Nearly six months passed since we closed the STEP action. In these months we printed and distributed the roadmap and we tried to maintain active the stream of news on Virtual Physiological Human (VPH) through Biomed Town.

The impact of the roadmap that has been funded and actively supported by the European Commission has already delivered positive outcomes.

• European Commission has issued a call for proposals committing € 72 Million
• A scientific community has been created in Europe that comprises of individuals, specific working groups (e.g Digital Patient of ERCIM) or priority areas of associations such as EAMBES.

Next effort should focus on convincing national agencies to commit in this area as well as promote co-operation on the international scale. As you might remember just before the end of STEP we were able to sign an agreement called World Integrative Research Initiative with some of the major research consortia in Europe, China and USA.

Also our Japanese colleagues were very interested, but asked us to wait until their Global Centre of Excellence (gCOE) program on in silico medicine would have been started. The Osaka group organised a first meeting of the gCOE in August, and the 2nd MEI International Symposium on 7-9 December, 2007, in Osaka, Japan, where they invited representatives of the major coordination actions on Integrative Research in the world.

The EuroPhysiome community was represented by Denis Noble (University of Oxford), Rod Smallwood (University of Sheffield) and myself (Rizzoli Institute). Peter Hunter (University of Auckland), Andrew McCulloch (UCSD), and our host, Yoshi Kurachi (University of Osaka), represented the IPUS Physiome Project.

We also had representatives of the funding agencies: the European Commission, represented by Ilias Iakovidis, and NIH by Grace Peng, who also represented the Interagency Modeling and Analysis Group (IMAG) and the Multiscale Modeling Consortium supported by the IMAG Multi-Scale Modeling Initiative (MSM). Last, but not least, the Japanese Ministry of Science and Technology, which is supporting the leading project Biosimulation, and the Global Centre of Excellence in In silico medicine, was represented by Yutaka Hishiyama.

The event was a very positive experience for all participants I talked to. Beside the proverbial hospitality of the Japanese colleagues, that we all enjoyed very much, I felt this was the first scientific meeting where really the centre of the stage was for Biomedical Integrative Research. This made the event of incredible quality and of incredible complexity, as you were taken between a talk of the HPC architecture of the future Japanese petaflops computer and it possibilities for multiscale models, one on a multiscale model of red cells fluid-solid interaction in an artery, another on the molecular pathways associate to cellular hypoxia, another on the neuromotor control in disable subjects. No matter who you are you had no changes to understand all subjects in depth. However, the experience was mind-blowing, and we all received an incredible amount of new ideas, lateral thinking, and completely different perspectives on known problems. I really hope as a community we shall be able to repeat a similar event once per year, moving it between European, Asia-pacific, and American continents. The presence of key figures transformed the event also in a very good opportunity to strengthen the scenarios of international co-operation on Biomedical Integrative Research. After two days of intense work we signed the Osaka Accord , a co-operation agreement among all participants.

While the Accord in itself is little more than a declaration of good will, it capture a common interest in the international pursue of the objectives set by Integrative Research, translated in concrete goals such as those listed in the WIRI Agreement, that is cited as an example of a concrete agenda to be followed. Moreover, based on the Osaka Accord, the participating funding agencies started closer talks on possible global co-operation between their relevant programs.

Looking into the immediate future, it will be clear soon what will be the new funded projects as well as what will be the next call of the European Commission focusing on. In USA, the Funding Opportunity Announcement on Predictive Multiscale Models of the Physiome in Health and Disease has recently been launched by the NIH under the Research Project Grant award mechanism.

One thing is for sure - the future of Biomedical Integrative Research, Physiome and VPH is much brighter than in January 2006, when the STEP Action started.

With sympathy Marco Viceconti STEP Action, Scientific Coordinator