Francis Collins’ reputation precedes him: A scientist’s scientist, he obtained a Ph.D. in physical chemistry before going to medical school and subsequently becoming a molecular biologist. He led the Human Genome Project, then directed 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 outspoken Christians in modern intellectual circles, having become one at age 27 after a two-year journey through the world’s religions convinced him that it was the only thing that could make sense out of both life’s big questions and the Big Bang.
“A lot of people said, ‘Your head’s going to explode because you’re a scientist who has studied DNA. This is just not going to work,’” he told journalists at an event in Wellesley, Mass. in early September. “I’m unapologetic about the fact that when it comes to science, you’d better show me your data or I will not accept your conclusions, but I’m also a person of faith who sees that foundation as a really critical part of who I am, and who I think is in a position, perhaps, to try to reach out to those people of faith and say, ‘I’m one of you, too,’ that science is not your enemy, that we can do these things together.”
In a new book out this past Tuesday, Collins attempts to address an issue he saw accelerating because of the Covid-19 pandemic: “We’re not just a hyper-partisan society, but we’re deeply cynical, distrustful of traditional sources of knowledge and wisdom,” he said. “I felt maybe if I have some credibility as a scientist, as somebody who’s had the chance to stand at the helm of the NIH, and previously at the genome project, I just have to do something.”
Collins talked about everything from how he found a video of himself in the methods section of a scientific study, to how the NIH might fare under another Trump administration.
This conversation has been edited for length and clarity.
On why he decided to bring religion to the discussion of science in America:
I did not grow up with any kind of religious perspective. But in medical school, encountering some of those deeper questions like “Why am I here? And what happens after you die? And is there a God?” and watching people struggling with the advances of their illnesses and their likely inability to survive, I realized I hadn’t given this a whole lot of thought.
I engaged, therefore, in an effort to try to strengthen my atheism, which is what I was at that point, and surprised myself by discovering that it was the least rational of the options…I have never found a conflict that was not fairly readily resolvable by making sure what kind of question you’re asking and what tools are you using to answer it. If it’s about nature, hey, use the tools of science. If it’s about more transcendental things, like “Why is there something instead of nothing? Why am I here?” — science doesn’t help me very much.
Then the fact that 60 to 70% of Americans are in fact believers in God can’t be ignored because a lot of the foundations of faith are pointing us towards solutions to the current divisiveness. Loving your neighbor — my goodness. Read the Sermon on the Mount. He goes all the way to “love your enemies.” We aren’t doing so well with that. If we could step away from the political messages, which are oftentimes full of venom and go back instead to those faith foundations which are much more about getting together and understanding each other — “Come, let us reason together” — we might actually have a bigger chance of solutions.
On whether he’s been able to convince anyone who’s weaponized faith against science:
There was an interesting study published in PNAS — but I didn’t even know they were doing this — where they had a video that was made to show people who were trying to decide about vaccination or not. And the video and the variety of individuals explaining the science and why this was something that was safe and effective. And they divided the group into two, randomized, and one of them, they showed that video plus an extra clip of me saying, “Yes, I think this is something that’s safe and good for you. By the way, I’m a person of faith. If that is something you’re worried about, believe me, I’m right with you on that. But I do think this is something that is consistent with your faith tradition.”
And when they looked to see what was the difference in who decided to go ahead with vaccination, the group that saw the extra clip with the assertion that this is actually consistent with Christian faith, had a significantly higher likelihood of getting vaccinated. I didn’t know about that study, I didn’t know I was actually being utilized in that way, but it is an interesting bit of data in terms of what it tells you about what it takes for people to trust in information.
On whether his cancer diagnosis and treatment revealed anything new to him about the health care system:
Yeah, it is different when you’re on the other side. One thing was the cancer I have is prostate cancer, and it was a pretty aggressive form. But I’ve been followed for five years [for] what appeared to be the kind of prostate cancer that is not requiring much except surveillance. But then it made a turn and required more than that.
I learned from that experience that we’ve come a long way in how to detect and respond to this cancer in the last ten years. But our health care system hasn’t necessarily figured that out. My care was at NIH. I was part of a clinical protocol so that we could learn as much as possible. There’s imaging capabilities now that are so much more sophisticated than they were a decade ago, and that give you the chance to be very precise in knowing whether this is something that needs an intervention or not. And a lot of the health care system hasn’t figured that out.
On how the NIH might fare under a potential new Trump administration:
Well, I worry quite a bit about the path that might be coming next. We were really fortunate that NIH, between 2015 and 2022, had a stable, predictable trajectory year after year of inflation plus a couple of percent, which made it possible to try new things and to provide more comfort to people who were worried about whether they were going to be able to keep going or not. And that was a testimony really to the Congress. It’s really important that the administration supports science, but it’s the Congress who really decides what the budget is.
What matters is who ends up leading this effort in the House and the Senate. And interestingly, if you look back over time, although people tend to think, “Oh well, the Democrats are more pro-science than the Republicans,” that’s not the way it has worked in terms of the funding. We have generally at NIH done better with Republicans in charge of the Senate. So if you’re concerned about the election, it’s not just about the president, folks. It’s about what happens in the Congress that will have a big impact on how NIH fares.
I am worried that there have been a lot of attacks levied against NIH, many of them based upon political attitudes about what happened with Covid and particularly attacks on Tony Fauci. And this is just deeply unfortunate that this would somehow get in a place where it results in this kind of animosity. And certainly Congress over many decades has been a big supporter of medical research as a nonpartisan thing. I hope we can get back to that same place where this is considered to be one of the great things the government does and has been incredibly successful. And let’s not turn that one into a political football.
On how we pay for increasingly expensive drugs that the NIH — and thus taxpayers — have had a hand in developing:
We’ve been talking about this for decades — what is the right balance of making government investments in basic science and then having those handed off to the private sector because the government is not going to make pills, and have that benefit the public at the most reasonable cost?
I don’t have easy solutions to this, but I don’t think the solution really is to try to get the NIH more engaged in trying to manage the downstream cost. We tried that; some 30 years ago, there was an effort, with contracts that were going to be put between the intramural program at NIH companies so-called CRADAs [Cooperative Research and Development Agreements], to put in a reasonable pricing clause. Remember that?
So basically, the company would have to agree that if that CRADA actually led to something that was on the path [to being a] product, that they were constrained at that point in terms of what kind of price they could charge. Those collaborations immediately ceased. I mean, it was breathtaking. Everything fell off a cliff — no company was interested in taking part in that kind of constrained, collaborative effort. And that clearly was not a good outcome.
Obviously the Inflation Reduction Act sought an approach to try to weigh in on the expensive drugs in a way that [was] received as pretty threatening by industry. But as far as getting NIH to become part of the solution, I am skeptical about whether that can work and certainly think the Bayh-Dole Act, unless you want to go ahead and change it, makes a lot of the things that people propose simply not legal based upon the fact that the intellectual property rights go to the grantee institution, and NIH no longer owns them.