Updated March 05, 2025 at 17:48 PM ET
Stanford University health researcher Dr. Jay Bhattacharya, who is poised to become the next director of the National Institutes of Health, told senators at his confirmation hearing Wednesday that agency officials "oversaw a culture of coverup, obfuscation, and a lack of tolerance for ideas that differed from theirs" over the last few years.
In response, Bhattacharya, promised to "establish a culture of respect for free speech in science and scientific dissent at the agency."
"Dissent is the very essence of science. I will foster a culture where NIH leadership will actively encourage different perspectives and create an environment where scientists – including early career scientists – can express disagreement respectfully," he said.
During the COVID pandemic, Bhattacharya clashed with the mainstream medical establishment, including the NIH, over lockdowns and other measures designed to control the spread of the virus. He says he was shunned and penalized for his views and he didn't want anyone else to suffer the same fate.
A physician and health economist, Bhattacharya made his remarks during a two-hour hearing before the Senate Health, Education, Labor and Pensions Committee, where he answered questions about his plans for the largest public funder of biomedical research in the world.
The agency is reeling from a series of actions by the Trump administration, including layoffs, resignations, restrictions on grants and a plan to slash some funding.
While Democratic senators on the committee pressed Bhattacharya on protecting the agency from political influence and cuts, Republicans repeatedly praised the nominee. He's expected to easily win confirmation.
"The NIH is the crown jewel of American biomedical science, with a long and illustrious history supporting breakthroughs in biology and medicine," Bhattacharya said. "I have the utmost respect for NIH scientists and staff over the decades who have contributed to this success."
Bhattacharya would take the reins of the NIH at a time when health, medicine and public health have become particularly politicized.
The NIH should support science that is "replicable, reproducible, and generalizable," Bhattacharya said, adding that "unfortunately, much of modern biomedical science fails this basic test."
Bhattacharya's most adamant critics say he is ill-equipped to run the NIH. While he is a physician, Bhattacharya's expertise lies more in economics than health, they note.
"Jay Bhattacharya had a career as a respected health economist, but has turned 180 degrees and now seems skeptical of science and hostile to the very agency he is tapped to lead," Dr. Lawrence Gostin, a professor of global health law at Georgetown University, wrote NPR in an email.
"There is considerable worry that he will oversee a sustained period of weakening the NIH through major cuts to funding and staffing, as well as reduced research funding for universities," Gostin wrote. "Worse still, he seems to have an anger toward public health and scientific leaders stemming from an ongoing feud over the handling of the pandemic."
Supporters, however, say Bhattacharya has a long record of solid academic research at a leading university and skeptical instincts that would help him make long-needed changes.
"Dr. Bhattacharya is exactly the right leader to defend — and promote — science for the public good," Dana Goldman, a professor of public policy, pharmacy, and economics at the University of Southern California Institute for Public Policy & Government Service, said in an email to NPR.
Even some of those worried about Bhattacharya think he may help insulate the agency from some of the policies of President Trump and Robert F. Kennedy Jr., who has advocated against vaccines, criticized NIH and now runs the Department of Health and Human Services Department, which oversees it.
But in his remarks, Bhattacharya said the NIH is "at a crossroads" because most Americans do not have a "great deal of confidence: in the agency." NIH should "focus on research to solve the American chronic disease crisis," echoing Kennedy's long-held stance.
"If confirmed, I will carry out President Trump and Secretary Kennedy's agenda of Making America Healthy Again and committing the NIH to address the dire chronic health needs of the country with gold-standard science and innovation," he said.
Changes at the National Institutes of Health
The NIH funds nearly $48 billion in scientific research through nearly 50,000 grants to more than 300,000 researchers at more than 2,500 universities, medical schools and other institutions that study everything from infectious diseases and addiction to chronic diseases and mental illness.
The NIH is among the agencies shaken by the Trump administration's efforts to downsize the federal government. NIH has lost about 1,200 of the agency's 18,000 employees so far.
At the same time, the administration has been restricting the NIH's activities, including the agency's ability to communicate with the public and process thousands of grant applications for billions of dollars.
The administration is trying to cap the rate at which the NIH pays for the indirect costs of doing medical research at 15%, which is far lower than the rate that has been paid at many institutions. Scientists say it could cripple medical research. A federal judge in Boston Wednesday issued a preliminary injunction blocking the cap from being implemented nationwide.
As a result, morale is low on the sprawling NIH campus just outside Washington, D.C. Many scientists fear the moves are just the beginning of what could eventually be a major restructuring of the NIH.
During the hearing, several senators pressed Bhattacharya about whether he would reverse the cuts, rehire staff and reopen the flow of funding. Bhattacharya promised to make sure scientists have the funding they need.
While the NIH has historically enjoyed bipartisan support, the agency came under heavy criticism from some Republicans in Congress and others during the pandemic.
That animosity has continued, especially towards some former long-serving NIH officials like Dr. Anthony Fauci, who led the National Institute of Allergy and Infectious Diseases for 38 years, and Dr. Francis Collins, NIH director from 2009 to 2021. Collins announced his retirement Friday in the latest departure of senior scientists and administrators from the agency.
During the pandemic, Bhattacharya co-authored an open letter called "The Great Barrington Declaration," which challenged policies such as lockdowns and mask mandates. The declaration called for speeding herd immunity by allowing people at low risk to get infected while protecting those most vulnerable, such as the elderly.
The declaration was denounced by many public health experts as unscientific and irresponsible. "This is a fringe component of epidemiology," Collins told The Washington Post shortly after the document was released. "This is not mainstream science. It's dangerous. It fits into the political views of certain parts of our confused political establishment."
Bhattacharya and his allies argue the intense criticism the declaration triggered exemplifies how insular and misguided mainstream scientific institutions like the NIH have become.
Bhattacharya has criticized the NIH grantmaking process as too slow and cumbersome. Critics say the NIH funnels too much money to older researchers at elite institutions, depriving younger, more innovative thinkers at lesser known institutions.
"My plan is to ensure that the NIH invests in cutting-edge research in every field to make big advances rather than just small, incremental progress over years and sometimes decades," Bhattacharya said.
His supporters applaud his approach.
"I think Jay is well-qualified for this position. Like Jay, I'd like to see the NIH streamline the grant application process and move towards funding bigger and more ambitious projects," said Jason Abaluck, a professor of economics at Yale University.
Reorganization and a revamp of grantmaking
Republican members of Congress as well as conservative think tanks like the Heritage Foundation have been proposing changes that would radically reorganize the NIH. One proposal would streamline the agency from 27 separate institutes and centers to 15. Another calls for imposing term limits on NIH leaders.
One idea causing special concern among NIH supporters would give at least some of the agency's budget directly to states through block grants, bypassing the agency's intensive peer review system. States would then dispense the money.
Many proponents of biomedical research agree that some changes in grantmaking could be warranted. But some fear they could result in budget cuts that could undermine the scientific and economic benefits generated by NIH-funded research.
The NIH may also crack down on funding "gain-of-function" research that became especially politically charged during the pandemic. That field studies how pathogens become more dangerous.
"The NIH must vigorously regulate risky research that has the possibility of causing a pandemic," Bhattacharya said in his prepared remarks. "It should embrace transparency in all its operations. While the vast majority of biomedical research poses no risk of harm to research subjects or the public, the NIH must ensure that it never supports work that causes harm. If confirmed, I will work with Congress and the Administration to guarantee that happens."
The NIH also funds other hot button experiments that involve studying human embryonic stem cells and fetal tissue.
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