‘The Best of Times, the Worst of Times’ for Biomedical Research

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Biomedical research may be facing significant challenges, but its trajectory remains one of rapid advancement and possibility, said Francis Collins, former director of the National Institutes of Health and former leader of the National Human Genome Research Institute.

Framing the moment as the beginning of a transformative era for science and medicine, Collins presented at the George Washington University's GW Med Talks event, "The Best of Times, the Worst of Times: Biomedical Research in 2026," on Tuesday. Borrowing from the opening line of Charles Dickens' "A Tale of Two Cities," he described the contrast between rapid scientific progress and the challenges posed by political polarization.

"If you're interested in or are already on the path towards a lifetime of doing medical research, this is going to be the golden era," he said. "We're going to solve so many mysteries that seem out of reach in the coming years with profound implications for how that's going to improve not just life span but health span, and that will be an amazing ride for anybody lucky enough to be in it."

The conversation, led by David Diemert, professor of medicine and of microbiology, immunology and tropical medicine and director of the GW Vaccine Research Unit, drew an audience largely composed of students, faculty, staff and, notably, researchers.

Opening the event, interim Vice President for Health Affairs and Dean of the GW School of Medicine and Health Sciences (SMHS) Andrew W. Artenstein reflected on the origins of the series and its future. Noting the conclusion of last year's SMHS bicentennial, Artenstein said one of the legacies of the year-long celebration was the establishment of the GW Med Talks series.

"We launched this series during that milestone year to showcase big picture thinking and to bring global health icons to our campus," he said. "Today, I am thrilled that GW Med Talks is moving from a commemorative event to a permanent cornerstone of our academic culture. There is no better guest to help us launch this next era of the series than Dr. Francis Collins."

GW President Ellen M. Granberg welcomed Collins and emphasized the importance of the moment. "Gatherings like this feel especially important right now," she said. "In recent years, we have seen how profoundly biomedical research can shape our world, from breakthroughs in genomics to the rapid development of lifesaving vaccines. These advances remind us that scientific discovery depends on innovation, collaboration and trust. It also necessitates a commitment to translating the knowledge we create into better health for communities everywhere."

In conversation with Diemert, Collins reflected on the breakthroughs he believes will have the most lasting impact, pointing to the Human Genome Project as a foundational achievement that has helped drive advances in precision oncology, gene editing technologies such as CRISPR, stem cell research and single-cell biology. These developments, he said, are already transforming the understanding and treatment of complex diseases.

"I have never seen a time of more amazing medical research potential and progress than right now," Collins said. "And yet we're in the midst of an unprecedented, serious challenge in terms of how to keep medical research momentum going in the face of threatened budget cuts, staff cuts, a lot of political imposition upon what is an acceptable scientific agenda and what is not."

He reflected on how dramatically the field has advanced within a single career. "I would not have imagined when I was a postdoc studying hemoglobinopathies that I would be alive when we started curing sickle cell disease with CRISPR-based gene editing therapy."

At the same time, Collins warned that the biomedical research ecosystem in the United States is under pressure. "The NIH has been threatened repeatedly by huge cuts in budget. The number of staff that are no longer there, including me, is in the thousands," he said. "Universities, which is where most of the wonderful research goes on, places like here at GW, are facing all kinds of challenges and stresses, sometimes with severe financial consequences."

Those conditions, he said, risk discouraging the next generation of scientists. "Understandably, some demoralization of people doing the scientific work, which threatens perhaps our future in this country if we don't figure out how to encourage people to dream big dreams."

Collins pointed to declining public trust and increasing polarization as obstacles to progress. "Let's be clear, I think the public's embrace of the value of medical research has not been as strong as it maybe should have been over the course of the last 30 or 40 years." In today's environment, he said, the country is "more polarized than most people have ever seen it," with political ideology shaping trust in scientific advances. "That's truly tragic."

To address the gap in public trust, Collins urged scientists to do more to communicate the value of biomedical research through human stories. "Conveying that reality of who you are…is hard for a scientist. You're told when you do science communication, you've got to have data, and you've got to have graphs, and you've got to have figures and you're going to convince everybody with your p-values," he joked. "That's not going to happen."

Closing on a note of perspective, Collins urged the audience to remain committed to advancing knowledge despite uncertainty, quoting Wendell Berry: "Be joyful, though you have considered all the facts."