Hannah Adamson speaks with Jay Bhattacharya, the director of the National Institute of Health

Let's start with cancer. There have not been any actual cuts. What's happening is a reprioritization of the NIH to focus on the diseases that actually afflict the American people. And for HIV, you know, we're still committed to doing all the advances that will actually make HIV—I mean, we actually now have the technology to eradicate HIV. That's something we're going to look at in coming days. There's a big advance where a single shot can prevent you getting HIV for a few years. I think refocusing the priorities of the NIH to address the actual health needs of the American people, rather than sort of political stuff that doesn't do much. If you think about where we are, since 2012, American life expectancy is flatlined. Almost no change in life expectancy between 2012 and 2019, and then of course during the pandemic, it just collapsed, and we haven't got back. And the mission of the NIH is to do science that improves the health and advances the longevity of the American people. In that sense, we kind of failed the last couple of decades. It's time to get back to real science, gold standard science, replicable science that's focused on the health needs of the American people. That's what I'm committed to doing.

No, we give grant money. The budget of the NIH is about 48 billion dollars. 80% of it goes to research done in the universities and labs around the country, and 20% of it goes to research done here at the National Institutes of Health. So it's not to take away money; it's quite the opposite.

Well, as I said, 80% of the money goes to universities and labs across the country. They're fundamentally partners in the scientific enterprise the United States is engaged with. The job of the NIH is to make sure that money actually serves the needs of the American people, and so focusing the money to universities so that it goes to science that actually looks at the chronic disease needs. We have heart disease rates, we have obesity rates, we have diabetes rates that are just tragically high. We have not solved the problem of Alzheimer's. We want to focus researchers of the country working at universities and other labs on these problems. And that's what all of the restructuring really is about.

I'm sorry, what do you mean by lead to? I want to know what causes autism. We've had a huge increase in autism rates since the last 20 years. The rate of autism now is something on the order of one in 30 or one in 32. That is a really, really high rate. And for a condition where, as a scientist, I don't know what causes it. And so it's really difficult to give good advice to parents about how to manage a condition where we don't know the etiology. And when in science you don't know the answer to something, you entertain a wide range of ideas: could it be environmental exposures, changes in our gut microbiome, you know, things that happen during pregnancy? It's really difficult to say unless you study it, and that's what we're going to do is we're going to study the cause of the rise in autism.

There's some evidence, for instance, that red dyes—forgetting the number now—but that that is potentially carcinogenic. I just say the philosophy of it is strange to me, because we have to prove that petroleum-based products that children eat at scale is bad in order to take it off the market. I think it has this flipped around. If you're going to give kids petroleum-based products in large amounts, I think the manufacturers that do it ought to prove that they're safe. We shouldn't just assume that they're safe, and I think this action that the FDA just recently took will be a spur to food manufacturers to think differently. Like why not use beet juice to color dyes? Why a petroleum-based product instead of a natural product like that? For some things, like drugs you give for patients with cancer, you have to prove that they actually work, right? The burden of proof is on the manufacturer to prove that they work before we say people can have it at scale. For some reason, with food dyes and lots of other additives, somehow the FDA has to prove it causes harm. Even when common sense tells you, look, why give this when there's an alternative that's natural? Beet, watermelon juice—those things are, I think, perfectly good substitutes.

Well, the SNAP program is a tremendously important program to provide food assistance for the poor people of the country. I don't think that we should be encouraging and enabling people to make choices that are going to lead them to worse chronic disease conditions. It's entirely appropriate for the American government to say, look, don't spend this money on sugary foods, spend it on other foods. The food deserts exist because there's a demand problem, right? If you have people asking for and wanting vegetables, meat, and other healthy aspects of their diet, rather than sugary sodas and snack items, you're going to get more of that. The problem right now is that we structure our assistance to poor families so that it's hard to demand those items. Removing sugary sodas from the SNAP program, I think, pushes in the right direction.