While in India last week to sign an agreement on diabetes research, Francis Collins, director of the National Institutes of Health (NIH), spoke with ScienceInsider about his visit. Collins said that NIH is collaborating with Indian scientists on cancer research and vaccine studies, and hopes to expand work on "affordable health" technologies. The questions and comments have been edited.
Q: India and the United States have been estranged democracies in the past; can you point to a breakthrough in biomedical cooperation?
F.C.: Well I am delighted that our democracies are now partnering together in many ways. I would point to the effort to develop and deploy a vaccine against rotavirus, which is the most common cause for childhood diarrhea and the cause of tens of thousands of deaths every year. ... Now we have a weapon against it. This vaccine was developed in India and is being manufactured in India with very promising results in advanced clinical trials. Expectations are that this may be licensed for future distribution in less than 2 years. That will be a marvelous success story and much credit to M. K. Bhan [secretary of India's Department of Biotechnology] and many other colleagues in India who have worked on this.
Q: So will it help newborn children in India?
F.C.: Absolutely, because parents would remember when there were times their children were stricken with diarrhea. Usually they get better, but this [rotavirus] is a very significant infection for some children who don't get better and can die as a consequence. This is a way to prevent that.
Q: To a lot of Indians "affordable health care," when promoted by Westerners, seems a euphemism for conducting cheap clinical trials. Will NIH make guinea pigs of Indians?
F.C.: Certainly NIH has no interest in using anyone as guinea pigs in any country. We see our responsibilities, though, as very significant not just in terms of reaching out to people in our own country but across the world. We are a part of the global village now, and with our friends and partners in India particularly we are working on ways to take advances and make them affordable. It doesn't do much good if you have come up with an advance which nobody can use because it costs too much. People may think everybody in America has all the money for healthcare, but we don't. So we can work with India to come up with ways like using cell phones for medical purposes -- then everybody wins.
Q: People think that Americans are coming to India because here the economy is growing, budgets are increasing. Are you looking to partner by way of money or is it resources what are you looking for?
F.C.: M. K. Bhan and I talked about this, and I think it's really interesting: Neither party is looking for money. We are looking for collaboration, innovation, opportunities for some of the best and brightest minds in India and the U.S. to find each other and work together. Yeah, we are a bit under a budget squeeze, but we still have a great deal of resources to spend on medical research. We admire what's happening in India. ... We just see this as a golden opportunity to work together.
Q: You helped decipher the genetic instruction book. What lessons did you draw from it, and will medical uses of it be real? It seems like hype after 10 years: Where's the personalized medicine it promised?
F.C.: We are making considerable progress, but I think there were unrealistic expectations. ... What we have now is the foundation of information that we didn't have before. I can tell you, if you walk in to any laboratory in India that is doing human biology and ask a graduate student, "Can you imagine doing this research without the human genome?" They would go frankly, "NO!" You can see the leading edge: ... In cancer for instance [we are] increasing abilities to identify why one cancer is different from another and deserves a different treatment -- there is no one size fits all. ... But the full flowering is 10 to 20 years away. And everybody should have known that as the sequence was coming out.
Q: In going around the biomedical community in India, are you excited by what you see?
F.C.: I am very excited. I have had a chance to visit with some remarkable scientists in places like the Indian Institute of Science, Bangalore, and I have met with young scientists who are full of imagination and creativity and innovation, all ready to change the world. I can sense that it is a remarkable time. Frankly, it's a remarkable time for biomedical science across the world. We have never had the abilities that we have now to figure out problems, to understand how life works and why disease happens. ... What an amazing experience that is. It makes me want to be 25 again.