This article was contributed by Carrie L. Lucas & Alison M. Taylor.  A version of this article was originally published in the Harvard Medical School Biological and Biomedical Sciences Bulletin.

The National Institutes of Health (NIH) is America’s largest source of funding for scientific research.  However, most people, including many researchers, don’t know much about the role of the person directing the NIH.  Here, we describe how the NIH Director is chosen and what his/her role is in science and science policy.  We conclude with a profile of the current NIH Director, Dr. Francis Collins.

The NIH is a federal agency within the United States Department of Health and Human Services (now led by Kathleen Sebelius) and was established in 1887 with the founding of the Laboratory of Hygiene at the Marine Hospital in Staten Island, NY.  Today, the NIH is headquartered in Bethesda, MD and invests approximately $31 billion annually in medical research to further its mission to promote this country’s success in the “pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.”

The official description of the role of the NIH Director is that he/she, “…plays an active role in shaping the agency’s activities and outlook. With a unique and critical perspective on the whole of the NIH, the Director is responsible for providing leadership to the Institutes and for constantly identifying needs and opportunities, especially for efforts that involve multiple Institutes.”  The Director stays involved in each of the 27 NIH Institutes and Centers through regular senior staff meetings and briefing sessions with Institute directors.  He/she is also advised by the Administration (via the Department of Health and Human Services) and by Congress and has the duty to advise the President on the annual NIH budget request to Congress.

In August 1887, Joseph J. Kinyoun began as the first NIH Director, and in August 2009, Dr. Francis Collins took over as the 16th Director.  Preceding Dr. Collins as NIH Director was Dr. Elias Zerhouni (2002-2008), Dr. Harold Varmus (1993-1999; the only Director with a Nobel Prize), and Dr. Bernadine Healy (1991-1993; the only female Director).  After Dr. Zerhouni’s resignation in October of 2008, Dr. Raynard Kington (deputy director of the NIH at that time) served as interim Director until Dr. Collins was sworn in on August 17, 2009.  All 16 NIH Directors have been scientists with medical degrees.

To become Director of the NIH, one must be nominated by the President of the United States and be confirmed by the US Senate.  He or she must have demonstrated skill in administration and communication as well as exceptional scientific capacities.  The ability to communicate the needs of biomedical research scientists to politicians and the public is a daunting task but one that must be mastered by the Director of the NIH.  The Director also must determine which research directions will advance our knowledge in ways that will best meet the health needs of our country.  As an example of ways in which the NIH Director can influence research trends, the former NIH Director Dr. Zerhouni started the NIH Roadmap for Medical Research in 2004 to promote high-risk and broad-scoped projects that necessitate spanning multiple areas of research.  Currently, components of the NIH Roadmap include multi-institute studies on epigenomics of human health and disease, the human microbiome project, and expansion of molecular probe libraries for high-throughput screening assays.  Other examples of incentives provided by the NIH Director for innovative, high-risk, and unconventional research endeavors include several types of grants that can be awarded to scientists to fund their studies.

For just over three months now, Dr. Francis Collins, a prominent geneticist, has been directing the NIH.  Collins grew up on a farm in Virginia, and upon graduating high school was primarily interested in chemistry and physical sciences.  He studied chemistry as an undergraduate at the University of Virginia, and went to Yale for a PhD.  However, early in his graduate career, Collins took a biochemistry class that made him realize that he wanted to focus his energy on biology and medicine.  Collins completed his PhD in Physical Chemistry before taking classes in medical genetics as a medical student at the University of North Carolina.  After residency at Chapel Hill and a fellowship in human genetics at Yale, Collins entered the tenure track at the University of Michigan in 1984. The focus of his research was developing what he termed “positional cloning,” or mapping the gene responsible for a certain phenotype.  By 1990, positional cloning allowed Collins and collaborators to identify the gene mutation responsible for cystic fibrosis, as well as that for neurofibromatosis. After several more years and much collaboration, Collins’ lab also identified the Huntington gene, which in mutant form is responsible for Huntington’s disease.  Collins received many accolades for his work, including induction into the National Academy of Sciences.

In 1993, Collins was invited to succeed James Watson as director of the National Center for Human Genome Research (now the National Human Genome Research Institute, NHGRI) at the NIH.  Collins oversaw the Human Genome Project and gained the reputation of a good manager and leader as this project was successful, under budget, and ahead of schedule.  In this role, Collins was regularly interviewed to explain the importance of genome sequencing to the public.  As NHGRI director, Collins maintained his own lab which was focused on the molecular genetics of cancer and diabetes.  In 2008, he resigned but stayed on as a “special volunteer,” giving his students and post-docs a chance to finish up their research.  A year later, President Obama appointed him to be the Director of the NIH.  With his leadership and communication experience at the NHGRI, he was approved by unanimous vote in the US Senate.

During his time as NHGRI director, Collins also enjoyed performing with his colleagues in an impromptu rock band called “The Directors”, in which he sang and played guitar.  He also became known for commenting on science and religion, writing a book called The Language of God: A Scientist Presents Evidence for Belief (2006).  He established the BioLogos Foundation in 2007 to promote harmony of science and religion and reach out to Christian schools and home schools to introduce and promote accurate science education that is compatible with their religious beliefs.  Since his appointment as NIH Director, Collins appeared on the Colbert show (for a second time) and discussed the future of personalized medicine, a topic on which his second book called The Language of Life: DNA and the Revolution in Personalized Medicine (2010) was written.

Dr. Collins has received much support from former directors, leaders of science advocacy groups, and the scientific community for his appointment as NIH Director.  At this point, it seems that his biggest challenge as Director will be to manage the budget drop that will occur in 2011 when $10 billion in stimulus funding will expire.  Collins has admitted that, “This is the [issue] that wakes me up in the middle of the night.”

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