Chaos at NIH – Throwing out the baby with the bathwater?

In the midst of “reorganization”, a pressing need for transparency

As a Professor who is still entrenched in academia, with funded research, but also a Christian constitutional conservative, I have unique insight into what is going on right now in the research enterprise. The rumor mill is rampant. These rumors and panic come from vaguely written NIH policy statements (this is nothing new to NIH – their policy statements have never been clearly written), so-called insiders that make presentations at academic institutions and are quoted in media, and frankly the active imaginations of stressed-out researchers. Both Dr. Bhattacharya (Director of NIH) and Secretary Kennedy (Director of HHS) have emphasized the need for greater transparency. I hope they read this, because there is greater time for transparency than the present! If the goal is to regain public trust in research, transparency is essential.

In no particular order, here the rumors that are flying around, and my thoughts on how they should be addressed:

Dismantling NIH and giving research money to the states to distribute:

On the surface, this sounds like a cute idea – NIH has become a corrupt behemoth (I’m not sure how much I believe in that statement, it might be partially true), and anything not clearly delegated to the federal government should be handled by the states according to the Constitution. First, this is a question of efficiency. If administration and distribution of research dollars will be handled by the states, you are talking about creating 51 mini NIHs (counting Washington DC since there are universities there). That means 51 systems of grant review. There are dozens of grant review panels (“study sections”) for a reason – to cover the diversity of research with appropriate expertise. You simply cannot find enough people with that wide variety of expertise within a state – at least not people that don’t have a conflict of interest. Second, this will make collaboration challenging. If someone in New York collaborates with someone in Tennessee, how does state money cross state lines? Collaboration is essential to strong research (first point here).

Getting rid of domestic subcontracts and NIH handling everything directly

The first problem with this couples with another rumor – the dozens of NIH employees that have ben fired already. Honestly, I have not seen confirmation of people being fired, but it is a pervasive rumor. So you’d need that workforce back in order to manage a financial administrative structure that has been handled by universities all this time. The other issue goes back to a point I made above – does this discourage collaboration? One of the key aspects of institutions administering subcontracts is that the “contact principal investigator” is ultimately responsible for affirming that the research proposed in the grant is actually being done. Does that role fall on program officers under this alternative strategy? If people are reporting to the NIH and not their collaborators, does that disrupt the productivity and cohesion of collaboration?

Having NIH distribute money to international researchers directly rather than through domestic institutions

This is only partially rumor – some of this is already underway: international components of research grants are being cut already. I will address one aspect of this below, but here I will talk about the logistics of NIH administering international sites directly. First, I understand where this is coming from. The Wuhan debacle is of course front and center, but it is unlikely that NIH is punishing the entire international research infrastructure because of the sins of one place. There is likely some corruption going on elsewhere. I’ve heard rumors of American institutions sending grant funds to the individual bank accounts of international researchers, who then in turn supposedly pay for the research, but some of that money might not go where it is supposed to go. But that is not universally true, not by a long shot.

But… before the NIH does this, they need to go back and see what has happened when they tried similar efforts before. Several years ago, the NIH has a mission to expand research capacity in Africa – H3Africa. This program revealed the lack of administrative capacity in many African sites. Some didn’t even have the ability submit grant proposals, others didn’t have the capacity to manage them financially. So if this is the covert way of ending international research because they “just can’t handle it”, well, that’s that I guess.

Ending all international research

Again, I get the motivation behind this. “Make America First.” “Why are we sending money overseas when we aren’t taking care of own people.” Absolutely valid points. There are three factors to consider here. First, generalizability – if the goal is to make discoveries in order to improve human health, then including the entire human race would be helpful. Find a solution that helps everyone not just the segment of the population you are able to study in the US. Second, and I’ll address this below – there are some diseases that do affect Americans, but are challenging to study here because they are somewhat uncommon. But the thing is about infectious diseases – they spread, unlike chronic disease. Third, this gets back to the value of collaboration – there are people in other countries that have expertise that Americans don’t have. Maybe the goal could be to have young American scientists study with those folks to gain that expertise – but that doesn’t happen for free. But you want the best researchers doing research, period.

Kicking females off of NIH institute councils simply because they are women

Some background first: Each institute (things like NIAID, NIGMS, NCI) have councils of senior-level scientists that make the final funding decisions after grant proposals have been reviewed by study sections. I don’t know how people are selected for these other than they have to go through a substantial background check. The rumor is that at least one woman was removed council “because she was a woman.” Okay, this is just ridiculous. Is the assumption that all women got to where they are because of DEI policies? That none of them earned their success on their own? I know that I personally have never been given a free pass on anything. If anything, policies meant to be inclusive (parental leave being the same as maternal leave) put child-bearing female scientists at a disadvantage. Maybe some DEI policies are too extreme – removing women from leadership positions is DEI to the other extreme.

Ending any and all research related to “diversity”

Some of this sounds like AI gone wild. I literally heard someone say that grants with “biodiversity” in their descriptions were being cut. Biodiversity has nothing to do with DEI. And I do know for sure that many many grants that aimed to understand the difference between different population groups have been cut. Let me be super clear here. Just because you try to understand why a certain population group has a different burden of disease, that does not mean that you are trying to give that population group an advantage in treatment, access to care, etc. In fact, by understanding why one population has a higher burden of disease, you understand why other populations have a lower burden, and that leads to better treatment strategies overall. There are clearly demonstrated differences between sex and race/ethnicity groups in the occurrence of disease. If we want to help the entire human race, these need to be better understood.

Ending any and all research related to “RNA”

This is another one that made me facepalm. Yes, I understand the motivation to get away from studying *mRNA vaccines*. But studying “mRNA” in the human body is a tool to understand human disease pathogenesis. This is another case of AI gone wild.

Ending infectious disease research

The focus of Make America Healthy Again is chronic disease. Absolutely needed. But infectious diseases still affect people. Will susceptibility to infectious disease be reduced once certain chronic diseases are addressed? Absolutely. But the challenge of infectious diseases is that they are contagious – and transmission has very little to do with chronic disease comorbidity. The goal here should be to clearly prioritize certain diseases that need to be a public health focus.

Lastly, I need to address why any of this matters at all, and why research infrastructure is important.

In order to develop new solutions to treating and resisting human disease, research is essential. Hopefully that point is clear enough. The question becomes, why does the federal government need to fund this? Why not foundations, charitable organizations, industry, etc? Here is the thing about foundations, industry, etc: They fund what interests THEM. Maybe someone had a friend or relative with a certain disease, or maybe they stand to make money treating a specific disease, etc. They generally do NOT have a global perspective. Even within charitable organizations that have a wide view on human disease, they have very specific things that they want to support, not the entire picture – if you thought NIH was narrow, the non-NIH research infrastructure is far worse. Is funding a behemoth like NIH with tax dollars the only solution? I don’t know. But it does enable scientists with independent expertise and interests to direct the research agenda. It adds perspective.