Francis Collins on diversity, politics, and his legacy

As he prepared to step down as director of the US National Institutes of Health, Francis Collins was feted by some of the US’s highest-profile politicians, scientists, and musicians.

A farewell video produced by the NIH included send-offs from four US presidents, dozens of scientists, and a multitude of other famous figures he’d encountered during his tenure at the NIH, such as comedian Stephen Colbert, musicians Yo-Yo Ma and Barbra Streisand, and historian Henry Louis Gates Jr. “It was astounding,” Collins told C&EN Dec. 17, 2021.

But while it’s nice to be recognized, Collins’s real legacy will be in the status of the agency he led for 12 years. That is the longest tenure of any NIH director since the position became presidentially appointed in 1971. The NIH consists of 27 institutes and centers that support health research. It employs scientists inside the agency and funds scientists at research centers throughout the US and world.

In the realm of US federal agencies, the NIH has become a favorite of politicians. That is in large part thanks to Collins, who has a physical chemistry PhD and became director after serving as head of the National Human Genome Research Institute beginning in 1993. When he first became director in 2009, the NIH was in the middle of budget stagnation that lasted more than a decade. But the budget has increased from $30.5 billion in 2009 to $41.7 billion in 2020, a 36% increase during Collins’s tenure. “A lot of heroes in the Congress made that happen, in both parties and in both houses” of Congress, Collins says.

Collins says he is proud that the NIH committed much of that funding to supporting individual investigators, especially early-career scientists. “I’ve worked really hard to try to provide a more welcoming on-ramp to those individuals, and particularly individuals of diverse backgrounds,” says Collins, who will continue working at the NIH in his research lab.

When he started, only 18% of individuals who applied for NIH R01 grants received them. That success rate was especially hard on young scientists, many of whom were forced out of science when they could not get funding. “They weren’t going to come back,” Collins says. “That was a really, really troubling situation.”

While NIH grants are still hard to get—the grant success rate was 21% in 2020—the agency has created programs to support early-career scientists, defined by the NIH as those within 10 years of getting their doctoral degree. The NIH prioritizes those scientists for funding in the review process.

In 2015, the NIH funded 600 early­career investigators, according to Collins. In 2022, that number was over 1,400. “This is actually a pretty good time to be somebody just starting out,” Collins says. “We want to get them started and get them in a place where they can pursue their dreams and flourish.”

Collins also wanted to improve racial diversity, both of NIH staff and of the larger community of grant recipients. “When I first came to be director and started asking about [diversity programs], I realized most of the answers were anecdotes” rather than data, he says. “That was a sign that most of these were not successful.”

So he brought in an advisory group to help him design a new plan. One of the group’s major recommendations was hiring a chief officer for scientific workforce diversity. That person’s “entire focus would be on how we could do these things more effectively and more rigorously, and not just be satisfied with things that sounded good,” Collins says. He created that position in 2014.

For internal investigators, the NIH created a program to hire at the same time cohorts of scientists who reflect more racial and gender diversity so they could support one another. And it has helped, Collins says. “If you look at the diversity of our workforce now compared to 2015, we’re a long way from where we need to be, but the slope of the curve, which had been pretty flat, is now on the upward trajectory,” he says.

Because of that success, in 2020 the agency decided to offer something similar for its grantee institutions, which would split the cost of simultaneously hiring a group of diverse faculty. “We got deluged with applications,” Collins says. “The interest is out there. The model should work.”

In the wake of and national protests in 2020 against anti-Black racism, the NIH also launched a program to directly confront structural racism in research. Collins hopes the program, called Unite, can improve racial diversity at the NIH for the long term. “We’re dealing with 400 years of structural racism, and that has affected every institution in our country, including the NIH,” Collins says. “To turn that around is going to take a willingness to be creative and to make some mistakes and to admit those when they happen, and then come up with something better. That’s what we’re going to do.” Currently, around 2% of NIH R01 grantees are Black and 5% are Hispanic/Latino, according to the agency’s website.

A big part of confronting structural racism in research means dealing with ongoing discrimination and harassment, he says. It also means taking a hard look at funded science, especially research on health disparities. “Are we really doing enough not just to catalog all of the factors involved in health disparities but actually to mount pilot efforts for interventions to see how to change this?” Collins asks. “We don’t need to publish a lot more academic papers that say the same thing. We need to do actual interventions that are going to have some impact.”

Collins says that addressing diversity is one area where he wishes he had made more progress. “If you just look at the actual current numbers of representation of African Americans and Hispanics in our workforce, it’s way short of what it needs to be. So I have not accomplished that,” he says. “I will argue I’ve tried to come up with a means to get there.”

Recently, Asian scientists have said they are concerned about being targeted by the federal government for scrutiny because of their race and background. The fear is especially high among those who collaborate with scientists in China. The research community had encouraged collaborations with scientists in China until about 5 years ago, when the federal government started to look at Chinese funding of scientists more closely. But when the NIH found out about grantees who had not disclosed international research funding or had diverted grant money for their personal use, the NIH felt that it had to act, Collins says. The agency did not target Asian scientists, he says. But often those who did not disclose were scientists who participated in Chinese talent-recruitment programs. Those programs often sought out scientists of Chinese descent, and Chinese officials told participants not to disclose the affiliations or funding.

“But I am deeply concerned that this seemed to look like sort of a xenophobic approach to the scientific community, which would be a disaster and completely unsupportable,” Collins says. The US depends on international scientists who come to the NIH and its grantee institutions—and sometimes go on to win Nobel Prizes, he says.

Transparency about why NIH identified for scrutiny or sanctioned individual scientists is key to reassuring people that the process is fair, he says. Asian scientists are “an incredible part of our brain trust, and anything I’ve been able to do to try to reassure people, I hope this helped.”

Transparency was also key to an initiative Collins points to as a success: improving the way the NIH deals with sexual harassment and other misconduct. For internal researchers, the agency created a clearer reporting system for harassment. “If you look at our intramural program and talk to the women involved, they would say it’s a different atmosphere,” he says.

Among its grantee institutions, “we don’t have the same levers out there, because those are not our employees,” Collins says. But the NIH has created requirements that universities report to the agency when a principal investigator has been found guilty of harassment. From 2018 to 2021, the NIH has removed 75 researchers from grants because of sexual harassment or other hostile-workplace claims, the agency reported in 2021.

To show his support for women scientists, in 2019 Collins declared he would no longer speak on all-male panels, sometimes called “manels.” “A lot of women were getting overlooked,” he says, and he thinks that his stand caused more people to rethink who they invited to appear.

“It’s been impressive to see how that had ripples,” Collins says. “A lot of other folks decided, ‘I should probably take the same stance.’ ”

Looking back at his tenure as NIH director, Collins says that much of the financial and political success of the agency has come from his willingness to engage with almost anyone who asked. Collins estimates he’s had 1,000 meetings with members of Congress.

“They have to trust you to tell them what’s going well, what’s not going well, to be straightforward and answer questions,” Collins says. “To develop that kind of personal relationship, that can really lead to a confidence that this is an institution that they can believe in.”

Not every scientist is in such a high-profile position, Collins says. “I have been fortunate to be in this unique role as the director of the NIH.”