(National Cancer Institute)
Dr. Harold Varmus is the director of the U.S. National Cancer Institute (NCI), part of the National Institutes of Health (NIH). Varmus previously has served as director of the NIH, president of Memorial Sloan-Kettering Cancer Center and a faculty member at the University of California, San Francisco medical school. In 1989, Varmus was co-recipient of the Nobel Prize in Physiology or Medicine for his studies on the genetic basis of cancer.

How is leading an agency with a scientific environment different from leading a typical federal agency?

The NCI and the other institutes of the NIH are part of the federal government, so there are political ties that affect us, but our major obedience is to the truth of what we do. We’re a science-based agency, and everything we do is served by science: We depend on evidence, and try to uncover more facts. Our primary motivation is knowledge and an improved ability to combat disease.

We also differ from other agencies by our very large set of constituencies--not just the 5,000 people who work here, but also the hundreds of thousands of scientists and technicians who do cancer research; the people throughout the country affected by cancer, including patients, families, disease advocacy groups and health-care providers; and the many institutions, especially universities and academic health centers, that depend heavily on us for financial support. The NCI is not just a bureaucracy, it’s not just a research institute in Bethesda--it’s the organization that awards grants, contracts and training programs, distributing a few billion dollars to literally hundreds of institutions across the country and abroad through a merit-based process of review.

How are you engaging the scientific community?

It’s very important to me to have strong contacts with many communities of scientists, here and abroad. To do this, I attend scientific meetings elsewhere, organize workshops at the NIH, follow the scientific literature and continue to run a small laboratory of my own at the NIH. My colleagues and I depend on new ideas from other scientists to guide the development of our research programs, both when budgets are growing and, as is true now, when budgets are flat or shrinking. Because of current pressures on our budget and the extraordinary opportunities in cancer research, it is especially important now to capture the collective wisdom of our scientific colleagues to be sure that we use every penny we get as wisely as possible.

What are the challenges to attracting young people to the scientific field?

Cancer is one of the great intellectual challenges of all time, and I believe this is a time of unprecedented scientific opportunity to advance virtually all phases of cancer research. So, people with an interest in the biological sciences should be extremely eager to engage in cancer research: It is inherently exciting at the most basic level and also compelling because it’s being used for patient benefit as we speak.

At the same time, the incentives to come into a field, even one as exciting as this, will be tempered by fiscal realities. When Congress contemplates shrinking the NIH budget, as it is now doing, young people will understandably be anxious about a medical research career. Even small decreases in our budget can have dramatic effects on the number of new grants we can issue, because a large fraction of our budget is already committed to existing, valuable programs. It may seem difficult to start an independent research career, but it is far from impossible and it is potentially thrilling.

Looking back on your career, who has influenced you as a leader and what lessons do you take from them?

Three people come to mind. I grew up in a household that was fully loyal to FDR because of his leadership of the nation in times of both war and Depression, as well as his remarkable personality, clarity of speech and the set of principles that guided this country through hard times. A truly remarkable human being.

Second, when I came to the NIH as director in 1993, I had no administrative experience, so I learned a lot from then Health and Human Services Secretary Donna Shalala. She liked to go through the facts, get to the heart of the issue, and make quick decisions in a responsible way by engaging colleagues on an even platform and hearing them out. I try to emulate her efficiency and fair-mindedness in dealing with complicated organizations.

Finally, Bruce Alberts, the head of National Academy of Sciences for a dozen years and my close colleague at the University of California, San Francisco, played a major role in convincing me by his example to seek opportunities to lead. An extraordinary scientist, Bruce has always maintained a very strong interest in education and the organization and politics of science. Through Bruce and some other colleagues, I became increasingly engaged in efforts to influence the direction the scientific community was taking and to inform the attitudes the public holds toward science.