Improving Science & Restoring Trust in Public Health | Dr. Jay Bhattacharya

KEYPOINTS

• 01

  Bhattacharya frames the NIH's mission around results for real people

  Bhattacharya, the NIH director and a Stanford health economist, describes the stated mission as supporting research that advances the health and longevity of the American people. NIH work underlies almost every drug Americans take. But he says US life expectancy was almost flat from 2012 to 2019 while Europe's rose, and it only recently returned to 2019 levels, so the investment isn't translating into longer lives.

• 02

  We have a 'sick care' system rather than a health system

  The hoped-for 'compression of morbidity', where people live long and are seriously ill only briefly at the end, hasn't happened. Advances instead let people stay sick longer with dementia, diabetes complications, kidney failure and heart disease. Bhattacharya says basic science matters but must eventually translate into better health, and he links this to the Make America Healthy Again push to meet the country's chronic-disease needs.

• 03

  Indirect costs concentrate funding in a few universities

  On top of each grant, universities receive overhead: about 55% at Stanford, so a $1 million grant costs taxpayers roughly $1.55 million. Some institutions charge up to about 75%, while the Gates Foundation pays around 15%. Infrastructure attracts grant-winners and grant-winners fund infrastructure, a ratchet that favors coastal elite schools. He also questions why a computer-based epidemiology lab gets the same rate as a wet lab. He wouldn't comment on the litigation that blocked a proposed 15% cap.

• 04

  Taxpayers fund research, then pay again for the results

  Huberman notes the public pays for research yet had to buy journal articles (around $34 each). Under a policy begun by former director Monica Bertagnolli and moved up under Bhattacharya, NIH-funded papers must be free to read immediately on publication.

• 05

  Americans pay 2–10 times more for the same drugs

  Often the same drugs come from the same factories as Europe's. Bhattacharya argues US taxpayers fund most basic research through the NIH and, through higher prices, the expensive late-stage trials, making them 'the piggy bank for the world'. He says a recent executive order aims to equalize prices through trade negotiations, tariff linkage and drug reimportation, so other wealthy countries share research costs.

• 06

  Young scientists get funding too late, which slows innovation

  The typical age for a first major R01 grant rose from the mid-30s in the 1980s to the mid-40s. His research found that scientists use the newest ideas just after their PhD, and the ideas they work on age by roughly a year with each year of their career. Huberman describes the 'shell game' of proposing work that's already done. Bhattacharya calls funding early-career labs a major priority.

• 07

  Bhattacharya wants replication rewarded, not buried

  He cites John Ioannidis's 2005 paper 'Why Most Published Research Findings Are False': peer review doesn't rerun experiments, statistical significance allows false positives, and negative results go unrewarded. Drug companies replicate findings privately. He plans large NIH grants for replication and meta-analysis and an NIH journal for replication results, like a Cochrane-style 'community notes' for the scientific literature.

• 08

  Bhattacharya says COVID lockdowns and school closures were known mistakes at the time

  Sweden kept schools open for under-16s and, comparing with Finland in summer 2020, found no difference in COVID outcomes, with teachers no worse off. He says Sweden ended up with Europe's lowest all-cause excess deaths, while heavily locked-down Peru fared badly, so lockdowns were neither necessary nor sufficient and they harmed poor and working-class people and children. Many American children fell two or more years behind in school.

• 09

  Bhattacharya says cloth-mask messaging wasn't based on evidence

  A Cochrane review of about a dozen pre-pandemic flu trials found weak evidence for community masking, and no randomized trial studied children. Yet the US recommended masks from age two, while much of Europe started around age 12. He argues false reassurance may have led vulnerable older people to take risks, and that messaging like 'mask on to walk in, off to eat' eroded trust.

• 10

  Bhattacharya says most vaccines save lives but the COVID vaccine wasn't net beneficial for everyone

  He says many vaccines, including childhood ones, save lives. But he believes the COVID vaccine was likely net harmful for some groups, especially healthy boys and young men (very roughly 12–30), while declining to set a firm cutoff. The pivotal mRNA trials followed people for only about two months, measured symptomatic infection rather than death or transmission, and underrepresented older people. He considers long COVID and vaccine injuries both real.