NIH's Collins Explains Why NCRR Must Go
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In what he admits has been his most controversial move as National Institutes of Health director, Francis Collins today explained his decision last month to create a new translational research institute partly by dismantling an existing NIH center. As ScienceInsider reported earlier this week, the plan has generated more than 1100 comments. Many are from researchers concerned about what will happen to their programs at the
Collins says he couldn't consult earlier with the community because of legal requirements. He had to first notify Health and Human Services Secretary (
Q: What do the letters to Congress say?
F.C.: That there is a proposal to create a new entity at NIH, the National Center for Advancing Translational Sciences (NCATS), and also a proposal to take the existing programs within the [NCRR] and distribute them around to other parts of NIH.
Q: So you're going to no longer have an NCRR?
F.C.: That's right.
Q: As you know, people feel like this decision [to dismantle NCRR] has been pushed through without much consultation. And you told me that you sent the recommendation on before collecting feedback. What's up with that?
F.C.: First of all, the SMRB [Scientific Management Review Board, an NIH advisory board] meeting in public for some 6 or 7 months talking about the creation of the new center for translation, certainly there was no secret about what this was about. Including the fact that ultimately they took a vote and approved it in a public session. ...
As far as the NCRR implications, the SMRB did not get engaged at any level of detail in considering that other than, of course, they recommended that the CTSAs [Clinical and Translational Science Awards], the largest program within NCRR, should move into the new center.
In terms of other aspects of NCRR, here is where we have in fact had our hands tied by statutory limitations. We are not allowed, and it's very clear in the law, to seek public comment or make public announcements about a change in the organization of the NIH until the congressional notification has gone forward. ...
Those letters only went out 1 week ago, Jan. 14. And at that point, we became able to begin to seek public consultation about the plan.
And NIH Deputy Director, Dr. Larry Tabak has been on three conference calls this week with hundreds of people together absorbing that input, I think, very effectively.
And again, in terms of what we're planning to do with NCRR, the programs, that it's very much a work in progress. This is not like we have it all figured out.
Q: It's not making sense to me that you cannot consult on it until you've notified Congress, but that means you've made the decision without consulting with the community first.
F.C.: Well, this is the government, remember. It is very clear in the legislation that we can't actually make announcements or seek public input until Congress has been notified.
I grant you, that is a somewhat unfortunate circumstance. In my best of all worlds, I would have wanted to have the chance to have a lot more discussion about this before that kind of announcement.
Q: It seems like even after the conference calls, nobody seems to be happy with what's happening, or very few people.
F.C.: Well, people are always shaken up by change, especially when it seems to be happening quickly. I understand that programs will continue. The people who run them will continue to be running them. The idea is to try to seek out adjacencies that will make those programs even more successful.
Q: Could you explain this "interim infrastructure unit" [a unit in the NIH director's office where many NCRR programs would be placed]?
F.C.: There are some programs within NCRR where the exact best answer for where they should be located is going to be difficult to arrive at in a short period of time. And hence the idea of creating this interim unit for such programs to reside in until it becomes easier to determine what the right answer is.
Q: Could that interim unit become a permanent part of the director's office?
F.C.: It is possible there might be a very short list of programs that ultimately make the most sense being in what we call DPCPSI [a division within the director's office]. The expectation is that the vast majority of NCRR programs will land in other institutes or centers, a lot of them in the National Institute for General Medical Sciences (NIGMS) because the familiarity and the similarity there between NIGMS and NCRR has always been fairly tight.
Q: Some people seem to think you need to keep all these things together. Why not just keep them within a smaller NCRR?
F.C.: I think you would tend to have gotten awfully small and maybe not even to the point of making a lot of sense. You begin to wonder why have we created that kind of administration support structure for such a small number of programs.
Q: But if you kept them all together [except for the CTSAs], it wouldn't be that small.
F.C.: I think even if the CTSAs were not driving this process, you could make a strong argument. For instance, the RCMI [a resource program for minority institutions] would belong more appropriately in the National Institute on Minority Health and Health Disparities than it does in NCRR.
Q: Are you also bound by the law limiting NIH to 27 institutes and centers?
F.C.: That has not been a factor in my own thinking, to be honest. I know some people somehow assume that that's driving this process. I mean, obviously by next year when the alcohol and drug abuse institutes get merged, that will no longer be an issue.
But I really think this is being driven by scientific opportunity and not by those kinds of numerical limits.
Q: You said last month that you thought you might be able to get some special permission from Congress to have 28 institutes for 1 year.
F.C.: And I didn't even ask, because I don't think it's the right thing to do.
Q: What's the timetable for all this?
F.C.: We need to present the straw model to the SMRB, which is going to be on February 23. There is within NIH a plan to have final recommendations about how to restructure by the end of February.
Q: Would you agree that creating this new institute and breaking up a new institute is the most controversial thing you've done yet as NIH director?
F.C.: I guess I would agree with that. I mean, I will not be apologetic for wanting to see the scientific opportunities that relate to translation approached in a very bold way. I think that the NIH director is called upon to look for scientific opportunities that aren't being met and to figure out how to make them happen, and that sometimes requires moving things forward at a rapid pace, and that affects a lot of people.
And of course change is always distressing, especially if people aren't quite sure where it's going. So I understand the anxiety that currently exists. But let's wait a year and see when this has all taken shape how people feel at that point. Will they say at that point that projects or programs at NCRR got dealt a bad deal? I bet they won't. Will they say they're excited about the translational science opportunities that are taking shape in the form of this new center? I bet they will.
You know, if I were trying to do this 5 years ago, it would have been too soon. If I had waited until 5 years from now, it would have been too late.