Trump’s opponents are quick to condemn his every action.  Tariff battles grab the headlines, but the administration’s actions in the field of medicine and public health have also  attracted unfavorable comments.  Often it requires a period of time to determine whether the President or his critics are right.

On April 17 I watched as Megyn Kelly interviewed recently appointed Federal Drug Administration Commissioner Dr. Marty Makary. FDA is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation. The FDA also provides accurate, science-based health information to the public.  It has about 18,000 employees and a budget of approximately 7 billion dollars per annum.  Dr. Makary contradicted recent claims of Trump administration opponents and insisted that recent layoffs in the FDA did not include scientists and other key personnel.  He also reported that FDA was working hand in hand with Robert F. Kennedy, Jr., Secretary of Health and Human Services, to identify the causes and remedies for America’s alarming rise in chronic diseases.  Makary appeared to be approaching this difficult and critical work with quiet confidence in ultimate success. 

Another key organization under Secretary Kennedy is the National Institutes of Health,  the primary agency of the United States government responsible for biomedical and public health research.  It has an annual budget of approximately 50 billion dollars. The NIH conducts its scientific research through its Intramural Research Program and provides significant biomedical research funding to non-NIH research facilities through its Extramural Research Program. As of 2013, the IRP had 1,200 principal investigators and more than 4,000 postdoctoral fellows in basic, translational, and clinical research, being the largest biomedical research institution in the world. 

The Trump administration has canceled hundreds of grants supporting research on topics such as diversity, equity, and inclusion; and the health of LGBTQ+ populations. Many employee terminations were a result of President Trump’s executive orders to abandon federal work on diversity and equity issues, and other resignations followed Senate confirmation of Kennedy to lead the Department of Health and Human Services, NIH’s overseer.

On April 1 Dr. Jay Bhattacharya became director of the NIH.  Chiefs of 4 of the 27 institutes and centers making up the NIH were removed from their posts, with some being offered reassignments.  At the same time, plans were announced for significant reductions to the NIH budget and workforce.   Consternation spread throughout the medical research community.  There was great concern about the future direction and funding of many important research initiatives.

Criticism of the Trump administration’s actions at NIH may be justified, but perhaps it is too early make a judgment. Who would wish a disruption of vital medical research? Kennedy and Bhattacharya must have a plan. Let them explain it.