Trump nominates Bhattacharya as NIH director

In a statement last week, Trump said Bhattacharya "will work in cooperation with [HHS Secretary nominee] Robert F. Kennedy Jr. to direct the Nation's Medical Research, and to make important discoveries that will improve Health, and save lives."

Bhattacharya is a physician, former research fellow at the Hoover Institution, and an economist at the RAND Corporation who rose to prominence during the COVID-19 pandemic as a critic of the federal government's response to the pandemic.

Bhattacharya also gained notoriety as a co-author of an October 2020 open letter known as the Great Barrington Declaration that called for rolling back coronavirus-related shutdowns while keeping "focused protections" for vulnerable populations like elderly Americans.

The proposal gained support from some politicians but was rebuked by some public health experts, including then-NIH Director Francis Collins, as premature and dangerous since COVID-19 vaccines weren't available yet. Many public health groups and experts criticized the letter's focus on herd immunity, arguing the goal would be difficult to achieve and would lead to unnecessary illness and death.

Dan Brennan, an analyst for TD Cowen, said to "expect reform" of NIH under both Bhattacharya and Kennedy, adding that Bhattacharya is "a longstanding critic of NIH's internal structure and funding priorities."

Bhattacharya has said that he would restructure NIH so power was decentralized from "a small number of scientific bureaucrats," whom he believes have stifled creativity in research and censored his own contributions. In a post on X, Bhattacharya said he aims to "reform American scientific institutions so that they are worthy of trust again."

Some of Bhattacharya's proposed reforms include increasing the number of studies that repeat other studies to increase confidence in science, encouraging academic freedom among other NIH scientists, and implementing term limits for NIH leaders.

"Those kinds of reforms, I think every scientist would agree, every American would agree, it's how you turn the NIH from something that is sort of how to control society, into something that is aimed at the discovery of truth to improve the health of Americans," Bhattacharya said on Newsmax in November.

Some public health experts have criticized the pick, with Angela Rasmussen, a virologist at the University of Saskatchewan in Canada, saying she doesn't believe Bhattacharya "belongs anywhere near the NIH, much less in the director's office. That would be absolutely disastrous for the health and well-being of the American public and actually the world."

Rasmussen added that she's concerned "that if somebody like Jay Bhattacharya comes in to 'shake up' the NIH, they're going to dismantle the NIH and prevent it from actually doing its job rather than just carry out constructive reforms."

However, Ashish Jha, dean of the Brown University School of Public Health and former COVID-19 response coordinator for President Joe Biden, said that he believes Bhattacharya is "fundamentally a very smart, well-qualified person."

"Are there views of his that I can look at and say, 'I think he was wrong' or 'They were problematic?' Yeah, absolutely," Jha said. "But when you look at his 20 years of work, I think it is hard to call him fringe. I think he's been very much in the mainstream."

Trump nominates Jim O'Neill as HHS deputy secretary

Meanwhile, in a separate statement, Trump announced his nomination of O'Neill for HHS deputy secretary, saying O'Neill "will oversee all operations and improve Management, Transparency, and Accountability to, Make America Healthy Again."

The deputy secretary for HHS oversees the day-to-day operations of the department's sub-agencies, including those that run Medicare and Medicaid, lead public health emergency preparedness, shape federal research, and more, STAT reports. O'Neill would also oversee the development and clearance of any HHS regulations while working under Kennedy.

O'Neill first joined HHS in 2002 under President George W. Bush's administration. He held several roles at the agency, including as a top aide to the then-deputy HHS secretary. O'Neill also worked on pandemic preparedness, FDA reform, and public health while at HHS.

O'Neill then went to Silicon Valley and worked with investor Peter Thiel, who advised Trump during his first term. O'Neill served as acting CEO of the Thiel Foundation and as managing director of Thiel's investment firm Mithril Capital Management, which also employed vice president-elect JD Vance.

In various posts on X, O'Neill has aligned many of his views with those of Kennedy, including a post in November that criticized vaccine mandates and posts that echoed Kennedy's concerns about fluoride levels in drinking water and the food industry's influence on dietary guidelines.

In addition, in a 2014 speech, O'Neill called for pushing back on FDA's mission to consider the efficacy of drugs in its decision to approve them, arguing the agency should only consider drugs' safety.

"We should reform FDA so that it's approving drugs after their sponsors have demonstrated safety and let people start using them at their own risk, but not much risk of safety," he said. "But let's prove efficacy after they've been legalized." (Diamond, Washington Post, 11/27; Stolberg, New York Times, 11/26; Johnson, Associated Press, 11/27; Rosenbluth/Anthes, New York Times, 12/1; Stein, "Shots," NPR, 11/26; Langreth, Bloomberg/Modern Healthcare, 11/27; Whyte, Wall Street Journal, 11/26; Lawrence, STAT+ [subscription required], 11/26; Suter, The Hill, 11/26)

Join us for a discussion about the state of the healthcare industry heading into 2025. We will unpack what leaders should know about the biggest trends in the industry — from the shifts upending care utilization to the impact of the new administration on health policy. Then we will dig into what the future holds for health system strategy in a world of constant disruption, rising costs, and evolving patient demand. Finally, we'll explore the cross industry power dynamics shaping provider networks, pharmacy competition, and harnessing shared healthcare data.