[[{“value”:”Trump has announced the appointment, so it is worth thinking through a few matters. While much of the chatter is about the Great Barrington Declaration, I would note that Bhattacharya has a history of focusing on the costs of obesity. So perhaps we can expect more research funding for better weight loss drugs, in addition
The post Jay Bhattacharya at the NIH appeared first on Marginal REVOLUTION.”}]]
Trump has announced the appointment, so it is worth thinking through a few matters. While much of the chatter is about the Great Barrington Declaration, I would note that Bhattacharya has a history of focusing on the costs of obesity. So perhaps we can expect more research funding for better weight loss drugs, in addition to other relevant public health measures.
Bhattacharya also has researched the NIH itself (with Packalen), and here is one bit from tthat paper: “NIH’s propensity to fund projects that build on the most recent advances has declined over the last several decades. Thus, in this regard NIH funding has become more conservative despite initiatives to increase funding for innovative projects.”
I would expect it is a priority of his to switch more NIH funding into riskier bets, and that is all to the good. More broadly, his appointment can be seen as a slap in the face of the Fauci smug, satisfied, “do what I tell you” approach. That will delight many, myself included, but still the question remains of how to turn that into concrete advances in public health policy. Putting aside the possibility of another major pandemic coming around, that is not so easy to do.
My main worry is simply that NIH staff will not trust their new director. The problem is not so much GBD, which can be compartmentalized as a “political” stance, but rather the earlier claims that many more people had Covid early than we had thought, and that expected fatalities were going to be quite low, with a maximum of 40,000. We all make mistakes, the question is how those mistakes get processed. If you interrogate Perplexity it will report “Bhattacharya has not publicly acknowledged or confessed to these mistakes in his early predictions.” You don’t have to agree with Perplexity (though contrary cites are welcome!), rather it suffices to say that reflects a common perception of the scientific community. He also seemed to be pushing those low fatality estimates for longer than might have been considered appropriate. And that is indeed a problem for his tenure at the NIH.
The danger is simply that NIH staff will double down on risk aversion, and they may not so readily support any attempt to make the grants themselves riskier, or rooted in the greater discretion of program directors, a’la DARPA and the like. They will fear that their director will not sufficiently follow the evidence, or admit when mistakes are being made and reverse course. Even if you fully agree with GBD and the like, I hope you are able to see this as a relevant problem. Every institutional revolution requires supportive troops on the inside, even if they are only a minority.
I very much hope this works out well, but in the meantime that is my reservation.
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Current Affairs, Medicine, Uncategorized
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