Neither man has previously served in government, but that was also true of Rochelle Walensky, whom President Joe Biden appointed to direct the Centers for Disease Control and Prevention. In their confirmation hearings, both took pains to pay homage to the institutions they would oversee. Bhattacharya repeatedly referred to NIH as the “crown jewel of American biomedical science” and reiterated his “utmost respect” for its scientists. Makary spoke about ensuring “the FDA holds to the gold standard of trusted science” and affirmed he is a “big believer in the professional career staff” there.
They are both considered nontraditional nominees because they gained fame for having views on covid-19 that ran counter to the medical establishment. Bhattacharya was co-author of the Great Barrington Declaration, which argued — in October 2020 — that population-wide measures against the coronavirus should stop in favor of “focused protection” of the vulnerable. Makary was also an early proponent of achieving herd immunity through infection, arguing in a Wall Street Journal commentary in February 2021 that covid would be “mostly gone” by that April.
At the time, I, like most public health experts, strongly disagreed. History shows that we were right, since allowing mass infection before the widespread availability of vaccines and treatments would have caused far more deaths than what the country experienced with precautions in place. But Bhattacharya and Makary were right to emphasize infection-induced immunity, which many scientists wrongly dismissed. And they were right that a narrow focus on virus control failed to account for collateral damage that mitigation policies had on other aspects of society, including education and the economy.
Then and now, I think that Bhattacharya and Makary were unfairly labeled “covid deniers” and unjustly ostracized in medical circles. During their confirmation hearings, both spoke about open discourse, dissent and debate as cornerstones of their tenures at NIH and the FDA. That’s a good thing. Scientific progress hinges on challenging conventional thinking, and I appreciated hearing their ideas for how things can be done differently.
For example, Bhattacharya wants NIH to study uses of cheap generic medications and other projects that industry would not fund, and to require NIH-funded research to publish negative results (when findings don’t support the hypothesis). Makary wants to use artificial intelligence to reduce bottlenecks in the drug approval process and to more quickly identify safety problems post-approval. He aims to study the impact of food on health and to pilot a program for schools to transition to healthier meals.
I hope these two leaders will also work behind the scenes to reduce the damage of the administration’s unwise proposals. Chief among them is the 15 percent cap on indirect cost rates for NIH grants, which would upend the ability of universities to train future scientists and severely limit research on cancer, Alzheimer’s and virtually every other disease. I am also distressed that indiscriminate firings across the federal government have left food inspectors and drug regulators less capable of safeguarding Americans’ health.
The nominees have promised senators that they will tend to these urgent issues as soon as they are in office. That’s a good reason not to hold up their confirmation. Another is that they are probably as competent and reasonable as we will find in any Trump appointee.
Senators from both sides of the aisle should approve them without delay. And members of the scientific and medical community, including those who once disparaged them as covid contrarians, should extend an olive branch. After all, Bhattacharya and Makary represent the country’s best chance to preserve its vaunted biomedical infrastructure.
