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Collins to step down as NIH head in transition for research agency

The NIH director’s position is one of the most high-profile health jobs in any presidential administration. The job involves overseeing the work of 27 different focused institutes and managing one of the biggest budgets in the federal government. Typically, NIH directors are well-known physicians or scientists.

Appointed by Obama, Collins was asked to stay in the job when former president Donald Trump took office in 2017, as Biden did earlier this year. When he steps down at the end of the year, Collins won’t leave government, but rather will resume work with the NIH’s Human Genome Research Institute, which he led before being appointed as NIH head.

His departure comes as the agency continues its prominent role in the government’s response to the coronavirus pandemic, after a year in which it was called upon to accelerate the launch of treatments, vaccines and diagnostics. The NIH’s National Institute for Allergy and Infectious Diseases conducts and funds trials on vaccines, boosters, treatments, viral transmission and the after effects of severe infection, while that division’s director, Tony Fauci, has been a chief government spokesperson on pandemic response.

Collins became NIH director at a time when the agency’s appropriated budget stagnated following a period of strong growth in the 1990s and early 2000s. Congress and the White House began significantly increasing funding again around 2015, and the 2022 budget request calls for a 14% jump to nearly $52 billion.

Collins oversaw the creation of a number of new initiatives, including gathering the health data of 1 million people to aid in the development of “precision medicines”; a multibillion-dollar effort to detect and understand brain pathologies in mental health disorders and degenerative conditions like Alzheimer’s disease; and the Cancer Moonshot, for which Biden became a major advocate.

This year, the Biden administration has moved forward with a Collins-backed effort called Advanced Research Project Agency for Health, or ARPA-H, modeled on a Defense Department center, which will support “high-risk, high-reward biomedical and health research in a way that is radically different than NIH’s grant-based system.” Congress has not yet passed legislation that would fund ARPA-H.