I just came back to Dallas, TX after a weekend meeting with the INFORMS Meetings Committee and the local conference planning committee in Phoenix, AZ to plan for the 2018 Annual Meeting. Obviously the 2017 Annual Meeting, scheduled for Houston, TX in less than two months, was heavily on our minds, with images of heart-breaking, staggering flooding on the news. INFORMS has been through a similar situation before, when the 2005 annual meeting that was supposed to take place in New Orleans, LA had to be moved to San Francisco. We haven't had a chance to go to New Orleans again, which also means that we - the ultimate problem-solvers - never got around to, as a community of thousands of experts, helping New Orleans get back on its feet. (I'm sure there must have been isolated researchers over the years who have been involved with New Orleans's renaissance efforts.)

Today I hope that we can still have the annual meeting in Houston (on its webpage the hotel says it currently remains open and operational with limited services available), and use the annual meeting for special events or discussion with local authorities on how operations research, management science and advanced analytics, applied to logistics, health care, law enforcement or any other topic, can help Houston recover from this tragedy. 

#TexasStrong #PrayForHouston

The edtech craze

FutureOfLearning2The July 22nd-28th issue of The Economist has a special segment on the future of learning, which I of course read with interest. My conclusion after reading it is that edtech is vastly overhyped. In all fairness, I was already leaning toward that conclusion before reading The Economist, and this may not be the conclusion The Economist had in mind when it printed those articles. 

As someone born in Europe, I do have to say the whole emphasis on technology to allow for personalized learning smacks of that whole American exceptionalism, where it apparently seems outrageous to parents that their child could benefit from the same learning approach as someone else's kid. I can hear the screams from here. (Nooooo! My child is unique!) I think what education needs is small classes with students of a similar level so no kid gets particularly bored and no kid gets left behind, even if it means the class would move at a different pace than another class for the same year, because the other students would be at a different level of preparedness.

But edtech has become a very profitable endeavor and it obviously isn't going to please a number of people if we admit that what kids most need is human contact while they try to master the material. (I think this remains true at the undergraduate level in college, although not at the graduate level. Edtech has its place in the education spectrum. The market segment where it, in my opinion, truly brings benefit is much too narrow for edtech's taste, though.)

I read The Economist's leader and then to be fair I also read the briefing, but the briefing was even worse. For instance, the lead example is that of a 10-year-old kid in Mountain View, CA.  That's next door to Stanford University. I'm not going to even try to estimate the number of Stanford professors' families that live in California, but I remember a prominent Stanford faculty coming to visit my former institution a while back and mention that this person's kid's high school had seen a number of teen suicides due to the pressure the kids are under to get into Harvard or M.I.T. or Stanford. So forgive me if I'm not particularly impressed by the potential of edtech when I hear about a seemingly privileged 10-year-old already angling for advantage. (It's not the 10-year-old's fault.) His parents must love the idea he's special, and the students I've taught who couldn't deal with the corporate world and launched their own startups at age 25 certainly thought they were special too. The dark secret, though, is that the 25-year-olds whose startups make them billionaires are startups that can scale. This is not even an original idea of mine; I first read it in one of MIT entrepreneur Bill Aulet's book. 

What I like about edtech is the potential to reach students that traditional educational techniques would otherwise leave behind, but those are not the students who have the ability to pay and justify sky-high IPO valuations. We've got to be honest on that. A whole mystique surrounds edtech (and MOOCs, and tech in higher ed) and the media loves a feel-good story but that's not what's going to pay startup bills. It's in the edtech field's interest to push for more and more technology in the classrooms, but it's not clear to me that we really need sophisticated tools.

As a course management tool, Canvas is quite good. Group videoconferencing abilities are going to become a must. Maybe little things will help, like annotating a student's submission directly on the website. Ultimately, though, software taking into account a student's learning style is really only helpful to students who are falling behind, and the marketing as an important tool reflecting a student's unique learning styles just helps parents feel good that their kid is unique. An ideal day in real life is a day where you only get bored a little, struggle a little, and then stretch yourself to an extent appropriate for your knowledge level. You don't have to be fascinated by what you're learning every single second to have a productive day. It doesn't mean it's (necessarily) a day wasted. People wouldn't run a marathon like a sprint. 

Again, if students in the classroom are from too disparate levels, then yes the best students will get bored, and maybe lose motivation for class, and lose the opportunity to become star achievers. If some students are always bored and others always struggle, there's something wrong in the class composition. (Although the French system often mixes such students so that the parents can't complain that their kid was put in a less-good section while they think their offspring is the next Nobel prize winner.)

I like that edtech makes education possible in places where it had not been likely before, but technology can't replace the main U.S. problem, which is that public schools are funded by local property taxes. As long as that system is in place, the kids from poor neighborhoods will struggle to have an education similar to kids from wealthier neighborhoods, and parents from wealthier neighborhoods will throw a fit if their property taxes don't go to their kid's school. The U.S. school system is particularly sensitive to money, which is why so many parents find themselves roped in for the latest fundraiser event or cookie sale.

The funding of U.S. public schools via property taxes is the main problem today, because of the U.S. place on the world stage. Even a global, U.K.-headquartered newspaper like The Economist is more sensitive to what happens in America. It's easy to look away from the school-funding-formula issue and let edtech startups thrill us (their CEOs would love that...), but that's just a Band-Aid. Entrepreneurs, though, won't make money from new public-school-funding formulas.

"The Skill that Industry Hires Need"

According to this post in Science magazine (geared toward PhD students and academics in science), industry employers particularly value project management skills in new hires, "including working in a team and delivering on schedule and on budget". I found this particularly striking because project management is perhaps the least used skill in graduate school. There is no timeline in submitting a research paper or getting a degree. Some doctoral students take five years to graduate; other take eight. There is little concept of a schedule to be kept, research-wise. In a way, not only are graduate students not taught project management, they are taught the opposite: it takes the time that it takes; what matters is the end result. No wonder then that graduate students with industry internships have an advantage over the competition when they seek industry positions.

(As a side note, this got me thinking about the skill that analytics students need the most, since I teach analytics rather than science. Of course project management is important for analytics students too, but based on my experience, students struggle the most with the idea that there might not be a single best model to be created from their data. You can create, say, a linear regression keeping only the coefficients that are significant at the 95% level, or you can focus on the 99% level, or you can have categorical variables, with some labels being very significant and others not as much, or you can have a logistic regression model and a classification tree model to predict a binary outcome, and each has its advantages and disadvantages. Students are disappointed sometimes when it feels like there isn't a unique best answer. But you create your models based on the data you have, and the process is necessarily imperfect. You can still get good insights from your model. )

Going back to the theme of this post, I think that undergraduate students learn more about project management through their capstone project at the end of their studies than doctoral students do. It makes sense, given that most undergrads go on to industry positions right after graduation (only a few get a Master's degree before starting work), but it is time to recognize the changed job prospects for PhDs too. Could we bring project management to academic research itself? Grant proposals ask us principal investigators to do as much, with budget justifications, deliverables and intermediate milestones, but graduate students are rarely involved in defining those. Maybe universities should provide more training on those matters.

Or maybe this could motivate a stronger emphasis on doctorate programs with time-constrained "praxis" capstone projects rather than dissertations, such as D.Eng. rather than PhDs. Perhaps it is even time for a renaissance of doctoral students that aren't PhDs in order to better meet industry needs, or the creation of an intermediary degree between Master's and PhDs. When I was at MIT, my department (Electrical Engineering and Computer Science) had a degree of Electrical Engineer, which was aimed at doctoral students who had completed all coursework in the PhD program: the All But Dissertation folks. Obviously most A.B.D.s don't plan on working in academia and maybe an advanced degree geared toward industry would be better suited for their career goals. This raises the issue of degree visibility and name recognition, if only a handful of universities deliver the new degree, but given today's pace of change, it'd make sense to introduce new degrees more suited to the needs of the workforce.

We could even imagine a system where students get credentials for each year of graduate study (or some number of credits to account for part-time students), with "Graduate Credential Level 1" being received at the end of the first year (maybe similarly to a Master of Engineering), "Level 2" at the end of the second year (equivalent to a Master of Science), and then adding "Level 3", "Level 4" etc, with the student being able to stop for a few years in-between if he so wishes. There is a lot of talk on campuses these days about continuing education, but it is unrealistic to expect these trends will fit neatly within existing degree programs. It is time for new graduate degrees.

A new type of queues

I just came back from IFORS17, which was a fantastic conference in a great venue (and I'm glad that many people showed up for my early-morning talk on binary optimization and R&D portfolio management), but for today's post I wanted to write something quick about the new TSA queues at the airport. In academia we talk a lot about queues like M/M/1 but I don't think there is a name for the queues in the new TSA system. (Maybe TSA is a queueing pioneer! It creates queues we academics have never imagined in our wildest nightmares.) If you know the names for the queues described below or any literature that supports their use, I'd love to hear about it.
Now there are two tracks in front of the X-ray machine, one divided into 5 "stations" where people put their stuff in the new bins and one parallel to the first one that actually feeds into the X-ray machine. The idea is that once you have your bin ready, it is going to go onto the main track that goes into the X-ray machine. It happens because "someone" pushes the bin forward onto the main track. The thing is, that someone isn't the traveler. The TSA agent wants to do that, perhaps to avoid having people knock other people's bins while they try to push theirs, but then travelers who arrived long after you could have their bins move forward long before yours.
If you have to put your stuff in more than one bin (even your rollerboard has to go in a bin, so it's likely you'll need more than one, although the new bins are very large), the bins are going to get separated from each other because your stuff goes in line on the main track for the X-ray machine when the agent feels like letting it get in line. This is not a good thing.
Also (1) the TSA agent at EWR kept saying laptops in a bin by themselves but the bins are enormous and since your stuff is going out of order it becomes really easy for someone else to take your laptop by mistake (it also went against the pictures I'd seen at DFW about how to properly pack the new bins - the important point is that nothing should be above or below the laptops but there can be things around them - but I wasn't going to argue with TSA) and (2) several lines of people at EWR had to merge into one line for the X-ray machines; at DFW people do "alternate merge" like it's second nature but at EWR you have people who just stare at the line and hope someone will be nice to them and (3) it's not FIFO anymore because you take the first available station by the X-ray, even if that station is closer to the X-ray machine than the station of people who were in front of you in line. 
I liked the old system a lot more. I particularly liked the FIFO part because it seemed fair. Sadly, I've seen the new approach both at EWR and DFW, so I'm assuming a nationwide rollout. I just hope whoever came up with the new way of doing things wasn't an engineer. It's suboptimal by a wide margin.
Ok, so here is the mathematical description. You have 1 X-ray machine, 2 lines of travelers that attempt to merge into 1 line to use the X-ray machine, 5 stations, 1 parallel track where the bins are later pushed onto to get Xray'd. The traveler goes to the first available station. Then he has to wait until his stuff goes onto the X-ray track, and if he has multiple bins he has to wait until he found a way to squeeze the last one in, then he queues for the metal detector, then he waits for his stuff to come out of the X-ray machine. Remember that the TSA agent, not the traveler, decides when the traveler's bins go on the X-rays track (the TSA agent makes the gaps between bins to let a new bin come onto the track). Therefore, people who came to available stations after the traveler might have their stuff pushed into the X-ray machine first and might go through the metal detector before the traveler. Compute the average time to go through security and compare with the average time in the old system. Also compute a new criterion called the Traveler's Sense of Shock and Disbelief at TSA's New Ideas, alternatively called "Did someone get paid to come up with this?", surely to be the focus of a case study either about the crazy things people come up with to justify their consulting gigs or the flaws in the decision processes that green-lighted this innovation. Discuss. 
I suppose whoever came up with this disliked having to wait behind, say, families with young children who had to take off their shoes, or elderly people who moved too slowly for their taste. It still seems there would be better, simpler ways to address this, starting with having more lines open so that people can move away from a slow line toward one that goes faster.
Maybe the lines should be per type of customers (although I'm not sure if travelers would comply if they're in a rush and another line goes faster, but perhaps having TSA lines matching the group numbers of the airlines, such as A/B/C for Southwest or 1/2/3/4/5 for United would be aligned with travelers' frequency of travel and presumably their familiarity with the screening process), or the lines could be based on the amount of luggage travelers have to screen (do they have a laptop, do they have a rollerboard) - something similar to the express checkout lane at the supermarket.
Or there could be a system where travelers don't enter the line to the X-rays until their stuff is in bins. (If we allow ourselves to dream for a second, TSA could invent a cart that carries multiple bins to the X-rays. Heck, it could be the X-ray machine of the future: a cart robot that has all your things neatly arranged on the cart and drives itself to the X-ray machine, and then the X-ray machine would be able to scan your things one by one, and your cart would re-appear at the other end of the machine, and then you could happily push your cart to the gate or return it at the checkpoint.)
It'd also be interesting to have a system where people can see the average time to go through security at different times of the day at their airport and the current real time, like what Google does for restaurants, although for airports we also need to have a measure of the staffing level to be able to compare numbers. 
If TSA was serious about decreasing waiting times at checkpoints, it would run a nationwide competition among universities (or at least industrial engineering departments) to suggest improvements that would be a bit more thought-out than this. I bet students could come up with a better alternative using IE/OR tools. In the end, just thinking I might have to go through the new screening system every time I go to the airport makes me very uneager to fly, and perhaps that's the point.

Purdue-Kaplan Universities Merger

I came across this interview of Purdue University's President Mitch Daniels on - for some reason I missed the announcement about the merger between nonprofit Purdue and for-profit Kaplan University earlier this year. The goal, as Daniels explains it, is to offer a different, non-traditional segment of the student population broader and cheaper access to higher education. There is no question that residential colleges are better fits for 18-to-22-year-olds than, say, 35-year-olds with a family and a mortgage, and acquiring Kaplan is a way to reach those non-traditional students without starting from scratch. The interview did not contain much new information about current trends - all of us in higher ed know that the demographics are changing, more college-bound high school graduates are not college-ready, the increasing cost of a diploma is becoming worrisome. (An interesting tidbit in the first NPR article was the "revenue theory of cost" of economist William Bowen, which basically says that colleges spend more because they can.)

Daniels did show he was aware of key trends such as the rise of alternative certifications and the need to educate students at different (nontraditional) ages. As a side note, the acquisition of Kaplan U addresses neither the lack of college-readiness for college-bound high school grads, nor the increasing cost of a diploma. Maybe there are more nontraditional students now because they were not college-ready 10 years ago, and perhaps it would be more helpful to deal with the root of the problem (the transition from high school to college, or even the high school curriculum) now rather than trying to take those people money when they have a bit of an income and realize their options are going to be limited if they don't get a college degree.

In the interview Daniels talks a little bit about the deal with Kaplan, which is an online university educating working adults. This other NPR article gives a fuller picture of it. More and more universities are entering the online market to help attract "non-completers" (people who started college but did not get a degree) and non-traditional students. Personally I like the use of basic technology, like videotaping the lectures, to help students understand the material by watching lectures in their dorm after class, but I'm ambivalent about online education. It's great when you're older (and so hopefully have the discipline to follow through even if the professor isn't in the same room as you), when you don't have a high-quality local option, and when the course is well-suited for an online format, but in order for it to replace on-campus education, it needs to reach a far more advanced state than the collection of short, simple videos that make a course on, say, Coursera. I also think that any good course requires the assessment of students' work by a real person, rather than multiple-choices quizzes that can be graded by a computer. But that'll be the topic of another post. 

I wonder about the traditional students who applied to Purdue and were rejected, and will see nontraditional students get the Purdue name on their degree. Can they hope to get into Purdue through Kaplan? What will make the Kaplan University education a Purdue education?

The NPR article explains: "In an atmosphere of ever-skinnier state budgets, these programs enable universities to reach a global market, cater to working adults, and potentially increase revenue without expensive capital investment." But one has to be cautious not to admit anyone just because they can pay the tuition. The article makes clear Kaplan will operate as a new, distinct unit of Purdue. Interestingly, it "will be exempt from Indiana open-door laws, access to public records and public accounting rules." A 2009 Senate investigation "accused Kaplan of using predatory marketing tactics, and putting more money toward recruitment and profits than education" While Kaplan is said to have reformed itself by the time a 2012 followup came around, it might get a little complicated to merge the cultures of both institutions.

Running a for-profit university and a nonprofit university are very different endeavors and Purdue has no existing skill set in that area. I don't get where the synergy is going to come from. If Purdue feels this is part of its mission as a land-grand institution, why isn't it merging with local community colleges? Oh, wait, they'd actually have to see the students. On the other hand, if the merger makes Kaplan U become a real nonprofit, then it could have a lot of positive developments for the nontraditional students who have spent so much of their money trying to get a degree, including veterans. Maybe it is in the public interest that Purdue merge with Kaplan, in the interest of Kaplan's students. But it's important that the faculty and students going through Kaplan U, now renamed "New U", aren't viewed as second-tier. I don't think faculty at for-profit institutions have tenure, for instance, I also doubt they do research, in contrast to Purdue's. So it'd be like an entire school at a research university being taught by adjuncts. They may well be highly competent adjuncts, but they are in a completely different category of faculty. 

Hopefully Purdue will also use Kaplan's online infrastructure to offer great online courses to its on-campus students, allowing them to take a mix of classes in person and online, but this also opens the risk of on-campus teaching positions being eliminated down the road and replaced by online education.  

Anyway, it'll be fascinating to watch what happens with that merger.

SMU Commencement Weekend, Part 4

SMU-logo2 I realized I never got around to writing about the rest of the events I attended during Commencement weekend (after writing Part 1, Part 2 and Part 3), so here is a summary.

I started the "weekend", which started on Thursday, with a public event unrelated to the Honorary Degree Recipients Symposium. It was a talk about creating technology for social change, or how to make change by creating and sharing media, by MIT's Ethan Zuckerman. He mentioned, among many good points he made, Christopher Hayer's distinction between institutionalists and insurrectionists, with institutionalists believing that institutions are reformable and insurrectionists arguing that we need to fundamentally question those institutions. It is hard to motivate young people to vote if they identify as insurrectionists precisely because they don't trust institutions. Protest becomes a hard sell too. Zuckerman mentioned the book Twitter and Tear Gas: The Power and Fragility of Networked Protest by Zeynep Tufekci. Zuckerman also talked about laws, software code, social norms and markets as effective tools for social change. An example of norms was the "Black Lives Matter" movement and which type of photographs were at first selected by the media to depict Michael Brown. A fascinating part of Zuckerman's talk focused on "landscape mappers", visual tools to highlight what communities and media outlets were talking about. For instance, he had a slide about Ebola as a political issue, "Obama's fault", etc, and CDC was unwilling to talk about quarantine but it turned out to be central to the conversation. Another tidbit was that Zuckerman explained that people who think there's a link between autism and vaccines are very interested in science, but it turns out that they do science very badly. 

The next event I attended was the "Ice Fishing for Neutrinos" talk by UW-Madison Professor Francis Halzen, who received a Honorary Doctorate from SMU during Commencement Weekend. I loved this talk because Halzen made such an excellent presentation tailored to a lay audience that I could follow all the key concepts and understand why the work was important, although obviously the physics completely eluded me. I took a lot of notes but I'll spare myself the embarrassment of posting something wrong if I misread what I wrote, so I'll just say the idea is to create reactions in ultra-pure ice - the kind of ice that exists at the Amundsen Scott South Pole station - rather than water to observe neutrinos, which can't be seen directly and have no charge. The only way to "see" them is to have them crash into the nucleus of an atom to initiate a reaction. The IceCube experiment was awarded PhysicsWorld's "Breakthrough of the Year 2013", after the researchers published in Science the first evidence for a very high-energy astrophysical neutrino flux. Funnily enough, Halzen was hosted by two SMU profs with whom I share a good friend (no Texas connection), and we had only met in person earlier that same week. 

The next day, I went to the Q&A with Dallas philanthropy powerhouse Nancy Nasher, who also received a Honorary Doctorate from SMU that weekend. She is well known locally for the Nasher Sculpture Center, which was started by her parents and helped revitalize the Dallas arts district (she is also known nationally for her philanthropy to the Nasher Museum of Art at Duke University), and she is a co-owner of NorthPark Center, one of the largest malls in America. She worked on it as a lawyer in the late 1970s, writing and negotiating leases. In the mid-1990s, Nasher and her husband acquired NorthPark and then the ground lease, and then they planned and oversaw the extension of the center. It is the 4th highest-grossing shopping center in the U.S. and the 2nd tourist attraction in Texas (1st in North Texas). What I love most about NorthPark Center is the abundance of top quality art on display in the public spaces. NorthPark is also a performing arts venue with 300 performing groups per year, including 200 in the 5 weeks between Thanksgiving and New Year. Nasher has been deliberate in her intent to use NorthPark as a venue to support performing arts organizations vital to Texas. 

In her opinion, the most pressing need in Dallas for arts is that Dallas needs more corporate support. Arts education is also vitally important, and needs more funding too. NorthPark has also launched "50 days of giving", about giving back to 50 nonprofits in the Dallas area. It also has a program where it provides transportation from Uplift schools to NorthPark to teach schoolteachers more about arts education, and help teachers decide how best to teach the material. She also mentioned the Business Council for the Arts, which was launched by her father and which develops support for the arts from business.

Nasher also talked about her career path - at Princeton she wanted to be a Russian literature major (I would've wanted to be one too!), was an English major, took a lot of courses in art history, her father suggested she would be a good lawyer, which is how she went to Duke for law school, where she was one of only 20 women, out of a class of 125. She was also in one of the first classes of women at Princeton. She interned at a law firm that put her on the NorthPark project from day one. Later that firm offered her a job. She only stopped when her mother became very ill and she went into business to help. Nancy Nasher is a very inspiring figure in Dallas and in hindsight, it stuns me that SMU didn't give her a Honorary Doctorate a long time ago. One thing I love about Dallas is how the most successful people so generously give back to the communities where they grew up. 

I can't wait to hear who next year's Commencement speaker and Honorary Degree recipients are going to be!

SMU Commencement Weekend, Part 3 - Commencement Address

SMU was fortunate to have NIH Director Francis S. Collins as its 2017 Commencement Speaker. And if you only have 3 minutes to spend on this post, then use them watching this hilarious YouTube video of Dr. Collins's guitar serenade to the graduates at the end of his address. 

If you have more time, you can watch his entire Commencement speech below. (This was before the latest federal budget was known, with its proposed 20% cut to the NIH budget, so don't expect any allusion to that.) It was thoughtful of Dr. Collins to acknowledge Congressman Pete Sessions in the audience and his support for biomedical research. I loved his point about SMU as a place where ideas are freely debated and civil discourse is part of the fabric of the institution - so true! 

One thing I loved about the speech is that Collins (I'll drop the Dr. for the rest of this post) didn't take himself too seriously, and not just because he played the guitar at the end. He admitted, for instance, that he didn't recall what the Commencement speaker said at his own graduation from the University of Virginia in 1970 with a degree in chemistry. 

I enjoyed how he talked about his meandering path to his present situation: at first he thought he was going to be an academic, then he discovered biology and went to medical school (UNC), and in 1992 he was asked to lead the Human Genome Project. This was, he was quick to add, before people thought it would work. He was appointed NIH Director by President Obama in August 2009 and expected to resign under the new President, but his resignation letter was rejected. (It is customary for people who have been appointed by the previous president to prepare their resignation letter, since the new president usually wants to make fresh selections.) This all seems a bit dry when I write about it now, but Collins was a wonderful speaker so his account of how he got to where he is now after graduation was a lot more engaging than it reads. 

He had three main messages for the graduates: 

  1. Be prepared for dramatic changes, whatever field you're in. Embrace it, and embrace that other doors are going to close.
  2. Your path is not always going to be smooth. Are you prepared for that? Collins's darkest hour was twenty years ago, when it turned out that a talented graduate student in his lab had been fabricating data. This became a New York Times front page story that required retractions of several scientific papers. Collins also talked about the heartbreak of seeing kids afflicted with progeria (premature aging) die, such as Sam Berns. 
  3. Clarify your definition of success, making the difference between resume virtues and eulogy virtues. (He mentioned The Road to Character by David Brooks.) Discover your True North and don't forget to have some fun! This made a great transition for his moment at the guitar. ("Music has a way of ruining otherwise dignified experiences.")

This Commencement speech will be hard to beat. I can't wait to learn who will be the 2018 SMU Commencement speaker.

SMU Commencement Weekend, Part 2 - Panel Discussion

Francis-S-CollinsIn the symposium given at SMU in honor of NIH Director Francis S. Collins, our 2017 Commencement Speaker and honorary degree recipient, Dr. Collins discussed 10 exceptional opportunities in biomedical research that might come to fruition within ten years.

Before going over his top 10 list, he pointed out that N.I.H.'s mission is to both "seek fundamental knowledge about the nature and behavior of living systems" as well as "the application of that knowledge to enhance health, lengthen life, and reduce illness and disability, and remarked that Texas received over $1bn in FY16. He also discussed statistics that suggest N.I.H. money has been rather well spent: (a) cancer death rates are now falling more than 1% per year, while each 1% drop saves $500bn. (b) cardiovascular disease death rates have fallen more than 70% in the last 60 years, and (c) HIV therapies now enable people in their 20s to live to age 70+.

On to his list of 10 exceptional opportunities. In ten years, we might have:

  1. advanced our analysis of individual human cells, which will help understand many disorders like lupus and rheumatoid arthritis,
  2. developed tools to identify new brain cell types and circuits, to help diagnosis, treatment and prevention of autism,
  3. identified those at risk for Alzheimer's before signs appear. Dr. Collins showed brain cells of six members of a family in South America known to be at risk of hereditary Alzheimer's, 4 with the amyloid gene carriers and 2 without, the six members are in the 35-39 range and Alzheimer's in their family has tended to have onset when people reached their 40s, and those brain scans showing the amyloid build-up in the 4 people at risk were breathtaking - Dr. Collins also mentioned that a possible reason why Alzheimer's treatments may not have been successful so far is that such treatments may have targeted people whose disease was too far advanced, but there is real hope if we are able to take action before the onset of symptoms. This is critical because the amount of money required to take care of the growing Alzheimer's population by 2050 will be equivalent to two Department of Defense budgets if we don't do anything.
  4. developed effective treatment for spinal cord injuries.
  5. optimized and widely distributed an artificial pancreas for diabetes. This is actually not that far in the distance since the FDA approved in September 2016 the first hybrid closed-loop system to track changes in blood glucose levels and provide precise doses of insulin.
  6. generated new organs from induced pluripotent stem cells.
  7. created a universal influenza vaccine. The idea is to teach the immune system to attack the invariant stem of the virus (instead of the head, which varies from year to year), in order to provide immunity to all flu viruses. We are overdue for a worldwide flu pandemic, so a universal influenza vaccine would be critical in mitigating such a pandemic's consequences. 
  8. deployed genomics, neuroscience, structural biology to uncover new targets for treatment of pain. The U.S. are in the middle of an opioid overdose epidemic, and 80% of people who ODed got started with a legitimate prescription for pain treatment, and some of those then switched to heroin, which apparently is very cheap, when OxyContin or similar was no longer readily available. (The prescription for the pain medication may be for 30 days, but people might feel very lousy when they stop, so they try to continue a little while longer, and when they really can't get a prescription renewal, those who are addicted switch to heroin.) There is a critical need to develop non-addictive pain medicine.   
  9. accelerated immunotherapy and other advances through the Cancer Moonshot. Dr. Collins discussed the case of Emily Whitehead in PA, who had a type of childhood cancer for whom traditional treatments had not worked, and who was saved thanks to immunotherapy.  
  10. actualized the potential of precision medicine through the "All of Us" research program, which aims at enrolling 1m Americans for a long-term research study combining data science, genomics, Electronic Health Records, technologies and patient partnerships. You can learn more about it at

Gene editing, which could have made the top 10 list, was discussed in the Q&A. 

Additional topics discussed in the Q&A were (I wish I could provide details on all of them, but this post is already long enough):

  • the WaPo op-ed by Eric Lander of the Broad Institute and Eric Schmidt of Google "America's "Miracle Machine" is in desperate need of a miracle"
  • Dr. Collins's meeting at the White House two weeks ago with senior WH officials and heads of industry and academia to discuss how to best foster a productive relationship between government agencies, corporations and universities regarding scientific research (following by a short meeting with the President afterward), and especially NIH's Accelerating Medicines Partnership, which was launched in February 2014 with the goal to "transform the current model for developing new diagnostics and treatments by jointly identifying and validating promising biological targets for therapeutics" in 3 disease areas: Alzheimer's disease, type 2 diabetes and autoimmune disorders (lupus and rheumatoid arthritis). Dr. Collins also mentioned Parkinson's as a current focus, and said that cancer might get added soon. 
  • the need for an interdisciplinary approach to many of those problems, and the potential of computational biology. 
  • the issue that over 60% of drugs now coming on the market first originated from academic research - why should N.I.H. fund this work if big pharma reaps the rewards? Dr. Collins talked about the National Center for Advancing Translational Science established in 2012 and the role of the Bayh-Dole Act in encouraging universities to file for patents, which also means that the N.I.H. holds no claims to those discoveries. 
  • drug pricing, which the N.I.H. has no role in.
  • the issue of drug-resistant bacteria, when a drug can take 12 years to be developed and a bacteria can take 2 years to become drug-resistant, the related need to limit the prescription of antibiotics, and the fact that biopharma can make a lot more money developing, say, cancer drugs.
  • Dr. Collins's book on "The Language of God" and his personal faith. He said he still gets emails almost every week, especially from young Christian students, who have been homeschooled and then are presented with the evidence for evolution in their first biology course in college and suddenly put their faith back in question. He said he wasn't a believer in college, only became at 27 in medical school, and insisted that science and faith aren't mutually exclusive.
  • diabetes. 80m people in the U.S. are pre-diabetic, but diet and exercise with a coach has been proved to lead to a 58% reduction in transition rates to the diabetic stage. There are data privacy issues because it is generally agreed that you should not have your genome used against you for jobs and health insurance. Interestingly, a bill about wellness programs currently under consideration could threaten that because some of those programs ask for DNA analysis and if you refuse, they're allowed to charge you a premium that is 30% higher than the premium if you had accepted.
  • the need to do healthcare more efficiently, since about 30% may be wasted now due to improper testing etc.
  • the future of healthcare, about which Dr. Collins mostly said (as a response to an audience question) that his crystal ball was rather cloudy, and that most people agree that kids who get sick should be able to get health care.       
  • The Q&A ended with the question about science funding, which was the topic of my previous post.

You can read SMU's release about N.I.H. Director Francis S. Collins being chosen as 2017 Commencement Speaker here. It is so exciting for SMU but also speaks volumes of its national reputation that we were able to attract such a high-caliber speaker to Dallas. I feel really blessed to have heard Dr. Collins give such an informative talk at the symposium and am looking forward to his Commencement speech tomorrow.