The director of the NIH on the promise of the human genome and what happens when you mix faith and science.
Dr. Francis Collins in New York City.
Do you have any concerns that NIH’s $30 billion budget is vulnerable?
I think history would say that medical research has, throughout many changes of parties, remained as one of the shining lights of bipartisan agreement, that people are concerned about health for themselves, for their families, for their constituents. The Republican Party has been in many past times at least as enthusiastic about medical research as the Democrats. So I am not actually that shaken up about some of the frightening stories about what this means for medical research. We can document that a dollar that NIH gives out in a grant returns $2.21 in goods and services to the local community in one year, which is better than most investments. So if you’re trying to get the economy back on its feet, this is a great way to do it.
In your last book, you had lots of optimistic things to say about the use of genomic information in medicine. Yet Craig Venter, who led the private effort to sequence the human genome, said recently that the Human Genome Project produced close to zero in terms of discoveries that can help sick people.
A substantial list of medical advances have occurred in the last 10 years [thanks to the genome project], but they have not directly affected the medical care of most people so far because they’re mostly about rare conditions. In breast cancer, for instance, a genome-based analysis to assess whether or not it has been cured by surgery and radiation or whether it needs chemotherapy is being used this year by 50,000 women. And a large number of them will, in fact, conclude they don’t need that chemotherapy, which was probably not going to help them and would’ve made them quite sick. And that’s saving our health-care system $100 million this year. That’s a direct consequence of having genome tools that come out of the project. In pharmacogenomics, a black-box warning on [the anti-clotting drug] Plavix says, if you’ve had heart trouble and you’re supposed to be on this drug to keep you from having another heart attack or a stroke, guess what? A third of you, it ain’t going to help. That’s a direct consequence of having the genome.
You’re a scientist and a person of faith. How do you reconcile the two?
Well, I’ve not had a problem reconciling science and faith since I became a believer at age 27, when I was already on a path to becoming a geneticist and a physician. Basically, science is the way to uncover valid, trustworthy information about how nature works, about things about the natural world. But if you limit yourself to the kinds of questions that science can ask, you’re leaving out some other things that I think are also pretty important, like why are we here and what’s the meaning of life and is there a God? Those are not scientific questions. I simply would argue you need to be thoughtful when you’re asking a question—is this a faith question or a science question? As long as one keeps that distinction clearly in mind, then I don’t see a conflict.
There is, of course, a group of rather vocal people who disagree with that, people like Richard Dawkins and Christopher Hitchens. I obviously don’t agree with their perspective, but I refuse to demonize them. I think they share with me the awe of what science can teach us about nature and the joy of that discovery and the promise that has for bettering the human condition. They don’t share with me the sense that there are other valid ways of finding truth. In terms of being the director of NIH, I don’t think anybody who’s worked with me would be able to identify a circumstance where my personal beliefs about faith have in any way interfered with my role as a scientific leader.