WASHINGTON – The director of the National Institutes of Health fielded pointed questions from House Republicans in a hearing Tuesday regarding how the agency would rebuild public trust and spend its nearly $50 billion budget.
“One of our top priorities is to earn back trust lost during COVID. We need to better communicate information about the research we do and how it benefits all Americans,” Dr. Monica Bertagnolli, who has helmed NIH since last November, told members of the House Appropriations Committee.
NIH is under particular scrutiny following President-elect Donald Trump’s announcement Thursday that he would nominate Robert F. Kennedy Jr. as secretary of health and human services, whose department includes NIH.
The nation’s medical research agency, NIH is headquartered in Bethesda, Maryland, and employs more than 18,700 federal staff.
In Kennedy’s unsuccessful 2024 presidential run under the banner “Make America Healthy Again,” he repeatedly spread misinformation about vaccine research, including casting aspersions on how vaccine trials were conducted during the pandemic. NIH funds vaccine research, including the mRNA sequencing used to develop the Moderna COVID-19 vaccine.
Despite a warning from presiding Rep. Robert Aderholt, R-Alabama, not to wade into controversial issues in Tuesday’s hearing, Republican Rep. Andy Harris of Maryland grilled Bertagnolli on how NIH grantees report the gender of clinical trial participants who do not identify with their biological sex.
When Bertagnolli replied that the answer depends on the research question at hand, Harris said, “And that’s why nobody trusts the NIH anymore.”
Harris said that despite budget increases for NIH, America is “getting sicker, not healthier.”
“Whatever we’re doing, it’s just not working,” Harris said. “And there’s a reason why, you know, Mr. Kennedy and Mr. (Elon) Musk are gonna have a say in this.”
Democratic Rep. Steny Hoyer of Maryland approached the subject of NIH accountability with a lighter touch, asking Bertagnolli whether directors of NIH’s largest institutes and centers would testify before the committee to account for their work in greater detail, to which Bertagnolli agreed.
Democratic Sen. Chris Van Hollen of Maryland told Capital News Service in a statement he will oppose Kennedy’s confirmation in the Senate, where Republicans will soon hold the majority with 53 seats.
Kennedy, if confirmed, would appoint an acting director of NIH to replace Bertagnolli. The Senate later would confirm a permanent head of the agency.
In a Nov. 9 interview with entrepreneur Joe Polish in Scottsdale, Arizona, Kennedy said he would fire and replace 600 NIH personnel on the first day of Trump’s second term.
Van Hollen said Kennedy’s threats to HHS agencies are deeply concerning, and Kennedy’s “promotion of anti-vaccine conspiracy theories and lack of expertise makes him unfit to lead this critical institution.”
Kennedy’s appointment is an initial step towards realizing the conservative vision for public health laid out in the Heritage Foundation’s Project 2025 roadmap for a second Trump term.
Project 2025 names NIH and the Centers for Disease Control and Prevention as “the duo most responsible — along with President Joe Biden — for the irrational, destructive, un-American mask and vaccine mandates that were imposed upon an ostensibly free people during the COVID-19 pandemic.”
The pandemic eroded the public’s trust in scientists, particularly among Republicans, according to a Pew Research Center survey published Thursday. That distrust was a recurring theme of the committee hearing Tuesday, where Republican lawmakers probed the NIH director more aggressively than their Democratic counterparts.
Yet despite skepticism in the halls of power, Pew’s polling signals a warming in conservative sentiment towards scientists. Republicans’ overall trust in scientists is up 5 percent over last year, the first positive gain since the start of the pandemic.
While there is broad support from the public and in Congress to fund scientific research writ large, several Republican lawmakers have proposed frameworks to reform operations at NIH.
In June, Rep. Cathy McMorris Rodgers, R-Washington, introduced a proposal to consolidate NIH’s 27 institutes and centers to 15 bodies. Rodgers also raised concerns over the “stagnant nature of leadership” at NIH, citing Dr. Anthony Fauci’s 38 years as director of the National Institute of Allergy and Infectious Diseases.
Bertagnolli told lawmakers Tuesday that NIH’s many centers work collaboratively and serve as “visible representations of certain disease groups and constituencies.” The National Institute on Aging, for example, is an important touchstone to those concerned about Alzheimer’s disease, Bertagnolli said.
Hoyer told CNS that examining NIH’s structure is “a worthwhile objective” but one that should not be rushed through Congress.
Caleb Watney, the Co-CEO at the Institute for Progress, a think tank focused on technology and science innovation policy, told CNS that should the Trump administration enact reform at NIH, the change is likely to be small and incremental.
The Republican-controlled Congress may pass some restrictions like term limits for directors, but major cuts to grant funding are less likely, Watney predicted.
“I would be surprised if there is large-scale, across-the-board NIH cuts, especially because…their fundamental mission is so bipartisan,” Watney said.
In May, Sen. Bill Cassidy, R-Louisiana, released a white paper scrutinizing NIH’s grant management process, including the peer-review process required before grant funding is approved.
The peer review system can take months or even years, a pace that itself is “a huge cost to science,” according to Watney.
Watney said that the new Congress should not take the public’s frustration with the federal COVID response, which was largely led by the Centers for Disease Control and Prevention, as a blank check to erroneously gut science research at NIH.
“I hope that our policy makers are being careful about applying the scalpel to the right institution, because it’s not going to fix everything if you slash and burn the NIH,” Watney said.
Trump attempted to curb the NIH budget in every annual spending proposal of his first term. Despite those efforts, Congress increased research spending year over year.
NIH’s Fiscal Year 2024 budget is nearly $48 billion, roughly 80% of which passes through to grantees at research organizations across the country.
NIH grants in Maryland total over $1.4 billion this year. Johns Hopkins University is the largest grant recipient in the state, receiving more funding than all others combined.
The largest grant awarded to Johns Hopkins supports the National Health and Aging Trends Study and the National Study of Caregiving. Nearly $17.5 million in federal support assists researchers studying Alzheimer’s disease, dementia and other late-life disabilities.
When asked whether NIH employees or grantees in Maryland should be concerned about a coming shakeup in the agency, Harris told CNS: “That will be up to the secretary (of HHS).”