BETHESDA, Md. -- In his first-floor office in the main building of the National Institutes of Health, Dr. Francis Collins, the director of the institutes, has hung a series of framed pictures.
Placed in two equal-length rows of three pictures, they show him sharing the stage with President Barack Obama, talking with Senate Majority Leader Harry Reid (D-Nev.), and standing side-by-side with conservative columnist George Will. There is a photo of Health and Human Services Secretary Kathleen Sebelius looking into a microscope during a visit, and another of House Majority Leader Eric Cantor (R-Va.) leading a congressional tour of the NIH campus.
It's a cross-ideological collage that illustrates the broad support the NIH has and continues to enjoy. You'd never know from looking at it that over the past year, Collins and the institution he leads have been bulldozed by the political system.
An already stagnant budget was made worse this spring when Congress and the White House failed to prevent sequestration. The NIH was forced to cut $1.7 billion from its budget by the end of September, lowering its purchasing power about 25 percent, compared with 2003.
Roughly six months into sequestration, however, the situation is worse than predicted. Internal NIH estimates show that it will end up cutting more than the 700 research grants the institutes initially planned to sacrifice in the name of austerity. If lawmakers fail to replace sequestration at the end of September, that number could rise above 1,000 as the NIH absorbs another 2 percent budget cut on top of the 5 percent one this fiscal year.
"It is so unimaginable that I would be in a position of somehow saying that this country is unable to see the rationality of covering what biomedicine can do," Collins said, in an interview with The Huffington Post. "But I'm not sure from what I see right now that rationality carries the day."
The real-world implications of irrationality, Collins added, are quite grave. His most vivid example is the flu vaccine, which he says could be as close as five years away from discovery. NIH officials are working to insulate that program from budget cuts. But sequestration will, at the very least, mean that research goes slower than it could.
"If you want to convert this into real meaningful numbers, that means people are going to die of influenza five years from now because we don't yet have the universal vaccine," he said. "And God help us if we get a worldwide pandemic that emerges in the next five years, which takes a long time to prepare a vaccine for. If we had the universal vaccine, it would work for that too.
"The clock's been ticking on the potential of the next eruption of a pandemic outbreak from South Asia or wherever. And we've gotten lucky so far [that it hasn't happened]. But are we going to stay lucky? So, how can you justify doing anything other than pulling out all the stops in that kind of circumstance? And yet we're prevented from doing so."
Talks with Collins -- at least these days -- tend to be a mix of depressing and utterly terrifying. But that's probably to be expected from someone who was placed atop the NIH during a time of promising scientific discovery, only to watch the financial rug pulled out from beneath him.
"It's intensely frustrating," he says of the current landscape. As for what the landscape will look like 10 years from now if sequestration isn't fixed, he doesn't mince words. "I think we'll be no longer the world leader in the production of science, technology and innovation. You can't look at the curves and say, 'oh, well, it'll be fine,' if we stay on this track. It will not be. China is coming up so fast, they are so convinced that this is their pathway toward world leadership; they're not going to slow down."
Tall and thin, with full head of gray hair, a mustache and glasses, Collins resembles the classic conception of a scientist (he is a physician-geneticist). His career has been filled with achievements in the field, most notably as head of the Human Genome Project, an extensive research effort to map human genes.
But Collins, 63, is too complex to be pigeonholed. He founded the BioLogos Foundation, which promotes the integration of science and religion, and was appointed to the Pontifical Academy of Sciences by the pope in 2009. He rides a Harley Davidson to work (his black helmet sits behind his desk), consumes Diet Dr. Pepper (not exactly the world's most medically sound beverage) and plays in a band. This past June, he strummed the "sequester blues" on his guitar to draw attention to the budget cuts.
Recently, his job has required him to wear a political hat. When he meets with lawmakers, including those whose pictures are on his wall, he becomes a sort of lobbyist of sorts, urging an end to sequestration.
"I've probably visited in the last year with over a hundred members of Congress, either by having them come here or meeting them down on the Hill," he said. "I can't tell you a single one of those meetings that went badly ...
"Whether I'm talking to Republicans or Democrats, and whether it's the Senate or the House, they all kind of go, 'yeah, you know, you're right.' But, there's always a 'but,' and then they say, 'But there's not really much we can do because we're at this sort of national impasse about what to do about our fiscal situation. And then various people will say whose fault that is. And nothing happens."
Sitting at a round table in his office -- tucked in the building where President Franklin D. Roosevelt first dedicated the NIH's Bethesda campus Oct. 31, 1940 -- Collins recounted a talk he had with a group of young scientists not long ago. At the same table, he addressed the fact that the field of science has become increasingly inhospitable, and that funding shortages are driving a generation of researchers to other countries and professions.
"This is really tough. I would like to be able to say, 'You know, we've had ups and downs in the past. There's a long tradition here of a roller coaster that NIH has to ride on. This just happens to be a tough interval. It always got better before; it'll get better this time.' But as I say those things, I'm not sure I'm completely right, or convinced that I'm telling the truth."