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The head of the National Institutes of Health on why he's stepping down


For some people, leading an effort to decode the human genetic blueprint would be the apex of a career - not for Dr. Francis Collins. After running the National Center for Human Genome Research, he went on to direct the National Institutes of Health for more than 12 years. And now, Dr. Collins has announced that he'll step down from leading NIH at the end of this year. He joins us for an exit interview.


FRANCIS COLLINS: Glad to join you, Ari, and talk about all of the things that NIH has been up to and what might happen next.

SHAPIRO: Yeah. Well, let's start with the pandemic. Do you have any hesitation about leaving before it's over?

COLLINS: I do, but I want to say that I think NIH's role is now in very solid and stable place in terms of what we've been doing about vaccines, about treatments, about diagnostics - hugely successful enterprises in all of those spaces led by really capable people. So I think my own involvement in that, which has been 24/7 for the last 20 months, can now fade over the course of the next couple of months without doing any harm to the research enterprise that is now in a really good place.

SHAPIRO: What do you think this pandemic experience has revealed about the shortcomings in our country's scientific research apparatus?

COLLINS: Well, we did find when the pandemic was upon us that we had a lot of work to do to pull all of the components together in the most efficient way to, basically, identify what were the most promising treatments and to get those into rigorous clinical trials - certainly, everything that was done with vaccines. But all of those were learning experiences. And as we are now contemplating what might happen in the future - because this is probably not the last pandemic the world will see - we have some lessons learned that we need to be sure don't get forgotten. And that's part of what a lot of us are spending time on right now - what you might call pandemic preparedness.

SHAPIRO: At the same time that NIH was scrambling to develop treatments and vaccines, you were dealing with misinformation, some of it coming from the man in the Oval Office. What was it like to see science and scientists attacked and denigrated on such a public platform?

COLLINS: It has been part of the difficulties of being in this role and stretches back probably further than maybe many people are aware of. If there's one thing that I find most frustrating about my 12 years as NIH director, it's that science has triumphed in many ways, and yet we find ourselves here today, particularly with COVID-19, where our culture wars have taken on an attitude about scientific facts that is not just inconvenient. It's actually resulting in people dying. And that I didn't see coming.

SHAPIRO: Those culture wars are often framed as religion versus science. And you're open about your religious faith. You've written a book about it. I know you've tried to bridge that divide throughout your entire career, and yet the divide seems to be getting wider and wider. What do you make of that?

COLLINS: Well, I am a person of faith, and I find that's an incredibly important anchor in stormy seas. I don't know that I would agree that the divide has gotten wider across the board, but it's certainly been the case that political perspectives have, in many ways, infected religious communities in a way that's not good for them. If faith has any meaning, for me as a person of faith, it's about truth, and it's about trying to find the truth and then share it with others. And somewhere along the way, we seem to have lost that in a lot of our society. I don't fault the people who are barraged by all kinds of information coming at them that's frankly not true. I do fault the people who are sending that information out there, knowing it's not true. That is a destructive force for our society that has to be addressed.

SHAPIRO: In your more than 12 years leading NIH, the pandemic has been the elephant in the room, by far the greatest challenge. But if it's possible to set that aside, what do you think is the most important thing you've accomplished in your time leading the organization?

COLLINS: You know, Ari, being NIH director gives you the ability to look across a whole landscape of what's happening in medical research and identify areas that are ripe for a sort of big leap forward. Things like the human project to understand the brain, the BRAIN Initiative, are things that I look at as having been exceptional moments of opportunity to bring together hundreds of scientists to figure out how those 86 billion neurons in your brain do what they do. We've got a long way to go to really figure that out, but we are so much further along because of that...

SHAPIRO: So you mapped the human genome. Now you want to map the brain.

COLLINS: Yeah. Why not? I mean, let's figure out how it works, and then figure out what that means for how to better treat things like schizophrenia or Alzheimer's disease or depression. That's the path we're on.

SHAPIRO: Big picture, the NIH budget grew 40% during your tenure, but Americans are still sicker and die younger than people in other developed countries. And even before the pandemic, U.S. life expectancy was actually going down for a couple of years. Why do you think the investment in NIH has not led to Americans leading longer, healthier lives?

COLLINS: Well, over a longer time range, it certainly has. You know, people used to die young from heart attacks 30, 40 years ago. Those deaths are down by 75%. - likewise with strokes. AIDS used to be a life sentence. Now it's appropriate to, basically, get on treatment and have a normal life expectancy. Unfortunately, we're up against other aspects of human health in terms of lifestyle, health behaviors, the problems of obesity and diabetes that our efforts to come up with answers collide with human decision-making and with a whole lot of things about our health care system that is, frankly, not easy for many people to be able to utilize for their own benefit. We still have an enormous difficulty in this country with health disparities. People of color are less likely to be able to live out the same life span because of what that means.

SHAPIRO: You're talking about some of the structural obstacles to human health and long life. If you could snap your fingers and change one thing, what would it be?

COLLINS: If we could have a health care system that actually was completely fair and equitable and gave everybody access to quality care, that would make a huge difference.

SHAPIRO: Now, if I'm not mistaken, you are 71 years old. You are...

COLLINS: That's right.

SHAPIRO: ...Fully qualified to retire, but instead, you are going back to your lab at the National Human Genome Research Institute. You told me before we started this interview you woke up at 4:30 this morning. Why not give yourself a break, Dr. Collins? Haven't you done enough?

COLLINS: (Laughter) Well, OK, I might be accused of being a little bit driven, but it's also what I love, Ari. And to have the chance at this point to be a working scientist - which I've continued to be able to do, running my lab since 1993 - yeah, maybe I won't be getting up at 4:30 in the morning.

SHAPIRO: (Laughter).

COLLINS: Maybe I'll ride my Harley a little bit more than I have for the last year. But I will still be doing what I love.

SHAPIRO: All right, it seems like every profile that has been written of you mentions that you ride motorcycles and sing songs. You often rewrite lyrics to popular songs, and there are lots of videos online where you have performed them. Can you choose one for us to go out on?

COLLINS: (Laughter) Well, "Here Comes The Sun" wouldn't be too bad. After all (laughter), we are, I think, going to get through this pandemic. We've been through an incredibly rough time. If we can all pull together, we might just be able to see the sun come out.

SHAPIRO: That is outgoing director of the National Institutes of Health, Dr. Francis Collins.

Thank you very much.

COLLINS: Thanks, Ari. It's great to be with you.


COLLINS: (Singing) It's been a long, dark COVID winter. Teleworking - can you believe it's been a year? Here comes the sun. Here comes the sun. I said, it's all right. Transcript provided by NPR, Copyright NPR.

Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.
Ashley Brown is a senior editor for All Things Considered.
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