New NIH Leadership Aims to Restore the Public's Trust in Science

• Life expectancy — Bhattacharya acknowledges the failure of America’s health institutions, which he intends to correct:

“Since 2012, there’s been no increase in American life expectancy. From 2012 to 2019, literally it was — well not literally — almost entirely flat life expectancy. And whereas the European countries had advances in life expectancy during that period. During the pandemic, life expectancy dropped very sharply in the United States …

Whatever those investments we’re making as a nation, in the research, are not actually translating into meeting the mission of the NIH, which is to advance health and longevity of American people.”

• Leadership didn’t listen to reason — During the COVID-19 pandemic, Bhattacharya was one of the biggest opponents of the lockdowns, even writing opinion pieces³ in mainstream media publications such as the Wall Street Journal:

“I was a very vocal advocate against the lockdowns, against the mask mandates, against the vaccine mandates and against the anti-scientific bent of public health throughout the pandemic.”

• We are now under a “sick care” system — Bhattacharya explains that health care nowadays is more reactionary than being proactive:

“The advances we’ve made have allowed people to stay sick longer. It hasn’t translated to a longer life, right?

There was a hope, I think, when I first started doing research in 2001, in population aging, there was this idea of a compression of morbidity that is, you live long, a long life, and the time you spent really sick and disabled was compressed at the very end of your life rather than spending a long time disabled and sick. And you die after having spending like a decade or more very sick.”

• The government needs to come clean with its involvement — One of Bhattacharya’s main criticisms of past NIH administrations is the secrecy surrounding their connection in SARS-CoV-2 research:

“I’ve also argued that the scientific institutions of this country should come clean about our involvement in very dangerous research that potentially caused the pandemic.”

• The current system favors a “rock star” scientist model — Individual researchers strive for personal fame rather than collaborative, meaningful breakthroughs:

“So, science is a collaborative process, but the incentives within science, for individual advance, can often lead to a sort of a structure that elevates careers without necessarily producing truth.”

• The flaw in peer review publications — Bhattacharya also criticizes the current peer review process. He points out its shortcomings below:

“The peer review actually doesn’t involve, as you know, the peer reviewers taking your data, rerunning your experiments. It doesn’t mean any of that. They just read your paper, looked for logical flaws, didn’t find any, and then they recommended the editor to be published.

So, the peer review is not a guarantee that it’s true. You have some significance that say that your data meet. Even with that, some percentage of the time, the published result is going to be false.”

• Collaboration is key — To address the current flaws in the scientific community, the NIH is now promoting collaborative lab clusters. These groups of scientists come together specifically to tackle complex, real-world health problems. Huberman recommends:

“The solution to this is collaboration. Instead of having independent investigators, you have clusters of laboratories hopefully distributed throughout the country, working on the same problems, collaborating. There are grants of this sort. But here’s the problem. As you point out, it’s a sociological issue.”

• Publishing “constructive failures” — Research that doesn’t achieve expected results is also critical. This openness helps build credibility:

“[W]e reward scientists for the influence that they have, and we reward scientists for the volume of papers they publish. What we don’t reward scientists for is honesty about their failures. We don’t reward scientists for pro-social behavior.”

• Failure is a stepping stone to better results — Bhattacharya notes that scientific research doesn’t get much leeway when it comes to making mistakes compared to tech companies that learn from failed startups:

“In Silicon Valley, a failed startup doesn’t mean that you can’t get another draw at trying to make a successful startup, right? Silicon Valley does not punish failure that sharply and that is the key to its success. Whereas in biomedicine, the current version of it we have now, we punish failure way too sharply.”

• Previous regulations held research back from the public knowledge — To help change perception regarding the NIH, Bhattacharya wants to make all NIH-funded research free for public consumption because it’s paid by your taxes:

“[My] predecessor Monika Bertagnolli … made a decision, a really great decision, essentially to say if the NIH supports a scientist’s work, and then that work leads to a journal publication, that publication ought to be available free to the public immediately upon publication. You’re not allowed as an NIH-funded scientist to publish in a journal that doesn’t have that as a policy. That policy was due to go into effect in December of this year …

If the American taxpayer pays for the research, why shouldn’t the American taxpayer be able to read the research for free? Because they already paid for it. Why do they pay a second time on the back end after the research is published?”

• Cost is no longer a roadblock because research can be published online — Bhattacharya is now tapping into the benefits of posting research online, making it instantly accessible to people who want to read them:

“[T]he marginal cost of publishing now is effectively zero. You put it online, right? I mean, yeah, there’s some costs for maintaining the webpage and all that and there’s some editorial staff, but like the level of investments that the public had been making for the NIH to then be asked to pay 30, 50, 100 dollars for the papers itself that are published, I mean, it’s just insulting.

And actually, it impedes the progress of science because it makes it so that there’s this barrier where regular people can’t get access to the things that scientists are talking about, right?”

• The flaws of the scientific method — The ability to replicate results among different researchers is important to solidify the findings of a topic, but Huberman states that this is not the case today:

“One of the major issues, I believe, that led to the so-called Replication Crisis is that it is very difficult, even with the best of intentions for two laboratories to do the same work in an identical way. Five minutes longer on a countertop at room temperature might change an antibody that could lead to a different outcome. I mean, there are so many variables.”

• Incentives have affected medical research — Monetary incentives to create groundbreaking research are creating loopholes in medical research, Bhattacharya says:

“So, a lot of what the things that we think we know, even with some fair degree of certainty, are probably not true … [T]the question is like, which half? Well, we don’t know the answer to that question …

And this is done even with pure goodwill and no fraud at all, right? And the reason is a combination of the fact that science is hard and the incentives we created for publication, right? Those two together mean that the biomedical scientific literature is not reliable.”

• Creating a collaborative community is imperative — The NIH is planning to create “pro-social” metrics to reward scientists who share data openly and willingly allow others to replicate their work:

“We don’t reward scientists for pro-social behavior … where you collaborate, you share your data openly and honestly. In fact, we punish scientists for that, right?

So, right now, if somebody comes to me and says, ‘Jay, I want to replicate your work.’ I’ve trained myself not to think this way, but it’s really hard not to, given the structure we’re in. I’m going to think of that as a threat. What if they don’t find what I’ve found, now I’m a failure, right?

The failure to replicate is seen as a failure of the scientist rather than the fact that science is hard and it’s difficult to get results that are true even with the best of will. And we punish scientists for that. So, we essentially reward scientists for a set of things that create incentives for the Replication Crisis to happen.”

• The mandates created stigmatized groups — One of the disturbing effects of the various COVID-19 policies was shunning citizens who spoke out, Bhattacharya says. In turn, those affected have little reason to trust the government:

“Essentially, we created a class of unclean people as a matter of public policy. You can understand why people who went through that would say, ‘Given that the vaccine didn’t turn out to stop you from getting and spreading COVID, why should I trust you on anything else?’ That, that’s where we currently are.”

• Sweden got it right all along — Bhattacharya concedes that the lockdowns weren’t helpful in curbing deaths caused by the COVID-19 pandemic:

“If you ask which country had the lowest all-cause excess deaths in all of Europe … it turns out it’s Sweden, which didn’t follow the lockdowns. So, the lockdowns were not a necessary policy in order to protect human life. And they weren’t sufficient to protect human life either, right? So, you had sharply locked down countries like Peru that had tremendous deaths.”

• There was a concerted effort to control medical experts — Instead of fostering a collaborative environment between experts, those in power opted to censor and vilify doctors who went against mainstream advice:

“[T]here was essentially a groupthink at scale. It was impossible to organize a panel with the kind of diversity of opinion that was needed.

There were [a] million or more — I know this from the set of people who signed the Great Barrington Declaration, tens of thousands of scientists and doctors who disagreed, but they were afraid to stick their head up for fear of getting chopped off. It’s not an accident that Stanford didn’t allow a scientific panel with my point of view about the efficacy of lockdowns until 2024.”

• Lockdowns affected marginalized groups — While many employees were able to continue their jobs during the lockdowns, Bhattacharya noted that these policies greatly affected other groups:

“[I]t was very clear to me with my background in health policy that we were going to harm the poor. We were going to harm children, and we were going to harm the working class at scale. The lockdowns were a luxury of the laptop class.”

• The messaging was more important than saving lives — In an effort to look unified and keep the public’s hopes high, authorities focused on united messaging instead of being honest about the side effects of their policies:

“[T]he problem here is that the scientific community embraced an ethical norm about unity of messaging and then enforced it on fellow scientists. And then it cooperated with the Biden administration to put in place a censorship regime that made it impossible even for legitimate conversations to happen. So, after the vaccines, COVID vaccines came out, there are a community of people who were vaccine legitimately vaccine-injured.”

• The shots need to be fully investigated — Because of the devastation caused by the rolling out the shots to the public, Bhattacharya is calling for an investigation of what went wrong. But even if he is now the NIH director, he is still helpless because of more powerful players:

“I think these are the kind of things that ought to be investigated, but it’s very difficult to investigate just because of the political aura around vaccines where if you really do investigate it and find something the public health authorities don’t like, you’re going to have trouble. I don’t know the answer to that question from a scientific point of view.”

• An open discussion and collaboration with the public — Bhattacharya says the NIH will work with the public more closely moving forward, allowing both parties to benefit from each other:

“The way forward isn’t to force people to say, ‘Look, you must acknowledge how great science is on these other things.’ The way forward is to be utterly honest about what we know and don’t know and treat people as partners rather than subjects.”

• Return to basics — The NIH aims to return to scientific research that will benefit public health, even if it means challenging beliefs that are hard to let go. Bhattacharya is hoping to fast track an open scientific competition to get to the bottom of autism:

“It includes basic science work, it includes epidemiological work, it’ll include environmental exposure work, and we’ll bring together data sets that we’ll make available to the researchers. We’ll have a competition among scientists, just like the normal NIH way with peer review panels, to ask who should get the awards. We’ll have a dozen or more scientific teams asking the question, ‘What is the etiology of autism?'”

• Honesty — To regain the public’s trust, the NIH aims to become more open to the pros and cons of the policies they recommend, especially when it comes to rolling out the shots. Bhattacharya believes that these contribute to the rise in autism but are not the sole reason for it.

“I want an honest conversation. I think that if you have an honest evaluation, you’re not going to find that the vaccines are the primary reason for the cause of the rise of autism. It’s going to be something much more fundamental and complicated.”

• Focus on research — Above all, the NIH needs to focus on producing quality research that benefits public health, which includes encouraging new and upcoming scientists to participate:

“The key thing is the content of the research and the standards we hold ourselves doing the research. Those are the things I want restructured. That’s really the fundamental question for me, as NIH director.

If I can accomplish some of the things we’ve talked about during this podcast, having replicability be the core of deciding what scientific truth is, refocusing the portfolio so that we enable young, early career scientists to test their ideas out, that we aim big for trying to address and we address the key health problems that Americans face. If we can do those things, I’ll consider myself a success.”