NIH Director Monica Bertagnolli, appointed by President Joe Biden to rebrand the agency following the COVID-19 pandemic, told a panel of NIH institute directors chosen for an internal review process that rebuilding trust in the organization and scientific expertise is a top priority. 

“Trust has to be earned, and it has to be earned every single day,” said Bertagnolli during the public event. “And the ways that you earn trust are, first and foremost, delivering what people need, really moving the needle on health problems that are plaguing people, and making it very clear and transparent as to why and how all of the results that come out of the NIH help to achieve that.”

During the last few months of the 2024 presidential campaign, President-elect Donald Trump took on the goal of former independent presidential candidate Robert F. Kennedy Jr. to “Make America Healthy Again” by reforming various health agencies, particularly the NIH.

At an event in Scottsdale, Arizona, this week, Kennedy described his role as an adviser to Trump in selecting key public health officials for the new administration and said 600 NIH employees would be replaced on day one of the new administration. 

Kennedy, who has been a sharp critic of the NIH, the Centers for Disease Control and Prevention, and the Food and Drug Administration, promised during his presidential campaign to reform the federal health agencies “overnight” with executive authority. 

The former environmental lawyer’s distrust of public health institutions predates the failures of pandemic-era policy decisions from the NIH and CDC, but Kennedy’s brand of skepticism, including his critique of vaccines, has garnered more support in the pandemic’s aftermath.

Kennedy has been a key advisor during Trump’s transition and is rumored to be in consideration for the position of secretary of Health and Human Services or another role that would give him authority to reshape the NIH and other federal health agencies.

The timing of the NIH Scientific Management Review Board meeting coincidentally aligned with the aspirations of Kennedy and Trump to reshape the organization in their image. 

The SMRB convenes every seven years to reevaluate the NIH’s organizational structure and authorities and set priorities for the 27 institutes and centers that make up the agency. The board is required to give a final report to the NIH director and the HHS secretary after a comprehensive internal review.

However, the stakes are high for this year’s recommendations.

Although none of the participants referenced Kennedy or Trump by name, they did reference the concern of antivaccination sentiments and the debate over water fluoridation, two matters on which Kennedy has championed against the mainstream scientific community. 

When asked specifically about how to combat distrust in science and medical misinformation, Bertagnolli said the agency needs to clarify that much of the NIH’s funding goes directly to universities across the county, connecting the idea of scientific breakthroughs to job opportunities at higher educational institutions.

“I come back to tie it to what matters to them,” said Bertagnolli. “What matters to them is more local than national.”

Bertagnolli also pushed back on the notion that the 27 institutes and centers that make up the NIH ought to be consolidated for efficiency or better collaboration, a proposal that has support among some Republicans in Congress.

“Before I came to NIH, I bought into ‘oh, it’s a whole bunch of silos, and nobody’s working together. And you know, wouldn’t it be great if you just rolled a few together because then there’d be more collaboration.’ Absolutely the opposite,” said Bertagnolli.

The NIH director said specific institutions corresponding to particular diseases or conditions, such as the National Cancer Institute, help the general public and scientific community better engage with the research projects in those particular areas of medicine.

“If we were to collapse, we would definitely lose something in terms of our engagement with the public,” said Bertagnolli. “I think that’s really critical.”

Principal Deputy NIH Director Lawrence Tabak told the members of the board that the plan is for the SMRB to meet at least five times during 2025 with the intention of producing at least a draft final report by November next year. 

Tabak also said most of the work of the board would be done during working group meetings outside of the five public events, but the details of each private meeting would need to be made publicly available.

“Everybody’s watching,” said Tabak. “So this information, no doubt, will also find its way to the general public, to legislators, and so forth. So what you do, what you say, will be widely and broadly disseminated. And that was the whole point.”

Tabak, who was the acting director of the NIH until Bertagnolli was appointed, has been under scrutiny for the past several years regarding the secrecy of leading NIH officials in determining the origins of COVID-19. This includes his testimony before the House Oversight Committee earlier this year, along with Anthony Fauci, the former director of the National Institute for Allergies and Infectious Diseases.

Public trust in scientists has decreased significantly since the onset of the COVID-19 pandemic. 

According to a Pew Research Center poll from 2023, the percentage of adults in the United States who reported having “not too much” trust in scientists rose from 13% in 2019 to 27% in 2023. In 2019, about 35% said they had a “great deal” of trust in scientists, but four years later, that fell to 23%.