IRA FLATOW: This is Science Friday. I’m Ira Flatow. Dr. Francis Collins, Director of the National Institutes of Health, will be stepping down from his post at the end of the year. Dr. Collins is the longest-serving NIH director, serving three presidents over 12 years. Before his role at the NIH, Dr. Collins was an acclaimed geneticist. He helped discover the gene that causes cystic fibrosis. He then became director of the National Human Genome Research Institute, where he led the project that mapped the human genome.

In a statement, President Biden called Dr. Collins one of the most important scientists of our time. A lot can happen in 12 years, especially if you work in health and science. So joining me today to talk about his tenure at the NIH is Dr. Francis Collins. Welcome back to Science Friday.

FRANCIS COLLINS: Hey, Ira. It’s great to be with you. So what are your first thoughts on leaving the job? What do you say to yourself about, where do I go now, considering what I’ve done during my career?

FRANCIS COLLINS: Well, it’s been an incredible privilege to have the chance to lead NIH, the largest supporter of biomedical research in the world, over this 12-plus-year period, serving three presidents, going through a wide variety of scientific experiences, and of course, over the last 22 months, being focused intensively on dealing with COVID-19, which has been all consuming and exhausting, and where I think science has really risen to the challenge in remarkable ways, even though we still have faced some issues about whether the public is ready to embrace all of the things that science has produced. And that’s been a bit frustrating. But I’ve just been so fortunate to work in this area with incredible people, because the NIH director really has the chance to look across the entire landscape of biomedical research, and which meant my horizons had to get really expanded. And as a scientist, that’s something you really like to do. Learning about new things every day, that is absolutely part of the job. And it’s a wonderful part of the job.

IRA FLATOW: And any specific reason for you stepping down besides, well, you know, it’s time to retire?

FRANCIS COLLINS: Well, you could argue what the shelf life of an NIH director should be. And I may have exceeded my– no previous NIH director appointed by a president has stayed on for more than one president. And here I am on the third of those. And 12 years is a long time. It’s really good for a scientific organization to have new vision and new leadership now and then. And this just seems like the time. And frankly, Ira, if I’m going not to stick it out for another three years, I need to give the president a chance to find the next director, nominate that person, and get confirmation through the Senate before the term gets too late, because it gets harder as you go along, so it seemed like the right time.

IRA FLATOW: I hear you. Now, being in the job for 12 years, longer than anyone else has it, what do you think, what do you recommend if the president asks you, or if someone like me asks you, what qualities does the director of the NIH need to have?

FRANCIS COLLINS: Well, first of all, this person needs to be a scientist of the highest order who really has themselves contributed to science, who has the respect of the scientific community. They’re going to trust this person is really going to be able to understand what they’re doing and why, so gravitas in a scientific sense. But the person also needs to be a visionary who really is able to look and see across this wide variety of scientific opportunities, where are we going? And what could NIH do to speed up the process of making progress? The person needs to be a good communicator, needs to be able to get other people to share that kind of vision, needs to be very good in terms of answering the long list of questions that come at us every day from stakeholders and from the Congress, and building that kind of trust that the organization really is founded on principles of getting evidence and applying them as quickly as possible to advancing human health, all of those things.

It would be great I think if the next NIH director also maybe represented the diversity a bit better than has been the case. We’ve only had one NIH director who is a woman. That was Bernadine Healy. All the rest of us have been white guys like me. I would love to see, as that search goes on, a real focus on trying to enhance the diversity of our leadership. And that would be something I think the president would resonate with.

IRA FLATOW: Who do you think should be the next director?

FRANCIS COLLINS: Ira, I’m not going to go there. I don’t want to tip the odds.

IRA FLATOW: Just between you and me. No one else is listening,

FRANCIS COLLINS: Nah, yeah, right, nobody else is listening, right? I have sitting in front of me and my computer a little piece of paper where I’ve been writing down names, but I’m not going to tell you what’s on there. We’re going to see how this plays out.

IRA FLATOW: Let’s talk about some of the accomplishments and some of the projects that you have worked on. There was the Brain Project which aimed to identify all cell types in the brain. You also helped launch the All of Us precision medicine project. Looking back, how do you gauge the success of these projects? And do you have a favorite one?

FRANCIS COLLINS: You’re asking me to pick amongst my children.

IRA FLATOW: Always.

FRANCIS COLLINS: The ones you just mentioned, All of Us, now enrolling 1 million participants in the most ambitious, most consequential, long-term longitudinal cohort study is just phenomenal in terms of what it’s going to offer us, both in terms of how to manage illness, but also how to prevent it by really moving into a precision medicine approach. The Brain Initiative just now this month, having come out with remarkable set of new observations about the cell census, of what’s going on in the motor cortex of both the mouse and the human, it’s breathtaking. And it’s on the way to even more to come.

And I guess I have to mention what we’ve done with COVID over the last couple of years, not something I planned, but once given the challenge, the ability to develop vaccines in 11 months, to run through more than 20 therapeutic agents with rigorous clinical trials, and to develop tests which are now making it possible for you to go to the drugstore and buy a home testing kit for COVID-19, those are all things I’m really proud of. It involved a lot of collaborations with academia, with industry, but moved science forward in remarkable ways.

IRA FLATOW: Yeah, because you know, I don’t think people really know what NIH does, right? They know that you’re there and in this magnificent glass tower in Bethesda. You get your own parking space out front. Do people understand, like, for example, that you helped develop the Moderna vaccine for COVID? I mean, how do these things happen?

FRANCIS COLLINS: Well, there is a good question, Ira. And people think they just sort of happen overnight. And a really important message about everything that we do is how it has to build upon decades of investment in basic science. And that’s another thing I really am proud of, is that we’ve been able to keep our basic science enterprise flourishing over the course of the last six years now with help from the Congress.

The budget for NIH has gone up by 43%. And half of that goes to basic science, where investigators come to us with their new and great ideas. And we put them through the most rigorous peer review system in the world and fund the ones that are most promising. And things were pretty tough six or seven years ago. The success rate for getting your grant funded was down around 12%, 13%. Now we’re up above 20%, which is still not as high as it should be, but it’s a lot better. And the basic science is flourishing.

So yeah, coming back to mRNA vaccines and Moderna, that didn’t just happen because somebody had an idea on January 10, 2020 when the sequence of the virus was released. That had already been worked on by people like Barney Graham and Kizzmekia Corbett at the Vaccine Research Center, because we were worried about coronaviruses after SARS and MERS, and trying to figure out, is there a way that you could make a vaccine much more quickly than the traditional approaches. And mRNA was under intense study.

And work had been done over more than 10 years. People like Katalin Kariko and Drew Weissman at the University of Pennsylvania, who, I think, eventually will win the Nobel Prize for their work on this, had set the whole foundation in place so that when the moment arrived where that sequence was there and you could see this is going to be a big threat to the world, that vaccine was designed in the Vaccine Research Center, working with Moderna, in about 24 hours. And 63 days later, the first individual volunteer was getting injected with that vaccine as part of a phase I trial, which is about 10 times faster than has ever happened before.

IRA FLATOW: One thing I’ve always found interesting about you, Dr. Collins, is that you’re a very religious man, but also a man of science. Was it ever difficult for you to balance your religion with your career in science?

FRANCIS COLLINS: You know, it never has been. I think people are still a little surprised that this isn’t an issue, that you don’t run into areas of conflict. I just haven’t. I was not raised as a person of faith. I became a believer in my late 20s as part of my experience being a medical student and a resident. And I found it’s enormously satisfying to have the ability to incorporate faith perspectives and science perspectives in a typical day.

You have to be careful, of course, about which kind of question you’re addressing. If it’s a question about how nature works, well, science is going to be the way you get those answers. And you better be really rigorous about that and not fool yourself. But if it’s a larger question about why am I here, and what exactly is the nature of morality, and what is the foundation for making ethical decisions, and what happens after you die, and why is there something instead of nothing, and why does beauty matter, I mean, all of those questions, to me, I want to be able to address those too.

And science falls short in being able to give answers there. Faith is where I go when I’m looking for that kind of question. And in medicine and in health, they’re all kind of wrapped up together. And it seems to me to be able to utilize all of those worldviews when you need them.

IRA FLATOW: I want to talk about someone who works for you. You’re his boss, Dr. Anthony Fauci.

FRANCIS COLLINS: Yeah.

IRA FLATOW: I think people see Francis Collins. And they say, oh, he’s Dr. Fauci’s boss. That’s who he is, right? What’s it like working with Dr. Fauci? And how did you two coordinate your messaging and your research aims and goals, especially around COVID?

FRANCIS COLLINS: Yeah, it’s been wonderful working with Tony. He is the most knowledgeable, most highly respected infectious disease expert in the world. And he is in exactly the place where we need him at this moment of global crisis from this pandemic, steering his own institute, one of the 27 Institutes at NIH, in a way that has made it possible for all of these advances to happen.

And he stays deeply and closely engaged with all the details of that research with remarkable staff in his institute that he’s recruited and trained. So it’s actually one of those things that I didn’t see coming, because I didn’t know the pandemic was coming. I’ve worked with Tony and other areas now for 30 years. But boy, over the last 22 months, we have been joined at the hip. I talk to him probably a couple of times a day and almost every evening sort of checking in about where we are, trying to decide about strategy.

And of course, a lot of that right now is also about the communication issues. It is really, I think, very sad and unforgivable to see the ways in which some people have decided to attack Tony because they don’t like what he’s saying. They don’t like hearing the truth about what’s happening with the pandemic.

And he even has to have 24/7 security, because some of this has gotten so nasty. That’s not a pretty picture. That’s a bad commentary on our society, that you could take a public servant of this remarkable sort who is simply there to tell you the truth and turn him somehow into an enemy that you have to attack. That’s one of the sad and shameful aspects of what’s happened with COVID-19. But Tony is a person of great integrity. He simply lets all that roll off and keeps doing what he has to do, leading the science and trying to educate everybody around him about what it says.

IRA FLATOW: Let’s conclude the last few minutes we have talking about your future. Are you going fishing or something? Or are you going to still be around doing work?

FRANCIS COLLINS: I wouldn’t know how. And I don’t intend to spend a lot of time in golf carts either. No, I’m not sure, Ira, what’s the next chapter. What am I supposed to do when I grow up? My plan is– I’m really looking forward to this– is to step back in a much more visible way into my own research laboratory, which has been actually very successfully working since I got to NIH over 28 years.

I’m type 2 diabetes. On this rare form of premature aging called progeria where we are on the track, I think, to potentially some pretty dramatic therapeutic steps using gene editing. I’m looking forward to that. It’ll give me a chance to reflect, to do some more reading about other areas of science I’m interested in, to do some writing, and to contemplate what is the next chapter, what’s the next calling, and maybe even to get some sleep. That would be nice too.

IRA FLATOW: That would be nice. This is Science Friday from WNYC Studios, talking with Dr. Francis Collins, outgoing director of the National Institutes of Health in Bethesda, Maryland. Are you satisfied with the progress that genetics has come along during your tenure?

FRANCIS COLLINS: Yeah, I think I am. You know, there is always this tendency when there is a breakthrough in basic science– and I think you could call the Genome Project that kind of breakthrough– to overestimate the immediate consequences and then underestimate the long-term consequences. That’s called the first law of technology, by the way. I think that’s been true here.

There were some bold statements probably made, hopefully not by me, that genomics was going to transform the practice of medicine overnight. Well, that didn’t happen overnight. But boy, it’s happening now. I mean, look at the way in which cancer has been completely revised as far as our understanding and our management by the ability to find out in every individual tumor what’s driving that malignancy. And also you can see how genome sequencing and the newborn nursery has become quite transformative, providing answers and mysteries that otherwise didn’t get answered, sometimes for months or years.

And certainly I would have to say, if you walk into any research laboratory that’s working in human biology, everybody is using genomics in almost everything they’re doing. It’s transformed the way in which we approach scientific questions. So I’m pretty gratified.

IRA FLATOW: That’s terrific. Do you have a message for other researchers that you’d like to leave with them following all of the years of experience that you have doing research?

FRANCIS COLLINS: So two messages– first of all, we must continue to deeply value basic science. And there is maybe a little too much emphasis now about targeted research that’s going to focus on a specific disease. And we need that. But if we don’t also fund the efforts that just build this foundation of understanding how life works, then we are going to be sorry in the longer term.

Second message, if we want to really move things forward in areas where opportunity arises, we need to come up with new approaches to do that more efficiently and quickly. And this is why I’m excited about the new program called ARPA-H, the Advanced Research Project Agency for Health, which takes a page out of the DARPA book that has done this sort of thing for defense and gave us things like the internet. And we could do that for health.

And I’m hoping, with congressional approval looking likely, that we’ll be able to launch ARPA-H at NIH in the next few months. And that will be a really exciting opportunity to bring use-driven projects forward and be able to move quickly and in a way that’s not averse to risk to fill in some of those gaps between scientific developments and clinical benefits. That’s going to be a big deal. Watch that space.

IRA FLATOW: We will be watching. And thank you for taking time. And thank you for all that you’ve done for us, Dr. Collins.

FRANCIS COLLINS: Oh, Ira, it’s nice to talk to you. It has been a privilege. I am a lucky guy. I never dreamed that this would be part of my life experience.

IRA FLATOW: Dr. Francis Collins, outgoing Director of the National Institutes of Health based in Bethesda, Maryland.

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