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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