Patrick Soon-Shiong, Francis Collins, Andy Harris and John Ioannidis are rumoured to be under consideration. Credit: Reuters/AP/Getty/Stanford

Could US president-elect Donald Trump be close to choosing a leader for the National Institutes of Health (NIH)?

Current NIH chief Francis Collins and Representative Andy Harris (Republican, Maryland), both front-runners for the job, met separately with Trump on 11 January, as did billionaire surgeon Patrick Soon-Shiong on 10 January. Several people familiar with the Collins and Harris meetings described them as job interviews.

Other rumoured candidates include Geoffrey Ling, a retired Army neurosurgeon and former director of biotechnology at the Defense Advanced Research Projects Agency (DARPA), who says that he met with Trump's transition team recently, and John Ioannidis, an epidemiologist at Stanford University in California who has pushed for reproducibility in biomedical science.

Although Ioannidis says that he has not been approached by Trump’s staff, sources close to the transition team say that the scientist has been floated for the NIH position. “If they call, my first priority would be to make sure there are no strings attached in promoting any anti-science ideas,” Ioannidis says, such as linking vaccines to autism.

But Collins — who has led the NIH since August 2009 — has already said that he would continue on if Trump asked. That would make Collins, the longest-tenured member of President Barack Obama’s science ‘dream team’, the first NIH director since the 1970s to be chosen by two presidents.

Known for his skill at communicating with lawmakers, Collins has the backing of four senior Republican members of Congress, who signed a 2 December letter urging Trump to keep him on. But extending a single director’s tenure for so long may not be in the agency’s best interest, says Ezekiel Emanuel, a bioethicist at the University of Pennsylvania in Philadelphia.

“In general, I think more than eight years has not been a good idea,” he says. “There’s a cycle, and eight years is hard to have new ideas and new energy.”

Others worry that Trump could go too far in the opposite direction, and pick an NIH chief without a significant science track record or experience in managing large research projects. With both Harris and Soon-Shiong, ”my concern would be that this is a person who hasn't really been tested”, says Keith Yamamoto, a biologist at the University of California, San Francisco. 

Culture clash?

Harris, an anaesthesiologist, has taken a strong interest in the NIH during his three terms in the House of Representatives. He helped to write the 21st Century Cures Act, a law enacted last year to reform research and development at the NIH and the Food and Drug Administration, and pushed the NIH to develop a five-year strategic plan.

And Harris has taken a special interest in early-career scientists, proposing legislation that would force the NIH to set aside more money for young researchers and to lower the age at which investigators receive their first grant.

Many lobbyists and science advocates contacted by Nature refused to comment on the record about Harris. Some expressed worry that his policy positions — including staunch opposition to research with human embryonic stem cells — would be at odds with the NIH’s culture.

He would be much more entrepreneurial in outlook and attitude” than Collins, says one long-time NIH-watcher, who works in science policy. “If it's Harris, I think there would be a mass exodus of senior leaders.”

Still, Harris may benefit from having served in the House with Representative Tom Price (Republican, Georgia), whom Trump has nominated to lead the Department of Health and Human Services, which oversees the NIH.

Business interests

And his interest in early-career scientists could give him an edge with key Trump advisers, including Silicon Valley billionaire Peter Thiel, who met with Trump on 11 January, and former House speaker Newt Gingrich. Both are said to be particularly interested in improving conditions for young researchers.

Another candidate who could appeal to Thiel is Ling. As the first director of DARPA’s biotechnology office, Ling oversaw the kind of ‘high-risk, high-reward’ projects that the NIH does not often fund — and Thiel has said that science needs more bold, entrepreneurial ventures.

Ling says that he met with the Trump transition team as recently as the week of 9 January, although he would not comment on whether he met with Trump himself. “They're really spending a lot of time trying to decide what direction they want to go,” he says.

If selected as director, Ling says that he would seek to increase NIH’s engagement with the private sector, particularly with start-up companies. Doing so could help the NIH navigate difficulties posed by its relatively flat funding and increase opportunities for young scientists. 

“NIH wants to grow,” he says. The start-up world “is a robust environment right now, it’s out there,” Ling says, “but with a little bit of help from NIH, I think it could really explode and that’s a good thing”.

Dark horse

If Trump is looking for an outsider candidate, that could boost the chances of Soon-Shiong, a billionaire surgeon who runs a network of health companies called NantWorks.

Soon-Shiong was among the scientists who advised vice-president Joe Biden’s Cancer Moonshot initiative. He also runs his own, separate programme called Cancer MoonShot 2020, a collaboration between several pharmaceutical companies that are developing immunotherapies.

Sources who have spoken with the transition team say that Soon-Shiong is also under consideration for other government positions, including presidential science adviser. (Another rumoured candidate for science adviser, former NIH director Elias Zerhouni, told Bloomberg News on 9 January that he did not want to leave his current post at drug giant Sanofi.)