dr. collins, you have been director now for about five months. what are some of your priorities? >> it is a great time for biomedical research. . .

then we have a chance to apply ericsson's not only to problems within our own country budget to apply our science normally to problems with their own country -- then we have a chance to apply our signs not only to problems within our own country, but around the world. we are anxious to step up the plate and provide that kind of evidence. >> could you be more specific about how uc nih fitting into the health-care debate? -- how you see nih fitting into the health-care debate? >> when you have a circumstance when there are more than one alternative, how do we know which one is the right one for that person?

that takes research, carefully designed research, and we do not have enough of that. oftentimes, it is sort of a good guess. physicians and patients tried to muddle along. wouldn't it be great if we just knew the answer? >> you are getting $400 million from the recovery act. talk to me about how you structure competitive effectiveness impersonalize medicine where you can target cell populations and genes might be susceptible to particular diseases. how does comparative effectiveness not interfere with

personalized medicine? >> something that there is a conflict between comparative effectiveness and person was medicine. you get the best of both. for someone who is already showing early signs of onset diabetes, there was a study done a few years ago by nih where diet and exercise is more effective than medical therapy. at the present time, we are going back to look and see if that was true for all of those people who were address for diabetes or their other factors that may difference where the diet and exercise approach worked better. all of that was based on personal affirmation, from

family history. that is the next level of sophistication that cannot be applied to effectiveness. we need to be sure that we are factoring personal. >> the funding was limited for pancreatic research into diabetes. it is different from what harvard allowed the new use for. these are referred to as gold standards in the field. can you talk about your thinking in limiting them? >> from december 2, i approved both team lines from boston children's and some from

rockefeller. they have no restrictions for what applications can be applied. the advisory committee that looks over stem cell lines, to see if they live up to the guidelines issued back in july by obama's executive order, caller: and the consent form wat these lines [unintelligible] there was the idea for how of the pancreas develops and helps in terms of diabetes. it was recommended to me that these lines be approved, but that they be restricted on circumstances that would fit. after considering recommendations, i had to agree. that is the reason for the

stipulation. these lines have been a novelized. -- have been anonymized. because this is such a visible area, there are so many justifiable level concerns, i felt that this was a circumstance where we should honor the original consent. >> we're hearing from stem cell researchers who are wondering how many more of these lines are going to get approved or not. can you say anything about your expectations for more lines being approved? >> there are more than 100 in the pipeline. if they were derived any fashion that is concordant with the nih guidelines in july, it can be done rather quickly through the

it ministration process. if there were derived some time ago, there needs to be more careful review by experts. but there will be more coming along regularly. some may be within the next month or two months. after all, we now have these 40 lines letter up on the registry and are available. 27 have restrictions and 13 are out. >> are there more in the minister pipeline? >> there are some in the administrative -- >> are there more in the administrative pipeline? >> there are some in the administrative pipeline. some look pretty promising. nih has to depend upon those who derive the stem cell lines to send in the documents. we can do anything until we have the material to look at.

if there are some of their they're taking their time, we hope that they will react. -- that they will hurry up. >> what is your response to those who say that embryonic stem cells are more important? >> [unintelligible] it is clear that they are not the same as the embryonic stem cell lines. last week, when i can meet all of the institute directors, we spent a day on it and we had experts the came and talked about a embryonic stem cells and the excitement in the room was

palpable. it was clear that ips cells are just as potent as the embryonic stem cells. they're still the gold standard. >> how would you characterize your perch to stem cell research as opposed to the approach that thof the bush and administratio. >> president bush has the credit of being the first president to do the approval for the research. but the science has moved on. what president obama decided to do in march was to say that we're also know when to put forward guidelines to allow stem cell lines that have been dropped since then and for lines

that are derived in the future. in and of the circumstances are federal funds being used to actually derive the stem cell lines from the original embryo. that is off the table. that is the duty weaker amendment. -- that is the dicky wicker amendment. as the science has gone for, more lines have become available. we want to understand how this can be applied ultimately to treat diseases, like spinal cord injuries, like diabetes, like heart disease. we need more people were keen on the problem. this promotes -- we need more people working on the problem. this promotes that in a very positive way. >> in the late 1990's, we saw

[unintelligible] earlier this year, with some $4 billion come to the nih from the stimulus package. can you talk about this trend of acceleration and deceleration? >> after five years of flat funding, from 2003 to 2008, the biomedical research committee struggled to maintain momentum. after all, inflation has been eating away at the buying power. grants have dropped by 15%. people are having a hard time keeping their labs going and really and good ideas were

going. obviously, the recovery of dollars committee released under for a moment. the devore -- the age of opportunity sidley appeared. a challenge grant was. that's a possibility for people to apply to. finally get 40045000 of the publications. weho 41,000 -- we'v usually get 4000 or 5000 of these applications. we got 41,000. there were breathtaking in their scope and their breath. we were only able to fund 4%.

hopefully, next year, some of these will come back. what are we going to be a will to do to help them? the recovery act money, understandable because it is there to support the economy, lasts for two years. then the big question is what about fiscal year 2011? nobody quite knows what it will be it is surly possible, barring any major change in the economy, that there could be success rates that will fall even further. maybe that is not the way to make this case. the public wants to know that science can be done. what would you do if you have a little more versus a little bit less. we could push the agenda faster on cancer and diabetes.

we could go faster in developing treatments for things they have no interest for in the private sector. we could do more in comparative effectiveness research. but all of that is going to be indexed by wood as possible in 2011. thank you for asking and i hope people are listening. it comes at a tough time in terms of our economy. >> is that not the kind of demand the guy is so many applications -- that the guy you so many occasions? if you get so many grants, does that not say something about to revamp the regular grant-making

process? you're the boss. you think about that? >> clearly, when money gets tight, the cred process does tend toward conservatism. if you have wonderful scientific proposals in front of you, do you put your money in establish investigators who have exciting proposals but maybe not that groundbreaking vs loss one from here, from an investigator you have never really heard of and an idea that may sound a little wacky? wackiness gets down to 80 bid. oftentimes, that is where the big excitement and ultimately comes from. we have to encourage those high- risk, but high reward applications. there is a new grant type that only allows for those kinds of proposals.

things that the transformative are onero1. all of those require innovation, otherwise you connected to the review process. frankly, all of this is much tougher. if we had a stable trajectory of the biomedical research as opposed to the feast or famine, which is so difficult for investigators to live with, then i do think we come up with a position to design a process that would encourage high-risk investigators. >> the push to have for translation, researching the innovations out, this 30 years

for the right to license and innovation. why is there still a push for transition research now? is it time to revamp that acted? are there other things you should be doing? i think the fact is one thing. i think the scientific work is another. [unintelligible] what can make that happen is when n.h. supports the -- when nih supports the project, including four high frequent screening -- including higher frequent screening and libraries. there are four centers around

the country that have capacity. they are available to academic investigators who just after writing a proposal that shows why this is a good news for the centers capabilities. it's we offer the chance for some compounds to go further down the road into the pre- clinical stage and ultimately to clinical trials. it is an idea whose time has come. nih should be doing more with [unintelligible] maybe we did not have the tools a few years ago. but now we do. but this is not intended to make nih a substitute for the private sector, but rather to work in partnership. nih can de-risk these and the

early stages. and then hand them off. >> the nih focus is supposed to be basic research. >> the focus is supposed to be basic research and exploring that basic research to discover the applications that will benefit human health. we are unapologetic about those parts. we're the national institutes of health. to the extent that we have the opportunity to push that agenda , in partnership with the private sector, making it more of foss hilfacile, then we are r jobs. >> error guest is dr. francis collins, director of the

national institutes of health. he is a graduate of yale, of the university of north carolina where he got his medical degree and the university of virginia where he got his undergraduate degree. he was former director of the nih national human genome research institute. you were home schooled up until the sixth grade. earlier this year, you founded in institute for religion and science. >> a foundation. >> is there a concern that your named the director of nih when you are an evangelical christian? >> there are concerns that perhaps is scientists who also happens to have talked openly

about his religious faith but somehow not be as hard-nosed at making decisions about scientific projects as he should be. anybody who worked with me at the human genome project would have stood up and said that this is not an issue. no one can say that my own particular interest in spiritual matters ever gone the way of signs. i do not want to be distracted in any way from what the president has asked me to do. >> we have time for one more round of questions. >> can you say a little bit about the flap could you got about a that? why should the suns community care whether you are a boost

toward hindu -- why should the science community care for the your a buddhist or hindu or whatever? >> i am not this bazaar out liar. the difference is that i have actually talked about it and it made some people uneasy. frankly, it is kind of unfortunate that we have such a polarized circumstance between the scientific material and the spiritual world view. it is as if they somehow must be at war with each other. many in the sent to the committee will argue that they need to renounce interest in spiritual matters because they may be a little soft in the head. i do not think there is a rational basis for that claim. having once been an atheist myself and having faced a

rational argument that atheism is the least viable arguments. it is a bulldog with to adopt. -- it is a bit of dogma to adopt. fundamentalism refuses to look at things from science, like the age of the earth, without the need to rebel against them. we are to ultimately want to lead to have the opportunity to find middle ground that expresses the potential harmony between science and the spirit. i find that satisfying. i pointed that out in the book that i wrote. is it a sensible alternative. >> i am thinking about physical

matters. when about conflicts of interest, they got a lot of attention during the last administration been done. >> i am concerned about it. the integrity of research is something that we cannot compromise. we need to get trustworthy data. if it is discover that investigators who are involved in such research and publish papers about such results have undisclosed conflicts of financial interest, but makes the whole deal look less than it should be. we have to tighten up on that. bwe have a notice of proposed rulemaking. it will appear in the next month or two. it will be quite a change.

it is largely left to institutions. now nih will have a more information as far as what investigators are up to in terms of conflict of interest. >> [unintelligible] >> in the past, university last investigators to voluntarily disclose any potential financial conflicts. they did not necessarily in force that. i ask for that to be done in a much more rigorous way in. -- rigorous way. there will also be a requirement to have much more open disclosure of this information on websites. if anyone is interested in trying to figure out if a doctor so and so is getting money from companywide, he will be allowed to do so. -- from company y, he will be allowed to do so.

>> [unintelligible] >> congress is a combination of really wonderful people who care. rarely, if ever, had been to a meeting with congress and not found valuable substantive interaction. i am lucky in that regard. this has never really been about which party you are in. it is about what can we do to alleviate suffering and tried to give people a chance to live long and healthy lives without being impaired. >> there is one more question about your new book. >> before hassle you about your book, i did want to follow up on the conflicts. is this writing appropriate for nih researchers? >> -- is bureau straying --

ghost -- is boast right thing -- is ghost writing pro career for nih researchers? >> [unintelligible] >> could you talk a little bit about the new book. it is coming out in january. 10 years ago, there were how many billions for the human genome. now people can pay $4,400 for one. what are we looking towards? >> the error of personalized medicine -- the era of personalized medicine is coming

very quickly and has already arrived for a lot of us. we have identified hundreds of well validated genetic variants that play a role in over two dozen diseases. when you find out about that risk, you cameron's of thing about yourself that you might find useful. you can practice better individualize prevention. therapeutically, we are learning that not every case of cancer ought to be treated the same way. you could do a better matching with that particular person's problem. the idea of the right drug at the right dose for the right person may be possible or rational evidence from the genome. classics, for instance, we learned that -- p;lavex, for

instance, we learned that for up to a third of the population that will let you very much for. over time, general interest and understanding and the way this revolution coming from the study of the genome can include the opportunity for human health. that is what the book is about. >> so you switch because of your genetic profile? >> i found out that i am at a higher risk of diabetes than the average person. i was surprised. i do not have a family history of that. but all of the people in my family have been quite lean. when i discovered this, i was little less lean. as a conen