, Moscow

• Joint Helmholtz Groups RAS Engelhardt Inst. of Molecular Biology, Moscow & RAS Inst. of Cytology, St. Petersburg

• SignGene PhD Program (MDC & Charité) Technion & Hebrew Univ.

• Helmholtz-Israeli Cooperation in Personalized Medicine

1 2

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The BERLIN INSTITUE OF HEALTH (BIH)

A joint venture of Charité and MDCincluding

• Center for Systems Medicine

• Research Infrastructure

• Clinical Research Units

• Medical Imaging Unit