NIH faces Republican call for reorganization

NIH faces Republican call for reorganization

Congressional Republicans are calling for a reorganization of the National Institutes of Health that would strip its authority over "gain of function" research and freeze the experiments until new reforms are established.

Why it matters: The draft plan feeds a narrative dating from the pandemic that portrays the government's health agencies as having lost the public's trust and could offer a blueprint for a GOP administration and Congress.

• It more immediately ratchets up pressure on NIH heading into what could be a difficult fiscal 2025 budget cycle after a long stretch of funding increases was already halted this year.

Driving the news: The plan from the House Energy and Commerce Committee would establish a new oversight process for certain risky pathogen research proposals and transfer power from NIH to a "public, independent oversight entity" to review, approve or reject and oversee the experiments.

• It would pause such work until "appropriate guardrails to monitor research" are enacted, and would bar NIH from conducting or supporting gain of function research in countries designated as foreign adversaries.
• It also would incorporate national security or intelligence reviews into the NIH's existing grant approval process, add reporting and conflict-of-interest policies and set five-year term limits for NIH institute directors — a not-too-veiled shot at longtime former NIAID director Anthony Fauci.

What they're saying: "Historical support for what an agency should or could be cannot prevent us from seeking to build upon past lessons or correct areas that have fallen short," Energy and Commerce Chair Cathy McMorris Rodgers (R-Wash.) and senior House appropriator Robert Aderholt (R-Ala.), who oversees Health and Human Services spending, wrote in Stat.

• HHS, the parent of NIH, says it adheres to strict biosafety measures in its infectious disease research. The Biden administration in May issued an updated policy for research on pathogens with enhanced pandemic potential that expands the scope of federally funded work subject to additional oversight.

The big picture: Even if the reorganization never gets off the ground, it keeps a spotlight on gain of function research, a field that involves boosting the transmissibility of viruses and other pathogens that's often brought up in the context of unproven theories that COVID-19 originated via a lab leak.

• While such work is touted as a way to understand how viruses evolve and guide pandemic preparedness efforts and the development of treatments, some researchers have voiced concerns about lax oversight of laboratory safety.
• The Obama administration in 2014 paused 18 research projects involving influenza, MERS and SARS viruses to evaluate risks and benefits, though seven were eventually allowed to continue.
• There's also lingering debate over whether some studies fall under the rubric of gain of function research, and if swapping natural strains of a virus — as opposed to creating new ones — constitutes "enhancing" a potential pandemic-causing pathogen, per Science.

Reality check: What most can agree on is that NIH has been put on the hot seat by a series of House investigations.

• A recent report from the committee's GOP staff found NIH misrepresented risky research on mpox — previously known as monkeypox — and denied that the work had been approved when queried by Congress.
• The House's Select Subcommittee on the Coronavirus earlier disclosed that a top Fauci aide used a personal email address to avoid government oversight and back-channeled with the nonprofit EcoHealth Alliance, whose backing of studies on bat coronaviruses in China put it at the center of the debate over the pandemic's origins.

What we're watching: Lingering partisan acrimony over the pandemic response combined with more recent bipartisan scrutiny of NIH — both on display during Fauci's recent return to Capitol Hill — could make for a rough road ahead for the agency.

• House Republicans are likely to continue NIH oversight hearings.
• NIH saw its federal funding decline this year after seven years of increases and could be in for another cut as House Republicans tighten topline figures for health spending.
• A recent Raymond James report estimated NIH's final FY25 funding could range from $47.9 billion in an optimistic scenario to $44.25 billion in a bearish one.
• House appropriators are due to begin marking up the main health discretionary spending bill on June 27.

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