BETHESDA DECLARATION SUPPORT LETTER

The mission of the National Institutes of Health (NIH) is to “seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.”

In public comments, NIH Director, Dr. Jayanta Bhattacharya, has recognized the critical nature of this mission and has described the NIH as the “crown jewel of American biomedical science”.

Unfortunately, many of the actions of the current administration are inconsistent with this mission and statement. These actions undermine the unique and productive partnership between the federal government and universities, academic medical centers, and research institutes that has served the American people well over many decades. They are damaging the hard-earned trust between the NIH, academia, and the public that is essential for long-term progress.

We commend the NIH staff who have come forward with the “Bethesda Declaration” to share concerns in the spirit of academic freedom, for the good of all. We stand with these committed professionals in support of reversing the harmful actions of this administration. 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.

As has been done historically, decisions and monitoring of applications and grants should be conducted by scientifically trained NIH staff through well-established processes including rigorous peer review. Such decisions must not be made by anonymous individuals outside of NIH.

Like any large organization, NIH would benefit periodic review and strategic reforms. However, any reforms should be developed in partnership with NIH staff and other stakeholders through careful and thoughtful analysis. They should not occur through arbitrary changes with no clear purpose or benefits, and without careful consideration of potential risks and adverse consequences—especially to the research participants who have entrusted NIH and its partners with their health.

The current endeavor to Make America Healthy Again (MAHA) refers to some undefined time in the past. 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. 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). These are but a few of many examples. Certainly, much work remains to better treat disease and improve the health of Americans, such as addressing increased rates of obesity, diabetes, and opioid dependency. But, glamorizing a mythical past, while ignoring important progress made through biomedical research, does not enhance the health of American people.

Before the mid-1960s, many of the advances that were ushering in a new era in biology were coming from Europe. However, with support from the NIH, the contributions of American scientists grew over the next decades and America became the internationally recognized hub for biomedical research and training. This, combined with the American entrepreneurial spirit, led to the creation of the biotechnology industry. America was an important partner in the successful international project to sequence the human genome in its entirety and to characterize many variations that contribute to health and disease susceptibility. These advances, and associated technologies, have provided profound insights into the mechanisms of many diseases, both common and rare, that are yielding opportunities for real progress to advance human health, some of which have been realized.

Now is the time to push forward the NIH mission and all that has been built to support it, not to disable it. We urge NIH and HHS leadership to work in partnership with the NIH staff members who have spoken out to refocus on this goal using time-tested processes to award and sustain support for the range of activities that drives the NIH mission, now and into the future.