As Director of the National Institutes of Health, Dr. Francis S. Collins, M.D., Ph.D., oversees more than 18,000 employees. With the support of the American people, the NIH annually invests over $28 billion in medical research. More than 83 percent of the NIH's funding is awarded through almost 50,000 competitive grants to more than 325,000 researchers at over 3,000 universities, medical schools, and other research institutions in every state and around the world. About 10 percent of the NIH's budget supports projects conducted by nearly 6,000 scientists in its own laboratories, most of which are on the NIH campus in Bethesda, Md.
What is your primary goal for NIH as Director?
Our most basic mission at NIH is to extend the knowledge of the nature and behavior of living systems. Our most fundamental human goal is to reduce the burdens of illness and disability on people and their families.
What inspired you to a life of research?
During my first year as a medical student, a pediatrician who also happened to be a geneticist brought some patients for us to interact with and interview. We met a young man with sickle cell disease, a child with Down syndrome, and others—all examples of how one small glitch in the genome can have great impact. That helped me to see how scientific investigation of the most basic aspects of life, of DNA, RNA, and protein, could have fundamental consequences for human beings. If I was going to be in medicine, I wouldn't be satisfied leaving those problems to someone else to figure out. That was 35 years ago.
Could you describe the state of NIH research today?
Investigator-initiated research has been the bedrock of NIH breakthroughs over the decades. Today, the number and variety of research activities and the depth of molecular understanding of how life works are breathtaking. Such basic information is critical to understanding what goes wrong when disease strikes.
There is also "big science"—projects like the Human Genome Project and others—that enables researchers to get answers more quickly, and use their resources more efficiently. The challenge is to decide how to support everything, with an emphasis on releasing the data from the big projects immediately, so that everyone can begin to take advantage of those discoveries.
How is NIH sharing what it learns?
President Obama continues to emphasize the importance of transparency, open government, public engagement, and collaboration. NIH uses a wide variety of programs and techniques to make as much information as widely available as possible. It's a matter of public trust.
We are committed to getting out the latest research about prevention, diagnosis, and treatment. One of our latest advances is a long-anticipated upgrade to the popular CRISP (Computer Retrieval of Information on Scientific Projects) Web site. Through the upgrade, called REPORT (Research Portfolio Online Reporting Tool http://report.nih.gov), anyone can see what NIH is currently supporting, down to the individual research grant. We believe this is transparency for the benefit of all.
What areas will you be emphasizing for NIH over the next few years?
We see five fairly broad opportunities that hold great promise.
New Technologies—Today's high-throughput technologies can help to break down the boundaries limiting our understanding of disease; for example, that what we thought we were doing to study cancer turns out to tell us something crucial about heart disease. Or that investigating a rare disorder affecting only a few hundred people has profound implications for millions of people with high blood pressure or asthma. The notion that medical research could be compartmentalized is turning out to be wrong. There is all the more reason to work together to understand scientifically how we're connected.
Genomics is one of those technologies that is changing our understanding of brain cancer, for instance. In a new pilot project, it is being used to look at the genetic script to identify and catalog the glitches that make a good cell go bad. This can be expanded to other cancers as well, changing forever what cancer is all about and how to prevent and treat it.
Discovery into Practice—I am particularly passionate about translating basic discoveries about the causes of disease into effective treatments, whether the disease is common or rare. We need to bridge the gap between discovery and development as quickly as possible.
"Science is not a 100-yard dash. It's a marathon. Our goal is to advance biomedical research in new, innovative ways that will benefit everyone's health."
— NIH Director Dr. Francis Collins
Healthcare Reform—We can put science to work to better understand how to rein in costs and improve outcomes. For instance, in the area of comparative effectiveness, NIH has been studying various clinical problems to see which treatment approaches are most effective and thereby less costly. In the same vein, various payment incentive models could be compared in a research environment to answer some of the questions floating out there.
We also must invest more in learning how drugs work differently in different people, and the personalized medicine agenda needs to be moved forward. We need to better understand the causes of health disparities and what can be done to dispel them. This is going to require social and behavioral research to clarify how people absorb information and actually alter their own health behaviors.
Global Health Focus—Partnering with the World Health Organization, the Gates Foundation, and other philanthropies, the opportunity has never been better for NIH to apply what we know therapeutically around the world. We have come quite a distance in understanding many of the diseases common to the developing world, but much more remains to be accomplished.
Supporting Scientists—We could do everything possible to come up with new ideas and new technologies, but if we don't have the people to do the research, then we're going to continue to lose out in terms of our standing in the world. Tomorrow's researchers must see that it is possible to have careers that support innovation and creativity. So we need to focus on supporting the scientific community the best way we can. At the same time, we need to make the case for the value of medical research, and use the resources we are given by the American taxpayer creatively. One particularly relevant project here is the NIH Roadmap for Medical Research, launched in September, 2004, to transform biomedical research by overcoming specific hurdles or filling defined knowledge gaps.
Do you have the funding to do all of this?
Under the American Recovery and Reinvestment Act, NIH has received $10 billion in stimulus funding, which represents an extraordinary opportunity. In addition, we have been given another $400 million for comparative effectiveness research.
What impact will this have, do you think?
Every grant we give out creates about seven jobs, and every research dollar generates more than two dollars in goods and services in less than a year. In terms of stimulating the economy, NIH is near the top of the list. But science is not a 100-yard dash. It's a marathon. Our goal is to advance biomedical research in new, innovative ways that will benefit everyone's health.
Watch Videos of Dr. Collins
To see online videos of Dr. Collins speaking about health and the NIH, appearing on The Colbert Report, and related appearances, visit www.nih.gov/about/director/ and look under the "Multimedia" heading.