{"id":34996,"date":"2025-04-02T16:44:19","date_gmt":"2025-04-02T20:44:19","guid":{"rendered":"https:\/\/www.thenewatlantis.com\/?post_type=article&p=34996"},"modified":"2025-06-13T11:28:54","modified_gmt":"2025-06-13T15:28:54","slug":"jay-bhattacharya-has-his-work-cut-out-for-him","status":"publish","type":"article","link":"https:\/\/www.thenewatlantis.com\/publications\/jay-bhattacharya-has-his-work-cut-out-for-him","title":{"rendered":"The New NIH Director Has His Work Cut Out For Him"},"content":{"rendered":"\n

In the wake of Covid, trust in scientific and medical experts has eroded and become starkly polarized, threatening the ability of science agencies to sustain broad public support. The National Institutes of Health in particular has become a lightning rod, due to the controversial roles of Anthony Fauci and Francis Collins during the pandemic as well as the agency\u2019s funding of research at the Wuhan Institute of Virology in China. Many Americans have grown reluctant to delegate political power to such expert bureaucracies.<\/p>\n\n\n\n

With Donald Trump\u2019s return to the White House and Republican majorities in Congress, it seemed almost inevitable that the federal scientific establishment was in for a shake-up. President Trump\u2019s selection of Jay Bhattacharya \u2014 best known today as a critic of the Covid response, but also a longtime advocate of science reform \u2014 to lead the NIH was a hopeful sign that the administration was serious about reform. These conditions created a historic opportunity to overhaul an institution that, though essential to scientific and medical progress, has for decades<\/a> resisted many of the reforms<\/a> that experts from across the ideological spectrum have argued are badly needed. But these hopeful prospects for reforming the NIH gave way to something else in the two months before Bhattacharya took office this week.<\/p>\n\n\n\n

A barrage of unilateral executive actions targeting diversity initiatives and capping indirect costs have engendered chaos and confusion not only inside the NIH but also in the thousands of universities, research laboratories, and medical schools across the country that receive NIH funding. Most remarkably, when the administration ordered federal agencies<\/a> to halt review of new grants and contracts on January 27, the NIH \u2014 the largest funder of biomedical research in the world \u2014 had to effectively freeze over 80 percent<\/a> of its $47 billion budget. On March 27, the Department of Health and Human Services, which oversees the NIH, announced<\/a> that it would be laying off 10,000 employees, including up to 1,200 at NIH, as part of a larger restructuring plan. This came after the NIH had slashed<\/a> over a thousand employees in previous weeks and saw departures from several high-ranking civil servants<\/a>. <\/p>\n\n\n\n

What we have seen these last two months is not an extreme version of past Republican efforts to rein in the federal bureaucracy; it is a challenge to the basic social contract underlying federal science. As in other domains of public policy, from trade to national security, the Trump administration has upended half a century or more of bipartisan consensus \u2014 in this case, regarding the federal government\u2019s role in supporting academic science.<\/p>\n\n\n\n

All this has opened up an enormous breach of trust between the government and the scientific community. And it has raised fundamental, even existential, questions about the purpose of scientific institutions and their place in our democratic society.<\/p>\n\n\n\n

Jay Bhattacharya takes the reins at NIH in a moment of profound crisis for federal science. The preconditions for this crisis long <\/strong>predate Trump\u2019s return to power, but the actions of his second administration have pushed the situation to the breaking point. Reforming \u2014 or, perhaps more accurately, rebuilding<\/em> \u2014 the NIH is both more urgent and more challenging now than ever. It will require nothing less than renegotiating the contract between science and society, and the precarious role of the federal government in underwriting it.<\/p>\n\n\n

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Jay Bhattacharya at a Senate confirmation hearing on March 5, 2025
AP Photo \/ Ben Curtis<\/a><\/cite><\/figcaption><\/figure><\/div>\n\n
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\r\n\t\tWhat Was the Social Contract for Science?\t<\/h5>\r\n<\/div><\/div>\n\n\n

After the successful mobilization of science to defeat Germany and Japan during World War II, the federal government\u2019s relationship to science changed in fundamental ways. It would no longer simply conduct or utilize scientific knowledge to address discrete practical problems \u2014 containing infectious disease outbreaks, collecting demographic information, mapping lands and waterways, or building weapons. The government would also establish an infrastructure to subsidize and sustain a flourishing scientific research enterprise, with a system of grants and contracts for funding research in universities and other non-governmental institutions.<\/p>\n\n\n\n

The underlying premise was that a vibrant research enterprise was necessary for national competitiveness, especially with the Soviet Union. Rather than directly conducting or controlling all research itself, the federal government would delegate most of the responsibility for carrying out research \u2014 as well as for determining how federal dollars should be dispersed \u2014 to the scientific community. The expectation was that this system would produce technological innovations to improve human health, contribute to the nation\u2019s military advantage, and grow the economy.<\/p>\n\n\n\n

In the 1945 report<\/a> Science \u2014 The Endless Frontier<\/em>, Vannevar Bush, who had overseen the mobilization of science during World War II, made what is perhaps the most famous case for the government\u2019s role in supporting academic science. Basic science, he wrote, \u201cis performed without thought of practical ends\u201d and thus \u201ccreates the fund from which the practical applications of knowledge must be drawn.\u201d In the following decades, economists Richard Nelson<\/a> and Kenneth Arrow<\/a> formulated an economic rationale: because the social returns were too uncertain, the private sector would underinvest in basic science, hence the government must step in to correct this market failure.<\/p>\n\n\n\n

The postwar period saw the creation or expansion of a battery of federal science agencies, from the National Science Foundation and the National Institutes of Health to the Office of Naval Research and the National Aeronautics and Space Administration. This is often considered the \u201cgolden age\u201d of federal science, the most spectacular success of which was the Moon landing in 1969.<\/p>\n\n\n\n

Yet by the 1970s, this system had fallen into crisis, as the research enterprise got caught up in public backlash to the Vietnam War, environmental crises, energy shocks, and an economic recession. The New Left attacked the alliance of science with the military\u2013industrial complex, while a New Right attacked the inefficiencies of government bureaucracy. Some, including the libertarian economist Milton Friedman, rejected the Nelson\u2013Arrow rationale for public support, arguing<\/a> for zeroing out the budgets of agencies such as the NIH. On the other end of the political spectrum, a prominent scientist in the New York Times<\/em> called for<\/a> the \u201cdisestablishment of science,\u201d urging any scientist who \u201cabhors the consequences of national war\u201d to \u201creject any contract, grant or project that comes to him from a military department.\u201d<\/p>\n\n\n\n

Ultimately, however, the 1970s saw not the disestablishment of federal science but a new institutional arrangement that preserved the social contract implicit in it. Concerned about federal budgets and an unaccountable executive, Congress increased its oversight of science agencies, tightening restrictions on some areas of research. The military, meanwhile, began redirecting resources toward research with overt technological payoffs. Although private-sector research funding would soon surpass that of the public sector, the government would remain the primary patron of basic science, pursued in universities, colleges, and medical schools.<\/p>\n\n\n\n

There were of course many scientific controversies in the coming decades. But neither the government nor the scientific establishment challenged the basic premise that the government should fund research that was unlikely to be taken on by private industry, and that decisions about such funding should be delegated to scientists themselves. With its mission to improve human health through investments in basic science \u2014 long an area of bipartisan agreement \u2014 the NIH emerged as the crown jewel<\/a> of the federal scientific establishment, garnering durable support in Congress through the early 2000s that translated into skyrocketing budgets.<\/p>\n\n\n

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\r\n\t\tFederal Science in Crisis\t<\/h5>\r\n<\/div><\/div>\n\n\n

Today, the NIH is being challenged again, but in a far more direct way than in the past. The second Trump administration\u2019s broadside against the biomedical research enterprise during its first two months echoes the 1970s in drawing on popular discontent with scientific elites and unaccountable bureaucracies. Yet while couched in the familiar libertarian rhetoric of efficiency and waste, the administration\u2019s actions do not appear to flow from a well-articulated libertarian position nor point to an alternative vision of what a flourishing research enterprise ought to look like.<\/p>\n\n\n\n

Traditional Republican NIH reform<\/a> agendas<\/a> tend to be tailored to specific policy objectives, such as prioritizing basic science, increasing congressional oversight, or reducing inefficiencies and redundancies. Even more extreme proposals such as Milton Friedman\u2019s were predicated on the idea that the private sector had a comparative advantage in allocating resources for certain areas of research. But proposals simply to cut the NIH have never been politically popular, historically, even among Republicans. After all, it was Newt Gingrich\u2019s Republican-controlled Congress in the late 1990s that began what eventually became a doubling of NIH\u2019s budget by the early 2000s, under President Bush.<\/p>\n\n\n\n

In sharp contrast, the second Trump administration has not only moved to curtail NIH\u2019s funding, it has done so indiscriminately<\/a>. Only days after its inauguration, the Trump administration issued<\/a> an executive order halting all federal grants and contracts, effectively shutting off NIH\u2019s funding to external scientists. While court orders<\/a> have blocked the administration\u2019s blanket funding freeze, the Department of Health and Human Services has utilized its own bureaucratic mechanisms \u2014 including a ban<\/a> on posting key public notices in the Federal Register \u2014 to maintain the pause in NIH funding.<\/p>\n\n\n\n

What has been frozen are not just progressive pet projects or Covid-era flashpoints such as pathogen research. Biomedical research of all kinds is in limbo, pinching both blue state and red state<\/a> research budgets. Clinical trials have been interrupted, research programs have been stymied, data sets have disappeared<\/a> from the Internet, and universities and medical schools have had to cut staff and, in some cases, halt<\/a> graduate student admissions \u2014 changes that will disrupt the scientific workforce regardless of whether or how funding returns. \u201cA lot of what has been broken in the last six to eight weeks is not repairable,\u201d said<\/a> Judd Walson, a chair of the Johns Hopkins Bloomberg School of Public Health. (Hopkins has lost over $800 million in funding from USAID<\/a> and HHS<\/a>, and has cut<\/a> more than 2,000 jobs as a result.)<\/p>\n\n\n\n

The actions taken by the administration before Jay Bhattacharya took office seem intended not so much to advance a positive conservative or libertarian policy agenda as to inflict punishment on institutions perceived to be hopelessly corrupted by left-wing ideology. Yet it is not only the apparent objective of these actions but also the means deployed that are unprecedented.<\/p>\n\n\n

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\r\n\t\tThe Fiction of Science\u2019s Autonomy\t<\/h5>\r\n<\/div><\/div>\n\n\n

In the 1970s, the process by which federal science was reformed followed the normal procedures of democratic government: Congress, responding to public pressure and seeking to assert its own institutional prerogatives, established mechanisms to keep federal science in check. Today, by contrast, it is not the legislative but the executive branch \u2014 even individual personalities within it \u2014 that is reshaping the federal scientific establishment and doing so by fiat. This is in keeping with the strategy of an administration that believes the president, rather than Congress, represents the will of the people.<\/p>\n\n\n\n

To be sure, many of the administration\u2019s actions face severe legal challenges and some have already been blocked<\/a> by lower courts. A great deal of NIH\u2019s structure and operations, including rates for indirect costs, originate<\/a> in congressional statutes. Moreover, Congress still holds the purse strings, and NIH funding is almost surely not going away, at least not without legislative action few senators are likely to take. The recent continuing resolution passed by Congress in fact holds NIH funding steady at $47 billion through 2025 \u2014 not the increase researchers always prefer but hardly an existential threat either.<\/p>\n\n\n\n

Setting aside their legality and constitutionality, however, the administration\u2019s actions over the last two months have thrown into sharp relief the utter dependence of the scientific research enterprise \u2014 and specifically biomedical research \u2014 on the federal government. Meanwhile, the example of Columbia University, which had $400 million of research funding halted by the Trump administration over the university\u2019s handling of student protests of the Israel\u2013Gaza conflict, serves as a warning to all research institutions that receive federal funding that they can be punished at any time if they step out of line ideologically.<\/p>\n\n\n\n

All of this has revealed the idea that science is an autonomous and self-governing community to be a fiction, reassuring perhaps but highly misleading. Since the creation of a vast system of federal support for research in the mid\u2013twentieth century, the self-governance of science has always been a thin rationale papering over a precarious political compromise. Congress agreed to fund scientific research and to delegate decisionmaking authority over the research enterprise to science agencies in exchange for the many technological benefits such research was expected to deliver \u2014 while nevertheless retaining both budgetary and oversight authority.<\/p>\n\n\n\n

The dependence of academic science on federal funding has always raised the specter of government control. During the Cold War, federal support for basic science was motivated and shaped, even if mostly indirectly, by national security priorities \u2014 a fact lamented by critics from the left. Historian Paul Forman puts<\/a> the point provocatively: \u201cthough they have maintained the illusion of autonomy with pertinacity, the physicists had lost control of their discipline. They were now far more used by<\/em> than using American society, far more exploited by than exploiting the new forms and terms of their social integration.\u201d Right-wing critics, on the other hand, have in recent decades decried the influence of progressive priorities \u2014 from climate change to \u201cdiversity, equity, and inclusion\u201d \u2014 on federal science funding.<\/p>\n\n\n\n

However one assesses the influence of such political pressures on scientific research, the government has generally exerted it indirectly through statutory or administrative means: Science agencies may choose (or be asked by Congress) to fund or prioritize politically salient research topics or require grant seekers to include social impact<\/a> or diversity statements<\/a> in their proposals. Yet by bringing the NIH and the many non-governmental institutions that rely on it under a more direct, even personal, mode of political control, the Trump administration has suspended the ordinary political and bureaucratic procedures \u2014 not only statutes and rules but also tacit norms and expectations \u2014 through which the social contract for science has operated, for better and worse, over the last 50 to 80 years.<\/p>\n\n\n\n

Not unlike our European allies who depend on the United States for their economic and national security, but who have been forced to recognize that the U.S. government is not a reliable partner, the scientific community may have to adopt a more defensive, skeptical, and transactional posture toward its federal patron going forward. More self-reliance and circumspection on the part of the scientific community toward the state may not be altogether bad in the long run. But what happens to the NIH \u2014 and the thousands of non-governmental institutions that rely on it \u2014 in the meantime?<\/p>\n\n\n

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\r\n\t\tObstacles to Reform\t<\/h5>\r\n<\/div><\/div>\n\n\n

As Jay Bhattacharya assumes the NIH directorship, the outlines of a longer-term plan for the agency may be discernible amid the tumult. In recent weeks, the Department of Health and Human Services has signaled<\/a> its intention to reopen NIH funding, while centralizing the peer review process and terminating<\/a> grants that run afoul of the administration\u2019s anti-DEI executive order. The NIH has also announced plans<\/a> to resume the grant review process, with the ominous caveat that the HHS and the Elon Musk\u2013led Department of Government Efficiency (DOGE) will review each Notice of Funding Opportunity. The goal would seem to be a reconceived NIH, more responsive to the president\u2019s policy agenda.<\/p>\n\n\n\n

Reconfiguring the NIH would be an ambitious project under any circumstances. But Bhattacharya will face several obstacles that, ironically enough, are the direct result of the administration\u2019s own reckless behavior in the past two months. First, the NIH has lost thousands of employees through mandatory cuts and voluntary departures, ranging from probationary employees to some in senior leadership roles. While this depletion of human capital might mean there will be less resistance to change in some quarters, it also deprives the agency of the capacity needed to identify problems and feasible solutions.<\/p>\n\n\n\n

Second, Bhattacharya assumes his new position with an open question about what role HHS and DOGE will continue to have in NIH operations. Will the administration give the director adequate leeway not only to implement reforms but also to hire or rehire the staff \u2014 or to build or rebuild trust \u2014 with the stakeholders whose expertise and buy-in will be needed to do so effectively? Will Bhattacharya be able, as he emailed<\/a> NIH staff on Tuesday, to \u201cimplement new policies humanely\u201d?<\/p>\n\n\n\n

The issue of trust points to a subtler and perhaps bigger obstacle to reform. Historically, NIH directors have individually embodied the hybrid nature of the organizations they lead. As both scientists and administrators working in a government bureaucracy, they were able to speak the language \u2014 and sustain the trust \u2014 of the political and scientific constituencies between which they mediate. A liability for such scientist-administrators is that they can grow resistant to change, preoccupied with the autonomy and power of the institutions they lead, even at the expense of the larger scientific and national goals those institutions exist to serve.<\/p>\n\n\n\n

This leads to a paradox for reform: those with the expertise and human relationships needed to drive change are often the very insiders who benefit from the status quo. Bhattacharya\u2019s impeccable credentials combined with his status as a relative outsider could therefore have proved a powerful combination for reform, especially given the large public appetite for change when Trump took office. But the extreme actions taken by the administration prior to his directorship have created an altogether different problem: a breach of trust with the scientific community, both inside the NIH and in the wider biomedical research enterprise, that may hamper efforts to implement enduring reforms, including those preferred by Trump\u2019s supporters.<\/p>\n\n\n

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\r\n\t\tThe Need for a New Contract\t<\/h5>\r\n<\/div><\/div>\n\n\n

The scientific community has responded to the current crisis by lamenting what has been lost. But what this moment really calls for is confronting basic, even existential, questions: What is the NIH \u2014 and the broader federal scientific establishment \u2014 actually for? Why do we fund scientific research at all, and why do we do it in this way? Does it deliver value to the American public?<\/p>\n\n\n\n

For too long, many in the scientific community, preoccupied with maintaining or increasing research budgets, have taken the answers to these questions for granted. When pressed by the elected representatives who control their budgets, science agencies have typically responded with a version of the Nelson\u2013Arrow argument that the government must step in where the market fails to incentivize basic science. But scientists have no entitlement to public funding for their research, and the public is not wrong to suspect that these arguments, whatever their merits, have come to function as little more than rationalizations for preserving the status quo.<\/p>\n\n\n\n

That status quo was broken before Trump returned to power. The research community owes it to the public to articulate a vision of the place and purpose of science in a fractured and pluralistic democratic society marked by fierce competition over scarce public resources. Gauzy clich\u00e9s about the endless frontier of knowledge and the inevitable technological benefits of federal science no longer suffice. The task now is not to defend an institutional status quo that, for better or worse, is unlikely to return, but to help build a federal scientific establishment anew, one with the vision and legitimacy to endure for another 80 years.<\/p>\n\n\n\n

Jay Bhattacharya has his work cut out for him.<\/p>\n\n\n\n