• The San Juan Daily Star

Francis Collins, who guided NIH through COVID-19 crisis, is exiting

Dr. Francis Collins director of the National Institutes of Health, during a ceremony where Vice President Kamala Harris is given the second dose of a COVID -19 vaccine at the NIH in Bethesda, Md. on Jan. 26, 2021.

By Noah Weiland and Gina Kolata

Dr. Francis S. Collins, director of the National Institutes of Health, holed up in an Airbnb in the countryside in May to ponder leaving the job he had held for more than a decade, over three presidencies.

“I spent a long weekend thinking about this and mapping out timetables and pros and cons,” he said. He prayed over it.

On Tuesday, he announced his decision: He would step down by the end of the year.

Collins’ successor, once nominated by President Joe Biden, will have to be confirmed in an evenly divided Senate. A division of the Department of Health and Human Services, the NIH describes itself as the largest biomedical research agency in the world. In a statement Tuesday, Biden called Collins “one of the most important scientists of our time.”

“After I was elected president, Dr. Collins was one of the first people I asked to stay in his role with the nation facing one of the worst public health crises in our history,” Biden said. “Millions of people will never know Dr. Collins saved their lives. Countless researchers will aspire to follow in his footsteps. And I will miss the counsel, expertise and good humor of a brilliant mind and dear friend.”

Collins, 71, was appointed in 2009 by President Barack Obama after more than a decade leading the National Human Genome Research Institute, which is part of the NIH. There, he led the international Human Genome Project, which mapped the genes in human DNA. The NIH said Tuesday that Collins would continue to lead his laboratory at the genome institute, which is studying the causes and prevention of Type 2 diabetes and new therapies for Hutchinson-Gilford progeria syndrome, a form of premature aging.

Among the NIH’s accomplishments under Collins was its support for research into mRNA vaccines, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH. Scientists at the health agency then made crucial discoveries that enabled the development of the Moderna and Pfizer-BioNTech vaccines.

In its announcement, the NIH noted that Collins had increased its substantial budget by more than a third, to $41.3 billion in 2021 from $30 billion in 2009 — the result, his admirers say, of a steady campaign to win over Congress.

“I heard it said that he is the best politician in Washington, and I think it is true,” said Mary-Claire King, professor of medicine and genome sciences at the University of Washington. “He really knows his subject and reads people well. He has kept biomedical research and the NIH in a positive light.”

A geneticist and physician by training, Collins oversees 18,000 federal employees and a sprawling research program. His agency awarded more than 50,000 grants to more than 300,000 researchers during the 2020 fiscal year alone. Its campus tells the story of its reach, spread across 27 institutes and centers in 75 buildings in Bethesda, Maryland.

During the pandemic, Collins helped found a project involving partnerships and collaborations with pharmaceutical and biotech companies that enabled numerous trials of antivirals and other treatments for COVID-19 to run simultaneously.

Fauci said that Collins made a critical pivot from his expertise to the broader pandemic response. It was, he said, “really extraordinary to get someone who is fundamentally a geneticist, whose diseases involved cystic fibrosis and progeria, who turns out to be a valued colleague in the arena of infectious diseases, pandemics, public health.”

Collins almost stepped down early last year, Fauci said. One evening, he visited Fauci in his office and admitted that he was considering leaving for personal reasons. “I begged him not to step down,” Fauci recounted, “because, I said, ‘We are in the Trump administration. If you step down, we have no idea who’s going to get appointed as director. So we need you to stay on with us. Don’t leave now.’ And he understood that.”

Collins received a doctorate in physical chemistry from Yale in 1974 but decided molecular biology was more exciting. He spent years training anew. He also wanted to be a doctor, and earned his doctor of medicine at the University of North Carolina.

He was not brought up with religion, but when a patient asked Collins if he believed in God, he realized, he has said, that he did not know. He began reading widely and was persuaded by the writer and theologian C.S. Lewis, who said faith could be a rational choice. At 27, he became a nondenominational evangelical Christian.

As director of the NIH, Collins said, he had promised that his faith would not affect his choice of projects for the institutes.

“It does guide me a bit in terms of how I approach a challenge in bioethics,” he said during an interview Tuesday. “But I find I usually come down in the same place on an ethical dilemma as people who are agnostics or even atheists.”

“I admit I prayed about those vaccines,” he added.

He said in the interview that one of his chief regrets as NIH director was the persistence of vaccine hesitancy during the pandemic. “Culture war has had terrible consequences,” he said. “Was there something else we should have done there in terms of anticipating that? Maybe investing more in the behavioral research side of this, to try and understand the basis of those resistances?”

During the Biden administration, Collins has stood behind the federal government’s increasingly assertive vaccine policy, endorsing a broad booster shot plan and Biden’s decision to require federal workers to be vaccinated against the coronavirus.

Collins has struggled with some persistent problems at the NIH, including a lack of reliable funding for young scientists, which forced many to abandon research careers. Although he points to progress, the issue still rankles.

On Tuesday, Collins said he had doubled the number of women who are institute directors at the NIH. He also said that he hoped his successor would be a woman.

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