In October 2020, just before the United States would begin rolling out Covid-19 vaccines, a significant document emerged known as the Great Barrington Declaration. Authored by Dr. Jay Bhattacharya, a health policy professor at Stanford University, along with two of his colleagues, the declaration advocated for a controversial approach to handling the pandemic: focusing efforts on protecting vulnerable populations while allowing those at lower risk to return to their pre-pandemic lives. The underlying goal was to achieve herd immunity through natural infection. This bold stance ignited an immediate backlash from the scientific community and public health officials, including the director-general of the World Health Organization, who labeled the proposal as “unethical.” Bhattacharya later described how the immediate outcome of this situation involved him and his declaration being subjected to suppression and censorship by authoritative scientific organizations.
Fast forward to recent developments, Dr. Bhattacharya himself has since risen to a leadership position as the head of the US National Institutes of Health (NIH). In this capacity, he is now confronted with dissent from his own staff. The employees at the NIH, advocating for their concerns regarding the politicization of scientific research and the stifling of scientific innovation under the Trump administration, issued a letter of dissent titled the Bethesda Declaration, named after the NIH’s headquarters in Bethesda, Maryland. In a poignant move, the letter mirrored the earlier Great Barrington Declaration and garnered signatures from over 300 NIH employees, including around 100 who chose to reveal their identities despite fears of potential retaliation.
This dissent coincided with Dr. Bhattacharya’s impending congressional testimony regarding budget allocations, coming just one day before. Signs of unrest have been palpable within the NIH in recent months, culminating in a walkout staged by employees during one of Bhattacharya’s town hall meetings, protesting against unsatisfactory working conditions and barriers to open dialogue with leadership. Dr. Jenna Norton, a program officer at the National Institute of Diabetes and Digestive and Kidney Diseases and one of the lead organizers behind the Bethesda Declaration, underscored the urgency of their stance, expressing that the silence of those in the research community could perpetuate harm to public health and research participants alike.
Among the requests articulated in the Bethesda Declaration were calls for reinstating research grants that had been delayed or terminated due to political motivations. The NIH employees also brought attention to the specific areas of focus that warranted swift action, such as COVID-19 research, health disparities, and the health impacts arising from climate change. Further, the letter referenced alarming statistics indicating that roughly 2,100 NIH grants—totaling an estimated $9.5 billion—had been terminated since the previous administration began. Unfortunately, the NIH budget, once around $48 billion annually, faced drastic proposed cuts nearing 40%.
Numerous staff highlighted that the premature termination of research projects results in a colossal waste of resources, suggesting that discontinuing a nearly completed study eliminates more value than simply cutting costs. Moreover, employees demanded Bhattacharya reconsider a new policy imposing a flat, lower 15% indirect cost rate for funding university research. Indirect costs are crucial for covering shared lab space and essential infrastructures, such as facilities and research instruments.
Support for the Bethesda Declaration also swelled externally, with a subsequent letter embodying additional advocacy from scientists, including over a dozen Nobel laureates. Their plea echoed the NIH staff’s concerns, urging NIH and the Department of Health and Human Services to refocus on scientific integrity rather than political agendas that strayed from the primary mission.
Furthermore, the letter underscored the need for a research grant process where scientifically trained NIH professionals, not external anonymous individuals, are the decision-makers, thus reinstating trust in the scientific evaluation process. It also criticized sweeping claims put forth by health policymakers who romanticize past healthcare records while ignoring significant advancements made over the decades through biomedical research.
Despite acknowledging persisting health challenges like obesity and opioid dependency, those behind the Bethesda Declaration emphasized that romanticizing an idealized past does not align with the efforts that have led to substantial health improvements. They echoed sentiments that support from the NIH helped establish the United States as a beacon of biomedical research and training—a reputation that has birthed landmark advancements in public health.
As Dr. Jeremy Berg, a co-organizer of the letter of support and a former director within the NIH, articulated clearly, health concerns transcend political lines and are fundamentally universal human concerns. Health equity and breakthroughs in science serve as essential pillars in advancing human welfare. In light of these developments, the relationships between science, government, and healthcare remain pivotal subjects of discussion, particularly as researchers strive to navigate the complexities of political influence in the realm of health and scientific inquiry.