Senator Bill Cassidy (01:43):
[inaudible 00:00:48]. Sir, if your name comes out just a little bit different every time I say it, I apologize in advance. Importantly, NIH grants have increased biomedical research capacities in states that otherwise would not have had sufficient resources to invest. My state, Louisiana, has received roughly $500 million through NIH's Institutional Development Award program, or the IDEA program, allowing institutions to bring life-saving cures and treatments to people in my state and around the world. However, NIH at times it appears, has prioritized funding for risk-averse incremental science. There's concern the current system incentivizes established scientists who study already proven concepts rather than younger scientists who have unproven ideas with potential as major medical breakthroughs. While this practice may ensure the short-term success of federal grants, it limits groundbreaking discoveries. I've discussed this with you sir previously and look forward to hearing more today. NIH is facing other serious challenges.
(02:47)
During the COVID pandemic, there is a general loss in trust in public health and scientific institutions. To restore that trust, officials need to be more transparent and provide reassurance that there are publishing health guidance that is best for American's health and not biased in any way. You have indicated you would like to promote a free and open debate at NIH, including among scientists who disagree, and this is encouraging. The NIH is at an inflection point. If confirmed as NIH director, you'll be tasked with leading an agency that desperately needs a reform. Last year, I released several proposals outlining ways to modernize NIH, improving operations to better serve the American taxpayer. I look forward to hearing your vision today and working with you on these proposals if you are confirmed. With that, I recognize Senator Sanders for his opening statement.
Senator Bernie Sanders (03:38):
Thank you, Mr. Chairman. Thank you Mr. Bhattacharya for being with us. Today, we will be considering the nomination of President Trump's nominee to be the director of the NIH, Dr. J. Bhattacharya. The NIH with a budget of 48 billion is the largest funder of medical research in the world. This research has led to new treatments and prescription drugs that have significantly improved the lives of Americans and people throughout the world, and I think all of us should be very proud of those accomplishments. But having said that, let me say a few words about my concerns. I don't have to tell any American that the healthcare system in our country is broken and it is failing. We spend almost twice as much per capita on healthcare as any other industrialized nation, yet we have 85 million people who are uninsured or underinsured. We don't have enough doctors, nurses, dentists, mental health specialists.
(04:41)
Not only is our life expectancy four years lower than other wealthy countries, the bottom 50% in this country live on average seven years shorter lives than the top 1%. In other words, being working class or low income in America is in many ways a death sentence. You're rich, you live long. Working class, seven years younger. And very relevant to the hearing that we are conducting right now, we pay, as I think every American knows, the highest prices in the world for prescription drugs. No great secret there. In some cases, we pay more than 10 times of what our friends in Canada or Europe pay. In my view, not only has the federal government not effectively regulated the price of prescription drugs, but the taxpayers of our country have over the years provided hundreds of billions of dollars in research and development into new prescription drugs that have provided enormous benefits, financial benefits to some of the most profitable pharmaceutical companies in the world.
(05:53)
In 2023, when I had the privilege of chairing the committee, this committee released the report that found that the average price of new treatments that NIH scientists helped invent NIH research over the past 20 years is $111,000. In virtually all cases, American taxpayers are paying far more than people in other countries for the exact same medicine that the NIH and taxpayers help develop. We developed the drug and then we ended up paying 10 times more than other countries for the drug that our taxpayer dollars help develop. For example, Astellas and Pfizer charged Americans with prostate cancer over $179,000 for Xtandi while the exact same drug can be purchased in Japan for just 18,000. We do the research, we pay for it as taxpayers, and then we get ripped off by the companies. In my view, we need an NIH director who is prepared to take on the greed of the pharmaceutical industry and use every tool at his or her disposal to substantially lower the cost of prescription drugs. Not a new issue, an issue that people on this committee have been talking about for decades.
(07:14)
But with all due respect, Dr. Bhattacharya, President Trump will not be giving you that authority. I don't know what your views are on the subject. You're not going to have that authority. That authority will rest with Mr. Elon Musk. Over the past several weeks, it has become abundantly clear that it really does not matter who the president nominates to be Director of the NIH. And I don't mean to be disrespectful in saying that. But it doesn't matter who he nominates to be director of the NIH or the Secretary of Labor or the Secretary of Education or the Commissioner of Food and Drug Administration, the real person in charge of all these federal agencies is Mr. Elon Musk. And that will continue to be the case no matter who the Senate confirms to these positions. It is my understanding that Mr. Musk and his minions at DOGE have moved to some 1,200 employees at the NIH already, 6% of its staff. Further, I've been told that Mr. Musk and DOGE played a major role in freezing nearly all grant money at NIH, including grants that could lead to a potential cure for cancer, Alzheimer's and many other life-threatening diseases. So bottom line is that in my view, the real gentleman we should be having up there, and again, no disrespect to you sir, is Mr. Musk. And Mr. Chairman, I would hope very much, and I think the American people would be really very grateful if we could bring the real leader of the NIH, Department of Education, many other agencies of government before us, and that is Mr. Musk. So I will be looking forward to working with you to see if we can schedule a hearing with Mr. Musk. Thank you.
Senator Bill Cassidy (09:00):
Before we turn to the nominee for his own opening statement, Dr. Bhattacharya will be introduced by Senator Pete Ricketts, who will make clear the connection between you and Nebraska, which I'm not quite sure what it is, but Senator Ricketts.
Senator Pete Ricketts (09:15):
Well, thank you Chairman Cassidy and Ranking Member Sanders for holding this hearing and to all the esteemed members of the committee. It is an honor and a privilege to be able to introduce and recommend to you Dr. J. Bhattacharya to be President Trump's nominee for the director of the National Institute of Health. And I had the opportunity to meet Dr. Bhattacharya during the COVID Pandemic. A little bit about myself, I was governor of Nebraska at the time, but in a prior life, I actually was a biology major undergrad and worked in a protein biochemistry lab. I'm actually published, you can go find it out there. So for a brief moment in time, I was actually involved in the research world that the NIH gives out grants to help support. And during the COVID Pandemic, obviously we didn't know a lot. There was no playbook. And so I was getting great advice from our folks at the University of Nebraska Medical Center.
(10:03)
But I also reached out to talk to other folks, like Dr. Bhattacharya, about how we should handle this pandemic. And one of the things about Dr. Bhattacharya is he showed great intellectual honesty and courage because he offered alternative suggestions about how to handle the pandemic. Now we know now that young people are not really impacted by the COVID virus as much as older people are. And typically in the past, what we had done is we had a policy of let's protect the vulnerable people and let other people go about their life. And we really kind of turned that on its head for the COVID Pandemic because we really didn't know what was going on. Dr. Bhattacharya helped give me a perspective, and it certainly demonstrated that he was thinking not just about how does the virus impact people, but if we do lockdowns and so forth, how will that impact people's health?
(10:57)
And there were other impacts from doing those shutdowns. For example, we saw many school districts across the country shut down, and certainly in Nebraska as well, in March and April, we made those recommendations as well. However, in July, I stood with my director of education, said, we expect kids to be in classrooms in August. And that was important because kids need to be in classrooms. We found out during the pandemic, one of the downsides of the pandemic is that kids learn better in the classrooms, generally with their kids. And so one of the results of that, according to the 2022 Nations report card, Nebraska scored highest in fourth grade math and test scores in eighth grade math was second overall. And we did very well in reading as well because our kids were back in the classroom and I saw states like California where they weren't in the classroom, and I just worry about the damage that did to those kids' education by not being in the classroom.
(11:50)
Dr. Bhattacharya helped us think about broadly, how are we going to look at everybody's health, not just about the virus, but mental health education. And in fact, Politico, I know you are all familiar with Politico, they ranked all 50 states on things like health outcomes, education, economy, and social well-being. And Nebraska ranked number one overall. Politico ranked us the number one best pandemic response state because of our balance-
Senator Bill Cassidy (12:21):
Who was governor?
Senator Pete Ricketts (12:22):
This is while I was governor, yeah. This is while I was governor. If there had been another guy, governor, I probably would've bragged about him too. But this is about when I was governor. But the point is it was going to people like Dr. Bhattacharya, who he's been published in 135 different peer-reviewed publications on a variety of topics from law, medicine, economy, but having a broader perspective really helped us frame a pandemic response in Nebraska that helped us be very, very successful. And again, outside sources like Politico recognize that. So I think what you're going to get from Dr. Bhattacharya is somebody who understands the scientific method, that it's not all about, "Hey, we all agree on this." It's about we publish a research paper. It's out there for it to be replicated. Other people are supposed to replicate that and see if they get the same results.
(13:10)
If they don't, then the papers disagree. That's okay. I read a lot of research papers during the pandemic. Guess what? A lot of them didn't agree. That's what science is about. It's not supposed to be about, we all have a group thing that this is the established way it is. It's about challenging ideas and about thinking, "Well, you've got this idea, prove it." And then, "Okay, you've done this experiment, I'm going to replicate it. See if it actually comes out the way you said it did." That's the way research is supposed to work. This is what Dr. Bhattacharya in the real world demonstrated during the pandemic that he had the courage to stand up and say, "Wait a second. I know this is what the established way of thinking is, but I think there's an alternative way to look at it."
(13:49)
And because he did that, because he had that courage, I can tell you specifically in Nebraska, we benefited and our school kids benefited by being in classrooms, our state benefited on a number of different areas that I just mentioned, whether it's health, social well-being, economy, education, we benefited. So I highly recommend to you Dr. Bhattacharya. I think he's great. He's used NIH grants in the past, so he gets how that program works. He'll be a great person to be able to make sure that we've got the right way that we're distributing those grants with transparency, accountability, and accomplishing what we want to accomplish, which is that basic research, which is why we have the health system we do in this country today. So with that, Mr. Chairman, thank you.
Senator Bill Cassidy (14:32):
Thank you, Senator Ricketts. Dr. Bhattacharya, you'd like to give an opening statement, please?
Dr. Jay Bhattacharya (14:41):
Sure. Thank you, Senator. Chairman Cassidy, Ranking Member Sanders, members of the Senate Health Committee, I'm honored to speak with you today and deeply humbled by President Trump's nomination. I'm delighted to have with me my wife, Cathy, my son, Matthew, and my brother, Deep. My two other adult children, Jodi and Benjamin, unfortunately could not attend today, but are here with me in spirit. The NIH has played a pivotal part role in my career. I served for a decade as a standing member of NIH grant committees. I helped train many trainees, prepare for scientific careers with NIH support, and I want NIH funding to study population aging, chronic disease, and obesity. I've made the study of scientific institutions, including the NIH itself, a focus of my own scientific work. The NIH is the crown jewel of American biomedical Sciences with a long and illustrious history of supporting breakthroughs in biology and medicine.
(15:41)
I have the utmost respect for the NIH scientists and staff over the decades who have contributed to this success. The NIH's mission to support scientific discovery, to enhance health and lengthen life is vital to our country's future and indeed the world's. I love the NIH, but post-pandemic, American biomedical sciences are at a crossroads. A November 2024 Pew study reported that only 26% of the American public had a great deal of confidence in scientists to act in the public's best interest. 23% have not much or no confidence at all. So how can I help the NIH better achieve its mission? I have five concrete goals if confirmed as director of the NIH. First, NIH research should focus on research that solves the American chronic disease crisis. American health is going backwards. Life expectancy flatlined between 2012 and 2019, plummeted during the pandemic, and still has not bounced back to pre-pandemic levels.
(16:48)
The chronic disease crisis is severe with hundreds of millions of Americans, children and adults suffering from obesity, heart disease, cancer, and more. If confirmed, I will carry out President Trump and Secretary Kennedy's agenda of committing the NIH to address the dire chronic health needs of the country with gold standard science and innovation. Second, NIH-supported science should be replicable, reproducible, and generalizable. Unfortunately, much modern biomedical science fails this basic test. The NIH itself just last year faced a research integrity scandal involving research on Alzheimer's disease that throws into question hundreds of research papers. If the data generated by scientists is not reliable, the products of such science cannot help anyone. It is no stretch to think that the slow progress on Alzheimer's disease is linked to this problem. The NIH can and must solve the crisis of scientific data reliability. Under my leadership, if confirmed, it will do so.
(17:53)
Third, if confirmed, I'll establish a culture of respect for free speech in science and scientific dissent at the NIH. Over the last few years, top NIH officials oversaw a culture of cover-up, obfuscation, and a lack of tolerance for ideas that differed from theirs. Dissent is the very essence of science. I'll foster a culture where NIH leadership will actively encourage different perspectives and create environment where scientists, including early-career scientists and scientists that disagree with me can express disagreement respectfully. Forth, the NIH must recommit to its mission to fund the most innovative biomedical research agenda possible to improve American health. My plan is to ensure that the NIH invests in cutting-edge research in every field to make big advances rather than just small incremental progress over years.
(18:50)
Fifth, the NIH must embrace and vigorously regulate risky research that has the possibility of causing a pandemic, must regulate risky research that has the possibility causing a pandemic. It should embrace transparency in all its operations. While the vast majority of biomedical research poses no risk of harm to research subjects or the public, the NIH must ensure that it never supports work that might cause harm. If confirmed, I will work with Congress and the administration to guarantee that happens. While I believe there are real problems to be addressed, I want to finish by reiterating my great respect for the work and mission of the NIH. If confirmed, I'll carry out President Trump's agenda of making the public science institutions of this country worthy of trust and serve to make America healthy again. Thank you.
Senator Bill Cassidy (19:46):
Thank you, sir. I'll start with questionings. One thing that's been a real topic has been the issue of measles vaccines and autism. And we can see that the false article in Lancet decades ago has led to a lot of people not getting their child vaccinated. There's now a child who died from a vaccine-preventable disease in Texas. Let me repeat that. A child who died from a vaccine-preventable disease in Texas. The secretary has put out an editorial, which is, if you just read it, the kind of understanding of it is that you should get vaccinated. Now, I've been told that you have said that we need to invest in NIH resources at looking at the link, a possible link between measles vaccine and autism. I've not heard that directly. It's hearsay. Any comment on that?
Dr. Jay Bhattacharya (20:38):
Senator, it's a tragedy that a child would die from a vaccine-preventable disease. I fully support children being vaccinated for diseases like measles that can be prevented with the vaccination efforts. As far as research on autism and vaccines, I don't generally believe that there is a link based on my reading of the literature, but what I have seen is that there's tremendous distrust in medicine and science coming out of the pandemic. And we do have, as you know, Senator, a sharp rise in autism rates in this country. And I don't know, and I don't think any scientist really knows the cause of it. So I would support a broad scientific agenda based on data to get an answer to that.
Senator Bill Cassidy (21:27):
But this has been fairly… Well, in fact, it's been exhaustively studied and there's limited resources. And if we keep plowing over ground that has been plowed over, knowing you can never prove a negative, and since we don't know the cause, we'll still have a problem. We've got a responsibility with limited resources. How do we address those things that we don't know the cause for or that can ameliorate those things that are related to this crisis of chronic disease. My state, by the way, is terribly affected by chronic disease, so I'm totally with you on that. But what I want to make sure is there's an appropriate use. So again, just going back to do you have an idea or an agenda that would once more, by golly, once more, prove that measles vaccine is not associated with autism, neither the schedule, the vaccine, or anything else associated with it? Because my concern is the more we pretend like this is an issue, the more we will have children dying from vaccine-preventable diseases.
Dr. Jay Bhattacharya (22:25):
Senator, I guess I've turned it around and say, I don't want to disprove a negative. That's impossible, really, but I want to address the rise in autism that-
Senator Bill Cassidy (22:36):
I accept that. I think that's laudable.
Dr. Jay Bhattacharya (22:37):
[inaudible 00:22:39].
Senator Bill Cassidy (22:37):
We need to do that.
Dr. Jay Bhattacharya (22:39):
Yeah, that's a positive-
Senator Bill Cassidy (22:40):
But I'm asking the specific question, will we once more have to go back over this particular issue? Because that has been exhaustively studied.
Dr. Jay Bhattacharya (22:48):
Yeah, I mean, I think, as I said, Senator, I don't think that there's a link between the MMR vaccine and autism. I'm convinced based on that literature. The only reason I'm not wholeheartedly saying yes to your question, which every instinct of mine is to do that, is that there are people who might disagree with me. I want to make-
Senator Bill Cassidy (23:08):
But that's life.
Dr. Jay Bhattacharya (23:09):
Yeah.
Senator Bill Cassidy (23:09):
I mean, there's people who disagree that the world is round.
Dr. Jay Bhattacharya (23:12):
That's true.
Senator Bill Cassidy (23:12):
And I say that not to minimize these concerns, but people still think Elvis is alive, and so if you just say someone disagrees with me, so therefore I'm going to put precious limited taxpayer dollars to this and not to addressing issues of obesity, heart disease, cancer. We've lost. There's an opportunity cost there. You're the economist. What am I doing talking about opportunity costs? So I'm pressing you on this because I think that kind of is a framework. If just because somebody is upset about something, do we have the opportunity cost of devoting resources at something which has already been pretty well examined?
Dr. Jay Bhattacharya (23:49):
I mean, I guess yes, you're absolutely right, Senator. We don't need to address every idea or concern, but if those concerns result in parents not wanting to vaccinate their children for a vaccine that is well-tested, my inclination is to give people good data. That's how you address those concerns. I don't know [inaudible 00:24:11].
Senator Bill Cassidy (24:11):
I'm not quite sure what endpoint we say we've got good data, because-
Dr. Jay Bhattacharya (24:17):
I mean, I'm convinced that we have good data on MMR and autism, but if other people don't agree with me and then they don't vaccinate their children, I think if I'm confirmed as NIH director, that one lever I'll have is to give them good data. That's really the lever I'd have.
Senator Bill Cassidy (24:33):
But that good data already exists. You're a scientist and you accept that.
Dr. Jay Bhattacharya (24:37):
Yeah.
Senator Bill Cassidy (24:37):
It seems more an endorsement with an appropriate allocation of current dollars would be a better way to spend precious limited federal dollars.
Dr. Jay Bhattacharya (24:46):
I think the most important childhood health problems have to do with childhood diabetes, childhood obesity. I that's what-
Senator Bill Cassidy (24:53):
I accept that we should be studying that.
Dr. Jay Bhattacharya (24:56):
That's the vast, vast majority of the efforts should go. Prevention of childhood infectious diseases also, I think is important. I mean, all of those, I think you and I agree would be the main priorities. That's the priorities I'll have if I'm an NIH director.
Senator Bill Cassidy (25:09):
Thank you. Senator Sanders.
Senator Bernie Sanders (25:11):
Thank you, Mr. Chairman. As I mentioned a moment ago, in some cases, we pay 10 times more for prescription drugs, the same drug that people in other countries pay. Something like one out of four Americans can't afford the prescriptions that the doctors write when they get sick. Why do we pay the highest prices in the world by far for prescription drugs, and what will you do if you are confirmed as NIH director?
Dr. Jay Bhattacharya (25:43):
I don't have a full answer to that question, but I agree with your concern and the fact that we do pay the highest prices in the world for prescription drugs. If I'm NIH director, if I'm confirmed as NIH director, I think there's a very specific thing that we haven't done, but we should do. The NIH should fund research on off-label use of off-patent drugs, inexpensive drugs. I'll give you an example from the pandemic, Senator. There was a tremendous achievement, I think. There was a study done in the United Kingdom of a cheap steroid called dexamethasone very early in the pandemic. If used during-
Senator Bernie Sanders (26:23):
I don't mean to… I apologize, but I don't have a lot of time and I hear what you're saying and I'm not in disagreement with that. Question is historically, the NIH has, as we all know, spent billions of dollars in developing important drugs, and yet despite that taxpayer expenditure, we end up paying far more than other countries. Should a company that benefits from the taxpayer dollar research, basic research at the NIH, be able to charge any price that they want, or should we attach to those contracts a reasonable pricing clause that says, "Hey, if we help develop this drug and it's effective, you're going to have to charge a reasonable price for it."
Dr. Jay Bhattacharya (27:10):
Senator, that's an issue where I think previous NIH directors have said it's very difficult as for an NIH director alone to take action. I think that's something that Congress and the administration would have to work together.
Senator Bernie Sanders (27:21):
Not quite true. Actually, I think what we're learning from the president is a lot can be done through executive orders, and I would disagree with you. I think that's something that the NIH can do. Would you be open to that idea?
Dr. Jay Bhattacharya (27:36):
Senator, I guess I would focus on the future. Imagine the NIH focuses on support for relatively inexpensive [inaudible 00:27:44].
Senator Bernie Sanders (27:44):
I'm hearing you though. Okay. Let me ask you this question. We talked about life expectancy, very important issue. Why is it that working class people in America lives seven years shorter lives than the rich?
Dr. Jay Bhattacharya (27:56):
Senator, it's the chronic disease crisis in large part, the chronic disease crisis-
Senator Bernie Sanders (28:00):
But why does somebody who's working class end up with more chronic disease than somebody who's wealthy?
Dr. Jay Bhattacharya (28:05):
I mean, I think, Senator, that's something I've devoted my career to trying to understand. I think that it is a tragedy that there's such a dispersion in life expectancy based on income. I think the solution that, NIH director, if I'm confirmed, I would fully commit to this, is to address the health problems that lead to that outcome, the rise in obesity, the rise in diabetes, the-
Senator Bernie Sanders (28:29):
Okay. Again, I apologize for interrupting, but what role does… The food industry out there sells a lot of crap to our children, right, and they spend zillions of dollars on advertising products that are really not healthy. What will you do about that?
Dr. Jay Bhattacharya (28:48):
Senator, I think excellent research to try to find alternatives to make clear the link between the junk food that kids eat and subsequent health outcomes can convince parents I hope to make better choices for their kids, to help them make better choices for their kids. I think the role of research is to elucidate those connections and give people tools.
Senator Bernie Sanders (29:11):
But you're going to have, if you're confirmed, a bully puppet so to speak. Would you support what a number of countries around the world are doing, in saying to the food industry, they cannot do TV advertising for unhealthy foods?
Dr. Jay Bhattacharya (29:28):
I mean, if I'm confirmed, I would absolutely advocate to give parents the tools they need so that their kids will eat healthy.
Senator Bernie Sanders (29:34):
Not answering the question. Sounds like a good politician here. There are TV ads, as we speak right now, telling kids to tell their mothers that they desperately need some food, which is really unhealthy. There are countries who say that those ads should not be allowed on television targeted to kids. Would you support those of us who agree with that?
Dr. Jay Bhattacharya (29:55):
I mean, if there's a movement to encourage advertisers to not push unhealthy foods, I certainly would be willing as director to say that.
Senator Bernie Sanders (30:03):
But you could lead that movement, not be… Will you help lead that movement?
Dr. Jay Bhattacharya (30:08):
I mean, absolutely. We want to make America healthy again. I don't know specifically how one would lead such a movement, but I'd be willing to work with you, Senator, to do that.
Senator Bernie Sanders (30:16):
Thank you very much.
Senator Bill Cassidy (30:19):
Senator Paul.
Senator Rand Paul (30:21):
Senator Sanders, I'm glad to see that you're interested in junk food. In fact, I have a great offer for you. Probably you could transform health more in our country by one policy change, and that would be removing junk food, sugar drinks, chips, Twinkies, ding-dongs from food stamps. We have an epidemic of obesity, particularly among our poor, particularly among those on food stamps. Why not just take the food formula and make it healthy food? We do this for WIC. We decided for pregnant women that we do, but I've had a bill out there for quite some time. I have no one from the other side of the aisle, so I'm glad to hear of your concern for junk food and hope I can get you to consider that. We talked about precious resources and we say, well, gosh, we can't study autism or any… We're done with vaccines.
(31:10)
The problem with that is there is a great deal of vaccine hesitancy and there does need to be convincing. It doesn't mean we need 99% of the NIH budget on autism and vaccines, but certainly I think we have room to have another study to try to convince those who are hesitant. We ought to look at populations of people who take no vaccines, the Amish and others, and try to compare them in a scientific way to those who do and see if we can learn something from that. But one way to have more precious resources directed towards good science is to get rid of the frivolous studies. William Proxmire started talking about this in the '70s. I've been talking about this for a dozen years. This is from the NIH, 2.1 million studying whether or not when you're at the Luby's cafeteria and somebody in front of you sneezes on the food, are you more or less likely to take the food? I mean, that kind
Senator Rand Paul (32:00):
That stuff's ridiculous. You could have real science if you weren't doing that, but that's been going on for decades. One of the first things that Proxmire mentioned was a study on what makes people happy. That would be great for Cosmopolitan Magazine, I really highly suggest it, but it's a stupid idea for taxpayer money for a study. But, that was 30 years ago. One of the ones he hated the worst was, What Makes People More Aggressive, Gin or Tequila? So they fed half the codfish gin and the other half the codfish tequila and we all know it's got to be tequila, right? I mean, geez, come on. We don't need to study that. But the thing is, there's lots of frivolous stuff out there that gives good science a bad name. I vote for almost no spending up here because it's almost all inflated, but I have voted for money for the NIH, but they've got to do a better job. And one of the things I hope is, is that you will direct it towards diabetes, heart disease, cancer, Alzheimer's, these big diseases.
(32:53)
But I don't think it's just good people, we got to change the way the grants are such that somebody on the grant committee maybe should be one of from the major five diseases should be on every behavioral study to make sure we're not wasting it on whether lonely rats use more cocaine than well-liked rats use. I mean that was from last year. So what do you think about trying to look at the way we do grants to try to, I don't know, populate the people on the grant, you said you were on a grant committee, to try to populate the grant committees where there's attention being paid maybe to the big five diseases and we don't get lost down a rat hole so to speak? Do you have any thoughts on that?
Dr. Jay Bhattacharya (33:35):
Senator, I think that the resources the taxpayers give to the NIH are precious, and if confirmed, I absolutely commit to changing the grant committee makeup so that they focus on the most important questions that impact American health. I mean there needs to be a mix of basic science work, and I'm not a basic scientist myself, but I can understand how some somewhat abstract basic science work can have advances. But at the same time, the research should really be focused on making America healthy. That's the mission of the NIH.
Senator Rand Paul (34:07):
You mentioned, and you got cut off a little bit on steroids, but this was a pretty amazing thing during COVID. So steroids are virtually pennies, they've been around forever. They found a 36% reduction in COVID deaths from people entering the ICU, they're either going on the ventilator or almost on the ventilator, there was a huge death rate among these people, and they found something for pennies that was a cure. And yet, when Dr. Fauci came to this committee in March of 2020, I asked him about using high dose steroids the way they do for necrotizing fasciitis and the other infections and he said, "oh, they don't work. We've tried it." And he was adamant that the steroids didn't work. And it turned out to be the best cure, and the cheapest, and yet the knowledge didn't get out there because there was a bias. Do you think that we can change that kind of bias and hear open debate and that it'll make a difference with disease?
Dr. Jay Bhattacharya (34:58):
Absolutely Senator Paul. That was such a signal success of the pandemic, the study. But the shame is that it was a group in the UK that ran that study, not a group in the NIH. That's something the NIH ought to have run with billions of dollars for infectious disease. It's something that is changeable just with prioritization alone. I think we can align the incentives of the NIH so that it looks for those kinds of opportunities because there's many of them out there.
Senator Bill Cassidy (35:30):
Senator Murray.
Senator Murray (35:33):
Thank you. Thank you Dr. Bhattacharya for being here, I really appreciate it. I don't think it's an exaggeration to say that right now President Trump and Elon Musk are really putting a lot of lifesaving research at risk. We've had grant freezes, pauses on advisory meetings, pauses on clinical trials, mass firings being carried out by the so-called DOGE, and it is really threatening our ability to treat childhood cancer, to mitigate the effects of Alzheimer's disease and other forms of dementia and to better understand and treat women's health issues. Do you support the recent researcher firings and grant freezes that have been implemented by Trump and DOGE?
Dr. Jay Bhattacharya (36:14):
Senator, I was not involved in those decisions. If I'm confirmed as an NIH director, I fully commit to making sure that all the scientists at the NIH and the scientists that the NIH supports have the resources they need to meet the mission of the NIH, which is to do research to make America healthy.
Senator Murray (36:31):
So do you support further cuts at NIH funding or staff?
Dr. Jay Bhattacharya (36:37):
Senator, I don't support. I don't have any intention to cut anyone at the NIH. If I'm confirmed as director-
Senator Murray (36:45):
Did you know about the grant freezes and the pauses on all the advisory committee meetings, all the pauses that are now in effect on clinical trials that are happening there right now?
Dr. Jay Bhattacharya (36:57):
So Senator, I've read the press accounts of it. It's hard to know outside. I've not interacted with people in the agency.
Senator Murray (37:05):
If you're confirmed, day one, what will you do about that?
Dr. Jay Bhattacharya (37:08):
Senator, I'm going to assess it as day one. I'm going to understand what resources the whole NIH needs and make sure that the scientists that are working at the NIH have the resources to do the lifesaving work that they do and that the scientists that are supported by the NIH also have that. The personnel decisions are hard to talk about unless I'm actually confirmed and I have more data.
Senator Murray (37:30):
I will just tell you right now that I am deeply concerned about the funding there, the research that's been stopped and all that's going on, and I want a very strong assurance that you will get that moving again day one.
Dr. Jay Bhattacharya (37:44):
Senator, absolutely. I'm going to be looking very carefully at the personnel decisions. I want the NIH to be staffed absolutely appropriately to meet the mission of the NIH. I'm happy to work with you and other members of Congress to make sure that happens.
Senator Murray (37:58):
Okay. Well just a few weeks ago, the Trump administration announced an illegal plan to cap indirect cost rates at 15%. That amounts to a massive funding cut for research institutions, large and small, red and blue states, everyone, and brings a lot of life-saving research to a screeching halt. Sick kids wouldn't get the treatment, clinical trials shut down. I want to ask you, do you know what the indirect cost rate was for Stanford, your own institution last year?
Dr. Jay Bhattacharya (38:27):
I think it's on the order of 55%.
Senator Murray (38:29):
That's correct. So if the 15% cap was implemented, Stanford would lose approximately $160 million per year. So what do you say today to your colleagues at Stanford, researchers in my home state of Washington, scientists across the country, but what do you say to the folks at Stanford that you know about this?
Dr. Jay Bhattacharya (38:48):
Senator, I've been a researcher at Stanford. I've earned NIH grants from the NIH while I've been a professor at Stanford. The money that comes to me, the direct costs as researchers, I understand exactly where that money goes. The indirect costs are kind of a tip, a 55% tip on top of that that goes to the administration.
Senator Murray (39:08):
So you would tell the Stanford researchers they don't need that?
Dr. Jay Bhattacharya (39:10):
Senator-
Senator Murray (39:10):
Or you're just saying Stanford's different than everybody else [inaudible 00:39:13]?
Dr. Jay Bhattacharya (39:12):
No, Senator, please let me finish. What I mean is that I don't know where that goes. I think that a lot of it likely goes to the things that are worthwhile and I've heard lots of folks, including from Stanford, who say that and I agree with them. Support for buildings, light bulbs to make sure that we can see in the lab and a whole host of other important things. But there's a lot of distrust about where the money goes because the trust in the public health establishment was collapsed in the pandemic. I think transparency regarding indirect costs is absolutely worthwhile and it's just something that universities can fix by working together to make sure that where that money goes is made clear. I want to make sure that the money goes to the research. I want the money to specifically, if it goes to things that are not researched and are labeled indirect costs, it's better to have that.
Senator Murray (40:01):
I just have a few minutes left and I wanted to ask you if you would get the research committees going again, the advisory councils, immediately upon day one?
Dr. Jay Bhattacharya (40:12):
Yes, as soon as, if I'm confirmed, I want those advisory councils, I want the all that to go.
Senator Murray (40:16):
I think we should all recognize that NIH is the largest medical researcher in the world. They're a global leader. We should be extremely proud of what they do. Nearly a third of all the Nobel Prizes to date have been awarded to scientists at NIH and supported by NIH funds. So we have to be very careful moving forward. I'm extremely concerned by the dramatic cuts and firings and stopping of the research that's going on at NIH right now.
Senator Bill Cassidy (40:43):
Senator Collins.
Senator Collins (40:45):
Thank you, Mr. Chairman. Dr, welcome. I very much enjoyed our wide-ranging discussion in my office. I'm going to follow up on Senator Murray's question about indirect costs. As I indicated to you, I am strongly opposed to the administration's ill-conceived and completely arbitrary proposal to impose a 15% cap on indirect costs for NIH grants. Research labs and universities across the state of Maine have contacted me to describe the devastating impact that this cap would have on life-saving and life-enhancing biomedical research, on ongoing clinical trials and on Maine's research-related jobs. In 2023, NIH supported 1,470 jobs in this field in the state of Maine alone. I think it's important that we all acknowledge that a one-size-fits-all approach makes absolutely no sense and that is why NIH negotiates with the individual grant recipient what the indirect cost cap should be.
(42:19)
And it's legitimate to say that we should take another look at that. Are we doing the right amount for Stanford versus Jackson Laboratories or the University of Maine? Those are legitimate questions. But to impose this arbitrary cap makes no sense at all. Furthermore, and I really want to stress this, this is against the law. Since 2017, we have had language in the Labor HHS Appropriations bill that specifically prohibits the indirect cost formula from being changed, and yet that is what has been done without congressional intent or agreement or consent. And the language has been carried every single year, including in the continuing resolution that we're now operating under. So I'm not surprised that a judge has stayed the order. So if confirmed, will you work immediately to rectify and reverse course on having a one-size-fits-all, 15% cap on indirect costs?
Dr. Jay Bhattacharya (43:48):
Senator, if confirmed, I absolutely commit to following the law, to addressing this issue very directly. I think that this is one of these issues, to me it's an indicator of distrust that some have of universities and of scientific process, and so I want to make sure that we address those concerns as well. But I absolutely commit to following the law and I'll consult with agency council immediately and work with you, Senator, as we spoke of in our meeting, to make sure that your concerns are addressed as well.
Senator Collins (44:22):
Thank you. You testified that NIH should focus on research involving chronic diseases, and I agree that we should do a lot more in this area. Half of all American families report having Alzheimer's disease in their family. And their suffering from this progressive and ultimately fatal disease is tragic, but the impact is not just humanitarian, it also has a huge financial impact on our nation and that cost burden is expected to reach a trillion dollars by 2050. For more than 12 years, Congress has supported a national strategic plan to look at ways for research to come up with the means of prevention, effective treatments, and ultimately a cure. I co-authored the original NAPA Act as we call it in 2011, and last year with my colleague, Senator Warner, led the reauthorization of the national plan through 2035. If you're confirmed, will you continue to support the national strategic plan targeting Alzheimer's?
Dr. Jay Bhattacharya (45:47):
Absolutely, Senator. For me, it's not just a theoretical issue, although I have studied it in my research work. I believe very fundamentally that there are very promising potential ways to prevent Alzheimer's that have not received support, including from some colleagues of mine at Stanford University, because they haven't aligned with a single dominant narrative about what causes Alzheimer's. I want to expand the set of things that we look at as a possible cause for Alzheimer's so that we can make advances. We should have had, I think, much more advances for the investments we've made to date. And I want to make sure that all the hypotheses that are out there get addressed because it's a vitally important problem, as you say, not just humanitarian, not just for health, but also for the fiscal health of our country.
Senator Collins (46:38):
Thank you. I'll submit the rest of my questions for the record. Thank you.
Senator Bill Cassidy (46:43):
Senator Baldwin.
Senator Baldwin (46:45):
Thank you. So I want to begin by discussing the Trump administration's actions to halt thousands of NIH grants and billions of dollars in NIH research funding. So canceled study sections, and importantly advisory council meetings, mean that NIH cannot award grants to fund critical medical research. Additionally, the administration attempted to illegally cap indirect costs, you've already gotten several questions about that, the indirect cost rates, and this is in blatant defiance of appropriations law, which prohibits NIH from capping these costs. I'm the ranking member of the Labor HHS Appropriations subcommittee, and I've been raising the alarm about this for weeks now. On Monday, I revealed that the Trump administration has halted $65 million in funding for Alzheimer's disease, stopping 14 Alzheimer's disease research centers from finding ways to treat and prevent this devastating disease. If NIH does not reverse course on these really disastrous decisions, the centers will run out of funding at the end of April. So, Dr. Bhattacharya, do you agree with President Trump that NIH should stop funding for research on cancer and Alzheimer's disease?
Dr. Jay Bhattacharya (48:25):
Senator, I don't believe President Trump has that as a priority. And I, of course, I wasn't-
Senator Baldwin (48:29):
His actions are accomplishing that right now.
Dr. Jay Bhattacharya (48:33):
Senator, if confirmed, I will follow the laws, as I said to Senator Collins, on the indirect cost recovery, and my commitment is to make sure that every single researcher at the NIH, every single researcher supported by NIH money, has the resources they need to do their life-saving research.
Senator Baldwin (48:51):
We're going to talk more about those researchers who've been fired, but right now this administration has halted funding for 14 Alzheimer's disease research centers. Do you agree with that decision?
Dr. Jay Bhattacharya (49:08):
Senator, I don't have access to that information from outside. If confirmed, I absolutely will look into it to make sure that-
Senator Baldwin (49:15):
I know that you're not consulting with people at NIH pending your confirmation proceedings here, but you're not unaware that this is happening and you should have a position on this. You've accepted President Trump's nomination and you're watching these actions taking place in an organization that you may someday lead. Do you agree with the stripping away of funding for cancer and Alzheimer's disease?
Dr. Jay Bhattacharya (49:48):
Senator, if I'm confirmed, I will make sure that the NIH researchers and the NIH researchers that's funded by the NIH, outside the NIH, have the resources they need to make sure that they do their research. That's the mission of the NIH. If I'm confirmed, my job will be to make sure that mission is met.
Senator Baldwin (50:05):
So moving on, I'm concerned about how the administration's recent actions are putting especially early-stage researchers at risk. We talked about that when you visited with me in my office. In the year 2016 I worked with Senator Collins to enact the Next Generation Researchers Act, and since then NIH has increased funding for early-stage investigators. But now, these researchers are precisely the ones being targeted by the Trump administration and Elon Musk in his unelected, unaccountable capacity. So due to the NIH funding freeze, university admissions for graduate students have slowed or even stopped, postdoctoral fellows can't find jobs to launch their research careers. President Trump and Elon Musk have fired nearly 1200 NIH employees so far, including hundreds of scientists conducting life-saving research. They put the rest of them on notice, that more reductions in force are coming. And new restrictions from Trump and Musk could push out about 3000 of the most promising early-career researchers by refusing to renew their positions.
(51:24)
This is the institute that you may be running. These actions threaten an entire generation of scientists. They threaten our future as a global leader in biomedical research. They threaten our future health and our ability to fight diseases. And frankly, they threaten our national security. So, Dr. Bhattacharya, you've said that as NIH director you want to increase support for the next generation of scientists. How will you repair the damage and support early-career researchers?
Senator Bill Cassidy (52:01):
Could you please answer quickly because we're now over time.
Dr. Jay Bhattacharya (52:03):
Sure. Just very briefly, I'm very committed to making sure early-career researchers have resources. I think that it's not just for their own sake, but also because they have ideas that are at the cutting edge.
Senator Baldwin (52:15):
So you'll hire them back?
Dr. Jay Bhattacharya (52:18):
Senator, I wasn't involved in any of the personnel decisions to date. If I look very carefully at the personnel decisions, if I-
Senator Bill Cassidy (52:25):
Thank you. And for the record, funding has not been canceled. The meeting to allocate it, the funding has been delayed. But just for the record. Senator Marshall.
Senator Marshall (52:35):
Well, thank you Mr. Chairman. As I listen to the conversation today, I'm reminded that we all should doubt our own infallibility and we should doubt the infallibility of the NIH as well. I'm flabbergasted as I listen to this conversation of people that really have never been involved in the scientific process and that they don't understand, indeed, the infallibility. When I think of the NIH, the waste that has occurred, and I think of Alzheimer's, the waste is the path we went down since 2005, 2006. Dr. Bhattacharya, do you recall there's, I'm trying to remember, an amyloid study that really… So all the NIH funds went that direction for 20 years and then we find out, oh my gosh, it was NIH funded research. Do you remember that project?
Dr. Jay Bhattacharya (53:29):
Yeah. I mean there's a whole set of projects, Senator, that have focused by the NIH on a particular hypothesis, the amyloid hypothesis, at the expense of other hypotheses. I agree with you about humility. That's the key to scientific progress. We have to, as scientists say, "We might be wrong." Because when we meet data that disagrees with us where we have ideas that we disagree with, maybe that other idea is right and we're the one that's wrong. If I'm confirmed as NIH director, I want to make sure that all the range of hypotheses are supported. That's how you make progress. One of the reasons I think that we have not made progress in Alzheimer's, as much as we ought to have, is because the NIH has not supported a sufficiently wide range of hypotheses.
Senator Marshall (54:20):
And we also have what, eight different supporting institutes studying it. They don't communicate with each other as well. I mean, my guess is when you make a five-year grant, 20% of those should be stopped after a year because they went down a road, it's a dead end. It's time to start over. I'm glad they're pausing these. I think that there's a significant amount of waste, fraud and abuse and incompetence in the studies funded by the NIH. Let's talk about chronic disease just for a second. The NIH has spent disproportionate amount of money on research on diseases that impacted very small minuscule amount of Americans. Meanwhile, 60% of Americans have a chronic disease. Speak a little bit about your vision of researching for figuring out the causes and treatments of chronic disease, specifically how food as medicine might be intertwined in your vision.
Dr. Jay Bhattacharya (55:12):
Senator, I think the chronic disease problem is something that the NIH ought to have done a better job at the last several decades. The mission of the NIH is to address the health needs the American people have and to expand life expectancy of the American people. And we have not achieved that, it's flat lined. And you say food as medicine, that's the kind of research idea that would be very difficult, I think to get research support from the NIH because it's not within the scope of the people who decide what NIH ought to support. I think we should expand the set of ideas to address a problem that we don't know how to address. The chronic disease problems of the United States are so broad that we need to have a lot more tolerance that the top scientists who controlled the ideas in their fields may be wrong. We need to allow other scientists who have other ideas. And food as medicine might be one of them to have support. I don't know what's going to be the answer, but I do know that if we don't-
Senator Marshall (56:16):
Are you committed to helping us figure out the causes of these chronic diseases?
Dr. Jay Bhattacharya (56:21):
I absolutely am Senator. I mean, I think that is the heart and soul of the Make America Healthy Again movement, and millions and millions of Americans are going to be looking to us to do that. And if I'm confirmed, I absolutely commit to doing that.
Senator Marshall (56:33):
Yeah, and a big part of that is the trust, that thanks to Dr. Fauci, no one trusts the NIH, the CDC anymore. And we need a referee to come in and try to say, "Well, what is the latest science?" Science is never settled. It's always changing. But what is it in ultra-process food that's causing this uptick in chronic diseases? Speak a little bit about the indirect costs of these situations. Look, I think most of us understand that that's just another grift for universities and we're paying their unfair share of overhead going forward, but what I'm concerned about is two-thirds of research dollars are funneled to four or five states it looks like to me. I'd Just like your commitment for us fly over states to spread the love a little bit, it'll prevent inbreeding, and hope that you do realize that not every good scientific idea comes from the coast.
Dr. Jay Bhattacharya (57:32):
Senator, I have scientists, colleagues from across the country, and I hear your concern that the NIH ought to be more committed than it has been to making sure that every scientist, no matter where they are, they don't have to be in California or the Northeast Corridor to get support. I absolutely commit to supporting the IDEAS program that the NIH uses to identify scientists and-
Senator Marshall (57:54):
And just to make an explanation point, the indirect cost in Kansas University or Kansas State are going to be less than the coast. I don't know why, it's their own problem. If their indirect costs are that high, it's their own problem. It's not my fault. If we can do the research more efficiently, less expensive at Kansas State University or KU, then let's move it there.
Senator Bill Cassidy (58:14):
Thank you. Dr. Marshall.
Senator Marshall (58:16):
Thank you.
Senator Bill Cassidy (58:16):
Senator Hassan.
Senator Hassan (58:17):
Thank you Senator Cassidy, and good morning still, we're in the morning and welcome. Congratulations on your nomination doctor. I'm going to start out with a question I start all these hearings now with, which is, if directed by the president to take action that would break the law, would you follow the law or would you follow the president's directive?
Dr. Jay Bhattacharya (58:36):
Senator, I don't believe the president will ever ask me to break the law.
Senator Hassan (58:39):
Well, that strains credulity given especially the last few weeks, and it's a disappointing answer. I will expect you to follow the law regardless of whether the president directs you to break it. Now, let me go to the second question. President Trump has effectively frozen NIH funding for existing grants, including grants that directly treat people with rare diseases. My office has heard from Christine in Brentwood, New Hampshire, who is receiving treatment for colon cancer through an NIH-funded clinical trial, but now no longer knows the fate of her care because these freezes have delayed doctors who might be needing to hire new research assistants in the trial. This colon cancer trial may not have the research staff that they need to continue treating patients. If confirmed, will you commit to reversing the across the board funding freezes at NIH that have delayed life-saving clinical trials?
Dr. Jay Bhattacharya (59:38):
Senator, first, I absolutely commit to following the law, just in response to the previous question. But I'll also say on this question now, absolutely. If I'm confirmed as director, I want to make sure that every single study that is advancing our knowledge about health, including colon cancer, goes forward. Absolutely.
Senator Hassan (01:00:02):
Well, the freeze is really delaying things and it can have an impact, as you know, on treatment and especially treatments for something like cancer, which can be very time-sensitive. That's the harm that these illegal freezes by this administration have really put into play here, and I hope you will speak up loudly and clearly and push back at the President and Mr. Musk on these freezes. These were appropriated funds, Article one of the Constitution and the law says that the administration is supposed to be spending those funds in accordance with the grants and the clinical trial plans.
(01:00:38)
President Trump has not only effectively frozen NIH funding for existing clinical trials, he's also stopped review of new grant applications to help develop new cures for diseases such as pediatric cancer. Your written testimony focuses heavily on questioning past NIH research, but you don't lay out a plan for supporting research by our talented scientists across the country to help treat devastating diseases. You've talked about this with some of my colleagues, but if confirmed, will you immediately restart all NIH Academic Review Committees and get all appropriated money out the door?
Dr. Jay Bhattacharya (01:01:14):
If confirmed, absolutely Senator. My job would be to make sure that those fundamental scientific meetings and other activities happen. The purpose of the NIH director is to support the mission of the NIH.
Senator Hassan (01:01:29):
Okay, thank you. I'm going to forego the other questions I was going to ask and just say this. For people watching this hearing, for parents who are worried about autism in particular, let me just say a couple of things. We see more cases of autism in this country than we used to for a number of reasons, part of which is we're much better at diagnosing it earlier and understanding what the spectrum of it is. We have ongoing science that is beginning to point at the NIH, among other places, to genetic issues that may play a part in the development of autism and environmental issues. The now retracted study that suggested wrongly and fraudulently that autism might have a relationship to the MMR vaccine has been refuted by seven studies, every continent, that involved hundreds of thousands of children. So for parents out there who may think that vaccines have something to do with autism, there is no scientific evidence that it does. And it disappoints me greatly that neither you nor the secretary now of health and human services, are willing to say that declaratively and strongly. Because what you do when you hesitate, what the secretary does, quite cynically in my view when he hesitates about this, is you turn and sow doubt and worry at a time when we should be focused on actually finding the cure, the cause and the cure of autism.
(01:03:03)
And similarly, when we talk about the causes of chronic disease in our kids, there is plenty of evidence, you've talked about it, working class folks in America have worse health than richer people. And yet, you are about to join an administration that is dedicated to giving more tax cuts to billionaires and taking away things from families, money and services from families, that could help them live healthier, better lives, and have children less subjected to things like hunger and housing insecurity, which contribute to chronic illness. So I hope you will think about that. I am over my time and I think Senator Tuberville is next.
Senator Tuberville (01:03:46):
Thank you. Thank you, doctor, for being here. It's always good to run into somebody that's name's harder to say than mine and mispronounce more. You've got a hard job in front of you, but I share the ideas and
Senator Tuberville (01:04:00):
… the desire the President has to root out waste and the fraud that we have in this country, because if we don't, we're not going to have a country left, it's going to be gone, and he's doing the right thing. You're going to have a tough job, you're going to have to put your team together and do the same thing. We have got to make sure we use the American taxpayers' money the right way. So give me your plan of how you're going to do this, when you come into office and are confirmed, how are you going to put your team together?
Dr. Jay Bhattacharya (01:04:29):
Senator, just to say, I have a background as an economist as well as being a doctor, and to me, that background, what it leads me to do is understand that every dollar wasted on a frivolous study is a dollar not spent… Every dollar wasted on administrative costs that are not needed is a dollar not spent on research. The team I'm going to put together is going to be hyper-focused to make sure that the portfolio of grants that the NIH funds is devoted to the chronic disease problems of this country. It's going to be devoted to making sure we have not just incremental progress, but research projects that have the capacity to make huge advances in treatment for cancer, for diabetes, for obesity. That's how I'm going to decide what the team is. And the NIH actually, I'm blessed in some ways, because it already has so many excellent scientists there to advise me on the areas I don't know about, and I want to tap that resource, I want to make sure I talk to every single person who's already a leader at the NIH to understand where those opportunities are.
Senator Tuberville (01:05:36):
Yeah. Well, thank you. For the past four years, I've been on this committee, and we've obviously gone through COVID, devastating to not just our country, but the world. Transparency and trust is going to have to be earned again from a lot of people. Most people across this country don't know what the hell NIH stands for, but now they do because of COVID. You said that science has to be reliable, exactly, but people also have to trust. We're finding out now we have biolabs in Ukraine where a war going on and we're finding them. And so, you've got to be on top of that and the American people have to trust you that you will say, "Listen, we're going to keep an eye on the biolabs in North Carolina," or wherever we have them, because it scares me to death of what's going on. What's your plan there of getting trust back in this country?
Dr. Jay Bhattacharya (01:06:26):
Senator, first of all, I want to work with Congress to make sure that there's appropriate regulation of any risky research. The NIH I don't think should be doing any research that has the potential to cause a pandemic, and I want to work with Congress to make sure that happens. As far as trust, I think the key thing is we have to be utterly open. If I'm confirmed, I'll be the head of an organization that's a scientific organization. As a citizen, I would often look for FOIA responses from the NIH, Freedom of Information Act requests, and they'd be fully redacted during the pandemic. You can't have trust unless you are transparent, and if I'm confirmed as NIH director, I'll fully commit to making sure that the American people can see all of the activities of the NIH openly with limited obfuscation, which has characterized, I think, unfortunately, the NIH's way that they interact with American people.
Senator Tuberville (01:07:21):
And I think that starts with being very visual on television, telling people the truth, don't hide anything, because we've been hiding things for years and that doesn't work, we found that out. Chairman Cassidy and I led a letter to the NIH under the last administration asking questions about a grant that the NIH funded focused on children transitioning genders. The study followed all these children, two of them committed suicide, devastating. So how can we ensure the NIH doesn't grant funds to things like this?
Dr. Jay Bhattacharya (01:07:54):
Well, first of all, I think if you have a negative result and it's politically inconvenient to you, you have an obligation as scientist to report it. So the NIH funds a study that shows that gender transition doesn't reduce suicide rate among adolescents, that researcher has an obligation to report it, even though she may think it's politically inconvenient. So I want to make sure that NIH research is required to report even negative results, and there's ways to do that we can talk about.
(01:08:24)
I think as far as the prioritization of studies, as I was telling Senator Paul, we want to make sure that the studies are focused on the diseases that really are hurting Americans, obesity. A lot of the research that… It's so easy to come up with examples, there's one of a shrimp on a treadmill, for instance, that was once funded. It's not that I'm necessarily against research like that, but American taxpayers should be focused on the needs of American taxpayers and the research should be focused on those needs, the health needs of Americans, and I want to make sure that the NIH, if confirmed, focuses on exactly that.
Senator Tuberville (01:09:01):
Thank you. Good luck.
Dr. Jay Bhattacharya (01:09:02):
Thank you, Senator.
Senator Tuberville (01:09:04):
Senator Hickenlooper.
Senator Bill Cassidy (01:09:06):
Yes. I hit it and it turned itself off. Thank you for being here, for all your service. As we've already heard today, and you're already well aware of this cap on the indirect fees for all NIH grants, it's been traumatic to the system, it's on a pause. Clearly, the solution is some sort of more transparent, well-thought-out, fair system, by which research in the center of the country, the south, the north, the east, the west, is all on a level playing field. Let's assume that we get the legal stuff sorted out, the chaos comes down a little bit, how long would it take to create a new system like that?
Dr. Jay Bhattacharya (01:09:51):
Senator, I don't know that it would take a new system necessarily. I think the key thing is, as you said, Senator, the transparency. So audits of university spending of indirect costs would, I think, help inform decisions. It's a complicated question. Of course, I wasn't involved in the decision about the cap. But if I'm confirmed as NIH director, that's something I'll look very carefully at. The broader problem is we have deep distrust by the American people of universities and the scientific establishment earned during the pandemic. To address that, transparency is the key way, just as I was telling Senator Tuberville, that transparency is what will solve this problem.
Senator Bill Cassidy (01:10:31):
We agree on that. We've been working on a project called the DeOndra Dixon INCLUDE Project Act. I think you know a little bit about it. But the idea is that we codify research activities at the NIH on co-occurring disorders of Down syndrome across multiple institutes of the NIH. I'm not asking your endorsement, but I am asking if you'll be willing to work with us on this, we're very serious about it. And then, also look more broadly on cross-institute work at the NIH to try and unlock new discoveries.
Dr. Jay Bhattacharya (01:11:03):
Senator, I'm absolutely committed to that, and I'd be delighted to work with you on that project that you just mentioned, as well as other projects. I think there's tremendous opportunities for cross-disciplinary work across the NIH. I think it's at the back of the minds of so many reform proposals of the NIH I've seen over the years, to try to make sure that NIH research doesn't stay siloed within one institute, but that it's useful for researchers all across the NIH.
Senator Bill Cassidy (01:11:29):
Right. I want to spend a little bit of time just… Thank you for that, I appreciate that. A moment just looking at, we've heard a lot of people suggest that somehow the NIH is allowing the United States to be taken advantage of in some ways. One fact that is striking to me, that in a 10-year period, 99% of the drugs approved by the FDA were developed with research to a lesser extent from NIH. Are you worried about the US ability to maintain that leadership? Do you think we're being ripped off in some way, the fact that we are affluent enough and care about science enough that we are leading the world in this research, is in some way this unfair?
Dr. Jay Bhattacharya (01:12:14):
Senator, I think the United States is the greatest country on Earth, and one of the reasons it is is that it has a sincere commitment to doing fundamental research that benefits all of humanity, and I think much of the NIH research does exactly that. I don't view it as ripping off when a scientist comes up with an amazing idea that treats diabetes better. Everyone on Earth benefits from that. So I think NIH is fundamentally an institution aimed at the public good.
Senator Bill Cassidy (01:12:46):
So here's a more difficult question which I have cause just to be suggestive, do you think we're spending enough on research, in terms of where you're coming in, part of your seat is going to say, are we running out of good ideas, is there a shortage of things that really demand our attention?
Dr. Jay Bhattacharya (01:13:06):
I think, as I outlined in my opening statement, I think there's some real problems in how the scientific establishment is operating, the replicability crisis, a lack of desire to focus on the diseases and the conditions that really are inflicting Americans, and also a tentativeness to focus on the big ideas. No matter what the budget is, I want to reform it in that direction. I'm happy to work with Congress, because it's Congress that decides the budgets of the NIH.
Senator Bill Cassidy (01:13:32):
No, no. We decide it based on a lot of your advice, so be thinking of that. Obviously, increased vaccine skepticism, we're seeing, just in the past school year, the number of kindergarten kids that are exempted for one or more routine vaccinations has continued to rise, highest levels recorded. Is this rising skepticism around vaccines, does that make vaccine-related research at NIH any less of a priority? And if confirmed, how do you balance the need to focus on research into chronic diseases with that need to invest in research on viruses and things that a vaccine can address?
Dr. Jay Bhattacharya (01:14:10):
Senator, I think the increasing skepticism, which I view as a hangover from the COVID pandemic overstatement about how the COVID vaccine worked, makes it more important to do vaccine research. Secretary Kennedy has already said he favors the MMR vaccine, I agree with that. Maybe I'm naive, Senator, but I believe very fundamentally that research, if it's done right, it's replicable, is so persuasive that it'll move people to take actions, and that's the philosophy I've operated under my entire career, and I intend to keep doing that if I'm confirmed.
Senator Bill Cassidy (01:14:48):
From your lips to God's ear. Thank you.
Chairman Cassidy (01:14:51):
Senator Moody.
Senator Moody (01:14:53):
Mr. Chairman, good to see you. As you know, I am the most junior member on this committee, and recently transitioned from my role as AG in the State of Florida, the great, free State of Florida, to US senator. And one of the things I have enjoyed the most is these confirmation hearings, because so much of what I've worked on in my prior roles, whether that was a judge or a federal prosecutor or the attorney general, have translated in my ability to be able to truly, in a meaningful way, talk to the nominees about their vision for these agencies or roles that they're taking over and how they might bring a different perspective or leadership or ideas to bear. And I particularly enjoyed that in our discussion, I'm honored that I was the last meeting you had before your confirmation hearing today.
(01:15:43)
As you know, in Florida, as we were experiencing COVID here in the United States, Florida took a very deliberate, scientific, very thorough approach to making decisions, and we tried to bring to bear many varying opinions as to not only what we were experiencing as to the virus, but what were the best ways to go about making decisions and providing leadership and protecting the health, safety and welfare of our citizens. And to some extent, many of those decisions were challenged or even the first of their kind in the nation, because we were truly examining all aspects of information coming in, not just what was being pushed through certain narratives, and in many respects, many ideas and scientific approaches were suppressed. And I want to talk to you a little bit about that, because I know you have been such an advocate of how we led in Florida, the things we did.
(01:16:48)
As you remember, when I was AG, we opened our schools right back up right away, we were sued by a teacher's union. And everything from how we dealt with masks to social distancing to the vaccines, there were misrepresentations abound during this time. And so, I want to talk to you about your opinion on how Florida handled that and how you think that might translate into your new role. Do you feel like your views and scientific opinions might have been disregarded or set aside in pursuit of some government narrative that may not have been based, especially I know even as to the six-foot rule, for example, my office led a grand jury investigation on all kinds of misrepresentations, from the six-foot rule to the vaccines, I just wanted to get your thoughts on that and how that might affect your role moving forward, if in fact you're confirmed.
Dr. Jay Bhattacharya (01:17:47):
Senator, thank you for that question. I am tremendously proud to have been involved in advising the Florida response to the pandemic. I was actually involved in the case that resulted in the Florida kids being able to go back to school. So even as my kids were left out of school, basically, not allowed to go back into the school buildings for a year and a half, the kids of Florida were allowed, and as a result, the results are so much better. Florida has a lower all-cause excess death rate during the pandemic than California did, so I think Florida's response to the pandemic was a tremendous success.
(01:18:24)
But I'm really glad you highlighted the role of censorship and restriction of scientific discussion. It was so refreshing to me to be allowed to speak my scientific views in Florida during the pandemic. A pandemic is a very difficult thing. So many people are going to have different ideas in an environment of uncertainty. The root problem was that people who had alternative ideas were suppressed. I personally was subject to censorship by the actions of the Biden administration during the pandemic. Science, to succeed, needs free speech, it needs an environment where there's tolerance for dissent. And the reason I think why Florida did so well was that it provided an outlet for that dissent, so that the government of Florida, the State of Florida, could adopt the best ideas for its… It's not that no mistakes were ever made.,You can't say that of any state in a pandemic. But in order to do well, you have to allow people to speak with each other openly, even when their ideas are controversial.
Senator Moody (01:19:31):
And so much of what we discussed and what you want to bring to bear, I believe, is taking publications or studies and having those replicated, and making replication of studies be a priority for NIH, because so often, you have people publishing and there's not that. Can you elaborate?
Dr. Jay Bhattacharya (01:19:49):
Sure. Senator, there's a crisis of replication. So many studies are not replicable. You do a study, and then someone else tries to do the study, and people won't cooperate and give the data to you to try to do the replication, and then other teams try to do and they can't replicate it. Many, many studies are published and it's not subject to replication at all. But replication is the heart and soul of what truth is in science. If I run a study and you find the same answers as me, then I'm more likely to be right. I want to make the NIH committed to that kind of notion of truth rather than authority as the way of truth is determined.
Senator Moody (01:20:23):
Thank you. I set you up to go over time, I apologize.
Dr. Jay Bhattacharya (01:20:24):
So sorry, Senator.
Senator Moody (01:20:25):
Sorry, Mr. Chairman.
Chairman Cassidy (01:20:26):
Senator Kim.
Senator Kim (01:20:27):
Thank you, Chairman. Doctor, thanks for coming on out. You had said before that you were in favor of decentralizing the decision-making at NIH, I think a quote, "Restructure the NIH to allow there to be many more centers of power," concern about individuals, or a small number of individuals, from dominating decision-making. Do you still stand by that, and if so, what's the importance of decentralization from your…
Dr. Jay Bhattacharya (01:20:50):
I think I do stand by that, Senator. The key thing to me about decentralization is the diversity of ideas to address uncertainties. When we have problems that we don't have the answer to, we have to allow there to be many people with different ideas to test them. Having a diversity of ideas, we talked already with some of the other senators about making sure state scientists from smaller states get access to NIH support, that's one way to do it, having younger scientists or early career scientists with different ideas also.
Senator Kim (01:21:25):
You're also saying decentralization in terms of who's making the actual decision, not where the resource is going, is that correct?
Dr. Jay Bhattacharya (01:21:30):
Well, if I'm confirmed as NIH director, the job will be to decide how to set processes to making those allocations. I want to make sure that those processes allow early career investigators to have support. I want to make sure that it allows scientists from non-traditional universities, not just the Stamfords and Harvards, to have support. I want to make sure that the people with different points of view about scientific hypotheses, not just amyloid hypothesis, but other hypotheses, have some capacity for support.
Senator Kim (01:22:03):
So in terms of the decision-making process, that we'll try to diversify that. My question to you, if you're pushing for a decentralized decision-making process for the grants, does that mean that you would oppose the HHS Secretary or the Trump White House from telling you to make decisions about where to spend money or funding grant decisions?
Dr. Jay Bhattacharya (01:22:25):
Senator, I agree with the goal to make America healthy, meaning address the chronic disease crisis. That's a decision about allocation to different disease areas. The scientific ideas inside those disease areas-
Senator Kim (01:22:38):
What if the HHS Secretary said, "I want you to fund this specific grant at this university"?
Dr. Jay Bhattacharya (01:22:44):
There's a process, Senator, for deciding who gets specific grants, there's a scientific-
Senator Kim (01:22:49):
But is that one of the processes? Is that something that you feel like is a valid way in which decisions can be made at the NIH?
Dr. Jay Bhattacharya (01:22:55):
Senator, I don't believe that either the Secretary or the President would ever ask me to do that.
Senator Kim (01:22:59):
Well, the reason why I ask this, you talked a lot about chronic diseases, I think all of us can agree, we need to make [inaudible 01:23:06] chronic diseases. My question to you is, do you think that our work on researching chronic disease needs to come at the expense of research for infectious disease?
Dr. Jay Bhattacharya (01:23:16):
Senator, I think that the allocation of funds to the different disease areas, first, Congress has a tremendous important role in deciding that, and I'll work with Congress, for sure, to make that happen. But also-
Senator Kim (01:23:27):
But you think that we could probably do both, right, both chronic disease research and infectious disease research?
Dr. Jay Bhattacharya (01:23:32):
Yes, Senator.
Senator Kim (01:23:32):
Okay. Well, the reason I mention this and I ask these questions about the Secretary's ability to direct NIH is that he had a quote that has just really stuck with me and alarmed me. He said, quote, "I'm going to say to NIH scientists, 'God bless you all. Thank you for public service. We're going to give infectious disease a break for about eight years.'" Now, does that sound like a good idea?
Dr. Jay Bhattacharya (01:23:55):
Senator, I've had many conversations with Secretary Kennedy, and he is supportive of excellent infectious disease research. The idea that-
Senator Kim (01:24:04):
You believe he no longer stands by that quote?
Dr. Jay Bhattacharya (01:24:07):
Senator, I don't know what that province of that quote, maybe it's on Twitter or something, people say things on Twitter, but as far-
Senator Kim (01:24:12):
He said it at a conference.
Dr. Jay Bhattacharya (01:24:14):
Yeah. Again, I don't know about… But my interactions with Secretary Kennedy, he's sincerely committed to making sure that every health need of this country is met, including infectious diseases.
Senator Kim (01:24:26):
In terms of a few other things, are there any vaccines out there that you are concerned about in terms of safety?
Dr. Jay Bhattacharya (01:24:33):
Senator, I was concerned about the COVID vaccines for young men causing myocarditis in 2021.
Senator Kim (01:24:40):
And do you have a view on long COVID?
Dr. Jay Bhattacharya (01:24:43):
Senator, I think it's a problem that affects millions of Americans and we need answers.
Senator Kim (01:24:48):
Is this something worth NIH funding?
Dr. Jay Bhattacharya (01:24:50):
Yes.
Senator Kim (01:24:51):
You had a quote before that I was concerned about, you said, quote, "There are more pressing health needs for the 1.1 billion that the NIH will spend on long COVID." Is that something you still stand by, that quote?
Dr. Jay Bhattacharya (01:25:03):
Senator, I think that the funds that have been spent to date on long COVID have not provided answers to the millions of patients. I think that they deserve answers. We need to do a better job with the funds we spend at the NIH so that it actually produces better diagnostics, better cures, better prevention.
Senator Kim (01:25:18):
On transparency, just real quick, you talked about the importance of transparency, are you familiar with something called the Richardson Waiver?
Dr. Jay Bhattacharya (01:25:25):
No, Senator.
Senator Kim (01:25:25):
Okay. Well, I ask if you're confirmed that you look into this. The Secretary just reversed this, and it is something that closes some transparency and public comment periods. Thank you.
Chairman Cassidy (01:25:37):
Thank you, Senator Kim. Senator Banks.
Senator Banks (01:25:40):
Thank you, Mr. Chairman. Doctor, congratulations again on your nomination. As I've said before, your nomination is one of the most exciting picks of the entire Trump administration. You showed incredible courage in speaking the truth about COVID-19 when much of the rest of the world stayed silent about it, and free-thinking people everywhere have not forgotten that, what you stood for then. And it's remarkable to see that you're nominated to be the head of the very institution whose leaders persecuted you because of what you believed during that period. I want to start by asking you about COVID. Lockdowns caused irreparable harm to our nation, and they are still harming us five years later, what is NIH's proper role in a pandemic, and how did Director Francis Collins overstep that role during his time?
Dr. Jay Bhattacharya (01:26:31):
Senator, the proper role of scientists in a pandemic is to answer basic questions that policymakers have about what the right policy should be. Our role isn't to make decisions to say, "You shouldn't be saying goodbye to your grandfather as he's dying in a hospital." It shouldn't be to say, "You can't have a funeral because it's too dangerous." The scientists should say, "Here's what the risks are," and then you decide the risks whether you take it. The role of the scientist shouldn't be to say, "You can't send your kids to school for two years, you should close hospitals so that they can't treat heart attack patients."
(01:27:13)
The role of scientists should be to address those problems by giving good data, and then let people make… Science should be an engine for knowledge and freedom, not something where it stands on top of society and says, "You must do this, this and this, or else." It shouldn't be pushing mandates for vaccines, like the COVID vaccines, that were tested for a relatively short period of time. I took the COVID vaccine myself, but I think that the mandates that many scientists pushed have led to the lack of confidence that so many of the public has in science. If science is a force for freedom and for knowledge, it will have universal support, that's what the role of science is.
Senator Banks (01:27:54):
Very well put. You were demonized for co-authoring the Great Barrington Declaration in October of 2020. Dr. Fauci called it, "Total nonsense." Rochelle Walensky called it, "Wrong and unsafe." Your opponents who wrote the John Snow Memorandum said it could harm, "Half a million people." Reading what you wrote in the declaration, you were undeniably right about all of it. You wrote, quote, "Current lockdown policies are producing devastating effects on short and long-term public health." Doctor, what does the public health data tell us today in the aftermath of COVID-19 in 2023 and 2024, what does that data tell us today?
Dr. Jay Bhattacharya (01:28:41):
Well, Senator, first, millions of children were out of school for years. The rates of suicidality and depression are through the roof. Learning loss will have consequences throughout their entire life. There were people who skipped their cancer screening who have late-stage cancer now that should have been picked up earlier. The trillions of dollars we spent, that actually caused the inflation that we still suffer from. The UN early in the pandemic estimated almost 100 million people would face starvation as a consequence of the economic dislocation caused by the lockdowns. This is devastating policy that didn't need to happen. The Swedish example, for instance, where there's lower all-cause excess death rates in Sweden relative to their neighbors, including Norway, including Germany, which locked down more, is an example that we didn't need to do the lockdowns. Florida having lower all-cause excess death rates than California, again, is an example where the lockdowns did not save lives, but had tremendous consequences on the well-being of the poor, the working class, on children and the vulnerable.
Senator Banks (01:29:53):
Yeah. I want to read a little bit more. You said in the declaration that, quote, "Keeping students out of school is a grave injustice." Now, today, we see student achievement and grades well below the pre-pandemic levels. You also wrote that, quote, "Young low-risk adults should work normally rather than from home. Restaurants and other businesses should be open. Arts, music, sports and other cultural activities should resume." Now, we see many communities and cities are unsafe today and have been dramatically changed because of the lockdowns during COVID. In a nutshell, Doctor, what would you have done? What would you do differently now than what these obviously ill-advised leaders at NIH and otherwise and other places do, how would you have done it differently, in a nutshell?
Dr. Jay Bhattacharya (01:30:40):
Well, I still would've opposed the lockdowns. But if I'm confirmed as NIH director, the kind of thing I would've done is I would have allowed there to be scientific debate and discussion. There's tremendous uncertainty what to do during a pandemic.
Senator Banks (01:30:52):
Thank you. I yield back.
Dr. Jay Bhattacharya (01:30:53):
We need debate.
Chairman Cassidy (01:30:53):
Thank you. Doctor… Senator Blunt-Rogester.
Senator Blunt Rochester (01:30:58):
I'm promoted. Thank you, Chairman Cassidy, and thank you, Dr. Bhattacharya, for meeting with me ahead of time, as well as your testimony today. I want to echo some of the concerns that my colleagues shared about the risk to the entire NIH research enterprise.
(01:31:21)
One, the concern about the reported 1,200 individuals who were fired, including hundreds of scientists. We talked about the concern for being able to recruit even and retain this kind of talent. Two, the blanket and illegal 15% cap on indirect costs on our research institutions, even in a bipartisan way, there was concern about that in this hearing. The funding and communication freezes, cuts in programs for training for future generations of scientists, and the fear that supporting diverse clinical trials will no longer be a priority, cause serious concern and alarm.
(01:32:02)
And to understand that, I think you can look no further than the issue of Alzheimer's disease and dementia. As we all know, Alzheimer's is a debilitating and costly disease, afflicting nearly seven million Americans and costing $360 billion in 2024. But this doesn't even include the cost of care that's provided by 11 million individuals, and it really doesn't even touch the toll that it takes on the individual and their families. I don't think there's anybody who hasn't been impacted by it, whether it's even my mother and my grandmother. Some of the most important work that NIH has been doing is on the disparities in cognitive aging. Do you think the administration's executive orders and terminations of aging research projects is harmful or helpful to improving our understanding of Alzheimer's?
Dr. Jay Bhattacharya (01:32:57):
Well, Senator, first, I should say I'm fully committed, and as is this administration, I believe, to making sure that all the health needs of every American is addressed, no matter what their race, color, sex, the goal of the NIH, the mission of the NIH, is to meet those. So for instance, the representation of minorities in trials, as you mentioned, is something that I'm fully committed to, and I see nothing in the President's executive orders to contradict that. In fact, quite the opposite.
Senator Blunt Rochester (01:33:28):
I think the challenge is they're vague and people are questioning what do they mean, what are the impacts. Even the fact that these programs that have been canceled or delayed include the Maximizing Access to Research Careers Program, training grants to support pre and post-doctoral scholars, the NIH Intramural Program, the 2025 NIH Summer Internship Program, the Advancing Diversity in Aging Research Program, and then the firing of 10% of the staff at the Centers for Alzheimer's and Related Dementias. That's what causes the concern, because we're thinking about the pipeline of those individuals that are going to work in this area. So can you help me to just understand how getting rid of these programs is going to improve our understanding of Alzheimer's prevention and treatment? And what safeguards would you put in place to ensure that these changes don't lead to poorer health outcomes by any gender, race, disability, ethnic group, or other vulnerable communities?
Dr. Jay Bhattacharya (01:34:33):
Well, Senator, first, as you know, I wasn't involved in any decision-making at the NIH up to this point. If I'm confirmed, I will look to make sure that those programs and other programs, if they're appropriate, will continue. I want to make sure that every single scientist at the NIH that's doing this kind of lifesaving work, including on Alzheimer's disease, especially maybe in Alzheimer's disease, and also scientists supported by NIH-funded research, have the resources they need. I'm committed to making sure that the NIH funds are spent to address America's chronic health needs.
Senator Blunt Rochester (01:35:05):
The reality is that we know that individuals with Down syndrome have a staggering 90% chance of acquiring Alzheimer's in their lifetime. Black and Hispanic individuals are more likely to develop Alzheimer's in a lifetime. Women are twice as likely as men. And so, I have some questions that I will potentially have to submit for the record, but will you commit to ensuring that researchers, specifically studying health disparities and working to increase clinical trial diversity, will not be targeted or penalized based on their work?
Dr. Jay Bhattacharya (01:35:39):
Senator, I commit to making sure that researchers that are addressing the health needs of minority populations, basically every American, will have the support they need.
Senator Blunt Rochester (01:35:48):
A lot of folks are using code words and selecting out, whether it's in a grant, they're doing targeting, sweeps, word searches, will you also commit that
Senator Blunt Rochester (01:36:00):
… that you will not do that as well.
Dr. Jay Bhattacharya (01:36:02):
Senator. I guess I'm not sure what you mean by targeting code words, but I'll say that I believe very strongly, I committed my life to addressing the health needs of vulnerable people, including minority populations. I'm absolutely committed to that. The NIH continues to do research to address those health needs.
Senator Blunt Rochester (01:36:18):
My time is expired. Mr. Chairman, thank you. And we want to make sure that we work with you.
Dr. Jay Bhattacharya (01:36:25):
I would look forward to that, Senator.
Senator Blunt Rochester (01:36:26):
That these executive orders don't have the adverse impact that we are already seeing. Thank you. I yield back.
Senator Bill Cassidy (01:36:33):
Thank you. Senator Rochester. Senator Hawley.
Senator Tuberville (01:36:36):
Thank you Mr. Chairman. Dr. Bhattacharya, congratulations on your nomination. Thank you for being here. I enjoyed getting to visit with you the other day. Let me just start with the subject that you and I visited about and that I also asked your soon-to-be boss, Robert Kennedy Jr., about when he was sitting right where you are and that's the use of abortive fetal tissue in NIH-funded research. I asked now Secretary Kennedy directly if he would reinstate President Trump's policy that prohibits abortive fetal tissue research in NIH-funded grants, he said that he would. Let me just ask you the same to make sure we're all on the same page here. Do you support that policy? Will you prohibit the use of abortive fetal tissue in NIH-funded research?
Dr. Jay Bhattacharya (01:37:21):
Senator, I'll absolutely follow the lead of Secretary Kennedy and President Trump on this. Just very quickly may say why it's so important that we have alternatives because during the pandemic I would often be on Catholic Radio and people would ask me whether the mRNA vaccines were made or developed with fetal stem cell lines. I had to say yes. And a lot of the folks who were calling in had ethical objections. In public health, we need to make sure the products of the science are ethically acceptable to everybody and so having alternatives that are not ethically conflicted to fetal stem cell lines is not just an ethical issue, but it's a public health issue. We need to make sure that everyone is willing to take the kinds of progress that we make and so I'm absolutely committed to that.
Senator Tuberville (01:38:13):
Very good. Thank you very much and I think it's a tremendous point that it is not only an issue of moral principle, although it is and an extremely important issue of moral principle in the first instance, but it is also a public health issue. We think about millions and millions of Americans who are understandably very concerned about the components, if you will, of many of these palliatives and vaccines. And we want them to be able to access this on the same basis as others. So thank you for making that point.
(01:38:38)
Let me ask you about something else that your soon-to-be boss Secretary Kennedy has said recently. He's talked about his concerns that NIH is working to advance in some instances big pharma's bottom line rather than the health needs and health interests of the American people. And he recently wrote in the Wall Street Journal that he wants to propose stopping NIH funding going from researchers who have conflicts of interest, who have a financial benefit with a big pharma company. Can you comment on that? Do you support that effort? And can you comment on the importance of making sure that what we're doing with our NIH funding is prioritizing the health of Americans, not the profit of any particula corporation?
Dr. Jay Bhattacharya (01:39:19):
Senator, I think the transparency in conflicts of interest is fundamental to trust in science and I'm absolutely committed to making sure that transparency is at the center of the work supported by the NIH. I also commit Senator and I mentioned this earlier, to supporting research on products that are already off patent that don't necessarily have a drug company behind it, but that could have potentially enormous benefit for treating chronic diseases or preventing chronic diseases. I think the NIH ought to be doing research in support of the public good, not just parochial research in support of a few companies.
Senator Tuberville (01:39:59):
Fantastic. I think that's so important to restoring the sense of credibility and trust that the American people frankly have lost in the NIH and much of our public scientific apparatus because of the financial conflicts of interest, because of the prevalence of big pharma, but also because, and you and I discussed this as well, what happened during COVID-19. And I just want to ask you about that in my remaining moments here. I had the opportunity to question the author or one of the co-authors of the now infamous proximal origin paper Dr. Robert Gehry is the individual who I have the opportunity to question. He wrote that paper on March 17th, 2020. You probably remember. Dr. This is the paper that infamously stated, and I'm going to quote it now, that, "The SARS-CoV-2 is not a laboratory construct or a manipulated virus." Under questioning by me. Dr. Gehry admitted he actually had no knowledge of that at the time.
(01:40:52)
He wrote that in March of 2020. He had no evidence to suggest that was the case. This was in fact a piece of purist propaganda. He has since had many of his research products withdrawn from peer-reviewed journals because he hasn't followed appropriate peer-reviewed standards. This effort, this propaganda effort, and that paper, as you remember, was used as the basis of government-directed censorship to those in the scientific community like yourself to millions of ordinary Americans. The net effect of this was a tremendous loss in confidence by the American people in the NIH and in our public health officials. You and I have discussed the vital importance of restoring some of that credibility. Talk to us about how you see going about doing that.
Dr. Jay Bhattacharya (01:41:34):
Senator, that episode is a low point in the history of science. The top officials of the NIH abuse their position to hide support for research that may have caused the pandemic. And I commit to making sure that all of the activity on the NIH, not just backwards, but going forward, are transparent and open to the American people and to Congress. That's vitally important for the future of the NIH and for future of science itself.
Senator Bill Cassidy (01:42:03):
Thank you, Senator Hawley. And now Senator Alsobrooks.
Senator Alsobrooks (01:42:06):
Thank you so much, Mr. Chair. Good morning Dr. Bhattacharya. I know you've had great experience at NIH and so it goes without saying that NIH is a crown jewel, not only in the state of Maryland, which happens to be my state, but it's a crown jewel for our country where we have many, many talented scientists and researchers who are there. That brings me to a quick line of questioning I have, I want to sound the alarm. There's some very dangerous things are happening to scientists and researchers at NIH right now, and I want to ask you whether you believe that it is appropriate, and you mentioned a moment ago about a concept around knowledge and freedom for scientists and whether you believe it is appropriate under any circumstance to retaliate against scientists or medical researchers based on the research they have done. Do you believe that?
Dr. Jay Bhattacharya (01:42:53):
No, Senator, I've been subject to that myself. I know what it's like to be subject of devastating takedowns by top officials at the NIH specifically, and I will never do that. I absolutely commit to making sure that scientists are treated respectfully, especially those that disagree with me.
Senator Alsobrooks (01:43:09):
Now, you have even said that you believe and you've spoken out against a culture of conformity in science and have criticized institutions that you allege destroy the reputations of scientists who do not conform with their viewpoint. I believe that is what is happening right now at NIH. In fact, you're soon-to-be boss Mr. Kennedy. When I questioned him about whether or not he would supplement his judgment for that of scientists, he said he intended to replace bad scientists with good scientists. Is this your viewpoint as well?
Dr. Jay Bhattacharya (01:43:39):
Well, Senator, I don't know exactly what the nature of that conversation, but I think that the way that you decide what is good and bad science is by conversation, by data, by replication. I am absolutely committed to making sure that those processes are in place at the NIH.
Senator Alsobrooks (01:43:59):
Okay, and you agree that we should never retaliate or even fire a scientist because of his or her peer-reviewed work that they publish?
Dr. Jay Bhattacharya (01:44:08):
Senator, I think retaliation and conflict that characterize the kind of discussions that we had among scientists, that comes from the top of the scientific institutions and I commit to making sure, in fact, it's one of the five points I emphasized in my opening statement, that we allow a culture of dissent and respectful conversation about scientific matters rooted in data at the NIH.
Senator Alsobrooks (01:44:32):
Okay. I just want to ask you about one other area of concern. It is no secret that this administration feels absolutely triggered by any mention of equality, any mention of inclusion, and the president himself in his own words last night essentially said America intends to erase any reference whatsoever to race or gender. Having said that, I'd like to refer to a study that you co-authored called Persistent Racial Disparities and Survival Following Heart Transplantation and to ask you whether or not, because I understand there are some watch lists that have been created, whether you believe that on the basis of this study, should that work be placed on a DEI watch list because it references racial disparities.
Dr. Jay Bhattacharya (01:45:15):
Senator, I'm not aware of any watch lists. I don't intend to implement any watch lists. I'll say this, that the health needs of the minority populations in this country are a vital priority for me. In fact, the health needs of every single American are a vital priority for me. I want to make sure that the research that the NIH does addresses those health needs and I don't see anything in the president's orders that contradict that. In fact, quite the contrary, what I've heard from the secretary and from the president is let's make America healthy, meaning all Americans.
Senator Alsobrooks (01:45:50):
Yeah, I know. I don't want to be naive though. He did mention that it is absolutely triggered by anything that mentions equality or inclusion or any reference to race or gender. And so the center that you co-direct, the Center for Advancing Sociodemographic and Economic Study of Alzheimer's Disease and Related Dementias mentions that your mission is to diversify the set of researchers who are working in the field, and I want to know whether or not based on that and that it also mentions mentoring diverse scholars, which I think is a reference to race and to gender and to people with different backgrounds. And so whether you believe that this project which received, by the way, $872, 000 million in taxpayer dollars, $800 million in taxpayer dollars.
Dr. Jay Bhattacharya (01:46:37):
No, no, not that that much.
Senator Alsobrooks (01:46:38):
That's right. Yeah.
Dr. Jay Bhattacharya (01:46:39):
It was less than that, but yeah.
Senator Alsobrooks (01:46:40):
Well, was this a radical and wasteful use of government spending on the basis of it doing this?
Dr. Jay Bhattacharya (01:46:45):
Senator, I'm proud of that project.
Senator Alsobrooks (01:46:46):
Yeah, I work.
Dr. Jay Bhattacharya (01:46:47):
Senator first I'm proud of that project. It's addressing Alzheimer's disease, and I'd say further the idea that diverse scientists, I think to me what that means is scientists with diverse ideas about scientific topics. I think fundamentally what matters is does a scientist have an idea that advances the scientific field they're in? Do they have an idea that ends up addressing the health needs of Americans? That's the key thing, and to me, that diverse set of ideas, allowing there to be a diverse set of ideas, people that disagree with each other is fundamental to advance in science. I think free speech, and I think -
Senator Alsobrooks (01:47:27):
That includes racial disparities. That's the work you've done, right?
Dr. Jay Bhattacharya (01:47:29):
Well, racial disparities are important to identify, but more important is to address the health needs of every American, no matter whether they're minorities or not.
Senator Alsobrooks (01:47:39):
Thank you so much. I yield. Thank you.
Senator Bill Cassidy (01:47:40):
Thank you, Dr. Alsobrooks. Very good sneaking that last comment in. You know what I'm saying? After the buzzer. Senator Husted.
Senator Husted (01:47:47):
Thank you, Chairman Cassidy. Dr. Bhattacharya, I thank you for being here. Although as someone who grew up watching professional basketball in the seventies and eighties, calling you Dr. J is a fun thing too.
Dr. Jay Bhattacharya (01:47:58):
That's a real thrill for me whenever I hear that.
Senator Husted (01:48:05):
Your nomination. Frankly, at this time in America is a victory for the scientific method. I know that you have been courageous in offering divergent views and backing them up and encouraging people to think differently about how we solve complex problems. That's what science is supposed to be about, so thank you for being a champion of that during difficult circumstances. I want to just talk briefly about something we talked about is we heard a lot of talk about inflation in America, but in this century, the number one inflationary cost that affects Americans, American business, the quality of life has been healthcare inflation. And the idea that we can think differently about how we address healthy living, our diets, how we improve the quality of life, drive down costs and improve outcomes is something I think is sorely missing today in the conversation about healthcare and thinking differently about it is critical to doing that. So just give some thoughts about how you think your role as a director could help advance that conversation.
Dr. Jay Bhattacharya (01:49:27):
Senator, I really enjoyed our conversation that we had in your office about exactly this. The chronic disease problem, let's just take obesity. It seems almost intractable. For decades, we've had body weight go up, diabetes rates, chronic disease, and in a way that's an indictment on how the NIH has functioned. The goal of the NIH is to make Americans healthy, is to have the research that makes Americans healthy. I think I want to make sure that we allow a broadest set of ideas as possible to address this problem because the set of ideas we've had so far have not actually addressed the problem. It's continued to get worse.
(01:50:06)
Fundamentally, to me, and this is an element of faith, I guess I believe that if we allow science to have lots and lots of different ideas, that we will be able to meet the health needs of the American people. But if we say, okay, only a few scientists with their ideas are allowed to have support with the narrowest one school of thought, we're not going to make any progress. I don't have the answer to how to solve the obesity crisis. If I did, I would've published it, but I want to make sure that the scientists that does that's out there has support from the NIH, even if their ideas can contradict what the top scientists of the NIH currently think.
Senator Husted (01:50:44):
Well, I spoke with this with Secretary Kennedy, and I know that this goes across agencies from the Department of Agriculture to Health Human Services, but it is a tremendous cost to the American taxpayer, to the quality of life, to American competitiveness, all of those issues, sustainability of our federal budget. So I just encourage creative thinking and collaboration on that issue. I want to mention lots of conversation these days on NIH grants and talking about containing costs of how we do scientific research, but make sure we're putting more lead on the target of that research rather than administrative costs. I know that in Ohio we have a number of entities, our universities, Cleveland Clinic, our hospital, so forth that are involved in this. I really believe that there are many institutions who are willing to work with you in sharpening their pencils, getting better, forcing change in how these grants are used, distributed and focused on the research that needs to be done. And just give some thoughts, if you would, about how we can advance those conversations on this topic.
Dr. Jay Bhattacharya (01:52:04):
Senator, I think the universities are partners of the NIH not opponents, I do think that there's a lot of distrust now coming out of the pandemic of the scientific enterprise and of universities also. The way to address the distrust is transparency, and I'm absolutely committed to working with you and with others to make sure that we can restore that trust by establishing transparency. Where did the administrative costs go? That's a question that could be answered with audits, for instance, and establishing the right rates. If I'm confirmed, that's something I'll look very carefully into. I think I want to make sure that every single dollar the American taxpayer entrusts the NIH to goes to addressing the needs, the research that will address the health needs of the American people.
Senator Husted (01:52:52):
Great. Thank you. Thank you, Mr. Chairman.
Senator Bill Cassidy (01:52:53):
Thank you. Senator Husted. Now, Senator Markey.
Senator Markey (01:52:56):
Thank you, Mr. Chairman. Dr. I've been hearing from researchers in Massachusetts and across the country about actions taken by Trump and Musk that are slowing down research into Alzheimer's, stroke, cancer and our mental health crisis. One PhD researcher who is working on finding better treatments for depression to prevent suicide, said hiring and funding freezers have "stalled their research and will stall the development of safer therapies for depression by years". A Massachusetts doctor and mentor for biomedical researchers says that Trump's executive orders and Musk-DOGE minions are leading us to face "an enormous brain drain" as there is little confidence that these institutions will be able to function normally. This doctor is thinking about leaving the country, which would mean the United States seeds ground in the fight to lead the world in biomedical innovation. A cancer researcher at the University of Massachusetts said that Trump administration's cuts to NIH will "send progress in curing human disease down the drain".
(01:54:10)
A professor of medicine and science working on improving care for Americans with dementia had their grant review meeting with NIH abruptly canceled without any plans to reschedule because of this administration's funding freezes. This will delay research by several months at least, and inconsistent funding will mean layoffs and disruption to services that improve care at nursing homes. And just this week, I received copies of letters sent to researchers who received funding from the NIH to study Alzheimer's disease and improving support for caregivers and to study how to improve mental healthcare in primary care settings.
(01:54:55)
The letters terminated funding for the studies stating the premise of the grant is incompatible with NIH priorities because the study explicitly included LGBTQ people and without this funding grant, recipients will now be forced to stop research to address the mental health crisis and Alzheimer's disease. People who have committed their lives doctor to these efforts will lose their jobs. By unanimous consent. I submit these letters for the record. Mr. Chairman.
Senator Bill Cassidy (01:55:29):
Without objection.
Senator Markey (01:55:30):
Doctor, in your testimony you stated that you want to encourage free speech and dissent among scientists. In the spirit of free speech and dissent, will you commit here today to object to any decision made by Donald Trump, Elon Musk or Robert F. Kennedy that would slow or stop life-saving research.
Dr. Jay Bhattacharya (01:55:53):
Senator, I'm not involved in the decisions of the NIH up to now if I'm confirmed. My commitment is to make sure that all the scientists at the NIH and all the scientists that receive funding from the NIH have the resources they need to do their life-saving research.
Senator Markey (01:56:07):
Will you object if it slows or stops life-saving research?
Dr. Jay Bhattacharya (01:56:12):
Senator, my interactions with Secretary Kennedy and President Trump to date suggest that they don't want to slow research. They want to speed it up.
Senator Markey (01:56:22):
Will you object if that becomes evident that they're slowing the research?
Dr. Jay Bhattacharya (01:56:29):
Senator, I have to say, I don't believe that they're ever going to ask me to do that. I think they're committed to innovation and research.
Senator Markey (01:56:35):
Will you commit here today to reinstating funding for scientists whose funding has been terminated because their research does not align with MAGA ideology?
Dr. Jay Bhattacharya (01:56:45):
Senator, I don't believe that ideology ought to determine whether one gets research or not. I believe very fundamentally in a wide diversity of research.
Senator Markey (01:56:54):
So funding research on the mental health conditions of the LGBTQ community, that should not be a basis for canceling funding for research. Is that what you're saying?
Dr. Jay Bhattacharya (01:57:03):
Senator, I'd have to look. If I'm confirmed, I'll absolutely will go look at the letters that are submitted for the records, so I can go look, but if confirmed, I'll go look carefully into that. I want to make sure that the processes that the NIH has to identify -
Senator Markey (01:57:18):
So I appreciate that on its face. Of course, that is absurd because they have mental health issues as well. So will you commit here today to do everything in your power to stand up for the American people in lifesaving biomedical research in the face of the Trump attacks on scientific freedom?
Dr. Jay Bhattacharya (01:57:37):
Senator, I absolutely commit to focusing and supporting the research that advances the health of the American people. I don't agree with you, senator, that the President Trump is opposed to that. In fact, quite the opposite. He is quite in favor of making American healthy and fundamentally the research that we do at the NIH will be in support of that.
Senator Markey (01:57:55):
I'm being told by the researchers in Boston that they can't even hire their new trainees because the trainees who are brilliant aren't certain there's going to be a career because there won't be funding. So it's just the opposite. Trump is actually freezing, scaring, frightening the whole next generation of scientists who believe the funding won't be there for them. That's the problem that we're going to be confronted. Thank you, Mr. Chairman.
Senator Bill Cassidy (01:58:20):
Thank you. Just a follow-up and then a closing statement. Again, thank you for being here. You said something, I'm trying to square first in context, we know that only about one fifth of NIH applications are funded, and you have spoken about improving that particularly for younger investigators, which by the way, I think your plan just on the face of it looks fantastic. So thank you for thinking creatively about that. And you've also, I think correctly said, we need to be putting more money into cutting edge research, which may fail. It's cutting edge, right?
(01:58:56)
But what's the alternative? So what I'm trying to square with that is the extra dollars for validation with all the kind of caveats you put, you'd have to have the full cooperation of the person whose study's being validated, and you'd have to have the same circumstances and the same genetic makeup and the same this and that and that and this. So it seems like the validation push would put more pressure on both the cutting edge research priority and the young investigators finding it easier to get money. So knowing that you've thought about that, how do you think about that?
Dr. Jay Bhattacharya (01:59:34):
Senator, I think of that validation work as central to doing good science. Any portfolio that doesn't have that kind of validation built into it is not going to be reliable. So even if you do cutting-edge research and it's not validated, you're not going to get the chances.
Senator Bill Cassidy (01:59:51):
What is the difference between doing the validation research and kind of what you have criticized that we sometimes do the same thing over and over again?
Dr. Jay Bhattacharya (01:59:59):
Well, so the difference is that validation research is focused on the particular results that a scientist may have. I published a study and you check my results. You get the same result as me. Incremental science is you propose a study that is like epsilon away from what already is known, and you do that.
Senator Bill Cassidy (02:00:18):
Now inherently, if epsilon away fails, it calls into question the original premise, correct?
Dr. Jay Bhattacharya (02:00:23):
Right. But it's much easier to be certain about research that's epsilon away from the frontier to work versus big ideas in different directions that might make big advances. Any research portfolio has to have lots of different approaches to this. I think the key to me is making sure that if early-care researchers, researchers with nontraditional ideas about hypotheses, for instance, with the example of Alzheimer's we already talked about, those get support, that are in the portfolio. Some of those won't fail and some of those will succeed and the ones that succeed can make big advances. I don't think that the validation research, validation is just a check, is the research that I did, it is do you find the same thing? That tends not to get support in the scientific community? And I think that's a mistake. The scientific community ought to support that, the NIH ought to support that. That way, the entire research portfolio as a whole, it becomes more reliable because we know that it's been validated by independent teams.
Senator Bill Cassidy (02:01:30):
I don't object to the validation research. It does seem that's going to be a tension. So I'll look forward to you resolving that.
Dr. Jay Bhattacharya (02:01:37):
Senator, I look forward to working with you on this.
Senator Bill Cassidy (02:01:39):
That'd be great. Let me just then conclude. The issue of autism just is one of those things that we all think about. I want to note that last year, Congress reauthorized the Autism CARES Act and Senator Collins and the HELP Committee were those that did that. And the law coordinates the federal autism research and is implemented by NIH. And so I look forward to working with you on that. But one thing that continues to concern me as I've listened to this conversation, there's an opportunity cost. If we continue to plow the barren ground of something which has already been validated multiple times, that there is not a connection between vaccination and autism, we don't have the money to go after the real thing. And you said something which just, I mean, just bing, bing, bing, bing, bing. I just thought was so good that you have a faith that a well-done research that provides answers will be convincing to people.
(02:02:40)
Well, we've already had that for the vaccination. What we need is the well-done research finding the true reason for autism, and that's what the hope is for the people with autism. And if we're pissing away money over here, that's that less money that we have to actually go after the true reason. You're an economist as well as an MD. You know this. And so I look forward to, I mean, the opportunity cost of wasting money on one more thing that's been proven exhaustively, denying the opportunity to find the real reason would be a tragedy for everyone who has to deal with autism, which is all of us.
Dr. Jay Bhattacharya (02:03:21):
Senator, I share that passion that you have for finding the cause of the increase. That's where the vast, vast majority of effort ought to go. We want answers. Parents want answers. Kids are suffering. And the NIH ought to be doing the research that provides those answers. That's the most important thing.
Senator Bill Cassidy (02:03:42):
Yes. Well, thank you again for being here. I admire your sons for being so well-behaved. I'm sure the presence of their mother right next to them had some influence over that. This concludes our hearing. For any senators who wish to ask additional questions, questions for the record will be due tomorrow at 5:00 PM. We're through.