Monica Bertagnolli to step down as NIH director
Read the full article in Politico.
National Institutes of Health Director Monica Bertagnolli plans to resign after just a year heading up the $47 billion biomedical research agency, Bertagnolli announced Tuesday.
The cancer surgeon briefly led the National Cancer Institute before taking the helm at NIH — making her the second woman to hold the agency’s top job. Bernadine Healy, from 1991 to 1993, was the first.
Contemporaries praised Bertagnolli for her commitment to advancing science and for her focus on improving patients’ lives. But her 14-month tenure shows how Republican anger over the agency’s handling of the pandemic before her arrival has thrust the NIH into the partisan maelstrom. Once championed by Democrats and Republicans alike, now many GOP lawmakers want to overhaul or downsize it. Members of the “Make America Healthy Again” movement led by Robert F. Kennedy Jr., President-elect Donald Trump’s pick to lead NIH’s parent agency, the Department of Health and Human Services, want to dismantle it.
“Unfortunately, it has become a political football, because of what happened during the pandemic,” said Dr. Elias Zerhouni, former NIH director under President George W. Bush, who sees the change as regrettable.
“I am so proud of what NIH has been able to achieve in such a short time under my leadership,” Bertagnolli said in a statement, citing her work on a primary care clinical research network pilot program and the Biden administration’s initiative on women’s health research as among her achievements.
“While I leave NIH unable to see these initiatives and more through to fruition, I am optimistic that they will continue under new leadership,” she added.
As director, Bertagnolli eschewed politics, focusing on day-to-day agency issues: diversifying and expanding clinical trials, collaboration, data sharing and navigating a tight budget.
In the aftermath of Trump’s victory, Bertagnolli reminded her staff that the NIH, the world’s leading funder of health research, has historically risen above the political fray.
“I want to acknowledge that change can leave us feeling uncertain,” she wrote in an email shared with POLITICO. “I do not want to dismiss those feelings, but I do want to remind everyone that throughout our 137-year history, the NIH mission has remained steadfast, and our staff committed to the important work of biomedical research in the service of public health.”
But from the get-go, the role Bertagnolli inherited from her predecessor, Francis Collins, was more contentious and political than the one Collins stepped into in 2009. Bertagnolli endured a rocky road to confirmation. Sen. Bernie Sanders held it up for five months because the Vermont independent wanted the Biden White House to commit to a plan to lower drug prices. It didn’t, but Sanders, the chair of the committee in charge of the nomination, ultimately called a vote after the administration announced a deal with one drugmaker to limit the price of a Covid therapy the company was developing with government backing. Democrats and five Republicans on the panel advanced Bertagnolli over his objections. Fourteen years earlier, Collins had sailed to confirmation by unanimous consent and was in his job just four weeks after President Barack Obama tapped him.
Ellen Sigal, founder of the advocacy group Friends of Cancer Research, praised Bertagnolli’s work, emphasizing that she led with compassion and showed deep commitment to advancing science and improving patients’ lives during her brief tenure.
Mary Woolley, president of Research!America, which represents universities, pharmaceutical companies, disease advocacy groups and others reliant on NIH funding, described Bertagnolli as “fiercely devoted to making sure that NIH is serving everyone and that everyone’s heard.” Building trust and confidence in the NIH is paramount, Woolley said, but neither is possible by force. “That doesn’t work. It’s inappropriate. You have to earn it every step of the way.”
Zerhouni, who directed NIH for seven years, pointed to Bertagnolli’s commitment to biomedical AI and re-energizing the National Library of Medicine.
“She has very clear ideas about how to get research closer to people in rural areas, in underserved areas. That’s something that resonates with a lot of people and she’s passionate about that,” he said, adding that he thought her short tenure was unfortunate. “It’s just too short to accomplish much.”
Still, many Republicans in Congress continue to resent Collins and Anthony Fauci, who was one of his top deputies before retiring in 2022, because the lawmakers believe the two scientists downplayed the possibility that Covid-19 emerged from a lab in China to protect the agency.
Sen. Rand Paul (R-Ky.), who sparred with Fauci in heated exchanges during pandemic hearings, now chairs the Homeland Security and Governmental Affairs Committee and plans to investigate Covid’s origins, an effort he believes will be more successful under Trump’s NIH than Biden’s.
Trump’s pick to replace Bertagnolli is Jay Bhattacharya, a Stanford University physician and economist known for his controversial views during the pandemic. If confirmed by the Senate, Bhattacharya, who has accused Collins and Fauci of suppressing scientific debate and research during the pandemic, is advocating for a major shakeup of the agency.
Dissatisfaction with the NIH’s performance has fueled plans from Bill Cassidy (R-La.), who now leads the Senate committee overseeing health policy, as well as House Republicans to overhaul the agency . Their proposals include balancing the NIH’s portfolio of early- and late-stage research, streamlining the grant review process, instituting term limits on NIH leaders and consolidating the agency from 27 institutes and centers to 15.
Alabama’s Robert Aderholt, a Republican appropriator who oversees the agency’s funding and is shepherding an overhaul proposal in the House, said he was disappointed during a hearing on the NIH’s budget last fall.
“Instead of a bold discussion on how to move NIH into the future, we have gotten staunch adherence to the status quo. Covid has shown that the status quo is unacceptable,” Aderholt told Bertagnolli. “For many in the American public, trust in the institution is gone, and once lost, it will take great effort to restore. I would encourage you to put as a top priority rebuilding the confidence in the NIH as a leader in unbiased, nonpartisan objective basic science.”
Aderholt said major change is needed. “The NIH we have today does not reflect the best structure to achieve its mission, or the best structure for science. We should not shy away from this reality.”
Republicans, who doubled NIH funding when Newt Gingrich was speaker in the 1990s, have lately sought to cut the budget. They held it flat in fiscal 2024.
Bertagnolli pushed back on the idea of consolidating institutes and centers during a recent meeting with outside advisers.
“If we were to collapse, we would definitely lose something in terms of our engagement with the public,” she said.
Woolley sees the House consolidation proposal differently. “Sometimes you have to put a straw man up in order to get folks to be specific in their responses,” she said. “Kick the tires on that.”
Zerhouni is looking on the bright side. A Republican Congress passed the 2006 NIH Reform Act while he was director, and it “really calmed down the waters,” he said. “We put the right reforms in place, then the agency regained its support from both sides.”
“I’m suspecting that again, there will be a long discussion that will ameliorate relationships, not make them worse.”
Still, Kennedy, an anti-vaccine activist and environmental lawyer whom Trump wants to lead the Department of Health and Human Services, wants to go even farther, proposing to fire hundreds of NIH staffers and shift its focus away from infectious diseases toward the underlying causes of chronic illness.
Given those workers’ civil service protections, that will be hard to do without Congress passing a law. Only two positions at the agency — the director and the head of the cancer institute — are appointed by the president.