'More harm than good': Trump nominee expected to push 'high-risk' health research

Donald Trump has nominated a controversial choice to oversee the National Institutes of Health, and both supporters and critics say he would likely push for more high-risk, high-reward research.

The president-elect tapped Dr. Jay Bhattacharya, who's both an epidemiologist and economist, to oversee the NIH and its nearly 19,000 employees across nearly 30 institutes and centers, and he's expected to shake up the research institution with a nearly $48 billion budget, reported Axios.

"The controversial Stanford professor could rattle the scientific establishment and turf-conscious lawmakers in Congress, but also satisfy skeptics' calls for a serious look under the hood at how NIH works," the website reported. "There's generally less risk-taking today that pushes science in new directions, in part because of economic incentives and the higher likelihood that research confirming earlier work will pay off."

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The health economist criticized Covid lockdowns and vaccine mandates during the pandemic and pushed the idea of protecting the elderly and other vulnerable populations while letting others resume their normal routines, which ex-NIH director Francis Collins dismissed as dangerous.

"Getting science right is arguably the single-most important thing we can do in society," says Caleb Watney, co-founder and co-CEO of the Institute for Progress.

Bhattacharya and his former student, University of Waterloo economist Mikko Packalen, have previously found that NIH is generally supportive of novel scientific ideas, but their analysis showed funding for innovative ideas trended away from clinical research toward basic science, which the private sector doesn't have an incentive to fund, and he has identified the grant review process as an area for reform.

"Everyone complains about peer review," said one former senior NIH official. "Picking the winners isn't that easy in science."

Even some of Bhattacharya's supporters have expressed cautious optimism that he could identify high-risk, high-reward programs worthy of public funding, but they also worry that he could make changes just for the sake of making changes.

"There is so much to do – none of this glamorous," said Pierre Azoulay, an MIT economist who was a co-investigator on a grant with Bhattacharya before the pandemic. NIH "still funds a lot of great research" and "you can imagine some reforms doing more harm than good."