Replace Francis Collins as NIH Director

For decades the NIH has been the premier funding agency in the world, fueling the rise of the US as the undisputed powerhouse of global science. But in his eight years in charge of federal efforts to understand, diagnose and cure disease, current NIH Director Francis Collins has systematically undermined the effectiveness of the institution and overseen a decline of American science.

Biomedical research in the US has been driven by the creativity and industry of individual investigators and their trainees. Collins has systematically diverted funds from investigator initiated projects in favor of  “big science” projects conceived in and managed from inside the Beltway.

The model for these initiatives is the well-regarded Human Genome Project. However Collins, who headed this project in its final years, learned all the wrong lessons from this effort, focusing on central planning and control, and the generation of massive datasets, while ignoring the importance of technology development. Hence his signature projects as NIH director have been ill-conceived and wasteful of precious research funds.

The NIH has always aimed to fund scientists based on their ideas and accomplishments, but under Collins’s big science paradigm, money is increasingly doled out based on researchers’ willingness to sacrifice their autonomy and creativity to Bethesda’s plans. Scientists are herded into consortia and spend endless hours on conference calls to produce data that are of fleeting value.

Collins’ has further corrupted the process of peer review by becoming too close to leaders of the major research institutions, who have had an outsized role in shaping billions of dollars of NIH initiatives, and then benefited disproportionately when funds from these projects were distributed.

The US has led the world in training biomedical scientists, attracting many of our most talented minds into science. Central to this was the expectation that they could build stable careers based on NIH funding. But under Collins this system has collapsed. “Young” PIs generally do not receive their first grants until they are in their 40’s, spend an increasing amount of time seeking funds, and no longer feel they can count on NIH funding.

American science has always enjoyed strong support from Congress and the public. This support depends on a high degree of trust. But Collins has repeatedly made unrealistic promises to Congress and the public to secure support for his signature initiatives. There is almost certain to be a public backlash against the NIH when these projects fail to deliver.

Scientific progress almost always begins with basic discoveries. But in his efforts to curry favor with Congress, Collins has consistently promoted translational research with a dubious track record over basic biomedical research. He has involved the NIH in massive translational projects that are either premature or that the NIH is ill-prepared to carry out.

Finally, science as an endeavor involved building on the research of others. However Collins’s NIH is mired in a serious reproducibility and reliability crisis. Confidence in NIH funded research is at an all-time low, and Collins has responded with bureaucratic measures that have little hope of correcting the problems, while leaving untouched the perverse incentives that lead to the production of unreliable research.

Fortunately, destroying the greatest scientific engine humanity has ever created takes time. The US remains the global leader in biomedical research, with a talented and creative scientific workforce eager to tackle pressing problems in basic science and public health, and a diverse array of commercial enterprises ready to turn their discoveries into products that improve the health and well-being of our citizens. There are many thousands of talented and dedicated people at the NIH. But more time with Collins at the helm would be a disaster.

The National Institutes of Health are an invaluable resource for the American people and our economy. But it is in serious need of reform if we are to benefit optimally from the opportunities of 21st century biomedicine. It’s time to replace Francis Collins and name a talented physician scientist with real vision and wisdom as NIH Director.

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  1. Jonathan Badger
    Posted December 13, 2016 at 6:24 pm | Permalink

    Given Herr Drumpf’s choices so far (a guy who denies climate change as head of the EPA, and most recently, choosing a man who wants the Department of Energy abolished as its future head), think twice before wanting *any* changes by his tiny hands — he’s likely to appoint a homeopath or something.

  2. DNA
    Posted December 14, 2016 at 6:38 am | Permalink

    “Fortunately, destroying the greatest scientific engine humanity has ever created takes time.”

    I think you’re underestimating the rabid incoming administration. It embodies the antithesis of fact, ability and intellect.

  3. R Benezra
    Posted December 14, 2016 at 6:49 am | Permalink

    I agree both with Eisen and the comment from J Badger. Which puts us between a pebble and a hard place. Very tough call right now.

  4. Posted December 14, 2016 at 3:01 pm | Permalink

    Your letter is a call for collaboration – in the Vichy sense – and I’m appalled that you actually sent it.

    A Trump appointee heading the NIH is a victory for Nazis, no matter who it is. You should be opposing every single one of his picks on principle.

    Don’t work with Trump and don’t ask Trump to help you out.

  5. David Ellison
    Posted December 22, 2016 at 1:10 pm | Permalink

    My scientific career has been built entirely on investigator initiated funding, and I strongly endorse the concept of its centrality to the NIH mission (even while working on some ‘translational’ projects). I would strongly agree on the dangers of shifting too much funding to top down programs; this may indeed be Collins’s Achilles’ heel. Yet, I don’t trust that anyone nominated by the new administration would bring any vision for science, let alone a background in science, to NIH. I am thinking that the Devil that we know may be better than one who we don’t (and at this time, that statement is an example of Evidence Based Thinking). We can all fight for a modest turn away from top down science, if we have someone who at least understands the issues.

  6. David Ellison
    Posted December 23, 2016 at 8:45 am | Permalink

    In many ways, you are right on the money. My research career has been supported entirely by investigator initiated grants, and I am strongly committed to them. On the other hand, and as a physician scientist, I do see the need for some big top down projects, especially dealing with applied research; developing a vaccine for Ebola, for example. The need is for the right balance of the two. I would favor tilting back toward more IIR support than it seems Francis Collins would, but my concern, like several above, is that the record of appointments by the new administration suggests that we might get someone without any science background or commitment, if a new Director is appointed. Thus, to me, better the devil that we know than the devil that we don’t know.

  7. Posted January 4, 2017 at 8:50 pm | Permalink

    I see your point but I think you are missing the perspective that congress tends to best respond to “crises” (think flint water, Zika etc in the past year). Some members of congress already checked the biomed research crisis box off with the doubling. Thus, if the current congress will not appropriate more discretionary funding to DHHS/NIH without cutting another important program in the discretionary pie (because repubs won’t increase deficit) then the alternative route is to somehow get mandated funding, such as through the brain initiative or precision medicine. So it is worth considering that Collins purposefully took the big initiative route to get biomed research more funding than would have been possible with the current congress and dwindling discretionary funding. That said, the fact that this has had consequences for how science is done is not something to be overlooked.