In September, President Bush approved a recommendation to close a number of Army institutions, among them the Walter Reed Army Medical Center and its Armed Forces Institute of Pathology division. When this column went to press, only a joint resolution from Congress could alter the fate of Walter Reed. What’s at stake may be the future of the world’s largest tissue repository.
AFIP houses the National Pathology Repository, a tissue trove of more than 2.8 million cases accessioned and catalogued since 1917, where 60,000 new cases are coded annually. This works out to holdings of more than 50 million slides, 30 million paraffin tissue blocks, and 12 million preserved wet tissue specimens.
Walter Reed received the bulk of media attention when the final report was delivered to the president in September, while the tissue bank’s fate has been less well documented. The final commission that reviewed the Department of Defense’s original recommendation decided that all of AFIP should be shut down with the exception of the National Medical Museum and the Tissue Repository. However, it failed to propose even a skeleton of what it means to do away with AFIP while maintaining two of its components. The president passed the report to Congress on September 15, forcing a Hobson’s choice from the legislature by October 30.
Yes, it has occurred to me that you, my reader, are in the future, and thus already know the outcome of this whole play. My earlier deadline places me at a distinct disadvantage when it comes to prognostication. But no matter what the outcome, the lack of provisions for maintaining such an important tissue bank begs the question: why isn’t this resource valued as highly as it should be? The tissue bank alone is virtually meaningless: it requires skilled management and constant curation to maintain its usefulness.
For those unconvinced of the basic value of the repository to systems biology, a brief historical interlude: The influenza pandemic that swept the world in 1918 killed 20 million to 50 million people. Known as the Spanish flu, it killed some 675,000 Americans, including 43,000 troops mobilized for World War I. Autopsy material from some of these servicemen was filed away in the form of formalin-fixed paraffin-embedded tissue and hematoxylin- and ecosin-stained sections at the massive tissue bank in Washington, DC.
Eighty years later, these tissue specimens provided the means for AFIP pathologists to determine the complete genetic characterization of the virus. And further efforts from those scientists to recreate the virus and pinpoint and sequence the genes responsible for its virulence led to papers published in Science and Nature this October. Thanks to nearly 90 years of scientific effort, we’re that much closer to developing antivirals and vaccines that may prevent another global flu pandemic.
This is just one recent example that highlights the tremendous scientific value of the repository, which itself represents a significant investment of time, people, and money since it was established in 1917. Military value has virtually no overlap with scientific value, so the tissue bank was bound to be underestimated in the DOD’s cost-benefit analysis. Congress should not be so hasty. Nor need it be, if informed by a constituency of scientists and medical researchers with first-hand knowledge of the intellectual capital contained in the tissue bank.
To prevent this type of problem, the scientific community has to become more of an advocate for the intelligent administration of these critical resources; they have importance that legislators and military don’t see. In addition, access to the tissue bank — currently limited to AFIP staff and research partner institutions — should be opened up to make more people stakeholders in the resource. With a broader user base and louder voices, the significance of a resource like this would not have to be questioned.
Jennifer Crebs, a senior writer at Genome Technology, can be reached at [email protected] Her Sense/Antisense column, which covers government research policy and regulatory issues, appears bi-monthly.