White House May Nominate Dr. Monica Bertagnolli To Be New NIH Director

It took over 15 months, but the Biden Administration may finally have—wait for it, wait for it—a nominee to become the next Director of the National Institutes of Health (NIH). According to Laurie McGinley and Dan Diamond reporting for the Washington Post, the nominee is likely going to be Monica M. Bertagnolli, MD. Bertagnolli is a cancer surgeon who became Director of the National Cancer Institute (NCI) not too long ago on October 3, 2022. If Bertagnolli indeed turns out to be the nominee and ends up being confirmed by the Senate, she would ascend to the helm of the premier Federal Agency responsible for conducting and supporting biomedical research throughout the U.S. It’s a super important position that you should pay attention to, assuming that you are not a table, a toilet seat, or any other type of inanimate object and are actually interested in your health. It’s also a position that’s likely going to face lots of challenges including the trash can of anti-science garbage being thrown around these days by certain politicians, personalities, loads of anonymous social media accounts, and others who keep trying to politicize the heck out of science.

Yeah, this hasn’t been the best time to take over 486 days or around 47 Scaramuccis to find a more permanent replacement for Francis S. Collins, MD, PhD, who stepped down from being Director of the NIH on December 19, 2021. Unlike Anthony Scaramucci who served as the Trump Administration’s Director of Communications from July 21 to July 31, 2017, Collins had served for over 12 years and under three U.S. Presidents after being nominated by then-President Barack Obama on July 8, 2009, and assuming the position on August 17, 2009. Lawrence A. Tabak, D.D.S., Ph.D., has been serving as the acting Director of the NIH since then. But the title “acting” typically brings a “just keeping the seat warm” feel with it. After all, you wouldn’t start making longer term plans with someone who told you that he or she was your “acting” significant other, would you? Delays in filling this oh-so-important position on a more permanent basis has left a “covfefe” amount of uncertainty at a time when a lot more certainty is needed.

Bertagnolli already plays a major role in an area that’s seems to be near and dear to President Joe Biden’s heart: the fight against cancer. Cancer claimed the life of one of Biden’s sons, Beau. In 2016, when Biden was the Vice-President under President Barack Obama, Biden launched the Cancer Moonshot, which didn’t mean launching cancer cells to the moon but instead was an initiative aiming to develop more treatments for cancer.

Then 2017 to 2020 happened. Boosting medical research wasn’t exactly the primary focus of then U.S. President and current Mar-A-Lago resident Donald Trump. And during the last year of the Trump Administration, a little thing called the Covid-19 pandemic occurred.

In 2022, as President, Biden announced what an NCI website describes as “a reignition of the Cancer Moonshot, highlighting new goals: to reduce the cancer death rate by half within 25 years and improve the lives of people with cancer and cancer survivors.” As Director of NCI, Bertagnolli has been central to Biden’s Cancer Moonshot, because the “C” in NCI stands for “cancer” and not something like cheese. Bertagnolli has already led the development the National Cancer Plan, which outlines the strategy on how to achieve the Moonshot’s goals and was recently released.

Bertagnolli has been focused on cancer treatment and research for much of her career. According to a NCI website, Bertagnolli is “the daughter of first-generation Italian and French Basque immigrants,” who “grew up on a ranch in southwestern Wyoming.” Her education includes a Bachelor of Science in Engineering degree from Princeton University and an M.D. from the University of Utah. After medical school, she completed residency training in surgery at the Brigham and Women’s Hospital and a research fellowship in tumor immunology at the Dana-Farber Cancer Institute. Prior to her position at NCI, she was the Richard E. Wilson Professor of Surgery in the field of surgical oncology at Harvard Medical School, a surgeon at Brigham and Women’s Hospital, and a member of the Gastrointestinal Cancer Treatment and Sarcoma Centers at Dana-Farber Cancer Institute. The website describes Bertagnolli as being at “the forefront of the field of clinical oncology, in particular, advancing current understanding of the gene mutation that promotes gastrointestinal cancer development and the role of inflammation as a driver of cancer growth.”

Soon after becoming the first woman to head the NCI, Bertagnolli, who is 64 years of age, faced her own cancer battle, being diagnosed with early-stage breast cancer. Fortunately, it turned out to be a very treatable form of breast cancer, hormone receptor-positive, HER2-negative, as McGinley and Diamond indicated.

Keep in mind that the White House has not officially announced its nominee for the next NIH Director. The Washington Post article was based on “people familiar with the situation,” which is certainly better than “people who have no idea what’s going on” but still not the same as the White House confirming the news. Whoever ends up taking the reins of the NIH is going to find some tough sledding ahead and will need to bring some big-time leadership to contend with what’s become a political pit of vipers, meaning the snakes and not the car.

As mentioned earlier, the NIH as well as other scientific organizations and institutions that had helped “make America great” are now facing a wave of anti-science sentiment that’s grown in recent years. It’s seemingly become in vogue for various politicians to use an “attack scientists” approach to promoting themselves, sort of like how the so-called cool kids in high school would bully nerds. That’s unfortunate, since society needs real science and real scientists, kind of how the castaways on the TV show Gilligan’s Island really needed the Professor. Fake-it-until-you-make-it doesn’t really work for science in the long term. It’s more like fake-it-until-an-infectious-pathogen-spreads-in-an-uncontrolled-matter-and-ends-up-killing-over-a-million-people.

At the same time, funding for biomedical research has gotten scarcer and scarcer for researchers around the country. In many years over the past two decades, the NIH budget, which is allocated by Congress, did not even keep up with inflation. Nowadays, in many cases, less than 10% of grant applications get funded, which isn’t going to motivate a lot of researchers to pursue more innovative research. By contrast, think about how much money in society is going to things like developing new apps to post selfies or finding more ways to collect and sell data on you.

Meanwhile, there’s certainly no shortage of health and biomedical problems in the U.S. going unsolved, ranging from the obesity epidemic to the continuing rise of chronic medical conditions to declines in mental health to the lack of new antibiotics being developed to deal with pathogens with growing antimicrobial resistance to, you know, actually figuring out how to prevent the next pandemic. There’s also a host of new methods and approaches ranging from systems science to AI (meaning artificial intelligence and not Allen Iverson) to new cell-level methods to various complementary and alternative health practices that could be much better integrated into biomedical research. A big question is how much the NIH’s current model of funding and supporting research needs to change and evolve with the times.

One thing’s for sure: putting the NIH more in the hands of politicians is not going to good for the U.S. When’s the last time that making something more political has actually improved it? When the last time you had a problem and said, “What we really need is more people playing politics.” It will be important to keep the NIH above the political fray that seems to be engulfing a lot of decision-making throughout the U.S. right now. And that’s going to take some really strong leadership.