In October 2020, Francis Collins, then the director of the National Institutes of Health, sent an email that maligned a colleague. A few days before, Jay Bhattacharya, a professor of health policy at Stanford University, had, with two others, put out a statement—the Great Barrington Declaration—calling for looser public-health restrictions in the face of the pandemic. In place of lockdowns, the statement contended, the nation could simply let infections spread among most of the population while the old and infirm remained in relative isolation. Collins, like many other scientists, thought this was a dangerous idea. Bhattacharya and his co-authors were “fringe epidemiologists” whose proposal needed a “quick and devastating” rebuttal, Collins wrote in an email that later came to light through a public-records request. Collins doubled down on this dismissal in a media interview a week later: “This is a fringe component of epidemiology,” he told The Washington Post. “This is not mainstream sncience.”
So where are these two now? Collins abruptly ended his 32-year career at NIH last week, while Bhattacharya is Donald Trump’s pick to take over the agency. The turnabout has created a pleasing narrative for those aggrieved at scientific governance. “It’s remarkable to see that you’re nominated to be the head of the very institution whose leaders persecuted you because of what you believed,” Jim Banks, a Republican senator from Indiana, said at Bhattacharya’s confirmation hearing yesterday. For Bhattacharya, a man who has described himself as the victim of “a propaganda attack” perpetrated by the nation’s $48 billion biomedical-research establishment, Collins’s insult has become a badge of pride, even a leading qualification for employment in the U.S. Department of Health and Human Services. The “fringe” is now in charge.
Last year, when Collins was asked by a House committee about his comments on the Great Barrington Declaration, he said he was alarmed that the proposal had so quickly made its way to his boss, Alex Azar, who was then the secretary of Health and Human Services. Now that role is filled by another figure from the fringe, Robert F. Kennedy Jr., and presumably, outsider scholars such as Bhattacharya—a health economist and a nonpracticing physician with a predilection for contrary views—will have greater sway than ever. (Bhattacharya declined to be interviewed for this story. Collins did not respond to a request for comment.)
“Science, to succeed, needs free speech,” Bhattacharya told the committee during the hearing. “It needs an environment where there’s tolerance to dissent.” This has long been his message—and warning—to the scientific community. In Bhattacharya’s view, Collins helped coordinate an effort to discredit his and others’ calls for an alternative approach to the pandemic; Collins’s role at an institution that disperses billions of dollars in research funding gave him a frightening power to “cast out heretics,” as Bhattacharya put it in 2023, “just like the medieval Catholic Church did.”
Now he means to use the same authority to rectify that wrong. In his opening remarks yesterday, Bhattacharya vowed to “create an environment where scientists, including early-career scientists and scientists that disagree with me, can express disagreement respectfully.” What this means in practice isn’t yet clear, but The Wall Street Journal has reported that he might try to prioritize funding for universities that score high on to-be-determined measures of campus-wide “academic freedom.” In other words, Bhattacharya may attempt to use the agency’s billion-dollar leverage in reverse, to bully academics into being tolerant.
These aspirations match up with those of his allies who are riding into Washington as champions of the underheard in science. Last month, Kennedy promised in his first speech to his staff that he would foster debate and “convene representatives of all viewpoints” to study chronic disease. “Nothing is going to be off-limits,” he said. Marty Makary, the nominee for FDA commissioner, has talked about his experience of the “censorship complex” and bemoaned an atmosphere of “total intolerance” in public health. Consensus thinking is oppressive, these men suggest. Alternative ideas, whatever those might be, have intrinsic value.
[Read: Revenge of the COVID contrarians]
Surely we can all agree that groupthink is a drag. But a curious pattern is emerging among the fringe-ocrats who are coming into power. Their dissenting views, strewn across the outskirts of conventional belief, appear to be curling toward a new and fringe consensus of its own. On the subject of vaccines, for instance, there used to be some space between the positions of Kennedy, the nation’s leading figure casting doubt on the safety and benefits of inoculations, and Bhattacharya. Kennedy has made false claims about the dangers of the mRNA-based COVID shots. Bhattacharya, meanwhile, once called the same vaccines “a medical miracle—extremely valuable for protecting the vulnerable against severe COVID-19 disease.” (He even criticized Anthony Fauci for downplaying the benefits of COVID shots by continuing to wear a mask after being immunized.)
Bhattacharya has in the past been tolerant of others’ more outrageous claims about vaccines. But that neutrality has lately drifted into a gentle posture of acceptance, like a one-armed hug. Under questioning from senators, he said that he is convinced that there is no link between autism and the MMR vaccine (and that he fully supports vaccinating children against measles). But he also floated the idea that Kennedy’s goal of doing further research on the topic would be worthwhile just the same. Last July, despite his past enthusiasm for mRNA-based COVID-19 shots, Bhattacharya said that he was planning to sign on to a statement calling for their deauthorization, because they are “contributing to an alarming rise in disability and excess deaths.” Kennedy has petitioned for the same, on the same grounds. (There is, in fact, no meaningful evidence that the vaccines have caused a spate of excess deaths.) In a post on X, Bhattacharya explained that he’d been hesitant to take this step at first, because some groups might still benefit from the vaccines, but then he came to realize that pulling the vaccine will create the conditions necessary for testing whether it still has any value.
[Read: The inflated risk of vaccine-induced cardiac arrest]
On this and other issues, the dissenting voices have started to combine into a chorus. The lab-leak theory of COVID’s origin provides another case in point. In yesterday’s hearing, Bhattacharya described scientific experts’ early dismissal of the possibility that the coronavirus spread from a lab in Wuhan, China, as “a low point in the history of science.” That’s an overstatement, but the criticism is fair: Dissenting views were stifled and ignored. But here again, what started as mere endorsement of debate has evolved into a countervailing sense of certainty. Although there’s still plenty of reason to believe that the pandemic did, in fact, begin with the natural passage of the virus from an animal host, the most important details about the pandemic’s origin remain unknown. Yet the fringe is nearly settled on the alternative interpretation. Bhattacharya has said that the pandemic “likely” started in a lab (a position that has been endorsed, albeit with low or moderate confidence, by almost half of the government agencies that have looked into it). Makary called the theory “a no-brainer.” And RFK Jr. published a 600-page book, The Wuhan Cover-Up, in support of it.
Based on the Senate’s Republican majority and the precedent of Kennedy’s confirmation, Bhattacharya is almost certain to sail through his Senate vote, and in short order. His prospects of delivering on his mission, though, are hazier. Some of his positions are already being undermined by the Trump administration’s prior actions. According to a new report in Nature, the agency is terminating hundreds of active research grants that may be construed to have a focus on gender or diversity, among other topics. Some work may be permitted to continue as long as any “DEI language” has been stripped from associated documents. This is hardly the “culture of respect for free speech” that Bhattacharya promised yesterday. Other, basic workings of the NIH have been dismantled under the second Trump administration: Approximately 1,200 employees have been fired, grant reviews have been frozen, and policies have been declared that would squeeze research funding for the nation’s universities. Bhattacharya is about to take the levers of power, but those levers have been ripped from their housing, and the springs removed and sold as scrap.
[Read: Inside the collapse at the NIH]
When pressed on these developments yesterday, Bhattacharya kept returning to a single line: “I fully commit to making sure that all the scientists at the NIH, and the scientists that the NIH supports, have the resources they need.” Whether he’d have the authority or know-how to do so remains in doubt. “Dr. Bhattacharya doesn’t really understand how NIH works, and he doesn’t understand how decisions are made,” Harold Varmus, who ran the agency in the 1990s, told me shortly after the hearing ended. As for Bhattacharya’s goals of promoting free speech among scientists and nurturing cutting-edge ideas for research, Varmus said that the problem has been misdiagnosed: Whatever conservatism exists doesn’t really come from the top, he said, but from the grant-review committees and the scientists themselves. “It’s exasperating for me to see what is about to happen,” he told me, “because this guy should not be in my old office.”
For what it’s worth, Bhattacharya has also shared other ambitious plans. He aims, for instance, to make science more reliable by incorporating into NIH-funded research the dreary work of replicating findings. “Replication is the heart and soul of what truth is in science,” he said during the hearing. That might help solve a pressing problem in the sciences, but it would also be a very costly project, started at a time when research costs are being cut. Under current conditions, even just the basic job of running the NIH seems pretty stressful on its own. Bhattacharya has, by his account, experienced lots of stress in recent years due to the many efforts to discredit him. His confirmation may not bring him full relief.