In October 2020, two months before Covid-19 vaccines would become available in the US, Stanford health policy professor Dr. Jay Bhattacharya and two colleagues published an open letter calling for a contrarian approach to managing the risks of the pandemic: protecting the most vulnerable while allowing others largely to resume normal life, aiming to obtain herd immunity through infection with the virus.
They called it the Great Barrington Declaration, for the Massachusetts town where they signed it. Backlash to it was swift, with the director-general of the World Health Organization calling the idea of allowing a dangerous new virus to sweep through unprotected populations “unethical.” Bhattacharya later testified before Congress that it – and he – immediately became targets of suppression and censorship by those leading scientific agencies.
Now, Bhattacharya is the one in charge, and staffers at the agency he leads, the US National Institutes of Health, published their own letter of dissent, taking issue with what they see as the politicization of research and destruction of scientific progress under the Trump administration. They called it the Bethesda Declaration, for the location of the NIH.
“We hope you will welcome this dissent, which we modeled after your Great Barrington Declaration,” the staffers wrote. The letter was signed by more than 300 employees across the biomedical research agency, according to the non-profit organization Stand Up for Science, which also posted it; while many employees signed anonymously because of fears of retaliation, nearly 100 – from graduate students to division chiefs – signed by name.
It comes the day before Bhattacharya is due to testify before Congress once more, in a budget hearing to be held Tuesday by the Senate appropriations committee. It’s just the latest sign of strife from inside the NIH, where some staff last month staged a walkout of a townhall with Bhattacharya to protest working conditions and an inability to discuss them with the director.
“If we don’t speak up, we allow continued harm to research participants and public health in America and across the globe,” said Dr. Jenna Norton, a program officer at the National Institute of Diabetes and Digestive and Kidney Diseases and a lead organizer of the Declaration, in a news release from Stand Up for Science. She emphasized she was speaking in a personal capacity, not on behalf of the NIH.
The letter, which the staffers said they also sent to US Department of Health and Human Services Secretary Robert F. Kennedy Jr. and members of Congress who oversee the NIH, urged Bhattacharya to “restore grants delayed or terminated for political reasons so that life-saving science can continue,” citing work in areas including health disparities, Covid-19, health impacts of climate change and others.
They cited findings by two scientists that said about 2,100 NIH grants for about $9.5 billion have been terminated since the second Trump administration began. The NIH budget had been about $48 billion annually, and the Trump administration has proposed cutting it next year by about 40%.
The research terminations “throw away years of hard work and millions of dollars,” the NIH staffers wrote. “Ending a $5 million research study when it is 80% complete does not save $1 million, it wastes $4 million.”
They also urged Bhattacharya to reverse a policy that aims to implement a new, and lower, flat 15% rate for paying for indirect costs of research at universities, which supports shared lab space, buildings, instruments and other infrastructure, as well as the firing of essential NIH staff and what they called disruptions to collaboration with foreign partners.
“The Bethesda Declaration has some fundamental misconceptions about the policy directions the NIH has taken in recent months, including the continuing support of the NIH for international collaboration,” Bhattacharya said in a statement Monday. “Nevertheless, respectful dissent in science is productive. We all want the NIH to succeed.”
An HHS spokesperson added that the agency is “actively working to remove ideological influence from the scientific process,” and “when projects have failed to meet these standards, they have been discontinued so we can redirect resources to rigorous, impactful science.”
The spokesperson said “there has been no halt to legitimate international collaborations,” questioned why some universities receive more than 15% for indirect costs from the NIH when funders like the Gates Foundation cap rates there, and noted HHS is reviewing cases of staff terminations and reinstating some. “Still, as NIH priorities evolve, so must our staffing model to ensure alignment with our central mission and being good stewards of taxpayer dollars,” the spokesperson added.
Those who wrote the Bethesda Declaration were joined Monday by outside supporters, in a second letter posted by Stand Up for Science and signed by members of the public, including more than a dozen Nobel Prize-winning scientists.
“We urge NIH and Department of Health and Human Services (HHS) leadership to work with NIH staff to return the NIH to its mission and to abandon the strategy of using NIH as a tool for achieving political goals unrelated to that mission,” they wrote.
The letter called for the grant-making process to be conducted by scientifically trained NIH staff, guided by rigorous peer review, not by “anonymous individuals outside of NIH.”
It also challenged assertions put forward by Kennedy, who often compares today’s health outcomes with those around the time his uncle John F. Kennedy was president, in the early 1960s.
“Since 1960, the death rate due to heart disease has been cut in half, going from 560 deaths per 100,000 people to approximately 230 deaths per 100,000 today,” they wrote. “From 1960 to the present day, the five-year survival rate for childhood leukemia has increased nearly 10-fold, to over 90% for some forms. In 1960, the rate of measles infection was approximately 250 cases per 100,000 people compared with a near zero rate now (at least until recently).”
They acknowledged there’s still much work to do, including addressing obesity, diabetes and opioid dependency, “but,” they wrote, “glamorizing a mythical past while ignoring important progress made through biomedical research does not enhance the health of the American people.”
Support from the NIH, they argued, made the US “the internationally recognized hub for biomedical research and training,” leading to major advances in improving human health.
“I’ve never heard anybody say, ‘I’m just so frustrated that the government is spending so much money on cancer research, or trying to address Alzheimer’s,’ ” said Dr. Jeremy Berg, who organized the letter of outside support and previously served as director of the National Institute of General Medical Sciences at the NIH.
“Health concerns are a universal human concern,” Berg told CNN. “The NIH system is not perfect by any stretch of the imagination, but has been unbelievably productive in terms of generating progress on specific diseases.”
The Bethesda Declaration garnered attention from lawmakers, with Democrats on the House Energy and Commerce health subcommittee writing a letter to Republican chair Rep. Brett Guthrie (R-KY) to request their own hearing with Bhattacharya. And NIH employees behind the letter said they hoped it would be a subject of Tuesday’s budget hearing.
“Biomedical research and global public health are facing an extinction-level event right now,” said Dr. Ian Morgan, a postdoctoral fellow at the NIH, who helped organize the letter and emphasized to CNN he was speaking on his own behalf.
Morgan noted his own research focuses on antimicrobial resistance, something that “would probably be unobjectionable to the current administration.”
“I could put my head down and try to hide away from this,” Morgan said. But “where would that leave me, with a world around me that’s been decimated?”
