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Ann West, chair of the ͵ÅÄ͵¿ú and ͵ÅÄ͵¿ú Biology Public Affairs Advisory Committee, sat down with Monica Bertagnolli, director of the National Institutes of Health in October, to discuss the importance of basic science and how the agency is addressing the needs of cutting-edge research.

The conversation has been edited for length, clarity and style.

West: What are some challenges and opportunities for the NIH as you think about the agency’s legacy and its role in driving the U.S. research enterprise forward?

NIH

Monica Bertagnolli is the first surgeon and the second woman to serve as director of the NIH. She previously served as director of the National Cancer Institute, a professor of surgery at Harvard Medical School, a surgeon at Brigham and Women’s Hospital and a member of the Dana-Farber Cancer Institute.

University of Oklahoma

Ann West, a professor of chemistry and biochemistry and the associate vice president for research and partnerships at the University of Oklahoma, has been the chair of the ASBMB Public Affairs Advisory Committee since 2023.

Bertagnolli: We’ve got a very big job because our work is about science transforming people’s lives, which means our work needs to cover the laboratory, the clinic and —because of an increasing realization that our health is not just the genes we inherit — it’s also the environments we live in, our culture, our communities. Our work has to span such a broad range of people, communities and cultures if we are to be successful.

We take the mandate that our work benefits everyone very seriously; that means our work must include everyone. We’re passionate about this, but that’s one of our biggest challenges right now.

West: You recently co-authored an eLife article with Larry Tabak and Jon Lorsch titled “Applied research won’t flourish without basic science.” What motivated you and your colleagues to comment on the role/value of basic scientific research?

Bertagnolli: I am very privileged to have spent time running a basic lab and consider myself to be a part of the basic science community to some degree. I felt it was very important to highlight this because, in public awareness and, frankly, our interactions with Congress, we hear stories about people and treatments that happen as a result of applying fundamental science. And I felt that it was really important to remind everyone that none of those advances would happen without investments in basic science, in fundamental research.

The other reason is that, as the NIH, we have to partner with everyone to achieve our goals. For example, therapy development. We have an amazing partnership with the pharmaceutical industry, with the technology industry, with academic institutions and community sites ... and those partners bring robust funding to the research enterprise.

But what about fundamental research? We are one of the main funders for that kind of research. I wanted to make sure everyone knew that we take our responsibility for being a primary funder of basic science very seriously.

West:  A large percentage of our ASBMB membership is funded through the NIH for basic scientific research. How can NIH balance its funding portfolio to support basic science and training for the next generation of researchers, and promote clinical and more applied research?

Bertagnolli: It’s a very broad spectrum, so we have to keep an eye on the goal, and the goal is helping all people live long and healthy lives. We know that we will not achieve that without fully robust funding for fundamental research.

So, what do we do? It’s a little bit of what I described; at the NIH we try to set clear goals and priorities for what we think is critical in biomedical research. And then we use our precious federal dollars the best way we can to achieve and fill the need areas that the whole ecosystem needs to thrive.

To put it bluntly, we really do spend a lot of time thinking about what research needs to be done overall, who are the partners and who can also contribute funding. Then, where there is not as robust funding or willing partners, those are areas that are going to be very high priority for us.

West: How can we get that message across to the public and our legislators and policymakers and build trust in science?

Bertagnolli: Communication is so critical. Let me just say, thank you so much for this interview. It allows us to illustrate the importance of what we do.

We never know where the next discovery is going to come from; we truly don’t. And there are some prominent examples we can turn to already. The one everyone thinks about is the new mRNA technology that helped us deliver a COVID vaccine. That came out of a research lab. We didn’t know where it was going; we had no idea it would be needed where it was, but when it was desperately needed, it was ready to go for us because of the investments in fundamental science.

Another example that comes from COVID demonstrates where we’re in trouble if we don’t have critical basic science — the issue of long COVID. Now we’ve got a vaccine, but so many people are having serious health challenges in the form of persistent symptoms postinfection, and here we are really missing some things that fundamental science could provide us. We do not have a good handle yet on the basic biology of what that virus is doing to produce those long-term effects. We don’t have a diagnostic test; we don’t have evidence from fundamental science showing how to identify a replication-competent virus within a person, which is a leading hypothesis that can show where to focus development of treatment.

With the same new disease, we have a great example of how fundamental science investment paid off tremendously and also where, if we don’t have fundamental science investment, we can really be behind in the tools we need to move forward for health.

West: We are definitely in agreement. I think most of the public may not be aware that the COVID vaccine, the rapid development of the vaccine, really came on the foundation of 15 to 20 years of virology and structural biology research that allowed us to target specific parts of that virus.

Bertagnolli: Absolutely. I can give so many examples that I’m really excited about. I can tell you that the new insights we’re getting out of cryo-electron microscopy and cryo-electron tomography. We are now seeing those technologies being applied to drug discovery, understanding biology in other ways that are going to lead to more effective diagnoses and treatments and prevention. That’s another brilliant example where tools developed to understand fundamental biological mechanisms will be applied to produce benefits for people.

West: You’re speaking my language because, as a structural biologist, I’ve been in the fray of all those developments, and we’re very excited about what new developments can come out of higher-resolution images of the molecules we study. This is an exciting time.

Bertagnolli: Well, there are a thousand examples. And any time you can give the line of sight for people, “look at this technology — we didn’t know what it was going to lead to but now we do.” Those are the stories we need to tell.

West: The NIH has supported several new efforts, including expanding Maximizing Investigators’ Research Award, or MIRA, grants and increasing postdoc stipends to address relatively flat grant budgets over the past few years. Are there other efforts at NIH to address these challenges that federally funded scientists face?

Bertagnolli: I have so much appreciation for how challenging it is to be a researcher and even to be an NIH-funded researcher. I will say — not a single week goes by that at some NIH meeting there isn’t a discussion on what we can do better, how can we support our researchers better. I also want to acknowledge that our grants go to institutions, not to individuals. And I want to really acknowledge that yes, our grants are not enough to pay full freight on what our research teams are doing. I also want to acknowledge the incredible leveraging we get from our institutions who also pull in dollars from philanthropy or other sources because we know someone has to make up that gap.

We would all love to see more and bigger grants. However, the only way we get bigger grants today is by giving fewer, because the budgets are not increasing across the board in ways that we would need. We haven’t yet taken the step of giving fewer grants so that we can give more. We continue to work with our institutional leaders to ask them what’s the very best way we can deliver dollars to support their scientific teams. So far, this has been our approach. More funding would definitely help us fund bigger grants.

West: How has your rural upbringing in rural Wyoming and career as a physician/scientist shaped your perspective on health care and the research enterprise?

Bertagnolli: It’s done two things that I know. First, it has shaped my perspective that there are disparities in this country; there are people, for whatever reason, who don’t have access to the care that they need to be healthy. When it comes to helping all people live long and healthy lives, that is something the NIH needs to be concerned about.

The other thing it’s done is given me a deep appreciation for so many amazing individual research scientists and research teams that exist across the entire country. The big institutions have a great wealth of people and a great variety of research in their teams. But, smaller places also have brilliance and creativity and excitement, and I have a great appreciation for making sure that our funding can reach those individuals as well as the bigger institutions.

West: The NIH recently re-established the scientific management review board. Can you tell us more about this?

Bertagnolli: I’m very much looking forward to working with this new board. I think we’ve had great interactions and benefits from the Advisory Committee to the Director, our current advisory body. But that committee has largely been dealing with scientific priorities and scientific vision.

It is very helpful to have now an advisory board that is going to help us with more operational issues — more about our administration, our infrastructure and other critical infrastructure.  I’m very much looking forward to getting more interaction and more advice on those issues.

West: Anything else you’d like to share with our members and the broader scientific community? What would you like them to know about your role, your tenure, your goals?

Bertagnolli: I think people realize very quickly how thoroughly I love this job and how privileged I feel every day to work with the incredible team at the NIH. It really is the excitement of a lifetime.

I’ll tell you one other thing. Every week, the team sends me a list of publications for just the week that passed. They help me keep track of what’s going on across the broader world of science.

It just blows me away, what I see week after week after week, coming in from our amazing research community. It’s really thrilling. We have never ever had this much potential, this much possibility, this much excitement throughout biomedical research.