When Dr. moved Monica M. Bertagnolli in the director’s suite at the National Institutes of Health, she brought a piece of art, a lithograph created by the grandson of a cancer patient she once treated. It depicts an abstract geometric figure of a woman and the organs she lost to cancer. Its title: “We Are Not What You Have Taken: A Response to Cancer.”
The image is talking to Dr. Bertagnolli, a cancer surgeon who previously chaired the National Cancer Institute and is herself a breast-cancer survivor.
After being nominated by President Biden in the spring and winning Senate confirmation last month, he became the 17th director of the NIH, which has a budget of more than $47 billion and occupies a sprawling campus in Bethesda, Md. She is only the second woman to lead the biomedical research agency on a permanent basis.
A few weeks into his tenure, The New York Times visited Dr. Bertagnolli in his office in Building 1, a stately brick structure where President Franklin D. Roosevelt dedicated the Bethesda campus in 1938. This interview has been edited and shortened.
How many weeks have you been here? What are your observations?
The research laboratories funded from it are fantastic for basic science. We have to continue all that work. But what has been a challenge for us is that we can really do our research deep in the clinics in each community where people are being treated and cared for.
I think we are very good at our major academic medical centers. But if we’re really going to do clinical research in a way that achieves the results we need, we all need to have the opportunity to participate.
It sounds like you want more participation in clinical trials from rural people, and you want to input the data we have into the treatment they’re getting.
Exactly.
I can’t help but wonder if growing up on a ranch in rural Wyoming knows that.
Of course. Because I understood that health care delivery was just different for people my age. From my ranch house to a paved road is 18 miles. And from the ranch house when I was growing up to the next landline for a phone was about 50 miles.
You have a phone, though?
No, we didn’t. Not at the ranch in the summer. When school started, my mother would move with the children to town. We also had a house in town. And we go back and forth to the ranch every weekend. We had a telephone in town.
Activists are pushing the NIH to use so-called march-in rights to claim patents on drugs developed with tax dollars, as a way to lower prices. Are you open to that?
Absolutely. This is part of my authority as NIH director. But I have to make sure that if the rights to march are exercised, that the result is the intended one — meaning people get better access, because that’s really the goal. We want everyone to have access to the benefits of biomedical research. (After this interview, the Biden administration issued a proposed framework to guide the agency’s exercise of marching rights.)
The NIH is under scrutiny for funding research benefit function — including in Wuhan, China — that some experts believe are dangerous and could lead to the next pandemic. Are you reviewing that kind of research and do you plan to make any changes?
The research-of-function research that you’re specifically referring to is the changes that are made to potential pandemic pathogens, correct? What if we could develop a vaccine before we see a new virus that becomes another Covid-19 virus? That’s a huge benefit. But if we do that kind of research, we have to make sure that the risks are completely minimized and always remember that the benefits justify the risks.
The White House is weighing in recommendations from the National Science Advisory Board for Biosecurity for improving oversight. Where does that stand?
To be fair, I don’t know yet. But this is a big priority for all of us, and I will be a very active participant, because supervision is critical for that kind of research.
The Pew Research Center recently release a poll showing that Americans’ trust in science continues to decline — and more among Republicans than Democrats. Are you worried about that?
Really too much. Everything we try to do in science is about getting people better care. It is absolutely impossible to deliver better care to treat people without trust.
But I think trust, writ large, in institutions like the NIH We see Republicans on Capitol Hill who critical of the NIH What can you do to bridge that partisan gap and restore American faith in the institution?
Be very clear, very honest about what we know and what we don’t know. Think about what we’ve all been through as a nation — the trauma we’ve all been through. It’s ridiculous to think that we wouldn’t go through such trauma without real consequences. But I also think that we can use this as an opportunity to really build trust in science, because I believe that science has helped us get out of the dark days of this pandemic.
You became a patient, and became that was discussed. how are you feeling Can you talk about your status?
I am a cancer survivor. I think we all have to be humble in the face of a cancer diagnosis. So my chances of living the rest of my life without cancer are very high. That’s the good news. And the point I tell everyone when asked about this is that all the evidence that guides my care comes from NIH-funded research.
I would be remiss if I didn’t ask you about being only the second woman out of 17 directors. I walked down this hallway and saw many portraits of men. How does this affect your thinking about the role you play?
I’m glad to see women getting opportunities to show what women can do. If you look down that hallway, all those years, there were really talented, capable women there too. They just didn’t stand a chance.
