This analysis was prepared by Venable, LLP on behalf of AACOM.

WITNESSES

• Dr. Jayanta Bhattacharya (testimony)

OPENING STATEMENTS

• In his opening statement, Chair Bill Cassidy (R-LA) began by acknowledging the world-renowned research and discoveries made by the National Institutes of Health (NIH) in the field of biomedical research including curing certain types of cancers and mapping the human genome. Cassidy then spoke on the benefits of the NIH’s Institutional Development Award program and other similar programs, which have allowed a more expansive group of states to receive research funding. Cassidy then shifted to criticizing NIH for occasionally funding risk-averse incremental science, as well as perpetuating a system that supports veteran scientists conducting proven research instead of encouraging younger scientists testing unproven ideas with enormous potential. Cassidy then spoke on the loss of trust between the American public and NIH during the COVID-19 pandemic and noted that Dr. Bhattacharya has made it clear he wants to support an environment of open debate within the NIH.

• Ranking Member Bernie Sanders (I-VT) first noted that NIH with its budget of $48 billion, is the largest funder of medical research in the world, and this research has led to many medical discoveries that have benefitted Americans greatly. Sanders then, however, shifted to discussing his various concerns with the American healthcare system. This included the fact that there are physician and nursing shortages, the inflated cost of healthcare even with the high levels of healthcare spending, and the high cost of prescription drugs. On this, Sanders explained that the government has not done enough to regulate the drug market and reduce costs. In fact, the same drugs in the U.S. cost several times more than they do in other countries, even though those drugs were developed using NIH research. Sanders then pivoted to criticizing the Trump administration and argued that it does not matter who is placed in charge of the agency, Elon Musk, and his team at DOGE (Department of Government Efficiency) will be the ones in charge of the agency. Sanders cited a few actions taken and planned at NIH including mass staff reductions and grant funding freezes. Sanders then ended by calling for Elon Musk to be brought before the committee.

• Dr. Jayanta Bhattacharya began by discussing the impact the NIH has had on himself and his career, and praised the NIH as an agency, as well as the scientists and staff for their work in biomedical research. Bhattacharya then pivoted and explained that there has been a negative shift with the agency and cited a 2023 Pew research study that showed only 26 percent of Americans have a high degree of trust in the nations scientists to keep them safe. 23 percent have not much or no confidence at all. Bhattacharya then listed off his five goals for the NIH. 1) NIH research should focus on solving the chronic disease crisis. Life expectancy has not returned to pre-pandemic levels and various chronic illnesses plague the American people across all ages. 2) NIH research should be replicable, reproduceable, and generalizable. Bhattacharya explained that the NIH has failed to follow these three basic principles. 3) Bhattacharya will establish a culture of respect for free speech and science and scientific dissent. 4) NIH must recommit to funding the most innovative biomedical research agenda possible to improve American health. 5) The NIH must regulate risky research that has the possibility of causing a pandemic and embracing transparency. Bhattacharya finished by reiterating his great belief in the NIH and promised to uphold President Trump’s agenda and Make America Healthy Again.

QUESTION AND ANSWER

• Chair Cassidy began his questioning by discussing the measles vaccine and false narratives that connect the vaccine to autism. Cassidy then asked Bhattacharya about rumors that he wants to invest in research that looks to see if there is a connection between the measles vaccine and autism. Bhattacharya responded that he supports children being vaccinated and does not think there is a link between vaccines and autism based on the literature. Bhattacharya then added that autism rates have skyrocketed and there is a general distrust of government health agencies, so he supports a broad agenda to explore the cause of autism. Cassidy responded that there has already been extensive research done on this topic and that there needs to be an appropriate use of research funding (especially when we have limited resources) and that implying there are any doubts increases vaccine hesitancy and reduces childhood vaccination rates. Bhattacharya responded that even though he is convinced there is no link between the vaccine and autism, there are people who disagree with him. Cassidy felt this was not adequate because there will always be people who disagree.

• Ranking Member Sanders first asked why the U.S. pays the highest prices for prescription drugs and what will he, Bhattacharya, do to address this. Bhattacharya responded that he does not have an answer as to why, but he said that, should he be confirmed, he would direct the agency to fund off-patent/off-label drugs to reduce drug costs. Sanders then asked if a company that benefits from taxpayer funded NIH research should be able to charge what they want, or if there should be limits to what they can charge. Bhattacharya responded that he is not sure that is something the NIH director can do. Sanders then argued that President Trump has shown that a lot can be done with executive orders. Sanders then asked why working-class people have a shorter life expectancy than the rich. Bhattacharya responded that he would commit to addressing the causes of chronic diseases that affect Americans. Sanders then asked what Bhattacharya thinks about the unhealthy food that is advertised. Bhattacharya responded that he would make sure the relevant health information is presented to families so they can make better decisions for themselves and their children. Sanders continued by asking if Bhattacharya would support a ban on tv advertising of unhealthy food targeted to kids. Bhattacharya said he would lead a movement to stop these ads but was unsure what that would actually look like.

• Senator Rand Paul (R-KY) first told Sen. Sanders that one way they can address unhealthy food is by banning the purchasing of unhealthy food with food stamps. Paul currently has a bill out to do just this, but no Democrats have signed on. Paul then gave his point of view that there does need to be more research on autism in order to reduce the amount of vaccine hesitancy, particularly within certain groups (i.e., the Amish). Paul then argued that to fund good science, there needs to be less funding for frivolous science. He then asked Bhattacharya, how do we populate grant committees to make sure major diseases remain a focus of all grant funding. Bhattacharya promised that he will make sure the grant committees stay focused. Paul then asked about using high dosed steroids as a treatment for COVID-19 and noted that while it has been found to be a great treatment, Dr. Anthony Fauci was insistent that steroids were not a valid option. Bhattacharya agreed that this was an unfortunate moment and was even more disappointed that the initial study on steroids and COVID-19 was from a UK study, not the NIH.

• Senator Patty Murray (D-WA) opened by saying that President Trump and Elon Musk are putting American health at risk with their staff firings and grant funding freezes. Murray then asked Bhattacharya if he agrees with these firings and funding freezes. Bhattacharya responded that he was not involved in those actions and that if confirmed, he will make sure his staff has what they need. He also added that he does not have a plan to cut staff and is unsure about the funding. Bhattacharya explained that he would need to assess the personnel and funding decisions once he is in charge. Murray then spoke on the Trump Administration’s plan to cap indirect costs rates to 15 percent. Murray then asked Bhattacharya about the indirect cost rate of Bhattacharya institution, Stanford University. At Stanford, the rate was 55 percent, with this in mind Murray asked Bhattacharya what he would say to his colleagues at Stanford and other institutions. Bhattacharya responded that with direct costs he knows where the money is going, but with indirect ones, which is additional funding on top of what is already needed. While that money may be going to worthwhile things, trust in institutions has gone done and to build trust, there needs to be more transparency. Murray then asked for confirmation that Bhattacharya will restart the advisory panels that have been paused. Bhattacharya confirmed he would restart them once he is confirmed.

• Senator Susan Collins (R-ME) started by explicitly stating she is opposed to the cap on indirect costs rates. Collins argued that there needs to be more individual analysis, and not an arbitrary cap. Additionally, this is an illegal action since there is appropriations language banning this cap. Collins then asked Bhattacharya if he were confirmed, would he reverse this cap on indirect costs. Bhattacharya responded that he would commit to following the law and addressing this issue directly. To him, this issue speaks to a lack of trust in the agency and institutions. On chronic disease, specifically Alzheimer’s, Collins asked Bhattacharya if he would support the National Alzheimer's Project Act (NAPA). Bhattacharya responded absolutely. Additionally, Bhattacharya said he wanted to expand the potential causes that are being researched in relation to Alzheimer’s.

• Senator Tammy Baldwin (D-WI) focused on actions taken by the Trump Administration and DOGE- specifically the funding freezes. This included funding freezes on Alzheimer’s research. Baldwin then directly asked Bhattacharya if he support’s President Trump suspending funding on cancer and Alzheimer’s research. Bhattacharya responded that he does not believe that is President Trump’s priority and, as he previously stated, he will follow the law and make sure his staff and scientists have what they need. Baldwin then again, asked directly if Bhattacharya agrees with these funding freezes. Bhattacharya once again responded that he would do his job. Baldwin then shifted to discussing early career researchers. Baldwin flagged that she, along with Senator Collins, supported legislation called the Next Generation Researcher’s Act, which helped increase funding for next generation researchers. However, recent DOGE actions have put these researchers at risk. Baldwin asked if Bhattacharya would support upcoming researchers. Bhattacharya responded that he would support those researchers and added that he does not have any insights into the personnel decisions currently happening.

• Senator Roger Marshall (R-KS) began by stating it’s important for there to be humility in the scientific processes, and Bhattacharya agreed with this. A full range of hypothesis must be supported. Marshall emphasized that he supports the pauses and believes there has been massive amounts of waste and incompetence. Marshall then asked Bhattacharya to address the chronic disease problem here in the U.S. and additional theories such as Food is Medicine. Bhattacharya first stated that the NIH should have done a much better job addressing the chronic disease problem and that the goal of the NIH should be to keep Americans safe and increase our life expectancy. On Food is Medicine, Bhattacharya explained that Food is Medicine, is something that would likely struggle to get research funding because the people at the top would not support it. Bhattacharya called for expanding the research being done and not limiting research to what those in top positions believe. Bhattacharya then committed to helping fund cures for top diseases. Marshall then shifted towards trust and the lack of trust between Americans and government health agencies due to Dr. Fauci and his actions during the COVID-19 pandemic. On indirect costs, Marshall called them grifts for university that force the government to pay an unfair amount of university overhead. Furthermore, Marshall expressed his concern that research funding is largely dedicated to the same four or five states. Bhattacharya said that he hears Marshall’s concern, and that great scientists are not only on the coast. Bhattacharya also promised to support the NIH IDeA program which helps provide funding for institutions that are often passed over. Marshall then added that indirect costs are the fault of the university, and it is up to them to solve. 

• Senator Maggie Hassan (D-NH) immediately asked Bhattacharya if he would follow a direct order from President Trump that would require him to break the law or if he would follow the law. Bhattacharya responded that the president would never ask him to break the law. Hassan was disappointed by this response. She then moved to discussing research funding freezes including one that made the status of a colon cancer clinical trial unclear. Hassan then asked Bhattacharya if he would commit to reversing the funding freezes. Bhattacharya responded, first, to the previous question, that he would commit to following the law. Second, Bhattacharya responded that he would commit to conducting necessary research. Hassan then went on to express her hope that Bhattacharya would follow the law and allow these grants to continue. Hassan then asked Bhattacharya if he would restart all academic review committees and get the money out the door. Bhattacharya responded yes. Hassan concluded by saying that autism rates have increased largely because we are better at identifying it, and there is already research into potential autism causes and the study connecting vaccines to autism is not based on fact. 

• Senator Tommy Tuberville (R-AL) opened by stating he agrees with President Trump’s efforts to reduce waste. He then asked Bhattacharya how he was going to put his team together. Bhattacharya responded that with his additional background in economics, he understands how to not to waste funding and he will make sure research is focused on addressed chronic disease. On transparency and trust, Tuberville asked Bhattacharya how he was going to make sure there was trust. Bhattacharya responded that he would work with congress to ensure transparency about any risky research, and that he would guarantee no research is done that could possibly cause a pandemic. He then committed to making sure to openly share what the NIH is working on (i.e., not redacting information shared through FOIA (Freedom of Information Act) requests. Tuberville then asked how Bhattacharya would make sure studies that prove ultimately harmful would be addressed. Bhattacharya responded that if a study had adverse results, it is important that those results are shared. Bhattacharya will focus research on diseases that affect Americans the most. 

• Senator John Hickenlooper (D-CO) began by asking how long it would take to create a new system of university research grants related to indirect costs. Bhattacharya responded that a new system is likely not required, but if confirmed, he, Bhattacharya, will focus on increasing transparency and building trust. Hickenlooper then asked if Bhattacharya if he would commit to supporting interdisciplinary research across the NIH. Bhattacharya committed to and emphasized that cross disciplinary research is critical to the scientific process. Hickenlooper than asked if the U.S. is being ripped off since it is the U.S. that produces majority of the medial discoveries that the globe then benefits from. Bhattacharya disagreed and said that NIH research is for the betterment of all people and that what makes the U.S. so great is that it is our country leading the world in these discoveries. Hickenlooper than asked if Bhattacharya thought NIH funding was too low. Bhattacharya answered that the problem is largely related to lack transparency, wrongly used funds and bad priorities. Hickenlooper then asked about childhood vaccine hesitancy and if this would affect the level of research the NIH does concerning vaccines and in general how Bhattacharya would balance chronic disease research versus virus research. Bhattacharya responded that the current levels of vaccine hesitancy is a symptom of what happened during the COVID-19 pandemic and that’s why it’s actually more important to do vaccine research and provide good data to convince people to make healthy choices. 

• Senator Ashley Moody (R-FL) asked Bhattacharya about his opinion on Florida’s handling of the COVID-19 pandemic and if he feels his own opinions and theories were suppressed or pushed aside for a different narrative regardless of the science. Bhattacharya found Florida’s response to the pandemic was tremendous. On censorship, Bhattacharya recalled being suppressed by the Biden administration. In his, Bhattacharya’s opinion, Florida did well because they allowed all opinions to be considered. Moody then asked Bhattacharya to speak to replication. Bhattacharya committed to this and emphasized that replication is key to good science. 

• Senator Andy Kim (D-NJ) asked about Bhattacharya’s opinions on decentralization. Bhattacharya agreed that decentralization was important including making sure the same schools and states are not the only ones receiving funding. Kim then pressed Bhattacharya on what does decentralization look like when talking about leadership. Kim asked Bhattacharya if his opinion on decentralization means Bhattacharya would oppose HHS (or the White House when he, Bhattacharya, disagrees with a grant and other funding decisions? Bhattacharya responded that there is a process for these grants to take place. Bhattacharya added that he does not believe President Trump or HHS Secretary Robert F. Kennedy Jr. (RFK) would ask him to do that. Kim then approached the question in a different way and asked Bhattacharya if he would support increases to chronic disease research funding at the expense of research on infectious diseases. Bhattacharya responded that Congress has a significant role in deciding how money is spent, and that both types of research can be done. Kim then asked Bhattacharya about an RFK quote where he said he wanted to pause work on infectious disease for eight years. Bhattacharya responded to this by explaining that in his conversations RFK, RFK has spoken to the importance of researching infectious diseases. Bhattacharya added that he has no knowledge of this RFK quote. Kim then asked Bhattacharya if he has any vaccines of which he is wary. Bhattacharya responded that he was concerned about the COVID-19 vaccine in 2021 for young men. Kim then asked Bhattacharya his opinions on Long COVID. Bhattacharya described it as a problem that affects millions of Americans and is worth funding research. Kim ended by asking Bhattacharya about his opinion of the Richardson Waiver (this waiver deals with public comment periods). Bhattacharya said he had not heard of it. 

• Senator Jim Banks (R-IN) asked what NIH’s proper role during a pandemic is and how did former NIH director Francis Collins overstep that role. Bhattacharya responded that the role is to provide the science and what the risks are. Role of science is to provide good data. Science is a force for freedom and knowledge. Banks then asked Bhattacharya what public health data tells us about the actions taken during lockdown. Bhattacharya responded that learning loss, missed medical screenings, economic dislocation etc., during the lockdowns did not save lives and instead had detrimental consequences for vulnerable groups. Banks then asked what Bhattacharya would have done differently. Bhattacharya responded that he would have done the lockdowns, but he would have promoted debate amongst his scientists. 

• Senator Lisa Blunt Rochester (D-DE) spoke on the recent actions taken by the Trump Administration and DOGE including mass firings, funding freezes, and the memos that state diverse clinical trials will no longer be a priority. Blunt Rochester asked Bhattacharya if he thinks the termination and executive order on aging research projects are harmful or helpful to improving our understand of Alzheimer’s. Bhattacharya first committed to making sure all the health needs of American’s are met no matter their identification. Bhattacharya added that clinical diversity is important, and he does not believe the Trump Administration is doing anything that says otherwise. Blunt Rochester then asked Bhattacharya how he will make sure these actions do not harm aging research. Bhattacharya reiterated that he was not involved in any of the policy decisions that have been made concerning the NIH so far and that should he be confirmed, he will make sure necessary programs are funded adequately. Blunt Rochester then asked for a commitment from Bhattacharya that researchers focused on increasing clinical trial diversity will not be penalized. Bhattacharya committed to supporting researchers focused on helping minorities. Blunt Rochester then asked if Bhattacharya would commit to not using what she described as “coded” language to target certain diversity programs at the NIH. Bhattacharya again committed to helping minority groups. 

• Senator Josh Hawley (R-MO) asked Bhattacharya if he would commit to banning the use of aborted fetal tissue in NIH funded research. Bhattacharya said he will follow the lead of RFK and President Trump. Bhattacharya also spoke to the need for ethical science so people are more willing to participate in public health such as vaccines. Hawley then asked Bhattacharya about his opinions on Big Pharma and not allowing researchers who have financial ties to Big Pharma. Bhattacharya explained that he supports transparency as well as researching off-patent products that can have huge benefits in treating chronic illnesses. Hawley then asked about the “Proximal Origin” paper- the paper that said SARS-CoV-2 was not a laboratory construct even though there was no evidence to this. Hawley then asked how Bhattacharya would move forward considering this. Bhattacharya called that paper a dark point in NIH’s history and accused leaders at the time of pushing an unsubstantiated narrative. 

• Senator Angela Alsobrooks (D-MD) immediately asked Bhattacharya if he believes it is ever appropriate to retaliate against scientists for their research or what they believe. Bhattacharya responded that he knows what it is like to be subject to takedowns like that, and he would never do that. Alsobrooks then asked about Bhattacharya’s opinions on diversity considering President Trump has spoken on his goal of removing mentions of race, gender, etc. Bhattacharya reiterated that, particularly for him, the health of minority groups is a priority, as is the health for all Americans. Bhattacharya also reiterated that he does not believe President Trump has said or done anything to the contrary. Alsobrooks then pushed on Bhattacharya to speak about his own projects that have received NIH funding and focused on improving minority health as well as diversifying the health researcher field. Bhattacharya responded that “diverse scientists,” refers to diverse ideas. 

• Senator Jon Husted (R-OH) first spoke about the most inflated costs within America- healthcare cost and what to address in healthcare. Husted then asked what Bhattacharya thinks about this and how he would address it. Bhattacharya responded that chronic disease is behind much of this cost and to address this, Bhattacharya believes, fundamentally, if all ideas are allowed to be supported, the needs of Americans can be helped. Husted then asked how the NIH can work with and utilize universities. Bhattacharya responded that transparency and reestablishing trust is  needed so that needed research can be done. 

• Senator Ed Markey (D-MA) began by citing stories from his constituents who are losing funding for their critical research and the potential for brain drain and research delays all due to the Trump Administration’s funding freezes. Markey then asked if Bhattacharya would oppose any decisions that would slow or stall life-saving research. Bhattacharya responded that he does not believe President Trump and Elon Musk have done that or would ask him to do that. Markey then asked Bhattacharya to commit to reinstating funding for scientists who lost funding due to their research not aligning with the MAGA ideology. Bhattacharya responded that he does not believe ideology should be a reason to lose funding and that, if committed, he will look into these reports. 

• Chair Cassidy asked a follow up on Bhattacharya’s validation push. Bhattacharya responded that validation work is central to good science. Cassidy then expanded and asked what the difference is between validation research and the unnecessary repeating of already confirmed research (incremental research). Bhattacharya answered that the difference is looking for the same results to confirm validity versus asking slightly different questions. 

• Chair Cassidy concluded by restating his original fear which is that consistently researching the connection between autism and vaccines will waste money that could go to finding a cause and cure for autism.