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Jay Bhattacharya chosen by Trump to lead the NIH: Shots

Jay Bhattacharya chosen by Trump to lead the NIH: Shots

 


Dr. Jay Bhattacharya speaks during a panel discussion with members of the House Freedom Caucus on the COVID-19 pandemic at the Heritage Foundation in late 2022. Tom Williams/CQ-Roll Call/Getty Images .

rock captionTom Williams/CQ-Roll Call/Getty Images

President-elect Donald Trump is tapping Stanford University health researcher Dr. Jay Bhattacharya to become the next director of the National Institutes of Health.

“Together, Jay and RFK Jr. will restore the NIH to the gold standard for medical research by examining the underlying causes and solutions to America's greatest health challenges, including our chronic disease crisis. Together “They will work hard to make Americans healthy again,” Trump wrote in a statement making the announcement.

Bhattacharya, a physician and health economist whose nomination requires Senate confirmation, would take the helm of an agency that employs more than 18,000 people and funds nearly $48 billion in scientific research through nearly 50,000 grants to more than 300,000 researchers in more than 2,500 universities and medical schools. and other establishments.

If confirmed, Bhattacharya could significantly affect the future of medical science. The NIH is the largest public funder of biomedical research in the world. But the NIH could be among the top targets for restructuring as the next administration attempts to overhaul the federal government.

While the NIH historically enjoys bipartisan support, Trump proposed cutting the agency's budget during his first term. The NIH has faced heavy criticism from some Republicans during the pandemic. This animosity continued, particularly toward some former longtime NIH officials, such as Dr. Anthony Fauci, who led the National Institute of Allergy and Infectious Diseases for 38 years, and Dr. Francis Collins, director of the NIH from 2009 to 2021.

One factor was an open letter titled “The Great Barrington Declaration,” which was released in October 2020 and questioned policies such as lockdowns and mask mandates.

Bhattacharya was one of the three authors of the document. The declaration calls for accelerating herd immunity by allowing people at low risk to become infected while protecting the most vulnerable, such as the elderly.

Many public health experts have denounced it as unscientific and irresponsible. “This is a marginal part of epidemiology,” Collins told the Washington Post shortly after the paper was published. “This is not mainstream science. It is dangerous. It fits with the political views of parts of our confused political establishment.”

“They were wrong,” says Dr. Gregory Poland, president of the Atria Academy of Science & Medicine, a nonprofit group based in New York. “So it’s concerning,” Poland says of Bhattacharya’s selection.

Others reacted even more strongly.

“I don't think Jay Bhattacharya belongs anywhere near the NIH, let alone in the director's office,” says Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. “It would be absolutely disastrous for the health and well-being of the American public and around the world.”

However, others are more measured.

“There were times during the pandemic where he took a set of views that were contrary to those of most in the public health world, including mine,” says Dr. Ashish Jha, dean of the Brown University School of Public Health who served as President Biden's COVID-19 response coordinator. “But he’s basically a very intelligent and very qualified person.”

“Are there any views on him that I can look at and say, 'I think he was wrong' or 'They were problematic?' Yeah, absolutely. But when you look at his 20 years of work, I think it's difficult to call him marginal,” says Jha. “I think he’s been very much in the mainstream.”

Possible changes at NIH

Bhattacharya's allies say the harsh criticism of the statement illustrates how insular and misguided mainstream scientific institutions like the NIH have become.

“I think he's a visionary leader and I think he would bring new thinking to these issues,” says Kevin Bardosh, who runs Collateral Global, a London-based think tank that Bhattacharya helped create. “I think he would return the agency to its mission and eliminate the culture of groupthink that has infected it over the years.”

Others agree that major changes are needed.

“We need to restore the integrity of the NIH,” says Martin Kulldorf, an epidemiologist and biostatistician who helped write the statement with Bhattacharya. “I think Dr. Bhattacharya would be a great person to do this because he is truly an evidence-based scientist.”

But other researchers have expressed concern about Bhattacharya taking the reins of the NIH, given his views on the pandemic and at a time when Robert F. Kennedy Jr. is poised to lead the Department of Health. Health and Human Services, which includes the NIH.

Kennedy, a vocal critic of mainstream medicine who questions the safety of vaccines and fluoridated water, said he would like to immediately replace 600 NIH employees.

“If Jay becomes director of the NIH, the hardest part will be protecting the NIH from some very bad ideas that RFK Jr. is pushing,” Jha says. “He will have to deal with a boss who has deeply unscientific views. It will be a challenge for Jay Bhattacharya but I suspect it will be a challenge for whoever becomes the head of the NIH.”

Republican members of Congress as well as conservative think tanks like the Heritage Foundation have proposed changes that would radically restructure the NIH. One proposal would streamline the agency from 27 separate institutes and centers to 15.

Another overhaul would impose term limits on NIH leaders to prevent the establishment of future figures like Collins and Fauci.

Fauci has become a hero to many scientists, public health experts and members of the public. But he has also become a lightning rod for Republican criticism over evolving guidance on masks, support for vaccines and, most stridently, over the origins of the virus.

“In the United States, we abandoned evidence-based medicine during the pandemic. That's why there is now, I think, a huge distrust of both medicine and public health. NIH have an important role to play in restoring the integrity of medical and public health research.” said Kulldorff.

One proposal that is raising concerns among some NIH supporters would be to give at least part of the NIH budget directly to states through block grants, thereby bypassing the agency's intensive peer review system. States would then distribute the money.

Many supporters of biomedical research agree that some changes in grantmaking might be warranted and helpful. But some fear it could lead to budget cuts for the NIH, which could jeopardize the scientific and economic benefits generated by agency-funded research.

“What worries me is that if someone like Jay Bhattacharya comes to 'shake up' the NIH, he is going to dismantle the NIH and prevent it from doing its job rather than just carrying out constructive reforms,” ​​said the University of,” says Rasmussen of Saskatchewan.

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The incoming Trump administration could also crack down on funding for research that has become particularly politically charged during the pandemic, known as “gain-of-function” research. This field studies how pathogens become more dangerous. The NIH also funds other hot experiments that involve the study of human embryonic stem cells and fetal tissues.

Restricting certain types of research has some supporters.

“There are some potential positives that a Trump administration could bring to the NIH and its program,” says Daniel Correa, executive director of the Federation of American Scientists. “Strengthening laboratory safety and reviewing and strengthening oversight of risky research, such as gain-of-function research, could be at the heart of the next NIH agenda. And I think that would be welcome .”

But Correa and others say the new administration also appears likely to reimpose restrictions on other types of medical research, like experiments on fetal tissue, that were lifted by the Biden administration.

“It would be wrong to reinstate a ban on fetal tissue research because it is based on false and misleading claims of a lack of significant progress and use of fetal tissue,” says Dr. Lawrence Goldstein, who studies fetal tissue at the University of California, San Diego. “If Americans want to see rapid research into repairing organ and brain damage and all the other diseases we're trying to fight, fetal tissue is a very important part of that toolbox.”

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