At today's Senate Appropriations Committee hearing, Sen. Katie Britt (R-AL) questioned NIH Dir. Dr. Jay Bhattacharya.
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00:00Senator Britt. Thank you, Madam Chair. Dr. Bhattacharya, thank you so much for, or how do you say it? Say it for me. I say Bhattacharya, but my cousins think I don't know how to pronounce this, Senator. No worries. Okay. Okay. Look, I want to talk about what Senator Kennedy just brought up. Before we do that, I want to talk about one of my top priorities, and that is supporting mothers before, during, and after pregnancy.
00:24Look, far too many women in this country are dying from pregnancy-related causes. You look at Alabama, we have one of the highest maternal mortality rates in the nation. It disproportionately affects black women, Native American women, those women in rural areas. When you look at rural areas in Alabama, we have one-third of our state's 67 counties are actually maternal care deserts, meaning they don't have access to birthing facilities or maternal care providers.
00:54I mean, look, it's 2025. These numbers should be moving in the opposite direction. I am really proud to have co-sponsored the NIH Improve Act. It's to help make sure that we have research to deal with the things that I just said. My question for you is, is can you tell us briefly what do we know today about the why of this is occurring, and where is the gap that we need to close in order to move these numbers in the opposite direction?
01:21I'm sorry. I was just looking at the numbers. I mean, it's a range of conditions, including maternal diabetes, you know, gestational diabetes, maternal hypertension, a whole host of conditions that are many of which are preventable if we just get prenatal care done early. It's an absolute heartbreaking situation when...
01:39Well, that's another thing. Many women don't even get care until about month five of pregnancy. I mean, these are things that we have to change. Look, we are doing this, and we're authorizing it on a year-by-year basis.
01:51It is my thought that if we actually want change, we have to allow for predictability. So my NIH Improve Act allows for seven years of predictability.
02:00My question to you is, is if that was the case, and you had that, do you think that we could have better research?
02:05The answer is absolutely yes.
02:06Okay. Great. Well, then I think that we've got to start thinking bigger picture in this body. Instead of segmenting things one by one, we've got to think, how do we actually achieve the result on the issue in front of us?
02:18And speaking of, back to Senator Kennedy's comments, let's talk about NIH. You know I have been a strong supporter, making sure where we have life-saving and life-changing research that it absolutely continues.
02:30I also know that we have to be good stewards of taxpayer dollars. We have to make sure that we create a system where we can continue to be the gold standard of biomedical research across the board.
02:40I have heard my colleagues today say and indicate that you want to give up on medical research. Is that true, yes or no?
02:47Right. They have said that you want to wipe out research. Is that true, yes or no?
02:51No.
02:51Okay. So let's have a productive conversation between the two of us right now. When we want NIH to remain the gold standard of research, we've got to make sure that the best idea wins, right?
03:02Absolutely.
03:02We've got to make sure that people have an opportunity to compete no matter where they came from, that we stop rewarding just legacy contracts, so to speak, and empower researchers and empower the research to go where it can save lives. Do you agree with that?
03:16Entirely.
03:17So how do we make sure that every dollar actually goes to discovery and not to institutional overhead? What ideas do you have?
03:25I mean, the key thing there is that we have to make sure that the institutional overhead funds are essentially part of a competition across universities.
03:34Okay.
03:35Right now, we have a system that guarantees that a very small number of universities are going to get all of the institutional support.
03:41So how do we fix that?
03:42Essentially, the key problem now is that we require the institution to have excellent researchers in order to get the institutional support.
03:50Okay.
03:51It's a vicious cycle because you only attract excellent researchers if you have the institutional support, the lab space, and so on.
04:00So we've got to break that cycle.
04:01Have to break that cycle.
04:02How do you do that?
04:03Well, I mean, there's lots of creative ways to do that. The ideas program that Senator Capito mentioned is one way to do that.
04:07There are other mechanisms to do that. I'd love to talk and work with Congress on how to do that.
04:11Absolutely. I think we've got to create a competitive environment where the best idea wins so that the American people win.
04:17We've got to stop churning and churning and churning because it's what we've always done.
04:22This is our opportunity to make a dollar go further and to make it have a greater impact.
04:26I guess my question to you is if we introduce competition into this arena, which I think is a great idea and a concept that we should explore,
04:35if we introduce it into maybe the indirect cost equation, how would that actually bolster, or do you think that that would break the system?
04:44No, I think it would actually strengthen the system because it would get support to researchers that are in nontraditional places
04:51but have excellent ideas that have a much harder time getting support from the NIH.
04:56And I think that that combat scientific groupthink expands the base of scientific ideas
05:01and it really addresses the critical roadblocks that we currently face.
05:05Well, I hope that you will continue to explore that.
05:08We certainly want to be your partner in this.
05:11I believe we owe it to the American people to ensure that NIH funding and every single dollar of it is driving actual innovation
05:19that achieves results, that makes an impact, that saves lives.
05:23And I look forward to continuing this conversation.
05:25Thank you for being innovative in how we approach this and working with our colleagues on this committee
05:29to modernize the outdated system that rewards legacy and not actual results.
05:36Thank you, Senator.