Trump nominates COVID-19 policy critic to lead the NIH

President-elect Donald J. Trump said late Tuesday that he would nominate Stanford University health policy professor Jay Bhattacharya to lead the US National Institutes of Health—a $47 billion juggernaut of scientific research that has become a target of Trump’s advisers.

Bhattacharya would report to Robert F. Kennedy Jr., whom Trump nominated to lead the Department of Health and Human Services (HHS) earlier this month, if they are both confirmed by the US Senate. Bhattacharya has distanced himself from some of Kennedy’s more unorthodox claims, like his endorsement of unpasteurized milk and his embrace of the debunked notion that vaccines cause autism. In an essay on the British news and opinion site UnHerd, Bhattacharya and University of Washington applied medical anthropologist Kevin Bardosh write that “Kennedy is not a scientist, but his good-faith calls for better research and more debate are echoed by many Americans.”

“The American public voted for disruptors like RFK Jr in 2024, and academic medicine now has an opportunity to atone for its Covid-era blunders,” Bhattacharya and Bardosh write. “If it engages constructively, it can participate in crafting and implementing reforms that would, indeed, make America healthy again.”

Kennedy has discussed a major shake-up that would involve firing 600 NIH employees and redirecting efforts away from infectious diseases. The Heritage Foundation’s Project 2025 document, a policy document designed to inform Trump’s second term, calls for other reforms, like setting term limits on NIH leaders, decentralizing research by giving block grants to states, ending scientists’ use of fetal tissue for research, and abolishing the Foundation for the NIH, a nonprofit that connects the agency to academics, industry researchers, and patient advocates. For his part, Bhattacharya has pushed for greater transparency from government scientists.

“Together, Jay and RFK Jr. will restore the NIH to the Gold Standard of Medical Research as they examine the underlying causes of, and solutions to, America’s biggest Health challenges, including our Crisis of Chronic Illness and Disease,” Trump says in a statement announcing Bhattacharya’s nomination.

Bhattacharya wrote in a post on X that he was “honored and humbled” by the nomination. “We will reform American scientific institutions so that they are worthy of trust again and will deploy the fruits of excellent science to make America healthy again!” he wrote.

Like other cabinet picks for Trump’s second term, Bhattacharya made a name for himself by criticizing key components of the US response to the COVID-19 pandemic. He became infamous in public health circles for coauthoring the Great Barrington Declaration in October 2020, which advocated—before vaccines or treatments were available in the US for COVID-19—that anyone who was “not vulnerable should immediately be allowed to resume life as normal” to build herd immunity.

Public health officials decried the manifesto as bad policy; infectious disease experts have said that with rapidly changing viruses like SARS-CoV-2, there’s effectively no such thing as herd immunity. Then–NIH director Francis Collins described Bhattacharya and his cowriters as “fringe” in an internal email at the time.

Bhattacharya also opposed COVID-19-era vaccine mandates, which he described as “unethical” and “unscientific” as recently as last week. In his view, the scientific community lost the public’s trust with such measures and now has the chance to rebuild it.

Some scientists worry that Bhattacharya’s appointment to the NIH will serve only to undermine research in the US. Joshua Weitz, a data analyst at the University of Maryland in College Park who focuses on viruses, is among them.

“It is problematic that the potential leader of NIH repeatedly took steps that were contrary to evidence and insisted that data meant that there was going to be a rapid conclusion to the pandemic and also that it would cause far less harm than it ultimately did,” Weitz says. “That, in my mind, is really inconsistent with what you’d want or expect from your leader.”

Weitz points to a study Bhattacharya coconducted in April 2020 estimating that COVID-19 cases in Santa Clara County, California, were 50 to 85 times as many as the official tally at the time, based on serological antibody tests (Int. J. Epidemiol. 2021, DOI: 10.1093/ije/dyab010). Bhattacharya and his coauthors published an early version of the paper on a preprint server in April 2020. The upshot was that if those results held on a wider basis, then COVID-19’s fatality rate was lower than previously assumed, and the world was already nearing “population immunity,” Weitz says. But the test the researchers used was imperfect, and Weitz and other outside researchers had concerns that the sample was not representative of the population.

“Reasonable people can have reasonable disagreements: how to lock down, when to lock down, when to come out of lockdown,” Weitz says. “People did not like lockdown. There were economic issues. There were many problems. But that is not the issue people should be focused on. They should be focused on the scientific decisions [Bhattacharya] and others made early in the pandemic.”

The NIH plays a critical role in basic science that often forms the foundation of new medical devices and pharmaceuticals. A Bentley University study last year (JAMA Health Forum 2023, DOI: 10.1001/jamahealthforum.2023.0511) found that most drugs approved by the US Food and Drug Administration involved NIH funding.

Government funding is also particularly key to studying diseases that are poorly understood or have been neglected by the pharmaceutical industry, like long COVID. The agency has allocated $1.7 billion to a program studying long COVID—including $515 million that’s slated to fund clinical trials for potential treatments for the condition, potentially starting in December.

Julie Gerberding, CEO of the Foundation for the NIH, indicated during a webinar about the future of the long COVID program last week that she was not concerned about whether the incoming administration’s priorities would include long COVID.

“What we need to concentrate on is long COVID is a public health priority. Congress recognizes that. We have bipartisan congressional support for this work,” Gerberding said. “I don’t want to sound like a Pollyanna, but I feel, from a realistic point of view, this work will get done. It is prioritized, and even if there is significant changes in the administrative overview of the NIH, the work will go forward.”