On October 7, the Senate confirmed Monica Bertagnolli, MD, as the new director of the National Institutes of Health (NIH). She will take over the job formerly held by Francis Collins, who stepped down in December 2021; Lawrence Tabak, DDS, PhD, has been serving as acting director since then.

“As a physician-scientist for more than 30 years, I have seen the transformative power of NIH research to produce results that save lives, including my own treatment for breast cancer,” Bertagnolli said in a statement. “As NIH director, I look forward to ensuring that NIH continues to be the steward of our nation’s medical research while engaging all people and communities in the research effort that includes informing medical practice that drives equitable access to health care for all.” 

Bertagnolli, a surgical oncologist, is a professor at Harvard Medical School and has practiced at Dana-Farber Cancer Institute and Brigham and Women’s Hospital. She is a former president of the American Society of Clinical Oncology (ASCO) and has served as director of the National Cancer Institute (NCI) for about a year. She was the first woman to lead the NCI and will be the second to hold the top NIH position.

When he nominated her in May, President Joe Biden said that “Dr. Bertagnolli is a world-class physician-scientist whose vision and leadership will ensure NIH continues to be an engine of innovation to improve the health of the American people.”

The Senate voted 62 to 36 in Bertagnolli’s favor, including 13 Republicans. Sen. Bernie Sanders (I-Vt.) delayed the vote for months in an effort to get a commitment from the White House to lower drug prices. “At this very difficult moment for American health care, we need an NIH director who is prepared to take on the greed of the pharmaceutical industry and use every tool at their disposal to substantially lower the outrageous cost of prescription drugs,” he said. Sanders and Sen. John Fetterman (D-Penn.) voted against her for this reason.

Bertagnolli takes the NIH helm at a challenging time in the wake of the COVID-19 pandemic. At her confirmation hearing, in addition to drug pricing, Bertagnolli was asked about maternal health, gender-affirming care for transgender people, mental health care, the opioid crisis and the origin of the coronavirus that causes COVID. She will oversee nearly $50 billion in science funding, which will no doubt be debated in the upcoming federal budget showdown.

As coordinator of the 27 NIH institutes, Bertagnolli said she is committed to strengthening collaboration and leveraging commonalities across all diseases, from biology to access to care.

“My research focused on how inflammation causes cancer,” said Dr. Bertagnolli. “We know, however, that inflammation also is a major component behind Alzheimer’s disease, autoimmune disorders, long COVID, arthritis and many other diseases. As NIH director, I’m excited to drive cross-cutting research to capitalize on such commonalities.”

Health officials, researchers and advocates lauded Bertagnolli’s expertise and experience, which include growing up in rural Wyoming and facing cancer herself. She has said that one of her goals is to make clinical trials faster, more inclusive and more responsive to the needs of people.

“We are delighted that the Senate has confirmed Dr. Bertagnolli as the next NIH director,” Philip Greenberg, MD, president of the American Association for Cancer Research (AACR), and AACR CEO Margaret Foti, MD, PhD, said in a statement after the Senate vote. “Her wealth of experience as a researcher, clinician and leader will help ensure that NIH continues to foster pathbreaking biomedical research that improves the health and well-being of millions and saves lives from cancer and countless other diseases.”

“Dr. Bertagnolli is not only an exceptional surgical oncologist, innovative scientist and leader with a strong track record of transforming organizations, she also has firsthand knowledge of the patient perspective as well,” Karen Knudsen, CEO of the American Cancer Society and American Cancer Society Cancer Action Network, said in a statement when Bertagnolli was nominated. “Dr. Bertagnolli understands not only the importance of advancing discovery but the criticality of ensuring that innovation is accessible to all. A fierce advocate for addressing healthcare disparities, particularly in underserved and rural communities, she played a key role in helping to advance the American Cancer Society Cancer Action Network’s work on Medicaid expansion." 

With her background coming from rural America, she brings to the job a fundamental recognition of the challenges facing people who struggle to access health care,” Donna Cryer, Founder and CEO of the Global Liver Institute, said at the same time.We share her concern that clinical trials need to be more diverse, a significant challenge for liver disease and cancers that disproportionately affect people of color.”

This report has been updated to include comments. from Bertagnolli.