How the NIH Decides What to Fund
Dr. Francis Collins has served as the director of the National Institutes of Health since August, 2009. He is the former director of the National Human Genome Research Institute, where he led the successful effort to complete the Human Genome Project—which mapped and sequenced all of the human DNA and determined aspects of its function. The project built the foundation upon which subsequent genetic research is being performed. He is a member of the Institute of Medicine and the National Academy of Sciences. In 2007 Collins received the Presidential Medal of Freedom, the nation's highest civilian honor, and in 2009 Pope Benedict XVI appointed him to the Pontifical Academy of Sciences.
Collins has also published several books about the intersection of science and faith, including the New York Times bestseller "The Language of God: A Scientist Presents Evidence for Belief."
Question: How does the NIH decide which medical research to fund?
Francis Collins: The process that NIH goes through to decide which research to fund is complex; there’s a lot of factors. Certainly the burden of the disease has to be one of those, but if that was all you paid attention to, rare diseases would get neglected so that can’t be the only story.
Scientific opportunity has to be a big part of it. There’s no point throwing money at a problem if nobody had any ideas about how to move the ball forward. And you can see then sometimes when a rare disease which may not affect that many people hits that moment of scientific opportunity, and oftentimes rare diseases teach you a thing about common diseases as well. So, it’s a complicated mix.
NIH depends very heavily on the scientific community to come forward with their best and brightest ideas, and they send us their grant proposals in an unsolicited way and that’s where the majority of our money goes. But we also identify areas which are ripe for exploration, where something is really starting to go great guns and we don’t want to slow that down, in fact, we want to speed it up. So in that situation, NIH would issue what’s called a "Request for Applications" saying, we think there’s opportunity here scientifically so we’re gonna set aside some money and we want people who have skills and interest in that area to come forward with some ideas and we’ll pay for the best in the group.
Question: Since becoming director, have you put a specific emphasis on addressing specific diseases?
Francis Collins: I think it’s hard to pick out individual diseases and say, "Well those are more important that the others." But I think one can look at circumstances where there are especially ripe opportunity. Cancer certainly would be on that list because we are beginning to understand cancer on a detailed molecular level, in ways that we never dreamed possible. So there’s a real potential there for moving forward in a new quantum leap into understanding.
Autism is certainly something many people are now focused on as an area of very high priority disease that affects now one in 100 kids. This seems to be more common all the time and we don’t understand it very well—a very high sort of public health significance. But many other things would also sort of fit on my list, diabetes, heart disease. Alzheimer’s disease—good heavens, when you look at the burden that is going to place on individual’s families and our economy.
It’s all a mix though, and frankly what I’ve tried to do since I became Director of NIH in August of 2009, is to identify specific areas that actually touch on multiple diseases that are ripe for investment, so I came up with a series of five themes that, if pursued vigorously, could really change the landscape, but they would really do that for lots of diseases not just a few that are specifically targeted.
Recorded September 13, 2010
Interviewed by David Hirschman
"Scientific opportunity has to be a big part of it," says Francis Collins. Sometimes when a rare disease hits that moment of scientific opportunity it can reveal things about common illnesses as well.
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- The complexities of grownup neural pathways are no match for the direct routes of young brains.
Both panoramic and detailed, this infographic manages to show both the size and distribution of world religions.
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- See how religions mix at both national and regional level.
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Melting ice is turning up bodies on Mt. Everest. This isn't as shocking as you'd think.
- Mt. Everest is the final resting place of about 200 climbers who never made it down.
- Recent glacial melting, caused by global warming, has made many of the bodies previously hidden by ice and snow visible again.
- While many bodies are quite visible and well known, others are renowned for being lost for decades.
The bodies that remain in view are often used as waypoints for the living. Some of them are well-known markers that have earned nicknames.
For instance, the image above is of "Green Boots," the unidentified corpse named for its neon footwear. Widely believed to be the body of Tsewang Paljor, the remains are well known as a guide point for passing mountaineers. Perhaps it is too well known, as the climber David Sharp died next to Green Boots while dozens of people walked past him- many presuming he was the famous corpse.
A large area below the summit has earned the discordant nickname "rainbow valley" for being filled with the bright and colorfully dressed corpses of maintainers who never made it back down. The sight of a frozen hand or foot sticking out of the snow is so common that Tshering Pandey Bhote, vice president of Nepal National Mountain Guides Association claimed: "most climbers are mentally prepared to come across such a sight."
Other bodies are famous for not having been found yet. Sandy Irvine, the partner of George Mallory, may have been one of the first two people to reach the summit of Everest a full thirty years before Edmund Hillary and Tenzing Norgay did it. Since they never made it back down, nobody knows just how close to the top they made it.
Mallory's frozen body was found by chance in the nineties without the Kodak cameras he brought up to record the climb with. It has been speculated that Irvine might have them and Kodak says they could still develop the film if the cameras turn up. Circumstantial evidence suggests that they died on the way back down from the summit, Mallory had his goggles off and a photo of his wife he said he'd put at the peak wasn't in his coat. If Irving is found with that camera, history books might need rewriting.
As Everest's glaciers melt its morbid history comes into clearer view. Will the melting cause old bodies to become new landmarks? Will Sandy Irvine be found? Only time will tell.
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