Selena Simmons-Duffy sul sito  NPR intervista Francis Collins, il direttore dell’NIH, National Institutes of Health (l’equivalente americano dell’Istituto Superiore di Sanità), a poche settimane dalle sue dimissioni, cercando di capire perché, nonostante i fondi destinati alla ricerca, non ci sono stati grandi miglioramenti nella salute generale degli americani.

Collins made his name doing the kind of biomedical research NIH is famous for, especially running The Human Genome Project, which fully sequenced the human genetic code. The focus on biomedicine and cures has helped him grow the agency’s budget to over $40 billion a year and win allies in both political parties.

Still, in a broad sense, Americans’ health hasn’t improved much in those 12 years, especially compared with people in peer countries, and some have argued the agency hasn’t done enough to try to turn these trends around. One recently retired NIH division director has quipped that one way to increase funding for this line of research would be if “out of every $100, $1 would be put into the ‘Hey, how come nobody’s healthy?’ fund.”

Il caso più recente è come la polarizzazione nella cultura americana abbia alimentato la resistenza alla vaccinazione

We basically have seen the accurate medical information overtaken, all too often, by the inaccurate conspiracies and false information on social media. It’s a whole other world out there. We used to think that if knowledge was made available from credible sources, it would win the day. That’s not happening now.

quindi la necessità di una comunicazione più efficace

We’re having serious conversations right now about whether this ought to be a special initiative at NIH to put more research into health communications and how best to frame those [messages] so that they reach people who may otherwise be influenced by information that’s simply not based on evidence. Because I don’t think you could look at the current circumstance now and say it’s gone very well.

Anche prima della pandemia esistevano gravi problemi. Di fronte ad enormi progressi come sulla cura dei tumori c’è stato un calo dell’aspettativa di vita essenzialmente a causa dell’obesità, del diabete e della crisi degli oppioidi.

In all of these instances, as a research enterprise — because that’s our mandate — it feels like we’re making great progress. But the implementation of those findings runs up against a whole lot of obstacles, in terms of the way in which our society operates, in terms of the fact that our health care system is clearly full of disparities, full of racial inequities. We’re not — at NIH — able to reach out and fix that, but we can sure shine a bright light on it and we can try to come up with pilot interventions to see what would help.

Se da una parte occorre puntare sulla prevenzione

One of the things I’ve tried to do is to provide additional strength and resources to our Office of Disease Prevention, because that’s a lot of what we’re talking about here. One of the knocks against the National Institutes of Health is that we often seem to be the National Institutes of Disease — that a lot of the focus has been on people who are already diagnosed with some kind of health condition. And yet what we really want to do is to extend health span, not just life span, and that means really putting more research efforts into prevention.

Dall’altro bisogna partire dalle condizioni oggettive, così suggerisce una direzione al suo successore.

I think the guidance is — you have to look at all the reasons why people are not having a full life experience of health and figure out what we, as the largest supporter of medical research in the world, should be doing to try to understand and change those circumstances. A lot of this falls into the category of health disparities. It is shameful that your likelihood of having a certain life span depends heavily on the ZIP code where you were born, and that is a reflection of all of the inequities that exist in our society in terms of environmental exposures, socioeconomics, social determinants of health, et cetera.

Però nella situazione attuale la cosa non è per niente facile.

Again, if there’s a major societal illness right now of tribalism and overpolarization and hyperpartisanship about every issue, probably the NIH is not well-positioned all by ourselves to fix that. We have an urgent need, I think, across society, to recognize that we may have lost something here — our anchor to a shared sense of vision and a shared sense of agreement about what is truth.