Bhattacharya outlines plan to restore credibility at National Institutes of Health

© Senate HELP Committee

The National Institutes of Health (NIH) would have five goals under new leadership, said the nominee to lead the world’s largest medical research organization.

On March 5, the Senate Committee on Health, Education, Labor & Pensions (HELP) held a hearing for Jayanta “Jay” Bhattacharya, MD, PhD, to serve as NIH director. Chronic diseases, infectious diseases, the aftermath of the COVID-19 pandemic and more all were part of questioning. Bhattacharya, a professor of health policy at Stanford University, outlined his vision to restore confidence in government-sponsored science.

“The NIH is the crown jewel of American biomedical sciences with a long and illustrious history of supporting breakthroughs in biology and medicine,” Bhattacharya said. “I have the utmost respect for the NIH scientists and staff over the decades who have contributed to this success. The NIH is mission to support scientific discovery, to enhance health and lengthen life is vital to our country's future and indeed the world's.

“I love the NIH, but post-pandemic American biomedical sciences are at a crossroads,” he said. A November 2024 Pew study found 26% of the American public had a great deal of confidence in scientists to act in the public’s best interests, while 23% had not much or no confidence at all, Bhattacharya said.

Five goals

As leader, Bhattacharya outlined five concrete goals for NIH:

• Focus on research that solves the nation’s chronic disease crisis. It is severe, and American life expectancy has not returned to pre-pandemic levels. NIH would commit to gold standard science and innovation.
• NIH-supported science must be replicable, reproducible and generalizable. Bhattacharya noted NIH last year had an integrity scandal involving research on Alzheimer disease. “If the data generated by scientists is not reliable, the products of such science cannot help anyone. It is no stretch to think that the slow progress on Alzheimer's disease is linked to this problem. The NIH can and must solve the crisis of scientific data reliability,” he said.
• NIH needs a culture of respect for free speech and scientific dissent. “Dissent is the very essence of science,” Bhattacharya said. “I'll foster a culture where NIH leadership will actively encourage different perspectives and create environment scientists, including early career scientists and scientists that disagree with me can express disagreement respectfully.”
• The institutes must recommit to the mission to fund cutting edge research in every field to make big advances, not just small, incremental progress.
• NIH must regulate risky research that has the possibility of causing a pandemic. “It should embrace transparency in all its operations,” Bhattacharya said. “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 might cause harm.”

NIH inflection point

NIH is at an inflection point, said committee Chair Sen. Cassidy, MD (R-Louisiana).

There is concern the current NIH system of funding favors established scientists studying concepts that are already proven, instead of younger researchers hunting for breakthroughs among unproven ideas. More broadly, NIH and other public health and scientific institutions lost people’s trust during the COVIC-19 pandemic, Cassidy said at the start of the hearing.

Who holds the power?

HELP Committee Ranking Member Sen. Bernie Sanders (I-Vermont), noted the $48 billion NIH has guided research that has significantly improved the lives of Americans and people around the world. He recounted a litany of problems with the American health care system: world-leading high costs, 85 million people uninsured or underinsured, a shortage of physicians and other clinicians, and lower life expectancy for low-income people.

Meanwhile, NIH pays for research that pharmaceutical companies use, then rip off American patients by charging more for prescription drugs in the United States than in other countries, Sanders said.

“In my view, we need an NIH director who is prepared to take on the greed of the pharmaceutical industry and use every tool at his or her disposal to substantially lower the cost of prescription drugs,” Sanders said. Bhattacharya won’t have that authority under President Donald J. Trump, who instead relies on Elon Musk, the tech billionaire leading the Department of Government Efficiency, Sanders added.

“Over the past several weeks, it has been about become abundantly clear that it really does not matter who the president nominates to be director of the NIH,” Sanders said. “And I don't mean to be disrespectful in saying that, but it doesn't matter who did he nominates to be director of the NIH or the Secretary of Labor, the Secretary of Education or the commissioner of Food and Drug Administration. The real person in charge of all these federal agencies is Mr. Elon Musk, and that will continue to be the case no matter who the Senate confirms to these positions.”

Pandemic response

In his introduction, Sen. Pete Ricketts (R-Nebraska) praised Bhattacharya for intellectual honesty and courage for suggesting ways to handle the COVID-19 pandemic. Bhattacharya’s ideas guided policies in Nebraska when Ricketts was governor there during the pandemic, and Nebraska earned the best grade for pandemic response from Politico, he said.

Physicians speak

Cassidy opened questioning by asking if Bhattacharya would devote limited NIH resources to research on connections between childhood measles-mumps-rubella vaccines and autism. That claim was based on discredited research now decades old, he said but people still believe it, as some people don’t believe the earth is round, or do believe singer Elvis Presley is alive. It is a tragedy that a measles outbreak in Texas claimed the life of a child, Cassidy said, and Bhattacharya agreed.

“It's a tragedy that a child would die from a vaccine preventable disease,” Bhattacharya said. “I fully support children being vaccinated for diseases like measles that can be prevented with the vaccination efforts. As far as research on autism and and vaccines, I don't generally believe that there is a link and based on my reading of the literature, but what I have seen is that there's tremendous distrust in medicine and science coming out of the pandemic. And we do have, as you know, senator, a sharp rise in autism rate in this country, and I don't know, and I don't think any scientist really knows the cause of it, so I would support an agenda, a broad agenda, a broad scientific agenda based on data, to get an answer to that.”

Vaccine hesitancy

Sen. Rand Paul, (R-Kentucky) said there could be room for another study about autism and vaccines to try to convince those who are hesitant. A study could examine populations of people who take no vaccines, such as Amish people, and compare them in a scientific way to those who do, he said. NIH also must eliminate frivolous studies and devote time and effort to diabetes, heart disease, cancer, and Alzheimer disease, he said. Bhattacharya agreed research should focus on making America healthy.

Trump and Musk are putting life-saving research at risk by firing NIH researchers and freezing funding, said Sen. Patty Murray (D-Washington). Bhattacharya said he was not involved in those decision, but would ensure NIH scientists and resources would meet the mission to do research that makes America healthy.

Bhattacharya affirmed to Sen. Susan Collins (R-Maine) that he would support the national strategic plan targeting Alzheimer disease. He added it is not just a theoretical issue for him, because he has studied it and some colleagues at Stanford University have not received support because they did not align with a single dominant narrative about that disease.

Frozen funding

Sen. Tammy Baldwin (D-Wisconsin) countered that the Trump administration has halted $65 million in funding for 14 Alzheimer disease research centers and their money will run out in April. Bhattacharya said he would investigate and he did not believe halting life-saving research is a priority for the president.

Senators should doubt their own infallibility and the infallibility of NIH as well, said Sen. Roger “Doc” Marshall, MD (R-Kansas), citing research on the amyloid hypothesis as a cause of that disease. Some NIH projects have focused on a hypothesis at the expense of other hypotheses, Bhattacharya said. “I agree with you about humility. That's the key to scientific progress,” he said.

Marshall asked for a commitment to figuring out the cuases of chronic diseases, and Bhattacharya agreed.

Sen. Maggie Hassan (D-New Hampshire) asked about the administration’s current freeze on research funding for diseases such as colon cancer and pediatric cancer. Bhattacharya said if confirmed, his job would be to make sure fundamental scientific meetings and activities happen.

MMR vaccine

Hassan returned to the issue of childhood autism and alleged connections to the MMR vaccine, stating she was disappointed in Bhattacharya and Kennedy.

“Because what you do when you hesitate, what the secretary does, quite cynically, in my view, when he hesitates about this, is you churn and sow doubt and worry at a time when we should be focused on actually finding the cure, the cause and the cure of autism,” Hassan said.

Chronic disease research

Bhattacharya told Sen. Tommy Tuberville (R-Alabama) that his team would by hyper-focused to ensure NIH’s portfolio of grants are devoted to the chronic disease problems of the nation. The funded research projects will have capacity to make huge advances in treatments for cancer, diabetes and obesity, he said.

Sen. John Hickenlooper (D-Colorado) also called on greater transparency to restore the public’s trust in NIH, and asked if was unfair or if the United States was being ripped off due to funding so much research.

“I think the United States is the greatest country on Earth, and one of the reasons it is, is that it has a sincere commitment to doing fundamental research that benefits all of humanity,” Bhattacharya said. “And I think much of the NIH research does exactly that. I don't view it as ripping off when a scientist comes up with an amazing idea that solves that treats diabetes better, everyone on Earth benefits from that. So I know I think NIH as fundamentally an institution aimed at the public good.”

Questioning continued with queries and comments from HELP Committee members Sen. Ashley Moody (R-Florida); Sen. Andy Kim (D-New Jersey); Sen. Jim Banks (R-Indiana); Sen. Lisa Blunt Rochester (D-Delaware); Sen Josh. Hawley (R-Missouri); Sen. Angela Alsobrooks (D-Maryland); Sen. John Husted (R-Ohio); and Sen. Ed Markey (D-Massachusetts).

The Senate HELP Committee is scheduled to hear from Martin A. Makary, MD, MPH, who is the president’s nominee to be commissioner of the U.S. Food and Drug Administration.