How can one person run NIH and CDC?

"An ineffectual health leader whose attention will be further fractured"

Imagine that you lead a company’s sales division. But now you’re being asked to lead the manufacturing division at the same time.

Or you’re a second-grade teacher who’s now expected to do that in the morning but then switch over and teach middle schoolers each afternoon.

Or you’re a scientist working on new drug development who is now expected to lead the company’s marketing department simultaneously.

Silly? Too big a stretch? Undoable? Can’t service both jobs?

A ridiculous reality

Last April, Jay Bhattacharya, MD, PhD, became director of the National Institutes of Health, which has more than 20,000 employees. The NIH consists of 27 institutes and centers.

Dissension in the ranks arose quickly. Last June, dozens of NIH staffers walked out of a town hall meeting when Bhattacharya suggested that NIH may have helped fund research that caused the COVID-19 pandemic. Then more than 60 NIH employees sent an open letter to Bhattacharya insisting that he reverse decisions that were reducing support for research. Another 250 or so anonymous colleagues joined the move to go public with their concerns.

Now Bhattacharya has taken on the dual role of being NIH director and acting director of the Centers for Disease Control and Prevention (CDC). STAT News reports that this comes at a time when…

… staff have criticized Bhattacharya for being largely absent in the day-to-day activities of running the $47 billion agency. … Many officials at the NIH have taken to calling Bhattacharya “Podcast Jay” because of the amount of time he spends doing interviews.

The CDC has a workforce of about 15,000. It has not had a full-time director since August when RFK Jr. fired Susan Monarez, PhD, who had been on the job for only 28 days. This was over her disagreement with vaccine policy.

So that brings a total workforce of about 35,000 people under Bhattacharya’s leadership. It’s a workforce already confused and concerned because of so many changes in both organizations. The two agencies have vastly different responsibilities. And they are headquartered in different states.

The Guardian reported that this move…

…(makes) him the fourth leader in a year at the embattled agency in an unprecedented move that further consolidates power among a small group of men at the helm of US health agencies.

He’s been an ineffectual health leader whose attention will be further fractured. ...

Bhattacharya will continue serving in his current role as NIH director, where he has overseen dramatic cuts to research and staff. The CDC has similarly slashed grants to states and enacted massive layoffs even as officials under Kennedy have dramatically reshaped policy on routine vaccinations.

TheHill.com reported:

“Candidly, this is someone who very clearly has an ax to grind with science and the scientific community in general,” Kayla Hancock, director of Protect our Care’s Public Health Watch project, said of Bhattacharya.

“We’ve seen with his record already at NIH and his history of Covid denialism before he even took this office that this is just not the kind of person that we need at the helm of our key public health and medical research institutions.”

Art Caplan, PhD, who heads medical ethics at NYU’s School of Medicine, was quoted in The Cancer Letter:

“The problem with this appointment is twofold. It concentrates too much authority in a single person, creating a conflict of roles in carrying out the requisite functions. …Assigning him greater authority in a domain outside his expertise will surely quickly create a problem of trust between CDC and the staff and extramural scientists seeking to carry out CDC responsibilities. ...

He has shown little support for vital cancer vaccines involving mRNA and
has not said a word about the health disaster, including cancer burden, that
will follow in the wake of the emasculation of the EPA. This is an appointment carrying many burdens.”

Think of the impact on NIH and CDC employees, contractors, and those working on or seeking grants from either agency. Think of the impact on policy-making. What will be prioritized? What will be shelved or back-burnered? What will be missed, falling through the cracks?

Is it possible that worklife in the federal health agencies could become more of a raucous roller coaster ride than it’s already been? I’ve come to believe that possibility is real.

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