I don't have my gavel but Senator Murray said it's a DOGE cut. Anyway, the Senate Committee on Health, Education, Labor, and Pensions will please come to order. Thank you Dr. Bhattacharya for appearing before the committee. The National Institutes of Health funds more biomedical research than any other public institution in the world. NIH's decades-long investments have helped the United States lead the world in addressing critical health challenges, helping us better understand heart disease, preventing and curing certain cancers, and leading to accomplishments like mapping the human genome. As a medical researcher who has engaged in NIH-sponsored research for decades, Dr. Bhattacharya understands the power of these investments. Importantly, NIH grants have increased biomedical research capacities in states that otherwise would not have had sufficient resources. However, NIH at times appears to have prioritized funding for risk-averse, incremental science. There is concern the current system incentivizes established scientists who study already proven concepts rather than younger scientists with unproven ideas. While this practice may ensure short-term success of federal grants, it limits groundbreaking discoveries. NIH is facing other challenges: during the COVID pandemic, there was a general loss of trust in public health institutions. To restore trust, officials need to be more transparent and provide reassurance that health guidance is best for Americans and unbiased. You have indicated you would like to promote a free and open debate at NIH, which is encouraging. The NIH is at an inflection point. If confirmed as NIH director, you will be tasked with leading an agency that desperately needs reform. I look forward to hearing your vision and working with you on proposals. With that, I recognize Senator Sanders for his opening statement.
Thank you, Mr. Chairman. Thank you, Dr. Bhattacharya, for being with us. Today we are considering the nomination of President Trump's nominee to be director of the NIH, Dr. Jay 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 improved lives. But having said that, let me say a few words about my concerns. Our healthcare system is broken. We spend almost twice as much per capita as any other industrialized nation, yet 85 million people are uninsured or underinsured. Life expectancy is four years lower than other wealthy countries, and the bottom 50% live on average seven years shorter lives than the top 1%. Being working class in America is in many ways a death sentence. We pay the highest prices in the world for prescription drugs, in some cases more than 10 times what our friends in Canada or Europe pay. The taxpayers of our country have provided hundreds of billions of dollars in R&D into new drugs that have benefited the pharmaceutical industry. In 2023, this committee released a report that found the average price of new treatments that NIH scientists helped invent is $111,000. American taxpayers pay far more than people in other countries for the same medicine that NIH and taxpayers helped develop. For example, a drug for prostate cancer is charged $179,000 in the US but can be purchased in Japan for $18,000. We need an NIH director prepared to take on the greed of the pharmaceutical industry. But President Trump will not give you that authority. The real person in charge of all these federal agencies is Mr. Elon Musk. It is my understanding that Mr. Musk and DOGE have terminated about 1,200 employees at NIH and played a major role in freezing grant money. Bottom line, the real gentleman we should be having up here is Mr. Musk. I hope we can schedule a hearing with Mr. Musk.
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...
Well thank you, Chairman Cassidy, and ranking member for holding this hearing. It is an honor to introduce and recommend to you Dr. Jay Bhattacharya for director of the NIH. I met him during the COVID pandemic. I was governor of Nebraska and I was a biology major and worked in a lab, so I understand the research world. During the pandemic, Dr. Bhattacharya showed great intellectual honesty and courage by offering alternative suggestions. He helped me think about how to protect vulnerable people while letting others go about their life. In Nebraska, we kept kids in classrooms and our fourth grade math scores were highest. Dr. Bhattacharya helped us think about everybody's health—mental health, education. Politico ranked Nebraska number one overall for pandemic response. What you will get from Dr. Bhattacharya is someone who understands the scientific method: challenge ideas, replicate research. He has the courage to stand up against established thinking. I highly recommend him.
Thank you, Senator Ricketts. Great. Dr. Bhattacharya, if you would like to give an opening statement, please.
Senator Chairman Cassidy, Ranking Member Sanders, members of the Senate HELP Committee. I'm honored to speak with you today and humbled by President Trump's nomination. I'm delighted to have with me my wife Kathy, my son Matthew, my brother Deep. My other adult children could not attend but are here in spirit. The NIH has played a pivotal role in my career. I served for a decade on NIH grant committees, trained trainees with NIH support, and use NIH funding to study population aging, chronic disease, and obesity. I've made the study of scientific institutions a focus of my work. The NIH is the crown jewel of American biomedical sciences. I have the utmost respect for its scientists and staff. The NIH's mission to support scientific discovery to enhance health and lengthen life is vital. 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 public had a great deal of confidence in scientists. How can I help the NIH achieve its mission? I have five concrete goals if confirmed: (1) NIH research should focus on solving the American chronic disease crisis—life expectancy has flatlined and plummeted during the pandemic. (2) NIH-supported science should be replicable, reproducible, and generalizable. Much modern biomedical science fails this test. The NIH faced a research integrity scandal involving Alzheimer's research. (3) Establish a culture of respect for free speech and scientific dissent at NIH. Dissent is the essence of science. (4) Recommit to funding the most innovative biomedical research to improve American health. (5) Embrace and vigorously regulate risky research that could cause a pandemic, and embrace transparency. If confirmed, I will work with Congress and the administration to make public institutions worthy of trust and make America healthy again.
I'll start with questionings. One topic has been measles vaccines and autism. A false article in The Lancet decades ago led to many not vaccinating their children. Now a child has died from a vaccine-preventable disease in Texas. The Secretary has put out an editorial advocating vaccination. I've been told that you said we need to invest NIH resources to look at a possible link between measles vaccine and autism. Any comment on that?
Senator, it is a tragedy that a child would die from a vaccine-preventable disease. I fully support children being vaccinated for measles. As for research on autism and vaccines, I generally don't believe there is a link based on my reading of the literature. But there is tremendous distrust in medicine and science coming out of the pandemic. We have a sharp rise in autism rates, and no scientist really knows the cause. I would support a broad scientific agenda based on data to find an answer. But I also recognize the need to allocate resources wisely. I don't think we need a specific study on the MMR vaccine and autism; I am convinced there is no link. However, I want to address the root causes of vaccine hesitancy by providing good data.
This has been fairly well, in fact exhaustively studied. We have limited resources. You are an economist and understand opportunity cost. I worry that if we pretend this is an issue, more children will die from vaccine-preventable diseases. I want to address the rise in autism, but not by re-studying the MMR-autism link. I am pressing you on this because someone disagrees doesn't mean we should put precious dollars into it. We should focus on obesity, heart disease, cancer. Don't waste resources.
Yes, you are absolutely right, Senator. We don't need to address every concern. But if those concerns result in parents not vaccinating, I think giving them good data is the right approach. I am convinced we have good data on MMR and autism. If confirmed as NIH director, the lever I have is to provide good data. That good data already exists. I agree that an appropriate allocation of dollars toward childhood diabetes, obesity, and prevention of infectious diseases should be the priority.
Thank you, Senator Sanders.
Thank you, Mr. Chairman. Dr. Bhattacharya, as I mentioned, in some cases we pay 10 times more for prescription drugs. One out of four Americans can't afford their prescriptions. Why do we pay the highest prices, and what will you do as NIH director? Also, should a company that benefits from taxpayer-funded research be able to charge any price, or should we attach a reasonable pricing clause? I think the NIH can do something. Also, what will you do about the food industry selling unhealthy foods to kids? Would you support restrictions on TV advertising of junk food to children?
Senator, I don't have a full answer, but I agree with your concern. If confirmed, I think a specific thing the NIH should do is fund research on off-patent, inexpensive drugs. For example, during the pandemic, a cheap steroid dexamethasone was found to be effective, but it was studied in the UK, not by NIH. Regarding pricing, that is something Congress and the administration would need to work on. I would focus on supporting research on inexpensive treatments. On the food industry, I think excellent research can elucidate the link between junk food and health outcomes. I would advocate for giving parents tools to make better choices. If there is a movement to encourage advertisers to not push unhealthy foods, I would be willing to help lead that.
Senator Sanders, I'm glad to see your interest in junk food. Actually, you could transform health by removing junk food from food stamps. There is an epidemic of obesity among the poor. We have precious resources. I also want to talk about wasting money on frivolous studies. For example, the NIH spent $2.1 million on a study about whether people are less likely to take food if someone sneezes on it. That's ridiculous. We should focus on big diseases. I hope you will direct NIH towards diabetes, heart disease, cancer, Alzheimer's. Also, change the grant committee makeup so that experts from major diseases are on every behavioral study. What do you think?
Senator, I think the resources the taxpayers give to NIH are precious. If confirmed, I absolutely commit to changing the grant committee makeup to focus on the most important questions that impact American health. The research should be focused on making America healthy. Also, regarding the steroid example, it was a signal success but the shame is that the UK ran that study, not NIH. We can align incentives at NIH to look for such opportunities.
Thank you, Dr. Bhattacharya for being here. I don't think it's an exaggeration to say that President Trump and Elon Musk are putting life-saving research at risk with grant freezes, pauses on clinical trials, and mass firings. Do you support these actions? Do you support further cuts? What will you do on day one about the illegal plan to cap indirect cost rates at 15%? That would cost Stanford $160 million per year. What do you say to your colleagues? Will you immediately restart the advisory councils and committees?
Senator, I was not involved in those decisions. If confirmed, I fully commit to making sure all scientists at NIH have the resources they need. I don't support further cuts. I will assess the situation on day one and ensure resources for life-saving work. Regarding indirect costs, I understand the concern. At Stanford, the rate is about 55%. I think transparency regarding indirect costs is worthwhile so that people know where the money goes. I want to ensure money goes to research. On restarting committees, yes, as soon as confirmed, I will restart advisory councils and committees. I want NIH to be staffed appropriately to meet its mission.
Impose a 15% cap on indirect costs for NIH grants. Research labs and universities across Maine have described the devastating impact this cap would have on life-saving biomedical research, ongoing clinical trials, and research-related jobs. In 2023, NIH supported 1,470 jobs in this field in Maine alone. A one-size-fits-all approach makes no sense. NIH negotiates indirect cost rates with individual grant recipients. It's legitimate to reexamine those rates, but an arbitrary cap is wrong. Furthermore, since 2017, the Labor-HHS Appropriations bill has specifically prohibited changing the indirect cost formula, yet that was done without congressional intent or consent. A judge has stayed the order. If confirmed, will you work immediately to rectify and reverse this 15% cap?
If confirmed, I absolutely commit to following the law and addressing this issue directly. I think this is an indicator of distrust of universities and scientific process. I want to address those concerns as well. I'll consult with agency counsel immediately and work with you, Senator.
You testified that NIH should focus on chronic diseases. I agree. Half of American families report Alzheimer's in their family. The financial impact is expected to reach a trillion dollars by 2050. I co-authored the original NAPA Act in 2011 and led reauthorization through 2035. If confirmed, will you continue to support the national strategic plan targeting Alzheimer's?
Absolutely, Senator. I've studied this issue. There are promising ways to prevent Alzheimer's that haven't received support because they don't align with a single dominant narrative. I want to expand the set of hypotheses we investigate. We should have made more advances given the investments. It's a vitally important problem for health and fiscal health.
Thank you. I'll submit the rest of my questions for the record.
Thank you. I want to discuss the Trump administration's actions to halt thousands of NIH grants and billions in funding. Canceled study sections and advisory council meetings mean NIH cannot award grants. The administration attempted to illegally cap indirect costs. I'm the ranking member of the Labor-HHS Appropriations subcommittee. On Monday, I revealed that the administration halted $65 million in Alzheimer's funding, stopping 14 research centers. If NIH doesn't reverse course, centers will run out of funding at the end of April. Dr. Bhattacharya, do you agree with President Trump that NIH should stop funding for cancer and Alzheimer's research?
Senator, I don't believe President Trump has that as a priority, but actions are accomplishing that now. If confirmed, I will follow the law and ensure every researcher supported by NIH has the resources they need for life-saving research.
Talk more about those researchers who have been fired. Right now, this administration has halted funding for 14 Alzheimer's research centers. Do you agree with that decision?
Senator, I don't have access to that information from outside. If confirmed, I will look into it and make sure the mission of NIH is met.
Moving on, I'm concerned about how the administration's actions are putting early-stage researchers at risk. We talked about this when you visited my office in 2016. I worked with Senator Collins on the Next Generation Researchers Act. Now, these researchers are being targeted by the Trump administration and Elon Musk. Due to the funding freeze, graduate admissions have slowed, postdocs can't find jobs, and nearly 1,200 NIH employees have been fired. New restrictions could push out about 3,000 early-career researchers. These actions threaten an entire generation of scientists and our global leadership in biomedical research. Dr. Bhattacharya, you've said you want to increase support for the next generation. How will you repair the damage and support early-career researchers? Please answer quickly.
I'm very committed to ensuring early-career researchers have resources because they have cutting-edge ideas. I wasn't involved in any personnel decisions to date. If confirmed, I will look carefully at those decisions. For the record, funding has not been canceled; the meetings to allocate it have been delayed.
Thank you, Mr. Chairman. As I listen, I'm reminded that we should doubt our own infallibility and the infallibility of NIH. I'm flabbergasted by people who have never been involved in the scientific process. There is waste at NIH. For Alzheimer's, the waste is the path we went down since 2005 with the amyloid hypothesis. Dr. Bhattacharya, do you recall that study? All NIH funds went that direction for 20 years, then we found out it was flawed. Let's talk about chronic disease. NIH has spent disproportionate money on diseases affecting a tiny number of Americans, while 60% have chronic disease. Speak about your vision for researching causes and treatments of chronic disease, specifically how food is medicine.
Senator, I think the chronic disease problem is something NIH should have done a better job on. The mission is to address health needs and expand life expectancy, but we haven't achieved that. Food as medicine is the kind of idea that would be difficult to get support for because it's outside the scope of those who decide what NIH funds. We need to expand the set of ideas and tolerate that top scientists may be wrong. I don't know what the answer is, but if we don't...
Are you committed to helping us figure out the causes of these chronic diseases?
I absolutely am, Senator. That is the heart and soul of the Make America Healthy Again movement. If confirmed, I commit to that.
Yeah, and a big part of that is trust. Thanks to Dr. Fauci, no one trusts NIH or CDC anymore. We need a referee. What is it in ultra-processed food causing the uptick in chronic diseases? Speak about the indirect cost situation. I think it's a grift for universities. Two-thirds of research dollars go to four or five states. I want your commitment to spread the love to flyover states.
Senator, I have colleagues across the country. I hear your concern that NIH should be more committed to supporting scientists everywhere, not just California or the Northeast. I commit to supporting the ideas program. The indirect costs at Kansas University or Kansas State are lower than on the coast. If we can do research more efficiently there, let's move it there.
