Francis Collins, former NIH Director for Science and God

Francis Collins' reputation precedes him: he is a scientist of science, having earned a PhD in physical chemistry before studying medicine and then becoming a molecular biologist. He led the Human Genome Project and then served as director of the National Institutes of Health for 12 years. When he stepped down in 2021, he became President Biden's science adviser.

But Collins is also one of the most open Christians in modern intellectual circles. He became a Christian at the age of 27 after a two-year journey through the world's religions led him to believe that this was the only thing that could explain both the big questions of life and the Big Bang.

“A lot of people said, 'Your head is going to explode because you're a scientist who has studied DNA. This is just not going to work,'” he told reporters at an event in Wellesley, Massachusetts, in early September. “I don't stand on anything when it comes to science: You better show me your data or I won't accept your conclusions. But I'm also a person of faith who considers that foundation a really crucial part of who I am, and who I think might be able to reach out to those people of faith and say, 'I'm one of you too,' that science is not your enemy and that we can achieve these things together.”

In a new book out Tuesday, Collins seeks to address a problem he says has been exacerbated by the Covid-19 pandemic: “Not only are we a hyper-partisan society, but we are also deeply cynical and distrustful of traditional sources of knowledge and wisdom,” he said. “I felt that if I had any credibility as a scientist, as someone who had the chance to be at the helm of the NIH and previously at the Genome Project, I just had to do something.”

Collins talked about everything from how he found a video of himself in the methods section of a scientific study to what the NIH might do under another Trump administration.

This conversation has been edited for length and clarity.

On his decision to bring religion into the scientific discussion in America:

I didn't grow up with a religious outlook, but when I was in medical school and faced deeper questions like “Why am I here? And what happens after death? And is there a God?” and watched people struggle with the progression of their diseases and their likely inability to survive, I realized I hadn't given it much thought.

So I struggled to reinforce the atheism I was at that point, and surprised myself when I realized that it was the least rational of the options… I've never encountered a conflict that wasn't pretty easily resolved by making sure you knew what kind of question you were asking and what tools you were using to answer it. When it comes to nature, hey, use the tools of science. When it comes to more transcendental things, like “why is there something rather than nothing? Why am I here?” – science doesn't help me much.

The fact that 60 to 70 percent of Americans actually believe in God cannot be ignored, because many of the foundations of faith point us to solutions to the current divisions. Love of neighbor – my goodness. Read the Sermon on the Mount. It says to “love your enemies.” We don't do that very well. If we could move away from the political messages, which are often full of venom and bile, and instead go back to the foundations of faith, which are much more about coming together and understanding each other – “Come, let us reason together” – maybe we would actually have a better chance of finding solutions.

On the question of whether he has succeeded in convincing anyone who uses their faith as a weapon against science:

There was an interesting study published in PNAS – but I didn't even know they were doing this – where they showed a video of people who couldn't decide whether to get vaccinated or not. The video and the different people were explaining the science and why it was safe and effective. And they randomly divided the group into two groups, and one of them was shown the video and an additional clip of me saying, “Yes, I think this is safe and good for you. By the way, I'm a person of faith. If you're worried about this, believe me, I agree with you. But I think this is something that's consistent with your faith tradition.”

And when they looked at what differences there were in the decision to get vaccinated, it showed that the group that had seen the additional clip claiming that this was actually consistent with Christian beliefs were significantly more likely to get vaccinated. I didn't know about this study, I didn't know that I was actually being used in this way, but it's interesting data in terms of what it says about what people need in order to trust information.

When asked if his cancer diagnosis and treatment had taught him anything new about the health care system:

Yes, it's different when you're on the other side. One thing was that I have prostate cancer, and it was a pretty aggressive form. But I've been under observation for five years. [for] It seemed like a form of prostate cancer that didn't require much other than monitoring. But then the disease took a turn and required more than that.

What I learned from that experience is that we've made a lot of progress in the last decade in detecting and treating this cancer. But our health care system hasn't necessarily figured that out yet. I was treated at the NIH. I was part of a clinical protocol so we could learn as much as we could. There are imaging techniques today that are much more sophisticated than there were ten years ago, and they allow you to very accurately identify whether or not intervention is needed. And a lot of the health care system hasn't figured that out yet.

How the NIH might fare under a possible new Trump administration:

Well, I'm pretty worried about what might happen next. We were really lucky that between 2015 and 2022, the NIH had a stable, predictable inflation curve of a few percent more year after year, which allowed it to try new things and provide more certainty to people who were worried about whether or not they could continue. And that was really a testament to Congress. It's really important that the government supports science, but it's Congress that really decides what the budget is.

What matters is who ends up leading these efforts in the House and the Senate. And interestingly, when you look back, while people tend to think, “Well, the Democrats are more pro-science than the Republicans,” that's not how it played out in terms of funding. We were generally more successful at NIH when Republicans controlled the Senate. So if you're worried about the election, it's not just about the president, folks. It's about what happens in Congress that's going to have a big impact on how NIH performs.

I'm concerned that there have been many attacks against the NIH, many of them based on political views on what's happening with Covid and particularly attacks on Tony Fauci. And it's just deeply unfortunate that this is somehow getting to a point where it's leading to this kind of hostility. And certainly Congress has been a great supporter of medical research as a bipartisan issue for many decades. I hope we can get back to where this is seen as one of the great functions of government and has been incredibly successful. And let's not make this a political football.

On the question of how we pay for the increasingly expensive drugs that the NIH – and thus taxpayers – were involved in developing:

We have been talking about this for decades: what is the right balance between government investment in basic research and handing that investment over to the private sector because the government is not going to make drugs, and delivering the most cost-effective benefit to the public?

I don't have any easy solutions to this, but I don't think the solution is really to try to get the NIH more involved in managing the follow-on costs. We tried that; there was an effort about 30 years ago with contracts that were supposed to be signed between the intramural program at NIH entities, called CRADAs. [Cooperative Research and Development Agreements]to introduce a clause on reasonable prices. Do you remember that?

So basically the company would have to agree that if this CRADA actually led to something that was on the way, [to being a] product that they were limited at that point in terms of the price they could charge. That collaboration was immediately stopped. I mean, it was stunning. Everything collapsed – no company was interested in participating in that kind of limited collaboration. And that was clearly not a good outcome.

Apparently, the Inflation Reduction Act was an attempt to reduce the costs of expensive medicines so that [was] by industry as quite threatening. But as far as the idea of ​​getting the NIH to be part of the solution, I'm skeptical that that can work, and I'm sure that the Bayh-Dole Act, unless you want to change it, just makes a lot of the things that people are proposing not legal, based on the fact that the intellectual property rights go to the beneficiary institution and the NIH no longer owns them.