By Bernadine Healy, M.D.
When I was director of the National Institutes of Health in the early 1990s, little did I know the man I was struggling mightily to recruit to NIH would, almost two decades later, become NIH director himself. It's not that Francis Collins wasn't director material even then. It was that I was too focused on bringing him on to be the first permanent head of what was one of NIH's most important scientific efforts of the 20th century: the Human Genome Project.
It was clear through all our negotiations that Francis was an original. Devoutly religious, motorcycle riding, and boyish faced, with a haystack of blondish hair and a devilish sense of humor, he was also one of the most prominent physician-scientists on the planet, having just recently identified the first gene to be linked to cystic fibrosis. Competitive, yes. Driven, of course. And also, just plain nice.
But snagging Francis, pulling him away from a cozy position at the University of Michigan to take on this task, was not easy. The search committee of leading scientists told me Collins was the hands-down No. 1 choice—but that we could never get him. NIH salaries were low, he was a single dad, and the University of Michigan would find every way to keep him.
What captured his head and heart, he told me, was the opportunity to lead the broader genomics effort, with all the great benefits it could bring to the world—to do, as is NIH's mission, science on behalf of humanity. We could not match his salary, but we could provide new laboratory space and enough positions to enable Collins to build the first genomics program within the NIH government laboratories in Bethesda, Md. Two successive health and human services secretaries, Louis Sullivan and Donna Shalala, supported the investment in this new recruit. And it all worked out.
Once in place, Collins led the genome project with his anticipated scientific splendor and ability to communicate complex science easily. And thanks to his great organizational skill in leading teams of scientists working on the effort nationwide, and responding to a little healthy private-sector competition from former NIH scientist J. Craig Venter, the nation saw its $3 billion investment reach fruition two years earlier than expected, and with a few hundred thousand dollars to spare.
Collins then moved quickly to focus on applying this powerful new genetic knowledge to human health and disease, and his project was elevated to become the National Human Genome Research Institute. One of its greatest applications has been in revolutionizing the cancer field. The ATLAS project, one of Collins's babies, is a major NIH effort to map the genes of the myriad forms of cancer. Cancer is driven by genes gone bad, and which genes go bad varies enormously even among tumors that look the same under the microscope. Knowing the genetic blueprints for even a few cancers is just beginning to revolutionize the approach to cancer treatment.
Recognizing the social, legal, and ethical dimensions of knowing someone's genome, Collins has been relentless in speaking out and supporting efforts to prevent discrimination based on genetic information.
Now Francis will be leading NIH in the 21st century. President Obama could not have made a better choice. Human genomics has ushered in a new era of personalized medicine, which has the potential to make medical care more precise, more efficient, and more lifesaving. Yet genome-based insights must hold their own at a time when there are temptations to control the cost of healthcare by squeezing everyone into uniform molds that don't actually fit many individuals. Francis Collins's ability to translate the science of the genome into medicine will bring a critical dimension to the changes that the NIH—and medicine as a whole—will face in the years ahead. He is just the person our nation needs to head this great American treasure today and tomorrow.
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