When Dr. Monica M. Bertagnolli moved into the director’s suite at the National Institutes of Health, she brought with her a single work of art, a lithograph created by the granddaughter of a cancer patient who ‘she had once cared for. It depicts an abstract geometric female figure and the organs she lost to cancer. Its title: “We are not what you took: an answer to cancer”.

The image is about Dr. Bertagnolli, a cancer surgeon who previously headed the National Cancer Institute and is a breast cancer survivor herself.

After being nominated by President Biden in the spring and winning Senate confirmation last month, she became the 17th director of the NIH, which has a budget of more than $47 billion and occupies a sprawling campus in Bethesda , in Maryland. She is only the second wife. lead the biomedical research agency on a permanent basis.

Several weeks into his tenure, The New York Times visited Dr. Bertagnolli in his office in Building 1, a stately brick structure where President Franklin D. Roosevelt dedicated the Bethesda campus in 1938. This interview been edited and condensed.

You’ve been here for a few weeks. What are your observations?

The research labs funded here are great for basic science. We must continue all this work. But what we’ve struggled with is being able to dig deeper into the clinics in each community where people are being treated and cared for.

I think we’ve done very well in our major academic medical centers. But if we really want to conduct clinical research in a way that gets the results we need, we need everyone to have the chance to participate.

It sounds like you want more participation of rural people in clinical trials and want to incorporate the data we have into the treatment they receive.

Exactly.

I can’t help but ask if that’s because you grew up on a ranch in rural Wyoming.

Of course. Because I realized that health care delivery was just different for the people I grew up with. From my ranch to a paved road was 18 miles. And from the ranch when I was a kid to the next landline for a phone was about 50 miles.

But did you have a phone?

No, we didn’t. Not at the ranch in the summer. When school started, my mother moved with the children to town. We also had a house in town. And we would come and go to the ranch on weekends. We had a telephone in town.

Activists are pressuring the NIH to use so-called gate fees to claim patents on drugs developed with taxpayer money to lower prices. Are you open to this?

Absolutely. This is part of my authority as director of the NIH. But I really need to be sure that if walking rights are ever used, the result is the intended one – which is that people get better access, because that’s really the goal. We want everyone to have access to the benefits of biomedical research. (After this interview, the Biden administration published a proposed framework to guide the agency’s use of entry fees.)

NIH faces scrutiny over funding gain of function research – including in Wuhan, China – which some experts consider dangerous and could lead to the next pandemic. Are you reviewing this type of research and considering making changes?

The gain-of-function research that you’re specifically referring to is about changes to potential pandemic pathogens, correct? What if we could develop a vaccine well before having to discover a new virus which would be another Covid-19 virus? This would be a huge advantage. But if we want to do this kind of research, we need to make sure that the risks are absolutely minimized and always keep in mind that the benefits justify the risks.

The White House weighs recommendations of the National Science Advisory Council for Biosafety to improve oversight. Where we are ?

To be honest, I don’t know yet. But it is a major priority for all of us, and I will be very actively involved in it, because monitoring is essential for this type of research.

The Pew Research Center recently take a survey showing that Americans’ trust in science has continued to decline – and more so among Republicans than Democrats. Does this worry you?

Quite. Everything we try to do in science is aimed at providing better care for people. It is absolutely impossible to provide better care to people without trust.

But I think about trust, in large part, in institutions like the NIH. We see Republicans on Capitol Hill being criticism of the NIH What can you do to bridge this partisan divide and restore Americans’ trust in the institution?

Be very transparent, very honest about what we know and what we don’t know. Think about what we have just experienced as a nation: the trauma we have all experienced. It is ridiculous to think that we will not go through such trauma without real consequences. But I also think we can use this as an opportunity to really build trust in science, because I believe science has helped us get out of the dark days of this pandemic.

You have been a patient and you have I have talked about that. How do you feel? Can you talk about your status?

I am a cancer survivor. I think we all need to be humble when faced with a cancer diagnosis. So my chances of living the rest of my life cancer-free are very, very high. That’s the good news. And the point I make to everyone when I’m asked about this is that all of the evidence that guided my care came from NIH-funded research.

I would be remiss if I didn’t ask you if you are only the second woman out of 17 directors. I walked down this hallway and saw a lot of portraits of men. How does this affect your thinking about the role you occupy?

I’m very happy to see women getting the opportunity to show what they can do. If you look down this hall, all these years there were also some really talented and capable women. They just didn’t have the chance.

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