NIH Director Collins: Confident about Future of Biomedical Research

National Institutes of Health Director Francis Collins delivered an upbeat assessment of what lies in store for the world’s largest supporter of biomedical research, projecting advances in battling genetic disorders such as sickle cell disease and the development of an atlas of human cells to expand knowledge about human tissues.

“We’re at a remarkable moment in biomedical research and its potential for making advances,” said Collins during a March 27 presentation on federal agency priorities on the opening day of the 42nd AAAS Science & Technology Policy Forum held at the Ronald Reagan Building in Washington.

France Córdova, director of the National Science Foundation, also addressed the forum, saying NSF’s agenda over the next decade will come from “10 big ideas” including understanding the changing Artic, leveraging artificial intelligence, harnessing big data, developing quantum enabled technology, studying the microbiome and advancing research about gravitational waves.

For his part, Collins, who has led NIH since 2009 and been kept on by the Trump administration, pointed to an array of promising NIH activities, including the development of new technologies to provide insights into human brain circuitry and function through the Brain Research through Advancing Innovative Neuroethologies ( BRAIN initiative) and the use of the gene-editing tool CRISPR-Cas9 to correct mutations and clear the way to develop and test a “curative therapy” for the first molecular disease: sickle cell disease.

NIH is also in active discussions with the Chan Zuckerberg Initiative, a philanthropic organization set up by Facebook founder Mark Zuckerberg and Priscilla Chan as well as international organizations, about a project to assemble the atlas of human cells, something Collins likened to a “Google map of the human body.”

“I don’t think we should overstate the significance of having technologies that now allow us to look at what is happening in a single cell… because that is, after all, the unit of living things,” noted Collins, saying the human cell atlas would bring engineering and biology to the effort.

Work is also underway to form a $240 million to $250 million public-private partnership to discover why some immunotherapies fail while others cure cancer as part of a new project under former Vice President Joseph R. Biden Jr.’s “cancer moonshot” program that launched last year, said Collins. An announcement about the alliance could come as soon as June, he added.

Another collaborative partnership that Collins said holds great promise is an ambitious, large-scale and long-term study of the genetics and health of 1 million or more volunteers. The initiative, known as “All of Us,” is slated to launch in the fall and would collect extensive health data on participants to permit researchers to identify factors that determine illness or health and advance individualized health care. Collins called the project a “cornerstone” of precision medicine: “The goal here is to be the foundation for almost everything you want to know about future individualized care and improved health.”

Throughout the presentation, Collins never let go of optimism about NIH’s top projects, even as he joked about still holding his post as head of NIH. “Yes I am still the NIH director,” he said. “I did not expect to be talking at a symposium like this with that title under my name, but when the message came through two days before January 20 that my resignation letter had been rejected, I figured that I better figure out what to do in this new role and certainly celebrate the opportunity to continue to lead this great institution, this noble enterprise called the National Institutes of Health.”

Just before Collins and Córdova addressed the Forum, Matt Hourihan, AAAS’ director of the R&D Budget and Policy Program, presented a historical analysis of presidential budgets over the last four decades. It found that prior to the Trump administration, the early Reagan administration stood as the toughest on science and engineering investment. “There’s a strong argument to be made that the Trump administration fiscal 2018 discretionary budget is the toughest of the post-Apollo era for science and technology, even with substantial information gaps still to be filled in,” according to the full analysis.

Looking at global trends in R&D investments, Kei Koizumi, a visiting scholar at AAAS, then noted that the investment picture is mixed: The United States ranks 10th in the world in terms of the percentage of the nation’s economy, measured by the gross domestic product, that is devoted to R&D investments, yet the nation still holds the top spot for the total expenditures on R&D projects. “We don’t need to dominate R&D research, but we do need U.S. scientists and engineers participating in cutting-edge science,” Koizumi added.

Collins betrayed no hint of concern about the Trump administration’s recent fiscal 2018 discretionary budget plan. That proposal, which is in the hands of Congress, would cut $5.8 billion from NIH’s $30.3 billion budget, reorganize its 27 institutes and centers and eliminate the Fogarty International Center, which creates partnerships with international biomedical research institutions.

In response to a question about the White House budget proposal’s potential impact on NIH’s ambitions, Collins pointed to passage late last year of the 21st Century Cures Act, a $6.3 billion measure that authorizes a decade of funding for the “moonshot” program to cure cancer, the Precision Medicine Initiative, the BRAIN initiative and efforts to combat opioid addiction.

Collins, however, was quick to point out that the Cures Act does not authorize funding for all the other areas of biomedical research NIH is conducting. Still, he said he has been heartened by comments from the House and Senate appropriations committee chairmen that Congress will provide additional funding for such research when it takes up spending levels for the remainder of fiscal 2017 next month. The current stopgap spending measure that has been funding government programs expires April 28.

“We have a lot of reason to be optimistic that the case here is sufficiently compelling, that the Cures Bill has passed, that the appropriators are determined that they are going to make this a priority,” Collins said. “We shouldn’t get too concerned about the need for shrinking the enterprise when the enterprise is so compelling.”