President-elect Donald Trump has picked a Stanford University health economist and outspoken critic of the U.S. government’s response to the COVID-19 pandemic to lead the world’s largest biomedical research agency, the $47.4 billion National Institutes of Health (NIH).
Jay Bhattacharya is a physician and economist who during the pandemic emerged from academia to become a pundit on X (formerly Twitter) and in conservative media, where he blasted NIH and other U.S. agencies for urging pandemic actions such as school and work closures. Like Trump’s other nominations for health positions, his selection is drawing a mixed response from biomedical scientists, some of whom question his claims and fear that he will upend the agency.
Trump’s announcement ends the suspense that built since The Washington Post reported on 16 November that Bhattacharya was a top contender for the NIH post. Some observers had wondered whether Trump was considering alternatives, and Endpoints News reported his team last week asked Moncef Slaoui, who led the Operation Warp Speed effort to develop COVID-19 vaccines, about taking the job but that Slaoui was not interested.
Trump announced late yesterday that he was “thrilled to nominate” Bhattacharya. The president-elect said that with Robert F. Kennedy Jr., his pick to head the Department of Health and Human Services, Bhattacharya “will restore the NIH to a Gold Standard of Medical Research” and find “solutions” to challenges “including our Crisis of Chronic Illness and Disease.” He would replace current NIH Director Monica Bertagnolli, a cancer researcher who has been in the post just 1 year.
Bhattacharya commented on X that he is “honored and humbled,” and that “We will reform American scientific institutions so that they are worthy of trust again.”
Some researchers worry his main priority will be to carry out the agenda of Kennedy, a vaccine skeptic who has vowed to replace 600 NIH employees on his first day and shift funding from infectious disease to chronic disease. He is “a self-interested extremist who gives cover to anti-vaxxers” and will “destroy” NIH, Angela Rasmussen, a virologist at the University of Saskatchewan, wrote on X.
But others in the research community told Science they are comfortable with Trump’s pick, who has criticized vaccine mandates but is not widely regarded as a general vaccine skeptic. Bhattacharya “is a strong albeit unconventional choice” whose views may win badly needed support for NIH from moderate Republicans in Congress, says Ned Sharpless, a former National Cancer Institute director appointed by Trump in his first term. NIH’s budget did not grow this year, and Congress is contemplating an overhaul of the agency’s structure.
The job will require Senate confirmation, but Republicans control that body and Bhattacharya is not seen as nearly a divisive choice as Kennedy. Senator Bill Cassidy (R–LA), who chairs the Senate health committee that will hold his confirmation hearing, wrote on X he is “interested in how Dr. Bhattacharya sees using his background as a health economist to guide the NIH.”
Bhattacharya’s academic work, funded by NIH’s National Institute on Aging, has explored topics ranging from the impact of Medicare on health outcomes to aging in Japan and antibiotic resistance in Africa. He has also examined how much innovative research NIH funds and called for it to take more risks with its grants.
At the start of the pandemic in early 2020, he shifted to the epidemiology of COVID-19. He and colleagues tested a sample of people in California for SARS-COV-2 antibodies and, like others doing similar surveys, they found evidence that many infections with the coronavirus were mild. They went on to argue that COVID-19’s fatality rate was comparable to influenza, suggesting there was no need for school and workplace closures and other strict pandemic restrictions. Others said the Stanford study was flawed, partly because it was small and recruited through Facebook—a biased sample—and criticized the group for posting it online without peer review.
In October 2020, Bhattacharya was one of three lead authors of the Great Barrington Declaration, an open letter arguing that school and work closures were not worth the societal and economic costs and that efforts should focus on protecting just the elderly from the virus. The rest of the population would quickly develop “herd immunity” as infections spread, the letter argued.
Public health leaders in the United States and around the world were critical. After later federal record requests turned up an email in which then–NIH Director Francis Collins called the authors “fringe epidemiologists,” Bhattacharya embraced the term, jokingly describing his own views as “fringe.”
He has since advised Florida to drop masking in schools earlier than other communities, joined a lawsuit challenging social media companies for suppressing his posts on X, testified before Congress, spoken at a Kennedy rally when he was running for president, and attracted nearly 550,000 followers on X. He regularly slams Collins and former NIH infectious disease chief Anthony Fauci for mishandling the pandemic.
Bhattacharya also shares the view held by some politicians and scientists that SARS-COV-2 did not jump from animals to humans naturally, but leaked from a Wuhan, China, lab that had genetically engineered the virus to be more dangerous. The lab had received NIH funding. Bhattacharya recently joined the board of Biosafety Now, a group of scientists and others who have pushed for banning U.S. funding for so-called gain-of-function research, which could make risky pathogens more dangerous to people. Microbiologists say a broad ban would be destructive, sweeping up much routine virology research and hindering efforts to understand whether the H5N1 virus infecting U.S. cows will jump to humans.
Bhattacharya is a signatory on letters calling peer-reviewed papers in Science and elsewhere that support a natural origin for SARS-Cov-2 “potentially products of scientific misconduct—including fraud” and deserving of retraction—a stance the journals have rejected. He has also been highly critical of the COVID-19 views of Science Editor-in-Chief Holden Thorp.
For some scientists, Bhattacharya’s argument that “herd immunity” would quickly end the pandemic went too far. “I consider Bhattacharya’s publications and media activity surrounding the pandemic to be disqualifying for consideration as NIH director,” says Keith Yamamoto, a biochemist at the University of California San Francisco who was recently president of AAAS, which publishes Science. “He has contributed to erosion of trust in science by attacking experts.”
But some points Bhattacharya has made, such as whether school closures went too far, have since gained more support among scientists, even from Collins. And many SARS-COV-2 infections were mild, as he argued. “My sense is that the establishment came down pretty hard on Jay,” says economist Bruce Weinberg of Ohio State University, who once shared an NIH grant with him. “I would welcome someone who I believe takes the science seriously whether I agree with him (even on important points) or not.”
Bhattacharya’s supporters also point to his analyses of NIH funding, including work showing scientists are more creative earlier in their careers and the idea of a “novelty” index to assess research. Such studies “made important points about the NIH’s funded research portfolio based on very careful analysis of the data,” says economist Donna Ginther of the University of Kansas. “If Jay were to be NIH director, I would hope he would bring that approach to the organization.”
Lawmakers in Congress share some of his ideas for NIH, such as term limits to rein in the power of the directors of NIH’s 27 institutes and centers and more funding to replicate research. He has also called for “decentralizing power.” Economist Mikko Packalen of the University of Waterloo, a former student and current collaborator, says one more radical proposal they’ve discussed is to break NIH up into regional centers spread around the country that would help “gain the population’s trust.” That would fit with Trump’s general push to move federal agencies out of the Washington, D.C., area but could also trigger an exodus of scientists.
But some scientists say his disruptive approach could do more good than harm at NIH. “Given that NIH restructuring is squarely on the table now,” Sharpless says, “this may be the right time for an outsider.”
More: https://www.science.org/content/article/controversial-health-economist-trump-s-pick-head-nih
