The Department of Health and Human Services is one of the larger federal departments in Washington D.C., and generates the most interest among consumers, scientists, and the medical community. It is also the department that directly and indirectly impacts this profession.
President Trump has already shown his inclination to “break China” [plates, not the country] with his recent appointments, particularly with newly confirmed Robert Kennedy, Jr. as secretary of Health and Human Services. [Read Dr. Sherry McAllister’s article in the April 2025 issue of Dynamic Chiropractic.] The profession supported Kennedy in his run for president and had a member of the profession on his campaign staff. The president continued to make waves by nominating other agency directors, all of whom questioned some COVID policies and other medical mainstream ideas.
One of the more critical presidential appointments at HHS is the new National Institutes of Health (NIH) Director, Jay Bhattacharya, MD, PhD, from Stanford University. While not specifically a chiropractic supporter, his thinking on many issues appears to be in line with ours – something which hasn’t occurred in this position before.
The NIH is comprised of 21 institutes and six centers, and is the focal point of funding for research on known and unknown diseases. (As an aside, the National Center for Complementary and Integrative Health Care [NCCIHC] is the agency that considers chiropractic research, along with that of other alternative health care professions.)
The new NIH director has had a reputation for being low-key and nonpolitical, but showed some aggressiveness when he wrote a series of papers in 2018 that created controversy in the mainstream health care community.
In one of the papers, he asked, “Does NIH fund edge science?” He answered, “Yes, but much less than in the past.” He found that the NIH increasingly funds research that seeks to build on more established ideas, rather than those pursuing novel ones. He concluded that incentives encouraged “me to research.”
Scientists respond to incentives as much as anyone, and they have strong incentives to follow public health leaders if they want to advance professionally and win government grants. Many young researchers, in particular those without secure positions, would be less likely to buck long-established scientific leaders, including Dr. Anthony Fauci, who served as director of the National Institute of Allergy and Infectious Diseases (NIAID) from 1984 to 2021; and former NIH Director Dr. Francis Collins, who was appointed by Obama in 2009 and continued in the position until 2021.
But comments Dr. Bhattacharya made in 2022 really got under the skin of the scientific elite. In October 2022, he co-authored “The Great Barrington Declaration” with Dr. Martin Kulldorf, professor of Medicine at Harvard University, and Dr. Sunetra Gupta, Professor at Oxford University. Forty-two other prominent medical and public health scientists and medical practitioners from other parts of the world signed off on the paper.
The Great Barrington Declaration stated in the first paragraph: “As infectious disease epidemiologists and public health scientists, we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommended an approach we call Focused Protection.” Instead of everyone getting vaccines, the recommendation was that they should only be given to the elderly and other targeted populations. Protecting those with the highest risk of death while allowing those who are at minimal risk of death to live their lives better protects those who are at the highest risk.
The declaration was distributed during the middle of the pandemic. It created quite a stir. No surprisingly, most establishment scientists, such as Dr. Fauci, Dr. Collins, and the World Health Organization, were critical of the declaration. (I understand it was shared with the new members of the Trump health team and received favorably.)
The scientific community will probably receive the new director with apprehension. He is responsible for setting policy and planning, as well as managing and coordinating the programs and activities of the various institutes. He will probably play a role in what occurs at each NIH institute. I suspect that he will use his authority to the fullest, particularly in what happens at the advisory councils.
The directors of each of the NIH institutes that Dr. Bhattacharya oversees have a two-tier approval process to review scientific grants, and this process can significantly influence the approval and distribution of funds. The first tier is the Study Committee, which comprises scientists who judge the relevancy of the grant and are appointed by institute directors. It is difficult for a grant request to be approved if it does not get a score of 75%.
If approved, it goes to the next level (advisory council), which is composed of scientists, the medical community, and consumers recommended by the institute director and approved by the secretary.
Few questioned the process and the role of the scientific community, although many health care grant requests were unsuccessful because they failed to get the required score from the Study Committee.
I can attest to what the scientific community can do when it feels threatened. In 1982, I was appointed by HHS Secretary Richard Schweiker as director of the HHS Secretary’s Advisory Committee office. A backwater committee got the recommended appointments from the NIH institutes and forwarded them to the secretary without comment, except to ensure that the committee had complied with provisions in the Federal Advisory Committee Act.
Schweiker, who had been a U.S. Senator and chairman of the health committee, wanted to have more impact and directed me to get alternative qualified candidates from health groups outside of government. Suddenly, we were changing some of the institutes’ recommended appointments even though we ran the changes by them.
We got their attention when I sent a memo to the secretary suggesting that appointees to committees like those outside of HHS must pay their own cost of travel attending meetings; and that the secretary renew the FDA advisory committees like other advisory committees.
The Food and Drug Administration (FDA) commissioner sent a multiple-page confidential email to the secretary, criticizing my office and the recommendations. Surprise, surprise: It was leaked to The Washington Post, which printed a front-page story critical of my office and me. For a few days, it wasn’t fun, but I was OK.
We did make some modifications to the appointment process, but I continued making changes. Months later, in early 1983, I went back to California. Schweiker announced his resignation three weeks later (clearly no connection). The influence of the office dropped significantly with the new secretary, and things went back to normal before my changes.
I suspect that Dr. Bhattacharya will want to play a more significant role in what happens with his institutes, notably since he has already suggested that the latest number of institutes / centers should be reduced from 21 to 15.
With the new HHS secretary, Dr. Bhattacharya and the other anticipated appointments, the environment for the profession has never been better. Sure, they have input from the NCCIHC; but they share this with other alternative health care providers. Pursuing consumer appointments on the councils in institutes such as the National Institute of Arthritis and Musculoskeletal and Skin Diseases, along with the National Institute of Neurological Disorders and Stroke Committee, among other things, broadens their experience and opportunities, and should be pursued.
But you know that the scientific elite will not be silent. It certainly will not be boring.
Notes
- The Great Barrington Declaration was written over two days and released on Oct. 4, 2020, at the American Institute for Economic Research in Barrington, Mass. It quickly secured over 30 co-signers, all of whom were prominent scientists. Left on a website, it has collected over 700,000 (unverified) signatures.
- Allysia L. “Jay Bhattacharya and the Vindication of the Fringe Scientists.” The Wall Street Journal, Dec. 1, 2024.
