The following is a conversation with Francis Collins, director of the NIH,

the National Institutes of Health, appointed and reappointed to the role by three presidents,

Obama, Trump, and Biden. He oversees 27 separate institutes and centers, including NIAID,

which makes him Anthony Fauci's boss. At the NIH, Francis helped launch and led a huge number of

projects that pushed the frontiers of science, health, and medicine, including one of my favorites,

the Brain Initiative, that seeks to map the human brain and understand how the function

arises from the neural circuitry. Before the NIH, Francis led the Human Genome Project,

one of the largest and most ambitious efforts in the history of science. Given all that,

Francis is a humble, thoughtful, kind man, and because of this, to me, he is one of the best

representatives of science in the world. He is a man of God and yet also a friend of the late

Christopher Hitchens, who called him, quote, one of the greatest living Americans. This is

a Lex Friedman podcast. To support it, please check out our sponsors in the description.

And now here's my conversation with Francis Collins. Science at its best is a source of hope.

So for me, it's been difficult to watch as it has during the pandemic become a

time's a source of division. What I would love to do in this conversation with you

is touch some difficult topics and do so with empathy and humility so that we may begin to

regain a sense of trust and science and that it may once again become a source of hope.

I hope that's okay with you. I love the goal.

Let's start with some hard questions. You called for, quote, thorough,

expert driven and objective inquiry into the origins of COVID 19. So let me ask,

is there a reasonable chance that COVID 19 leaked from a lab?

I can't exclude that. I think it's fairly unlikely. I wish we had more ability to be

able to ask questions of the Chinese government and learn more about what kind of records might

have been in the lab that we've never been able to see. But most likely this was a natural origin

of a virus probably starting in a bat, perhaps traveling through some other intermediate yet

to be identified host and finding its way into humans. Is answering this question within the

realm of science, do you think will we ever know? I think we might know if we find that intermediate

host. And there has not yet been a thorough enough investigation to say that that's not

going to happen. And remember, it takes a while to do this. With SARS, it was 14 years before we

figured out it was the civet cat that was the intermediate host. With MERS, it was a little

quicker to discover it was the camel. With SARS COVID 2, there's been some looking, but especially

now with everything really tense between the US and China, if there's looking going on, we're not

getting told about it. Do you think it's a scientific question or a political question?

It's a scientific question, but it has political implications. So the world is full of scientists

that are working together, but in the political space, in the political science space, there's

tensions. What is it like to do great science in a time of a pandemic when there's political

tensions? It's very unfortunate. Pasteur said science knows no one country. He was right about

that. My whole career in genetics, especially, has depended upon international collaboration

between scientists as a way to make discoveries, get things done. Scientists by their nature

like to be involved in international collaborations. The Human Genome Project, for

heaven's sake, 2400 scientists in six countries working together, not worrying who is going to

get the credit, giving all the data away. I was the person who was supposed to keep all that

coordinated. It was a wonderful experience. And that included China. That was sort of their first

real entry into a big international, big science kind of project, and they did their part.

It's very different now. Continue on the line of difficult questions.

Especially difficult ethical questions. In 2014, US put a hold on gain of function research in

response to a number of laboratory by security incidents, including anthrax, smallpox, and influenza.

In December 2017, NIH lifted this ban because, quote, gain of function research is important

in helping us identify, understand, and develop strategies and effective countermeasures against

rapidly evolving pathogens that pose a threat to public health. All difficult questions have

arguments on both sides. Can you argue the pros and cons of gain of function research with viruses?

I can. And first, let me say this term, gain of function, is causing such confusion

that I need to take a minute and just sort of talk about what the common scientific use of

that term is and where it is very different when we're talking about the current oversight

of potentially dangerous human pathogens. As you know, in science, we're doing gain of function

experiments all the time. We support a lot of cancer immunotherapy at NIH right here in our

clinical center. There are trials going on where people's immune cells are taken out of their body,

treated with a genetic therapy that revs up their ability to discover the cancer that that

patient currently has, maybe even at stage four, and then give them back as those little ninja

warriors go after the cancer. And it sometimes works dramatically. That's a gain of function.

You gave that patient a gain in their immune function that may have saved their life.

So got to be careful not to say, oh, gain of function is bad. Most of what we do in science

that's good involves quite a bit of the hat. And we are all living with gains of function every

day. I have a gain of function because I'm wearing these eyeglasses. Otherwise, I would not be seeing

you as clearly I'm happy for that gain of function. So that's where a lot of confusion has happened.

The kind of gain of function which is now subject to very rigorous and very carefully defined oversight

is when you are working with an established human pathogen that is known to be potentially causing

a pandemic and you are enhancing or potentially enhancing its transmissibility or its virulence.

We call that EPP enhanced potential pandemic pathogen. That requires this very stringent oversight

worked out over three years by the National Science Advisory Board on Biosecurity.

That needs to be looked at by a panel that goes well beyond NIH to decide are the benefits worth

the risks in that situation. Most of the time, it's not worth the risk. Only three times in the

last three or four years have experiments been given permission to go forward. They were all

in influenza. So I will argue that if you're worried about the next pandemic, the more you

know about the coming enemy, the better chance you have to recognize when trouble is starting.

And so if you can do it safely, studying influenza or coronaviruses like SARS, MERS,

and SARS CoV2 would be a good thing to be able to know about. But you have to be able to do it

safely because we all know lab accidents can happen. I mean, look at SARS where there have been

lab accidents and people who have gotten sick as a result. We don't want to take that chance unless

there's a compelling scientific reason. That's why we have this very stringent oversight.

The experiments being done at the Wuhan Institute of Virology as a subaward to our grant to EcoHealth

in New York did not meet that standard of requiring that kind of stringent oversight.

I want to be really clear about that because there's been so much thrown around about it.

Was it gain of function? Well, in the standard use of that term that you would use in science in

general, you might say it was. But in the use of that term that applies to this very specific

example of a potential pandemic pathogen, absolutely not. So nothing went on there

that should not have happened based upon the oversight. There was an instance where the

grantee institution failed to notify us about the result of an experiment that they were supposed

to tell us where they mixed and matched some viral genomes and got a somewhat larger viral

load as a result. But it was not EPPP. It was not getting into that zone that would have required

this higher level of scrutiny. It was all bat viruses. These were not human pathogens.

So they didn't cross a threshold within that gray area that makes for an EPPP?

They did not. Anybody who's willing to take the time to look at what EPPP means and what

those experiments were would have to agree with what I just said.

What is the biggest reason it didn't cross that threshold? Is it because it wasn't jumping to

humans? Is it because it did not have a sufficient increase in virulence or transmissibility?

What's your sense? EPPP only applies to agents that are known human pathogens of pandemic potential.

These were all bat viruses derived in the wild, not shown to be infectious to humans.

Just looking at what happened if you took four different bat viruses and you tried moving the

spike protein gene from one into one of the others to see whether it would bind better

to the ACE2 receptor, that doesn't get across that threshold. And let me also say,

for those who are trying to connect the dots here, which is the most troubling part of this,

and say, well, this is how SARS CoV2 got started, that is absolutely demonstrably false.

These bat viruses that were being studied had only about 80% similarity in their genomes to

SARS CoV2. They were like decades away in evolutionary terms, and it is really irresponsible

for people to claim otherwise. Speaking of people who claim otherwise,

Rand Paul, what do you make of the battle of wars between Senator Rand Paul and Dr. Anthony Fauci

over this particular point? I don't want to talk about specific members of Congress, but I will

say it's really unfortunate that Tony Fauci, who is the epitome of a dedicated public servant,

has now somehow been targeted for political reasons as somebody that certain figures are

trying to discredit, perhaps to try to distract from their own failings. This never should have

happened. Here is a person who's dedicated his whole life to trying to prevent illnesses from

infectious diseases, including HIV in the 1980s and 90s, and now probably the most knowledgeable

infectious disease physician in the world, and also a really good communicator, is out there

telling the truth about where we are with SARS CoV2 to certain political figures who don't want

to hear it and who are therefore determined to discredit him, and that is disgraceful.

So with politicians, they often play games with black and white. They try to use the gray areas

of science and then paint their own picture, but I have a question about the gray areas of science.

So like you mentioned, gain of function is a term that has very specific scientific meaning,

but it also has a more general term, and it's very possible to argue that the, not to argue,

not the way politicians argue, but just as human beings and scientists,

that there was a gain of function achieved at the Wuhan Institute of Virology,

but it didn't cross a threshold. I mean, it could have, too. So here's the thing,

when you do these kinds of experiments, unexpected results may be achieved, and that's the gray area

of science. You're taking risks with such experiments, and I am very uncomfortable

that we can't discuss the uncertainty in the gray area of this.

Oh, I'm comfortable discussing the gray area. What I'm uncomfortable with is people deciding to

define for themselves what that threshold is based on sort of some political argument. The

threshold was very explicitly laid out. Everybody agreed to that in the basis of this three years

of deliberation. So that's what it is. If that threshold needs to be reconsidered, let's reconsider

it, but let's not try to take an experiment that's already been done and decide that the threshold

isn't what it was, because that really is doing a disservice to the whole process.

I wish there was a discussion, even in response to

Rand Paul. I know we're not talking about specific senators, but just that particular case. I'm

saying stuff here. I wish there was an opportunity to talk about, given the current threshold,

this is not gain of function, but maybe we need to reconsider the threshold and have an actual,

that's an opportunity for discussion about the ethics of gain of function. You said

that there was three studies that passed that threshold with influenza. That's a fascinating

human question, scientific question about ethics, because like you said, there's pros and cons.

You're taking risks here to prevent horribly destructive viruses in the future,

but you also are risking creating such viruses in the future. With nuclear weapons and nuclear

energy, nuclear energy promises a lot of positive effects, and yet you're taking risks here.

Mutually shared destruction of nations possessing nuclear weapons.

Oh my.

I hope we're not going there.

Well, we're not, but a lot of people argue that that's the reason we've, nuclear weapons is the

reason we've prevented world wars, and yet they also have the risk of starting world wars,

and this is what we have to be honest about with the benefits and risks of science, that you have

to make that calculation of what are the pros and what are the cons.

I'm totally with you, but I want to reassure you, Lex, that this is not an issue that's been ignored.

That this issue about the kind of gain of function that might result in a serious human pathogen

has been front and center in many deliberations for a decade or more, involved a lot of my time

along the way, by the way, and has been discussed publicly on multiple occasions, including two

major meetings of the National Academy of Sciences getting input from everybody,

and ultimately arriving at our current framework.

Now, we actually back in January of 2020, just before COVID 19 changed everything,

had planned and even charged that same national science advisory by board on biosecurity to

reconvene and look at the current framework and say, do we have it right? Let's look at the

experience over those three years and say, is the threshold too easy, too hard?

Do we need to reconsider it? Let's look at the experience. COVID came along, the members of

the board said, please, we're all infectious disease experts. We don't have time for this

right now, but I think the time is right to do this. I'm totally supportive of that, and that

should be just as public a discussion as you can imagine about what are the benefits and the risks.

And if somebody decided, ultimately, this came together and said, we just shouldn't be doing

these experiments under any circumstances. If that was the conclusion, well, that would be the

conclusion, but it hasn't been so far. If we can briefly look out into the next 100 years on this,

I apologize for the existential questions. But it seems obvious to me that as gain of function

type of research and development becomes easier and cheaper, it will become greater and greater

risk. So if it doesn't no longer need to be contained within the laboratories of high security,

it feels like this is one of the greatest threats facing human civilization. Do you worry that at

some point in the future, a leaked manmade virus may destroy most of human civilization?

I do worry about the risks. And at the moment where we have the greatest control, the greatest

oversight is when this is federally funded research. But as you're alluding, there's no reason to

imagine that's the only place that this kind of activity would go on. If there was an evil source

that wished to create a virus that was highly pathogenic in their garage, the technology does

get easier. And there is no international oversight about this either that you could say has the same

stringency as what we have in the United States. So yes, that is a concern. It would take a serious

a seriously deranged group or person to undertake this on purpose, given the likelihood that they

too would go down. We don't imagine there are going to be bio weapons that only kill your enemies

and don't kill you. Sorry, we're too much alike for that to work. So I don't see it as an imminent

risk. There's lots of scary novels and movies written about it. But I do think it's something

we have to consider what are all the things that ought to be watched. You may not know that if

somebody is ordering a particular oligonucleotide from one of the main suppliers, and it happens to

match smallpox, they're going to get caught. So there is effort underway to try to track any

nefarious actions that might be going on in the United States or internationally. Is there an

international collaboration of try to track this stuff? There is some. I wish it were stronger.

This is a general issue, Lex, in terms of do we have a mechanism, particularly when it comes to

ethical issues, to be able to decide what's allowable and what's not and enforce it. I mean,

look where we are with germline genome editing for humans, for instance, there is no enforcement

mechanism. There's just bully pulpits and governments that get to decide for themselves.

So you talked about evil. What about incompetence? Does that worry you? I was born in the Soviet Union.

My dad, a physicist, worked at Chernobyl. That comes to mind. That wasn't evil. I don't know

what word you want to put it. Maybe incompetence is too harsh. Maybe it's the inherent incompetence

of bureaucracy. I don't know. But for whatever reason, there was an accident. Does that worry you?

Of course it does. We know that SARS, for instance, did manage to leak out of a lab

in China two or three times, and at least in some instances people died, fortunately quickly contained.

All one can do in that circumstance, because you need to study the virus and understand it

in order to keep it from causing a broader pandemic. But you need to insist upon the kind

of biosecurity, the BSL 2, 3, and 4 framework under which those experiments have to be done.

And certainly at NIH, we're extremely rigorous about that. But you can't count on every human

being to always do exactly what they're supposed to. So there's a risk there, which is another

reason why if we're contemplating supporting research on pathogens that might be the next

pandemic, you have to factor that in, not just whether people are going to do something

that we couldn't have predicted, where all of a sudden they created a virus that's much worse

without knowing they were going to do that, but also just having an accident. That's in the mix

when those estimates are done about whether the risk is worth it or not.

Continuing on line of difficult questions.

We're going to get to fun stuff after a while.

We will soon, I promise.

You are the director of the NIH. You are Dr. Anthony Fauci's technically his boss.

Yep.

You have stood behind him. You have supported him, just like you did already in this conversation.

It is painful for me to see division and distrust,

but many people in politics and elsewhere have called for Anthony Fauci to be fired.

When there are such calls of distrust in public about a leader like Anthony Fauci,

who should garner trust, do you think he should be fired?

Absolutely not. To do so would be basically to give the opportunity for those who want

to make up stories about anybody to destroy them. There is nothing in the ways in which Tony Fauci

has been targeted that is based upon truth. How could we then accept those cries for his firing

as having legitimacy? It's a circular argument. They've decided they don't like Tony,

so they make up stuff and they twist comments that he's made about things like gain of function,

where he's referring to the very specific gain of function that's covered by this policy,

and they're trying to say he lied to the Congress. That's simply not true.

They don't like the fact that Tony changes the medical recommendations about what to do with

COVID 19 over the space of more than a year. They call that flip flopping and you can't

trust the guy because he says one thing last year and one thing this year. Well, the science has

changed. Delta variant has changed everything. You don't want him to be saying the same thing

he did a year ago. That would be wrong now. It was the best we could do then. People don't

understand that or else they don't want to understand that. When you basically whip up a

largely political argument against a scientist and hammer at it over and over again to the point

where he now has to have 24 seven security to protect him against people who really want to

do violence to him. For that to be a reason to say that then he should be fired is to hand

the evil forces the victory. I will not do that.

Yet there's something difficult that I'm going to try to express to you.

So it may be your guitar playing. It may be something else, but there's a humility to you.

It may be because you're a man of God. There's a humility to you that Garner's trust.

And when you're in a leadership position representing science, especially in catastrophic

events like the pandemic, it feels like as a leader, you have to go far above and beyond

your usual duties. And I think there's no question that Anthony Fauci has delivered

on his duties, but it feels like he needs to go above as a science communicator. And if there's

a large number of people that are distrusting him, it's also his responsibility to Garner their trust,

to gain their trust as a person who's the face of science. Are you torn on this?

The responsibility of Anthony Fauci of yourself to represent science, not just the communication

of advising what should be done, but giving people hope, giving people trust in science

and alleviating division. Do you think that's also a responsibility of a leader? Or is that unfair to

ask? I think the best way you give people trust is to tell them the truth. And so they recognize

that when you're sharing information, it's the best you've got at that point. And Tony Fauci does

that at every moment. I don't think him expressing more humility would change the fact that they're

looking for a target of somebody to blame, to basically distract people from the failings of

their own political party. Maybe I'm less targeted, not because of a difference in the way in which

I convey the information. I'm less visible. If Tony were out of the scene and I was placed in

that role, I'd probably be seeing a ratcheting up of that same targeting.

I would like to believe that if Tony Fauci said that when I originally made recommendations not

to wear masks, that was given on our best available data. And now we know that is a mistake. So admit

with humility that there's an error. That's not actually correct. But that's a statement of

humility. And I would like to believe despite the attacks, he would win a lot of people over with

that. So a lot of people, as you're saying, would use that, see that here we go, here's that Dr.

Anthony Fauci making mistakes. How can we trust him on anything? I believe if he was

that public display of humility to say that I made an error, that would win a lot of people over.

That's kind of my sense. To face the fire of the attacks from politics, politicians will

attack no matter what. But the question is the people, to win over the people. The biggest

concern I've had is that there is this distrust of science that's been brewing. And maybe you

can correct me, but I'm a little bit unwilling to fully blame the politicians because politicians

play their games no matter what. It just feels like this was an opportunity to inspire people with

the power of science. The development of the vaccines, no matter what you think of those

vaccines, is one of the greatest accomplishments in the history of science. And the fact that

that's not inspiring, listen, I host a podcast. Whenever I say positive stuff about the vaccine,

I get to hear a lot of different opinions. I bet you do. The fact that I do is a big problem to

me because it's an incredible, an incredible accomplishment of science. And so I'm sorry,

but I have to put responsibility on the leaders, even if it's not their mistakes. That's what the

leadership is. That's what leadership is. You take responsibility for the situation. I wonder

if there's something that could have been done better to give people hope that science will

save us as opposed to science will divide us. I think you have more confidence in the ability

to get beyond our current divisions than I do after seeing just how deep and dark they have become.

Tony Fauci has said multiple times the recommendation about not wearing masks

was for two reasons, a shortage of masks which were needed in hospitals, and a lack of realization

early in the course of the epidemic that this was a virus that could heavily infect asymptomatic

people. Has that changed? He changed. Now, did he make an error? No, he was making a judgment

based on the data available at the time, but he certainly made that clear over and over again.

It has not stopped those who would like to demonize him from saying, well, he just flip flopped.

You can't trust a guy. He says one thing today and one thing tomorrow.

Well, masks is a tricky one. Early on, I'm a coauthor on a paper, one of many,

but this was a survey paper overlooking the evidence. It's a summary of the evidence we have

for the effectiveness of masks. It seems that it's difficult to do rigorous scientific study

on masks. It is difficult. There's a lot of philosophical and ethical questions I want to ask

you within this. It's back to your words and Anthony Fauci's words. When you're dealing with so much

uncertainty and so much potential uncertainty about how catastrophic this virus is in the early days

and knowing that each word you say may create panic, how do you communicate science with the world?

It's a philosophical. It's an ethical. It's a practical question. There was a discussion

about masks a century ago and that too led to panic. I'm trying to put myself in your mind

and the mind of Anthony Fauci in those early days knowing that there's limited supply of masks.

Nick, what do you say? Do you fully convey the uncertainty of the situation of the

challenges of the supply chain or do you say that masks don't work?

That's a complicated calculation. How do you make that calculation?

It is a complicated calculation. As a scientist, your temptation would be to give a full brain

dump of all the details of the information about what's known and what isn't known and

what experiments need to be done. Most of the time, that's not going to play well in a sound

bite on the evening news. You have to distill it down to a recommendation that is the best you can

do at that time with the information you've got. You're a man of God. We'll return to that to talk

about some also unanswerable philosophical questions. But first, let's linger on the vaccine

because in the religious, in the Christian community, there was some hesitancy with the vaccine.

Still is? Still is. There's a lot of data showing high efficacy and safety of vaccines,

of COVID vaccines, but still they are far from perfect as all vaccines are. Can you empathize

with people who are hesitant to take the COVID vaccine or to have their children take the COVID

vaccine? I can totally empathize, especially when people are barraged by conflicting information

coming at them from all kinds of directions. I've spent a lot of my time in the last year

trying to figure out how to do a better job of listening because I think we have all

got the risk of assuming we know the basis for somebody's hesitancy and that often doesn't

turn out to be what you thought. The variety of reasons is quite broad. I think a big concern

is just this sense of uncertainty about whether this was done too fast and that corners were cut.

And there are good answers to that. Along with that, a sense that maybe this vaccine

will have long term effects that we won't know about for years to come. And one can say that

hasn't been seen with other vaccines. And there's no particular reason to think this one's going

to be different than the dozens of others that we have experience with. But you can't absolutely

say, no, there's no chance of that. So it does come down to listening and then trying in a

fashion that doesn't convey a message that you're smarter than the person you're talking to,

because that isn't going to help, to really address what the substance is of the concerns.

But my heart goes out to so many people who are fearful about this because of all the information

that has been dumped on them, some of it by politicians, a lot of it by the internet,

some of it by parts of the media that seem to take pleasure in stirring up this kind of fear

for their own reasons. And that is shameful. I'm really sympathetic with the people who are confused

and fearful. I am not sympathetic with people who are distributing information that's demonstrably

false and continue to do so. They're taking lives. I didn't realize how strong that sector of

disinformation would be. And it's been, in many ways, more effective than the means of spreading

the truth. This is going to take us into another place. But Lex, if there's something I'm really

worried about in this country, and it's not just this country, but it's the one I live in,

is that we have another epidemic besides COVID 19. And it's an epidemic of the loss

of the anchor of truth. The truth as a means of making decisions, truth as a means of figuring

out how to wrestle with a question like, should I get this vaccine for myself or my children,

seems to have lost its primacy. And instead, it's an opinion of somebody who

expressed it very strongly, or some Facebook post that I read two hours ago.

And for those to become substitutes for objective truth, not just, of course, for vaccines, but

for many other issues like, was the 2020 election actually fair? This worries me deeply. It's bad

enough to have polarization and divisions, but to have no way of resolving those by actually saying,

okay, what's true here, makes me very worried about the path we're on. And I'm usually an optimist.

Well, to give you an optimistic angle on this, I actually think that this sense that there's

no one place for truth is just a thing that will inspire leaders and science communicators to speak

not from a place of authority, but from a place of humility. I think it's just challenging people

to communicate in a new way, to be listeners first. I think the problem isn't that there's a

lot of misinformation. I think that the internet and the world are distrustful of people who

speak as if they possess the truth with an authoritarian tone, which was, I think, defining

for what science was in the 20th century. I just think it has to sound different in the 21st.

In the battle of ideas, I think humility and love wins. And that's how science wins,

not through having quote unquote truth. Because now everybody can just say, I have the truth.

I think you have to speak, like I said, from humility, not authority. And so it just challenges

our leaders to go back and learn to be, pardon my French, less assholes and more kind and,

like you said, to listen, to listen to the experiences of people that are good people,

not the ones who are trying to manipulate the system or play a game and so on, but real people

who are just afraid of uncertainty, of hurting those they loved and so on. So I think it's just

an opportunity for leaders to go back and take a class on effective communication.

I'm with you on shifting more from where we are to humility and love. That's got to be

the right answer. That's very biblical, by the way. We'll get there. I have to bring up Joe

Rogan. I don't know if you know who he is. I do. He's a podcast or comedian, fighting commentator,

and my now friend. And Ivermectin believer too. Yes, that is the question I have to ask you about.

He has gotten some flak in the mainstream media for not getting vaccinated. And when he got COVID

recently, taking Ivermectin as part of a cocktail of treatments, the NIH actually has a nice page

on Ivermectin saying, quote, there's insufficient evidence to recommend either for or against the

use of Ivermectin for the treatment of COVID 19. Results from adequately powered, well designed,

and well conducted clinical trials are needed to provide more specific evidence based guidance

on the role of Ivermectin in the treatment of COVID 19. So let me ask, why do you think there has

been so much attack on Joe Rogan and anyone else that's talking about Ivermectin when there's

insufficient evidence for or against? Well, let's unpack that. First of all, I think the concerns

about Joe are not limited to his taking Ivermectin much more seriously, his being fairly publicly

negative about vaccines at a time where people are dying. 700,000 people have died from COVID 19.

Estimates by Kaiser or at least 100,000 of those were unnecessary deaths of unvaccinated people.

And for Joe to promote that further, even as this pandemic rages through our population,

is simply irresponsible. So yeah, the Ivermectin is just one other twist. Obviously, Ivermectin

has been controversial for months and months. The reason that it got particular attention is

because of the way in which it seemed to have captured the imagination of a lot of people

and to the point where they were taking doses that were intended for livestock. And some of them

got pretty sick as a result from overdosing on this stuff. That was not good judgment.

The drug itself remains uncertain. There's a recent review that looks at all of the studies

of Ivermectin and basically concludes that it probably doesn't work. We are running a study

right now. I looked at that data this morning in a trial called Active Six, which is one of the

ones that my public private partnership is running. We're up to about 400 patients who've been randomized

to Ivermectin or placebo and should know perhaps as soon as a month from now in a very carefully

controlled trial. Did it help or did it not? So there will be an answer. Coming back to Joe,

again, I don't think the fact that he took Ivermectin and hoping it might work

is that big a knock against him. It's more the conveying of we don't trust what science says,

which is vaccines are going to save your life. We're going to trust what's on the internet

that says Ivermectin and hydroxychloroquine really do work, even though the scientific

community says probably not. So let me push back on that a little bit. So he doesn't say

let's not listen to science. He doesn't say don't get vaccinated. He says it's okay to ask questions.

I'm okay with that. How risky is the vaccine for certain populations? What are the benefits

and risks? There's other friends of Joe and friends of mine like Sam Harris who says if you look at

the data, it's obvious that the benefits outweigh the risks. And what Joe says is yes, but let's

still openly talk about risks. And he often brings up anecdotal evidence of people who've had

highly negative effects from vaccines. Science is not done with anecdotal evidence.

And so you could infer a lot of stuff from the way he expresses it. But he also communicates a

lot of interesting questions. And that's something maybe you can comment on. There's certain groups

that are healthy. They're younger. They exercise a lot. They get nutrition and all those kinds

of things. He shows skepticism on whether it's so obvious that they should get vaccinated. And the

same as he kind of presents the same kind of skepticism for kids, for young kids. So with empathy

and listening my Russian inelicant description of what Joe believes, what is your kind of response

to that? Why should certain categories of healthy and young people still get vaccinated, do you

think? Well, first, just to say it's great for Joe to be a skeptic, to ask questions. We should all

be doing that. But then the next step is to go and see what the data says and see if there are

actually answers to those questions. So coming to Healthy People, I've done a bunch of podcasts

besides this one. The one I think I remember most was a podcast with a worldwide wrestling

superstar. Very nice. He's about six foot six and just absolutely solid muscle. And he got COVID

and he almost died. And recovering from that, he said, I've got to let my supporters know,

because you can imagine worldwide wrestling fans are probably not big

embracers of the need for vaccines. And he just turned himself into a spokesperson for the fact

that this virus doesn't care how healthy you are, how much you exercise, what a great specimen you

are. It wiped him out. And we see that. You know, the average person in the ICU right now with COVID

19 is under age 50. I think there's a lot of people still thinking, oh, it's just those old people in

the nursing homes. That's not going to be about me. They're wrong. And there are plenty of instances

of people who were totally healthy with no underlying diseases, taking good care of themselves,

not obese, exercising, who have died from this disease. 700 children have died from this disease.

Yes, some of them had underlying factors like obesity, but a lot of them did not. So it's fair

to say younger people are less susceptible to serious illness. Kids even less so than young

adults, but it ain't zero. And if the vaccine is really safe and really effective, then you

probably want everybody to take advantage of that. Even though some are dropping their risks more

than others, everybody's dropping their risks some. Are you worried about variants? So looking out

into the future, what's your vision for all the possible trajectories that this virus takes in

human society? I'm totally worried about the variants. Delta was such an impressive arrival

on the scene in all the wrong ways. I mean, it took over the world in the space of just a couple

months because of its extremely contagious ability. Viruses would be beautiful if they weren't

terrifying. Yeah, exactly. I mean, this whole story of viral evolution, scientifically, is just

amazingly elegant. Anybody who really wanted to understand how evolution works in real time,

study SARS CoV2, because it's not just Delta, it's Alpha, and it's Beta, and it's Gamma, and it's

Gamma, and it's the fact that these sweep through the world's population by fairly minor differences

in fitness. So the real question many people are wrestling is, is Delta it? Is it such a fit virus

that nothing else will be able to displace it? I don't know. I mean, there's now Delta AY4,

which is a variant of Delta that at least in the UK seems to be taking over the Delta population,

as though it's maybe even a little more contagious. That might be the first hint that we're seeing

something new here. It's not a completely different virus. It's still Delta, but it's Delta Plus.

You know, the big worry, blacks, is what's out there that is so different that the vaccine

protection doesn't work. And we don't know how different it needs to be for the vaccine to

stop working. That's the terrifying thing about each of these variants. It's always a pleasant

surprise that the vaccine seems to still have efficacy. And hooray for our immune system,

may I say, because the vaccine immunized you against that original Wuhan virus.

Now we can see that especially after two doses and even more so after a booster,

your immune system is so clever that it's also making a diversity of antibodies to cover some

other things that might happen to that virus to make it a little different. And you're still

getting really good coverage. Even for beta, which was South Africa B1351, which is the most

different, it looks pretty good. But that doesn't mean it will always be as good as that if something

gets really far away from the original virus. Now the good news is we would know what to do

in that situation. The mRNA vaccines allow you to redesign the vaccine like that and to quickly

get it through a few thousand participants in a clinical trial to be sure it's raising antibodies

and then bang, you could go. But I don't want to have to do that. There will be people's lives

at risk in the meantime. And what's the best way to keep that from happening? Well try to cut down

the number of infections because you don't get variants unless the virus is replicating in a

person. So how do we solve this thing? How do we get out of this pandemic? What's like if you had

like a wand or something? Or you could really implement policies. What's the full cocktail

of solutions here? It's a full cocktail. It's not just one thing. In our own country here in the US,

it would be getting those 64 million reluctant people to actually go ahead and get vaccinated.

There's 64 million people who didn't get vaccinated? Adults, yes. Not even counting the kids.

64 million. Isn't that astounding? Get the kids vaccinated. Hopefully their parents will see

that as a good thing too. Get those of us who are due for boosters boosted because that's going

to reduce our likelihood of having breakthrough infections and keep spreading it. Convince people

that until we're really done with this and we're not now, that social distancing and mask wearing

indoors are still critical to cut down the number of new infections. But of course, that's our country.

This is a worldwide pandemic. I worry greatly about the fact that low and middle income countries

have for the most part not even gotten started with access to vaccines and we have to figure out a

way to speed that up because otherwise that's where the next variant will probably arrive

and who knows how bad it will be and it will cross the world quickly as we've seen happen

repeatedly in the last 22 months. I think I'm really surprised, annoyed, frustrated that testing,

rapid at home testing from the very beginning wasn't a big, big part of the solution. It seems,

first of all, nobody's against it. That's one huge plus for testing that it's everybody supports.

Second of all, that's what America is good at, is mass manufacture of stuff,

stepping up, engineer stepping up and really deploying it. Plus, without the collection

of data, it's giving people freedom. It's giving them information and then freedom to decide what

to do with that information. It's such a powerful solution. I don't understand. Well, now, I think

the Biden administration has emphasized the scaling of testing manufacturers. But I just

feel like it's an obvious solution. Get a test that costs less than a dollar to manufacture,

costs less than a dollar to buy, and just everybody gets tested every single day.

Don't share that data with anyone. You just make the decisions. I believe in the intelligence

of people to make the right decision to stay at home when the test is positive.

I am so completely with you on that. NIH has been smack in the middle of trying to make that

dream come true. We're running a trial right now in Georgia, Indiana, Hawaii, and where's the other one?

Oh, Kentucky. Basically, blanketing a community with free testing. That was beautiful. And look

to see what happens as far as stemming the spread of the epidemic and measuring it by

wastewater because you can really tell whether you've cut back the amount of infection in the

community. Yeah, I'm so with you. We got off to such a bad start with testing. And of course,

all the testing was being done for the first several months in big box laboratories where

you had to send the sample off and put it through the mail somehow and get the result back sometimes

five days later after you've already infected a dozen people. It was just a completely wrong model,

but it's what we had. And everybody was like, oh, we got to stick with PCR because if you start

using those home tests that are based on antigens lateral flow, probably there's going to be false

positives and false negatives. Okay, sure. No test is perfect. But having a test that's not

acceptable or accessible is the worst setting. So we NIH with some requests from Congress got

a billion dollars to create this program called rapid acceleration of diagnostics, RADX. And

we turned into a venture capital organization and we invited every small business or academic lab

that had a cool idea about how to do home testing to bring it forward. And we threw them into what

we called our shark tank of business experts, engineers, technology people, people understood

how to deal with supply chains and manufacturing. And right now today, there are about two million

tests being done based on what came out of that program, including most of the home tests that

you can now buy on the pharmacy shelves. And we did that. And I wish we had done it faster,

but it was an amazingly speedy effort. And you're right, companies are really good. Once they've

gotten FDA emergency use authorization, and we helped a lot of them get that, they can scale

up their manufacturing. I think in December, we should have about 410 million tests for that

month ready to go. And if we can get one or two more platforms approved. And by the way, we are

now helping FDA by being their validation lab. If we can get a couple more of these approved,

we could be in the half a billion tests a month, which is really getting where we need to be.

Wow. Yeah, that's a dream. That's a dream for me. It seems like an obvious solution,

engineering solution. Everybody's behind it. It leads to hope versus division. I love it. Okay.

A happy story.

A happy story.

I was waiting for one.

Yeah. All right. Well, one last dive into the not happy, but you won't even have to comment

on it. Well, comment on the broader philosophical question. So NIH, again, I said Joe Rogan is

the first one who pointed me to this. NIH was recently accused of funding research of a paper

that had images of sedated puppies with their heads inserted into small enclosures containing

disease carrying sand flies. So I could just say that this story is not true, or at least the...

I think it is true that the paper that showed those images cited NIH as a funding source,

but that citation is not correct.

That was not correct.

Yeah. But that brings up a bigger philosophical question that could have been correct. How

difficult is it as a director of NIH or just NIH as an organization that's funding so many

amazing deep research studies to ensure the ethical fortitude of those studies

when the ethics of science is... There's such a great area between what is and what isn't ethical.

Well, tough issues. Certainly animal research is a tough issue.

I was going to bring up... It's a good example of that tough issue is in 2015,

you announced that NIH would no longer support any biomedical research involving chimpanzees.

So that's like one example of looking in the mirror, thinking deeply about what is and isn't

ethical, and there was a conclusion that biomedical research on chimps is not ethical.

Well, that was the conclusion. That was based on a lot of deep thinking and a lot of input from

people who have considered this issue and a panel of the National Academy of Sciences

that was asked to review the issue. I mean, the question that I wanted them to look at was,

are we actually learning anything that's really essential from chimpanzee invasive research

at this point? Or is it time to say that these closest relatives of ours should not be subjected

to that any further and ought to be retired to a sanctuary? And that was the conclusion that

there was really no kind of medical experimentation that needed to be done on chimps in order to

proceed. So why are we still doing this? Many of these were chimpanzees that were purchased

because we thought they would be good hosts for HIV AIDS, and they sort of weren't,

and they were kept around in these primate laboratories with people coming up with other

things to do, but they weren't compelling scientifically. So I think that was the right

decision. I took a lot of flack from some of the scientific communities, said, well, you're caving

in to the animal rights people. And now that you've said no more research on chimps, what's next?

Certainly when it comes to companion animals, everybody's heart starts to be hurting when

you see anything done that seems harmful to a dog or a cat. I have a cat. I don't have a dog.

And I understand that completely. That's why we have these oversight groups that decide before you

do any of that kind of research. Is it justified? And what kind of provision is going to be made

to avoid pain and suffering? And those are, those have input from the public as well as the scientific

community. Is that completely saying that every step that's happening there is ethical by some

standard that would be hard for anybody to agree to? No, but at least it's a consensus of what people

think is acceptable. Dogs are the only host for some diseases like Leishmaniasis, which was that

paper that we were not responsible for, but I know why they were doing the experiment, or like

lymphatic filariasis, which is an experiment that we are supporting in Georgia that involves dogs

getting infected with a parasite, because that's the only model we have to know whether a treatment

is going to work or not. So I will defend that. I am not in the place of those who think all animal

research is evil, because I think if there's something that's going to be done to save a child

from a terrible disease or an adult, and it involves animal research that's been carefully reviewed,

then I think ethically why it doesn't make me comfortable, it still seems like it's the right

choice. I think to say all animal research should be taken off the table is also very

unethical, because that means you have basically doomed a lot of people for whom that research

might have saved their lives to having no more hope. And to me personally, there's far greater

concerns ethically in terms of factory farming, for example, the treatment of animals in other

contexts. Oh, there's so much that goes on outside of medical research that is much more

troubling. That said, I think all cats have to go. That's just my off the record opinion.

That's why I'm not involved with any ethical decisions. I'm just joking internet. I love cats.

You're a dog person. I'm a dog person. I'm sorry. Have you seen the New Yorker cartoon where

there are two dogs in the bar having a martini and one is saying that they're dressed up in their

business suits and one says to the other, you know, it's not enough for the dogs to win. The cats

have to lose. It's beautiful. So a few weeks ago, you've announced that you're resigning from the

NIH at the end of the year. I'm stepping down. I'm still going to be at NIH at a different

capacity. At a different capacity rate. And it's over a decade of an incredible career overseeing

the NIH as its director. What are the things you're most proud of of the NIH in your time here as

its director? Maybe memorable moments. There's a lot in 12 years. Science has just progressed in

amazing ways over those 12 years. Think about where we are right now. Something like gene editing,

being able to make changes in DNA, even for therapeutic purposes, which is now curing sickle

cell disease. Unthinkable when I became director in 2009. The ability to study single cells and

ask them what they're doing and get an answer. Single cell biology just has emerged in this

incredibly powerful way. Having the courage to be able to say we could actually understand the

human brain seems like so far out there. And we're in the process of doing that with the brain

initiative. Taking all that we've learned about the genome and applying it to cancer, to make

individual cancer treatment really precision. And developing cancer immunotherapy, which seemed

like sort of a backwater into some of the hottest science around. All those things sort of erupting.

And much more to come, I'm sure. We're on an exponential curve of medical research advances,

and that's glorious to watch. And of course, COVID 19 as a beneficiary of decades of basic

science, understanding what mRNA is, understanding basics about coronaviruses and spike proteins,

and how to combine structural biology and immunology and genomics into this package that

allows you to make a vaccine in 11 months. Just, I would never have imagined that possible in

2009. So to have been able to kind of be the midwife, helping all of those things get birthed,

that's been just an amazing 12 years. And as NIH director, you have this convening power

and this ability to look across the whole landscape of biomedical research and identify

areas that are just like ready for something big to happen. But it isn't going to happen

spontaneously without some encouragement, without pulling people together from different

disciplines who don't know each other and maybe don't know how to quite understand each other's

scientific language and create an environment for that to happen. That has been just an amazing

experience. I mean, I mentioned the Brain Initiative as one of those. The Brain Initiative

right now, I think there was about 600 investigators working on this last week. The whole issue

of Nature Magazine was about the output of the Brain Initiative, basically now giving us a cell

census of what those cells in the brain are doing, which has just never been imaginable.

And interestingly, more than half of the investigators in the Brain Initiative are

engineers. They're not biologists in a traditional sense. I love that, maybe partly because my PhD

is in quantum mechanics. So I think it's really a good idea to bring disciplines together and

see what happens. That's an exciting thing. And I will not ever forget having the chance to

announce that program in the East Room in that White House with President Obama, who totally

got it and totally loved science. And working with him in some of those rare moments of sort of

one on one conversation in the old office, just him and me about science, that's a gift.

What's it like talking to Barack Obama about science? He seems to be a sponge. I've heard him,

I'm an artificial intelligence person, and I've heard him talk about AI. And it was like, it made

me think of somebody whispering in his ear or something because he was saying stuff that totally

passed the BS test. Like he really understands stuff. He does. That means he listened to a bunch

of experts on AI. He was explaining the difference between narrow artificial intelligence and strong

AI. Like he was saying all this both technical and philosophical stuff. And it just made me,

I don't know, it made me hopeful about the depth of understanding that a human being

in political office can attain. That gave me hope as well and having those experiences.

Oftentimes in a group, I mean, another example was trying to figure out how do we take what we've

learned about the genome and really apply it at scale to figure out how to prevent illness,

not just treat it, but prevent it. Out of which came this program called All of Us, this million

strong American cohort of participants who make their electronic health records and their genome

sequences and everything else available for researchers to look at. That came out of a

lot of a couple of conversations with Obama and others in his office. And he asked the best

questions. That was what struck me so much. I mean, a room full of scientists and we'd be

talking about the possible approaches and he would come up with this incredibly insightful

penetrating question. Not that he knew what the answer was going to be, but he knew what the

right question was. I think the core to that is curiosity. Yeah. I don't think he's even like

he's trying to be a good leader. He's legit curious. Yes. Legit. Almost like a kid in a

candy store gets to talk to the world experts. He somehow sneaked into this office and gets

to talk to the world experts. That's the kind of energy that I think leads to

beautiful leadership in the space of science. Another thing I've been able to do as director

is to try to break down some of the boundaries that seem to be traditional between the public

and the private sectors. When it comes to areas of science that really could and should be open

access anyway, why don't we work together? And that was obvious early on. And after identifying

a few possible collaborators who are chief scientists of pharmaceutical companies,

it looked like we might be able to do something in that space. Out of that was born something

called the Accelerating Medicines Partnership, AMP. And it took a couple of years of convening

people who usually didn't talk to each other. And there was a lot of suspicion. Academic scientists

saying, oh, those scientists at Pharma, they're not that smart. They're just trying to make money.

And the academic scientists getting the rap from the pharmaceutical scientists, all they want to do

is publish papers. They don't really care about helping anybody. And we found out both of those

stereotypes were wrong. And over the course of that couple of years, built a momentum behind

three starting projects, one on Alzheimer's, one on diabetes, one on rheumatoid arthritis and lupus,

very different, each one of them trying to identify what is an area that we both really

need to see advance, and we could do better together. And it's going to have to be open access,

otherwise NIH is not going to play. And guess what industry, if you really want to do this,

you got to have skin in the game. What cover half the cost, you got to cover the other half.

I love it. And forcing open access, so resulting in open science.

Millions of dollars gone into this. And it has been a wild success. After many people were skeptical.

A couple years later, we had another project on Parkinson's. More recently, we added one on

schizophrenia. Just this week, we added one on gene therapy, on bespoke gene therapy for

ultra rare diseases, which otherwise aren't going to have enough commercial appeal. But if we did

this together, especially with FDA at the table, and they have been, we could make something happen,

turn this into a sort of standardized approach where everything didn't have to be a one off.

I'm really excited about that. So what began as three projects is six, and it's about to be

seven next year with a heart failure project. And all of us have gotten to know each other.

And if it weren't for that background, when COVID came along, it would have been a lot harder

to build the partnership called active, which has been my passion for the last 20 months,

accelerating COVID 19 therapeutic interventions and vaccines. We just had our leadership team

meeting this morning. It was amazing what's been accomplished. That's a pretty much 100 people

who dropped everything just to work on this about half from industry and half from government and

academia. And that's how we got vaccine master protocols designed. So we all agreed about what

the endpoints had to be. And you wondered, why are there 30,000 participants in each of these

trials? That's because of active group mapping out what the power needed to be for this to be

convincing. Same with therapeutics. We have run at least 20 therapeutic agents through trials

that active supported in record time. That's how we got monoclonal antibodies that we know work.

That's been, that would not have been possible if I didn't already have a sense of how to work

with the private sector that came out of a hemp. Amp took two years to get started.

Active took two weeks. We just kept 100 people over. Yeah, kept the lawyers out of the room.

Now you're going to get yourself in trouble. I do hope one day the story of this incredible

vaccine development of vaccine protocols and trials and all this kind of details,

the messy, beautiful details of science and engineering and that led to the manufacturing

and the deployment and the scientific test. It's such a nice dance between engineering and the

space of manufacture of the vaccines. You start before the studies are complete. You start making

the vaccines just in case that if the studies proved to be positive, then you can start deploying

them just like so many parties, like you said, private and public playing together. That's just

a beautiful dance that is one of the, for me, the sources of hope in this very tricky time where

there's a lot of things to be cynical about in terms of the game's politicians play and the

hardship experience of the economy and all those kinds of things. That to me, this dance

was a vaccine development was done just beautifully and it gives me hope.

It does me as well and it was in many ways the finest hour that science has had in a long time

being called upon when every day counted and making sure that time was not wasted

and things were done rigorously but quickly.

So you're incredibly good as the leader of the NIH. It seems like you're having a heck of a lot of

fun. Why step down from this role after so much fun? Well, no other NIH director has served more

than one president after being appointed by one. You're sort of done and the idea being carried

over for a second presidency with Trump and now a third one with Biden is unheard of. I just think

Lex at scientific organizations benefit from new vision and 12 years is a really long time

to have the same leader and if I wasn't going to stick it out for the entire Biden four year term,

it's good not to wait too late during that to signal an intent to step down because the president's

got to find the right person, got to nominate them, got to get the Senate to confirm them which is a

unpredictable process right now and you don't want to try to do that in the second half of

somebody's term as president. This has got to happen now. So I kind of decided back at the

end of May that this should be my final year and I'm okay with that. I do have some mixed emotions

because I love the NIH. I love the job. It's exhausting. I'm traditionally for the last 20

months anyway working 100 hours a week. It's just that's what it takes to juggle all of this

and that keeps me from having a lot of time for anything else and I wouldn't mind because I don't

think I'm done yet. I wouldn't mind having some time to really think about what the next chapter

should be and I have none of that time right now. Do I have another calling? Is there something else

I could contribute that's different than this? I'd like to find that out. I think the right

answer is you're just stepping down to focus on your music career. That might not be a good plan

for anything very sustainable. But I think that is a sign of a great leader as George Washington

did stepping down at the right time. Ted Williams. Yes. He quit. I think he hit a home run on his

last at bat and his average was 400 at the time. No one to walk away. I mean it's hard but it's

beautiful to see in a leader. You also oversaw the Human Genome Project. You mentioned the

Brain Initiative which is a dream to map the human brain and there's the dream to map the

human code which was the Human Genome Project and you have said that it is humbling for me and

awe inspiring to realize that we have caught the first glimpse of our own instruction book

previously known only to God. How does that if you can just kind of wax poetic for a second?

And how does it make you feel that we were able to map this instruction book, look into our own

code and be able to reverse engineer it? It's breathtaking. It's so fundamental and yet for

all of human history we're ignorant of the details of what that instruction book looked like and then

crossed the bridge into the territory of the known and we had that in front of us still written in

the language that we had to learn how to read and we're in the process of doing that and will be for

decades to come but we owned it. We had it and it has such profound consequences. It's both a book

about our history. It's a book of sort of the parts list of a human being, the genes that are in

there and how they're regulated and it's also a medical textbook that can teach us things that

will provide answers to illnesses we don't understand and alleviate suffering and premature death. So

it's a pretty amazing thing to contemplate and it has utterly transformed the way we do science

and it is in the process of transforming the way we do medicine although much of that still lies

ahead. While we were working on the genome project it was sort of hard to get this sense of

awowness because it was just hard work and you were getting another megabase, okay this is good

but when did you actually step back and say we did it? It's the profoundness of that. I mean there

were two points I guess. One was the announcement on that June 26, 2000 where the whole world heard,

well we don't quite have it but we got a pretty good draft and suddenly people are like realizing

oh this is this is a big deal. For me it was more when we got the full analysis of it published

it in February 2001 and that issue of nature paper that Eric Lander and Bob Waterston and I were

the main authors and we toiled over and tried to get as much insight as we could in there about

what the meaning of all this was but you also had this sense that we are such beginning readers here

we are still in kindergarten trying to make sense out of this three billion letter book

and we're going to be at this for generations to come.

You are a man of faith Christian and you are a man of science. What is the role of religion

and of science and society and in the individual human mind and heart like yours?

Well I was not a person of faith when I was growing up. I became a believer in my 20s

influenced as a medical student by a recognition that I hadn't really thought through the issues

of what's the meaning of life? Why are we all here? What happens when you die? Is there a God?

Science is not so helpful in answering those questions so I had to look around in other places

and ultimately came to my own conclusion that atheism which is where I had been

in was the least supportable of the choices because it was the assertion of a universal negative

which scientists aren't supposed to do and agnosticism came as an attractive option but

felt a little bit like a cop out so I had to keep going trying to figure out why do believers

actually believe this stuff and came to realize it was all pretty compelling that there's no proof

I can't prove to you or anybody else that God exists but I can say it's pretty darn plausible

and ultimately what kind of God is it? Caused me to search through various religions and see

well what do people think about that and to my surprise encountered the person of Jesus Christ

as unique in every possible way and answering a lot of the questions I couldn't otherwise answer

and somewhat kicking and screaming I became a Christian even though at the time

as a medical student already interested in genetics people predicted my head would then

explode because these were incompatible worldviews they really have not been for me I am so

fortunate I think that in a given day wrestling with an issue it can have both the rigorous

scientific component and it can have the spiritual component COVID 19 is a great example

these vaccines are both an amazing scientific achievement and an answer to prayer

when I'm wrestling with vaccine hesitancy and trying to figure out what answers to come up with I get

so frustrated sometimes and I'm comforted by reassurances that God is aware of that this is

I don't have to do this alone so I know there are people like your friend Sam Harris who feel

differently Sam wrote a rather famous op ed in the New York Times when I was nominated as the NIH

director saying this is a terrible mistake you can't have somebody who believes in God running

the NIH and he's just going to completely ruin the place well I have a testimonial Christopher

Hitchens a devout atheist if I could say so oh yeah was a friend of yours and referred to you as

quote one of the greatest living Americans and stated that you are one of the most devout believers

he has ever met he further stated that you were sequencing the genome of the cancer that would

ultimately claim his life and that your friendship despite their differing opinions on religion

was an example of the greatest armed truth in modern times what did you learn from Christopher

Hitchens about life or perhaps what is the fond memory you have of this man with whom you've

disagreed but who's also your friend yeah I loved Hitch I'm sorry he's gone iron sharpens iron

there's nothing better for trying to figure out where you are with your own situation and your

own opinions your own worldviews than encountering somebody who's completely in another space

and who's got the gift as Hitch did of challenging everything and doing so over a glass of scotch

or two or three yeah we got off to a rough start where in a interaction we had at a rather high

brow dinner he was really deeply insulting of a question I was asking but you know I was like

okay uh that's fine let's let's figure out how we could have a more civil conversation

and then I really learned to greatly admire his intellect and to find the jousting with him

and it wasn't all about faith although it often was uh it was really inspiring and innovating

energizing and then when he got cancer I became sort of his ally trying to help him find pathways

through the various options and maybe helped him to stay around on this planet for an extra six

months or so and I have the warmest feelings of being in his apartment downtown over a glass of wine

talking about whatever sometimes it was science he was fascinated by science sometimes it was

Thomas Jefferson uh sometimes it was faith and I knew it would always be really interesting

so he's not gone yeah do you think about your own mortality are you afraid of death

I'm not afraid I'm not looking forward to it I don't want to rush it because I feel like I got

some things I can still do here but as a person of faith I don't think I'm afraid I'm 71 I know

I don't have an infinite amount of time left and I want to use the time I've got in some sort of way

that matters I'm not ready to become a full time golfer but I don't quite know what that is

I do feel that I've had a chance to do amazingly powerful things as far as experiences

and maybe God has something else in mind I wrote this book 16 years ago the language of God

about science and faith trying to explain how from my perspective these are compatible these

are in harmony they're complementary if you are careful about which kind of question you're asking

and to my surprise a lot of people seem to be interested in that they were tired of hearing

the extreme voices like Dawkins at one end and people like Ken Ham and answers and Genesis

on the other end saying if you trust science you're going to hell and they thought there must

be a way that these things could get along and that's what I tried to put forward and then I

started a foundation by Ologos which then I had to step away from to become NIH director

which has just flourished maybe because I stepped away I don't know but it now has millions of people

who come to that website and they run amazing meetings and I think a lot of people have really

come to a sense that this is okay I can love science and I can love God and that's not a bad

thing so maybe there's something more I can do in that space maybe that book is ready for a second

edition I think so but when you look back life is finite what do you hope your legacy is

hmm I don't know this whole legacy thing it's a little bit hard to embrace it feels a little

self promoting doesn't it I've sort of feel like in many ways I went to my own funeral

on October 5th when I announced that I was stepping down and I got the most amazing responses

from people some of whom I knew really well some of whom I didn't know at all who were just telling

me stories about something that I had contributed to that made a difference to them and that was

incredibly heartwarming and that's enough you know I don't want to build an edifice I don't have a

plan for a monument or a statue God help us I do feel like I've been incredibly fortunate I've had

the chance to play a role in things that were pretty profound from the genome project to NIH to

COVID vaccines and I ought to be plenty satisfied that I've had enough experiences here to feel

pretty good about the way in which my life panned out we did a bunch of difficult questions

in this conversation let me ask the most difficult one that perhaps is the reason you turn to God

what is the meaning of life have you figured it out yet expect me to put that into three sentences

we only have a couple of minutes at least hurry up

well that's not a question I think science helps me with so you're gonna push me into the face

zone which is where I'd want to go with that I think well what is the meaning why are we here

what do we put here to do I do believe we're here for just a blink of an eye and that our existence

somehow goes on beyond that in a way that I don't entirely understand despite efforts to do so

I think we are called upon in this blink of an eye to try to make the world a better place

to try to love people to try to do a better job of our more altruistic instincts and less of our

selfish instincts to try to be what God calls us to be people who are holy not people who are

are driven by self indulgence and sometimes I'm better at that than others but I think that

for me as a Christian is a pretty clear I mean it's to live out the sermon on the mount

once I read that I couldn't unread it all those beatitudes all the blessings

that's what we're supposed to do and the meaning of life is to strive for that standard

recognizing you're going to fail over and over again and that God forgives you

hopefully to put a little bit of love out there into the world that's what it's about

Francis I'm truly humbled and inspired by both your brilliance and your humility

and that you would spend your extremely valuable time with me today it was really an honor thank

you so much for talking today I was glad to and you asked a really good question so your reputation

as the best podcaster has worn itself out here this afternoon thank you so much thanks for listening

to this conversation with Francis Collins to support this podcast please check out our sponsors

in the description and now let me leave you with some words from Isaac Newton reflecting on his

life and work I seem to have been only like a boy playing on the seashore and diverting myself

and now and then finding a smoother pebble or a prettier shell than ordinary whilst the great

ocean of truth lay all undiscovered before me thank you for listening and hope to see you next time