Yesterday a large group of NIH employees submitted an open letter to NIH Director Jay Bhattacharya objecting to his complicity with and participation in the wholesale destruction of NIH. This was an act of great courage on the part of my colleagues at NIH, given that those who signed their names may be fired, and those who signed anonymously are now likely going to be the subject of investigations to identify them. I have always been impressed with my colleagues in government, because they do incredible scientific work and, despite better opportunities for renown and salaries in industry or academia, they chose public service to benefit the American people.

This letter represents hundreds of NIH employees and signatories from the scientific community and the general public challenging Bhattacharya with evidence on the evisceration of NIH research that he has presided over. It could not be better timing, since Bhattacharya testified before the Senate Appropriations Committee today about the president’s budget request, where he spent most of the hearing evading direct questions about the impacts of annihilating the NIH budget to the tune of $18 billion. He would not directly admit complicity with a fascist anti-vax death cult, so instead he’ll say that he’s reforming NIH and rebuilding trust by encouraging dissent.

Bhattacharya loves dissent. He talks about it constantly. He has mythologized himself as a persecuted whistleblower who was marginalized for his courageous contrarian beliefs, mostly on the basis of being butthurt for being criticized by actual public health professionals including former NIH Director Francis Collins and former NIAID Director Tony Fauci. And he thinks dissent is the answer to all of NIH’s problems, so long as it’s a dissenting opinion that he shares. You see, the problem with science is that the public doesn’t trust us anymore and it’s because we were wrong about various things during the pandemic, we said stupid or poorly phrased things to the press, and we expressed opinions. In my case, I also used too much profanity. According to Bhattacharya, scientists lost public trust for being human and having the audacity to reject his mass death-promoting pandemic policy ideas. In particular, he’s especially peeved that scientists correctly pointed out scientific flaws in studies he conducted and public health policies that he has promoted. He insists that he, a former professor at Stanford, was diminished, excluded from the public discourse, and not taken seriously despite being on Fox News every other week telling Laura Ingraham about how “the laptop class” was preventing poor people from fulfilling their destiny of getting COVID and dying for the sake of the GDP.

I have infinite respect for my colleagues at NIH for taking a page out of Bhattacharya’s book and dissenting. They were evidently so inspired that they not only dissented, they modeled their dissent after Bhattacharya’s trailblazing example.

The Great Barrington Declaration

In late 2020, Bhattacharya and two colleagues, Martin Kulldorff and Sunetra Gupta, wrote a policy proposal called the Great Barrington Declaration. This was sponsored by the American Institute for Economic Research, a libertarian think tank that was keen to reopen the economy at any cost, even if that cost was the lives of millions of Americans. None of the GBD authors had prior experience with designing pandemic policies or any expertise in immunology or virology. Bhattacharya is a health economist who has spent most of his career writing papers about health care spending and its impact on the economy. Kulldorff is a statistician whose major contributions were developing software packages for statistical analyses, as well as an insufferably self-pitying essay airing his many grievances with public health everywhere except Sweden, equating criticism with slander, and disclosing that he was fired from Harvard for refusing to get a COVID vaccine. Gupta is a theoretical epidemiologist who studies transmission, but has no specific expertise in coronaviruses, as her pre-pandemic work largely focused on malaria, HIV, tuberculosis, and various genetic disorders.

The GBD called for an approach to pandemic control they called Focused Protection, which is a euphemism for isolating old and/or sick people indefinitely and lifting all pandemic public health measures so that everyone else can go out and get COVID. Supposedly this mass infection strategy would result in population-wide immunity, creating a happy ending to the pandemic in which “society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.”

At the time, I thought this was a very bad idea and so did most of my colleagues. Encouraging people to get infected with a deadly pathogen is incredibly dangerous. Increasing the number of infected people is not a reasonable or effective strategy for ending any ongoing outbreak, much less a pandemic, since containment depends on decreasing the number of infected people. In October 2020, there were no available COVID vaccines. In people with no prior immunity to COVID, disease can be severe even in people with no known risk factors. Epidemiological modeling showed that even a partial implementation of the GBD would have led to a greater than 150% increase in mortality. In the US, that would have translated to at least a million additional deaths.

I signed the John Snow Memorandum, a statement published in The Lancet that strongly opposed the GBD. I also wrote a commentary in Med explicitly stating my belief that vaccination is the only ethically and scientifically acceptable approach to achieving herd immunity. In the intervening years, I have come to see the GBD as something even more insidious than just a shitty policy proposal from a trio of unqualified medical contrarians with conflicting financial interests. The GBD invites people to deny the obvious truth that outbreaks end when there are no more cases, and instead to imagine a world in which there is no public health and people are happily dying of pandemic pathogens for the sake of increased consumer spending. It does not disclose that the authors were hosted at the bucolic western Massachusetts mansion owned by a think tank devoted to wealthy assholes remaining and becoming increasingly wealthy. It does not disclose that Bhattacharya had already accepted money from the CEO of JetBlue to downplay the mortality rate of COVID-19 via a poorly executed and unethically recruited serology study. It tested whether or not bullshit dressed up in clumsily deployed scientific language would fly with the American people. The GBD didn’t as policy, but the nihilistic views of society at its core persist: most people don’t matter except as effectors of the economy, and thus they are expendable. The GBD world view is that pandemics should be managed based on what is in the best interest of the people in charge, not the number of people who will die as a consequence. Criticism of these ideas is slander and lying is “dissent.”

The NIH Director dissents

Bhattacharya clapped back on the preferred social media platform of MAHA fascists. As he so often does when challenged, his response is a revisionist attempt to reframe the destruction he is overseeing as a good thing, actually. Rewriting the narrative for Bhattacharya amounts to bullshitting about his devotion to dissenting opinions without actually demonstrating said devotion. Rather than address the concerns in good faith, Bhattacharya resorted to his favorite tactic: lying.

Virtually every claim here about “misconceptions” in the Bethesda Declaration is false. “Oh, you just don’t understand” is one of Bhattacharya’s go-to methods for condescendingly dismissing criticism without engaging with it. It’s also what he does when he’s getting ready to lie, which he does extensively in this thread. Let’s unpack the lies in his response to the dedicated public employees at his own agency.

“We’re working to remove ideological influence from science. NIH funding must be based on provable, testable hypotheses, not ideological narratives. Projects that don’t meet that bar are discontinued so we can focus on rigorous, impactful research.”

This appears to be in response to the Bethesda Declaration’s concerns about politically-motivated defunding, which laid out very clear examples of research that has either been terminated or is at risk of termination for running afoul of the NIH’s new anti-woke ideology. Bhattacharya’s claim that terminated grants were “ideological narratives” that weren’t actually pursuing hypothesis-driven research is both absurd and easily disproven. Of the grants that have been terminated, all were investigating “provable, testable hypotheses,” as a quick look at grant-watch.us confirms. Anyone who has ever applied for a NIH grant can tell you that a testable hypothesis has to be clearly elucidated in the proposal’s Specific Aims.

In reality, terminated grants did not undergo any type of scientific merit review and were often terminated for merely containing words that offended the HHS censors trying to eradicate DEI on the basis of it being ideologically forbidden. Nobody bothered to look at whether these grants were testing falsifiable hypotheses. They were terminated on the basis of using words like “trans”, “expression,” or “bias,” most of which have multiple meanings in science and in many cases were not addressing hypotheses related to diversity, equity, or inclusion. As I wrote yesterday, programs like the CREID network were terminated for purely political reasons.

Here are some examples of grants that evidently did not meet Bhattacharya’s standard of “rigorous, impactful research”:
Testing how brain cells communicate with each other to better understand neurological and psychiatric disorders.
Investigating how mitochondria work to understand and treat aging and metabolic diseases.
Defining risk factors and understanding mechanisms of Alzheimer’s disease progression
Developing new vaccines and antiviral drugs for COVID-19 and other pathogens
Studying pandemic viruses to inform prevention, preparedness, and response efforts
Dissecting how the immune system functions in infectious disease, autoimmunity, and cancer
Developing new antibiotics and studying ways to detect and overcome antibiotic resistance

Damn, it took me a lot of time to look at those grants and confirm that they are indeed testing hypotheses that have major impacts on public health. But it was worth it to confirm that Bhattacharya has likely not reviewed a single cancelled grant, at least not in the context of an objective scientific assessment. If he had, he could never have made such a demonstrably untrue claim, at least if he were competent.

“NIH hasn’t halted legitimate international collaborations. We’re simply ensuring accountability, a basic duty when spending taxpayer dollars wisely. We need to know who’s doing the research.”

I’m not sure how ending research because NIH has cancelled foreign subawards across the board doesn’t mean halting international collabotarions, probably because this is a lie. When I was in the US, I oversaw grants with foreign subawardees. In Canada, I have been the PI of a subaward to a foreign institution. In both situations, I have never considered reporting requirements to be lax or optional, because in fact they are not. NIH subawards require annual reporting and every university, including mine, employs a staff of administrators to ensure compliance with the grant. This is also why it’s silly to act like the NIH has no idea who foreign subawards are being issued to. There is a shitload of paperwork associated with issuing or getting a NIH subaward in any country!

The idea that foreign recipients of NIH funds are getting taxpayer money and spending it on anti-American research is absurd. Not only does NIH know what foreign subawardees are supposed to be doing with their money, they actually can and do demand regular financial reporting. If a foreign subrecipient decided to spend their entire award on something completely unscientific and unrelated to the grant, like Chanel bags or luxury vacations or MAGA shitcoins, they would still need to account for it. At minimum, they would never get NIH funds again without adequate justification for spending.

What this is really about is Bhattacharya suggesting that foreign collaboration is inherently suspicious because he maintains that the COVID-19 pandemic was a lab leak for political reasons.

“Claims that NIH is undermining peer review are misunderstood. We’re expanding access to publishing while strengthening transparency, rigor, and reproducibility in NIH-funded research.”

Apart from the fact that Bhattacharya doesn’t specify what NIH is doing to supposedly expand access to publishing, this avoids addressing very specific issues raised by the Bethesda Declaration: “NIH is ignoring peer review to cater to political whims, pulling applications prior to review and removing high-scoring grants from funding consideration. HHS has redirected this funding to unvetted projects, like the Taubenberger-Memoli vaccine project.” This refers to the $500M awarded to NIH Principal Deputy Director Matthew Memoli and Acting NIAID Director Jeffrey Taubenberger to develop a universal influenza vaccine using vaccine technology so ancient it may as well be written on papyrus. No scientific review occurred prior to NIH bestowing half a billion dollars on Memoli—who did mostly unremarkable and incremental flu research until he swore loyalty to the new regime—as a presumed award for presiding over all of NIH’s grant and employee terminations prior to Bhattacharya’s confirmation.

It’s hard to see how Bhattacharya has expanded access to publishing. The NIH preclearance policy for intramural employees remains in place (a process in which papers go through pre-publication internal review), despite Bhattacharya’s claims that it has been lifted. There are no other restrictions for any NIH-funded researchers to publish their work in peer-reviewed scientific journals besides the requirement to make the research open access. Prior to Bhattacharya’s confirmation, both intramural and extramural NIH-funded scientists had plenty of access to publishing and they still do, at least for now.

But when it comes to “undermining peer review,” Bhattacharya appears to be the one who misunderstands. The Bethesda Declaration very clearly takes issue with how Bhattacharya’s NIH is reviewing and awarding grants, not sending papers for publication. The problem is not that NIH-funded researchers need more access to publishing, it’s that NIH is taking funds away from grants that were peer reviewed and scored on the basis of their scientific merit for ideological reasons: the grants are deemed to be DEI, they are about COVID-19, they are about mRNA vaccines, they mention climate change, or any of the other arbitrary and unscientific justifications offered for terminating meritorious research programs. Bhattacharya and his lieutenants’ judgment about what is transparent, rigorous, and reproducible is not a substitute for the external peer review process that scores grant proposals, particularly since cronyism, grifting, and bigotry seem to be the primary considerations for funding decisions.

“Lastly, we are reviewing each termination case carefully and some individuals have already been reinstated. As NIH priorities evolve, so much our staffing to stay mission-focused and responsibly manage taxpayer dollars.”

This sounds to me a lot like “we haven’t rehired any of the people we fired for no reason” and “we haven’t restored any of the grants we terminated.” My colleagues at NIH haven’t told me any stories in which their axed co-workers miraculously reappeared in the lab like Jesus Christ on the third day. My colleagues at Columbia University are still reeling from all their funding being stripped, including the T32 training grant to the Department of Microbiology and Immunology that funded me for the first 3 years of my PhD studies. Nobody at Columbia has gotten a penny returned to them from these terminated grants, despite the university bending over backwards to placate Trump’s demands. Instead, there have been layoffs, with more likely to come. I also find it hard to believe that each individual case is being carefully reviewed, since all we have is Bhattacharya’s word that this is occurring.

It’s also really important to note that however NIH priorities evolve, the NIH Director does not have the authority to fire people across the agency or stop funding grants. Congress has appropriations power, so it is their decision, not Bhattacharya’s, to set NIH priorities and fund the agency accordingly. Responsible management of taxpayer dollars would mean spending the NIH budget according to what Congress has appropriated, which Bhattacharya has not done and continues to not do. And although Bhattacharya loves to blame termination decisions on his predecessor (Memoli, who served as Acting NIH Director prior to Bhattacharya’s confirmation), he bears full responsibility for all the damage inflicted upon NIH in this administration.

Sign the Bethesda Declaration

Bhattacharya evidently finds the Bethesda Declaration to be inconvenient to his agenda, which, to be clear is the illegal impoundment of Congressionally appropriated funds in violation of the US Constitution. I suspect that this is to both make the spurious argument that NIH doesn’t need such a big budget and also to undermine Congressional power to control the federal budget. The Bethesda Declaration authors called this out: “Combined, these actions have resulted in an unprecedented reduction in NIH spending that does not reflect efficiency but rather a dramatic reduction in life-saving research. Some may use the false impression that NIH funding is not needed to justify the draconian cuts proposed in the President's Budget. This spending slowdown reflects a failure of your legal duty to use congressionally-appropriated funds for critical NIH research. Each day that NIH continues to disrupt research, your ability to deliver on this duty narrows.”

Notably, Bhattacharya did not deny that he is participating in illegal impoundment. He has not given any specifics about how he will uphold his duty to spend money as Congress has directed. He will not commit to anything more than following the law while he pursues “gold standard research,” which as far as I can tell means research that is ideologically aligned with Kennedy and Trump, regardless of its scientific justification or potential for public health impact. He is a simpering minion who provides cover and does the bidding of the fascists who installed him in this role. Rather than the culture of productive intellectual dissent he promised at his confirmation hearing, Bhattacharya has created “a culture of fear and suppression” that silences opposition and stifles scientific progress.

The people who are not simpering minions are my brave colleagues at NIH who wrote the Bethesda Declaration in spite of Bhattacharya’s catastrophic mismanagement of the nation’s biomedical research enterprise. I am endlessly grateful for their courage and conviction. The least I can do is add my name to the ever-increasing roster of signatories who stand behind evidence and scientific integrity. Not only do I want them to know they have my trust and support, I want Bhattacharya to know that he does not. And that a growing chorus of scientists, health care providers, economists, activists, and concerned members of the public condemns his authoritarian bootlicking and dereliction of duty. I signed the Bethesda Declaration. I encourage you to do the same.