Utah alum Bertagnolli could make big changes as next NIH leader, Catharine E. Krebs writes

National Institutes of Health has nominated former chair of Huntsman Cancer Institute’s external advisory board and 1985 graduate of Spencer Fox Eccles School of Medicine

Dr. Catharine Krebs

More than a year after Francis Collins’ retirement as the NIH director, it was finally reported that President Biden nominated Dr. Monica Bertagnolli for director of the National Institutes of Health (NIH). The NIH is the largest funder of biomedical and public health research in the world. If the Senate approves this nomination, Dr. Bertagnolli will have the exciting opportunity to lead the charge to bring medical research techniques into the 21st century, without animal experiments.

Advancing research tools and approaches that are human-focused is crucial if we want to tackle the growing number of major health threats and crises. Between the devastating effects of COVID-19, the rising number of Americans with Alzheimer’s and related dementias, and the growing recognition of health-related harms caused by racism and other forms of oppression, precious federal funds for medical research must be invested wisely̶ —utilizing ethical, human data and human-based research.

The public will look to the new NIH director to address these health research challenges with an innovative approach and an appropriate sense of urgency. Success will come from recognizing the need to reduce wasteful and poorly predictive animal experiments. Despite its own recognition of the serious scientific and ethical limitations of animal experiments, the NIH continually attempts to expand and improve them. Indeed, some half of NIH-funded grants use animals, which results an estimated 100 million monkeys, dogs, cats, mice, rats, and other animals used and/or killed in U.S. laboratories each year. The new director can offer new commitments in the form of measurable, time-bound actions to reducing and replacing animal experiments at all institutes and centers of the NIH.

To improve the relevance and translatability of experimental systems to the clinic, the NIH must increase support for human biology-based models. This can only be achieved if the NIH strategically prioritizes and invests in the development and use of nonanimal, human-specific approaches.

Human-specific research uses human cells, tissues, and data to investigate health and disease and includes a broad range of methods, from tissue chips and organoids to computational modeling. It also includes human subjects research, such as the use of electronic health records and measures of neighborhood disadvantage. The NIH has many successful existing programs in human-specific research, like the Tissue Chip for Drug Screening program, the NeuroBioBank, and the Human Tumor Atlas Network. But there is opportunity to expand upon these programs and create new ones to ensure further progress in human-specific, nonanimal models.

Prioritizing human-specific approaches also allows researchers to recenter patients and communities. Animals are incapable of modelling social determinants of health or community interventions. The NIH bias toward mechanistic research aimed at pharmaceutical interventions diverts resources away from the kind of research that can address health disparities or that can prevent disease by addressing modifiable risk factors, such as environmental exposures. This inequitable bias disadvantages Black investigators, who are more likely to propose research on topics with lower award rates, such as health disparities or research involving human subjects.

Dr. Bertagnolli took over as the director of the NIH’s National Cancer Institute in October 2022, where she has been a champion for inclusive, patient-centered cancer research — exactly the kind of research the agency needs to invest in more broadly. A new directive, through the upcoming NIH-wide strategic plan, to increase development of human-based approaches combining analysis between biological, social and structural determinants of health, will help the NIH remain a world leader in science.

Time will tell if Dr. Bertagnolli’s leadership will steer the agency away from the methodological inertia still slowing down progress and toward a human-focused research direction. What is indisputable is that vision and action are needed to renew the public’s confidence in the NIH to uphold its scientific charge. If Dr. Bertagnolli can pull off this difficult task, celebrations will be in order for both patients and animals alike.

Catharine E. Krebs, PhD, is a medical research specialist with the Physicians Committee for Responsible Medicine, a Washington, DC-based national nonprofit promoting preventive medicine, conducting clinical research, and encouraging higher standards for ethics and effectiveness in research and medical training.