As scientists around the world rush to stop the spread of COVID-19, they will be aided by pioneering genetic breakthroughs discovered a few short years ago. A Virginia native, Dr. Francis Collins, led an international effort to map the human genome. And now, as Director of the National Institutes of Health, he is playing a key role in developing a COVID-19 vaccine. Before the coronavirus outbreak spread in the US, he spoke with VPM’s Charles Fishburne.
Charles Fishburne:
Dr. Collins, you recently participated in the Ken Burns documentary "The Gene," set to air on PBS. What is the scope of this program? And what exciting stories does it purport to tell?
Dr. Francis Collins:
Well, the films which are remarkable in the Ken Burns way, are based upon a book by Sid Mukherjee, called "The Gene," which is quite the comprehensive historical review of what do we know about inheritance and the particles that convey that, namely genes. It goes all the way back to Mendel.
And it goes forward through the Human Genome Project to present time in terms of precision medicine and some projecting about where it's going in the future, including potential cures for many genetic diseases that currently don't have those. So it's a broad sweep in those four hours.
Fishburne:
You mentioned the Human Genome project that you headed that was 17 years ago. What did it accomplish and how has it changed the medical landscape in those 17 years.
Collins:
The idea was to read out all three billion letters of the human DNA instruction book. It was my job to lead that effort, which meant serving as the project manager for about 2400 scientists in six countries, trying to meet these deadlines, trying to invent technology as we went along.
Happily, that all succeeded. In fact, it ended up ahead of schedule and under budget in 2003. And we had this. It has changed everything as far as our understanding about human biology and medicine. Nobody doing research in human biology can imagine now how you ever did it without having that information about the human DNA instruction book. In terms of medicine, it's really transformed our understanding of cancer because cancer is a disease of DNA misspellings and DNA caused cancer and now we can find them in each individual and optimize the treatment accordingly.
It's teaching us a lot about hereditary influences on future risk of illness and differences in response to treatment. And it's uncovered the actual cause of some 6500 diseases that we now know quite precisely, what is the basis of those conditions, and therefore, we're much closer to knowing what to do for them. So it has been transformative
Fishburne:
Thirteen years in $2.7 billion to sequence a human genome. And now I understand it can be done in a single hour for less than 1500 dollars. We're talking about speed and efficacy here.
Collins:
And we are, you know, people say, when you want things faster, better, cheaper, you've got to pick two out of three, for DNA sequencing, we got a full house here and get all three of those.
Fishburne:
One of those things where speed is so important is this coronavirus, and understand that sequencing of the corona virus in China enabled our scientists to begin work on a possible vaccine targeting that spike protein. Is that part of your work?
Collins:
Absolutely we at NIH are deeply into that working in collaboration with a company called Medina to try to generate a vaccine against coronavirus in record time. And it was crucial to have sequencing capability which we and China and many other countries now have to get that information about the virus almost immediately. And that information is all it takes now, to basically start a process to make a vaccine. Let's be clear, it's still a long process. We won't have a vaccine for a coronavirus for about a year, but normally it would have been five or six years. So this is moving out.
Charles Fishburne:
Now, you're the director of the National Institutes of Health overseeing 27 institutes and centers. And there were three potential breakthroughs that you thought were very exciting a couple of years ago, the Brain Initiative, the cancer immunotherapy, and using gene editing with the CRISPR CAS technology. Are these things going to change medicine as we know it?
Collins:
We are at a remarkable moment in terms of have the ability to speed up our understanding of the causes of disease and how best to prevent and treat it. Many of those technologies have just been invented.
Right now we are pursuing this dramatically challenging effort to understand how the human brain works. And to use that information to come up with better strategies for things like autism and schizophrenia and Alzheimer's disease.
Were also in the, in the phase of trying to understand what to do about cancer when it has spread beyond its original sight and figuring out how to activate the immune system to find those cancer cells which the immune system has somehow ignored. That's been revolutionary for many people, and we want it to extend even further to other types of cancer. Certainly, the idea of using gene editing with this so called CRISPR CAS system has produced some dramatic findings in just the last year or two.
We've now had a few individuals with sickle cell disease who have been cured with this approach and many other diseases waiting for their chance to be next.
Fishburne:
So medicine in our lifetime, really, and some of the work that you've done with genetics is literally the power to change the world as we know it. Is humanity mature enough to deal with that?
Collins:
People are concerned about whether these technologies could also be misused. My position generally has been that knowledge is knowledge. It's what you decide to do with it that then takes on moral consequences.
I am one of those who thinks this gene editing revolution, which can be incredible for saving lives from diseases like sickle cell disease, ought not to be used for the hereditary part of the DNA, which will basically modify the very nature of who we are, I think we don't know enough about how to do that. And that has lots of really serious philosophical and theological consequences.
So scientists have to be both really excited about their science and willing to recognize that there may be limits to which that science should be applied. And we need the public's input on that because Scientists tend to want to do science and they need to have other views at the table, asking the question about whether this is the right thing to do.
That was Charles Fishburne speaking with Dr. Francis Collins, Director of the National Institutes of Health. Learn more about genetic research on the Ken Burns special, “The Gene,” on VPM PBS premiering Tuesday April 7 and 14 at 8:00 PM.
