NIH Power Struggle: Leadership Crisis Deepens – A Deep Dive into Politicization
The transition of power in the United States invariably brings changes to the federal bureaucracy, with each new presidential administration tasked with filling approximately 4,000 positions. These political appointees are intended to implement the president’s agenda and ensure government agencies are responsive to elected officials. While some roles, like the Secretary of State, are highly visible, many others, such as the Deputy Assistant Secretary for Textiles, Consumer Goods, Materials, Critical Minerals & Metals Industry & Analysis, operate behind the scenes. Traditionally, science-focused agencies like NASA and the National Institutes of Health (NIH) have experienced less political interference than other parts of the government. However, recent developments suggest a shift in this dynamic, raising concerns about the increasing politicization of scientific leadership.
Historical Context: NIH’s Tradition of Scientific Autonomy
For decades, the NIH, the nation’s premier biomedical research agency, has maintained a relatively low profile in terms of political appointments. Prior to the early 2000s, and continuing until recently, the NIH workforce of around 17,500 (as of November 2025, following significant budget cuts) typically included only a handful of political appointees. The selection of directors for the 27 institutes and centers comprising NIH was largely driven by staff scientists and external experts, minimizing direct White House or Congressional oversight. This arrangement stemmed from a widely held belief that scientific endeavors should be guided by scientists themselves, with minimal political interference. This approach fostered a culture of independent research and innovation.
The Shifting Landscape Under the Trump Administration
Recent years have witnessed a growing tension surrounding the NIH’s autonomy. The arrival of political appointees in positions traditionally held by career civil servants, coupled with alterations in hiring practices, has sparked anxieties among current and former officials about a new era of politicization. Historically, NIH has enjoyed strong bipartisan support, but conservative lawmakers have periodically questioned its spending. A 2014 survey indicated that federal executives generally perceive NIH as a progressive institution. Furthermore, data suggests a growing trend of scientists identifying as liberal relative to the general population since the early 2000s.
COVID-19 and the Rise of Criticism
The COVID-19 pandemic significantly amplified these criticisms. Many conservatives voiced concerns about NIH’s funding of virology experiments perceived as potentially contributing to the pandemic’s origin, and challenged public health strategies promoted by the agency as unscientific or authoritarian. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) from 1984 to 2022, became a particularly polarizing figure, often portrayed on the right as an unelected official wielding excessive power. This heightened scrutiny laid the groundwork for calls for greater oversight and accountability within the NIH.
Calls for Reform and Term Limits
Even before the recent political shifts, some biomedical researchers advocated for changes to NIH’s leadership selection and retention processes. In 2019, the agency announced plans to implement term limits for certain mid-level roles, aiming to diversify its management. More recently, Dr. Joseph Marine of Johns Hopkins University argued in an essay for The Free Press that five to ten-year term limits should be imposed on the directors of individual NIH institutes. He posited that “regular turnover of leadership brings fresh ideas and a healthy reassessment of priorities.” This debate highlighted a desire for increased dynamism and responsiveness within the agency.
Trump’s Appointment of Jay Bhattacharya and the Project 2025 Roadmap
Following his 2024 election victory, Donald Trump appointed Jay Bhattacharya, a vocal critic of NIH, to lead the agency. This move signaled a clear intention to reform the NIH and potentially reshape its priorities. Signs of impending political scrutiny of institute directors emerged even before Trump’s second inauguration. The Heritage Foundation’s Project 2025, a proposed roadmap for the Trump administration, explicitly argued that “funding for scientific research should not be controlled by a small group of highly paid and unaccountable insiders at the NIH, many of whom stay in power for decades.” This statement underscored a desire to dismantle what was perceived as an entrenched and unresponsive bureaucracy.
Leadership Turnover and the Increase in Political Appointees
Shortly after the inauguration, several senior NIH officials were placed on administrative leave or abruptly departed, including Lawrence Tabak, who had served as principal deputy director for over a decade and as NIH’s interim leader during the COVID-19 pandemic. Simultaneously, the administration significantly increased the number of political appointees at NIH. By late June, federal records indicated nine political appointees, up from four the previous year – a figure higher than in most prior years. Notable appointments included Seana Cranston, a former Republican Congressional staffer serving as chief of staff to the NIH Director (replacing a career civil servant with nearly 40 years of service), and Michael Allen, appointed as chief operating officer for NIAID without a public announcement or readily available biographical information.
Despite this increase, NIH still had fewer political appointees than comparable agencies like NASA. However, the changes signaled a clear departure from the traditional approach.
Departures from Traditional Hiring Processes
The administration also deviated from the established process for hiring directors of NIH’s 27 institutes and centers, who oversee most funding decisions and day-to-day operations. In the spring of 2025, five directors – including the head of NIAID – were fired or placed on administrative leave. In September, a search committee for the National Institute of Mental Health was abruptly disbanded and then reinstated. In October, the directorship of the National Institute of Environmental Health Sciences was filled by a close personal friend of Vice President JD Vance, without any apparent search process – a move described by multiple former NIH officials as potentially unprecedented.
Growing Vacancies and Compressed Timelines
By October, 13 other NIH institutes and centers had vacant leadership positions. Further departures followed: Walter Koroshetz, leader of the agency’s main neuroscience research institute, left in December, bringing the total number of open posts to 15. The searches for replacements appear to be proceeding on a compressed timeline, and the agency has reportedly abandoned the practice of forming search committees comprising both NIH career scientists and external experts. Instead, the Department of Health and Human Services stated that “an NIH leadership team with experience in scientific agency management will consider the applicant pool and make recommendations to the NIH Director,” without specifying the composition of this team or explaining the change in process.
Concerns About Political Control and Congressional Response
These changes have fueled speculation that the Trump administration is seeking to exert greater political control over the selection of institute directors. Mark Histed, an NIH scientist, emphasized the importance of external members on search committees to prevent politicization, arguing that their involvement makes it more difficult for the White House to impose its preferences. He highlighted that this open and non-politicized search process is widely used by scientific institutions globally and has been instrumental in NIH’s success.
Members of Congress have also expressed concern. Language included in the current appropriations bill directs NIH “to maintain its longstanding practice of including external scientists and stakeholders” in the search process (though these instructions are not legally binding). Representative Diana DeGette of Colorado has sponsored a bill to “Protect NIH From Political Interference” by capping the number of political appointees at the agency.
A Historical Perspective on the Tug-of-War
Mike Lauer, the former NIH grants chief, offered a broader historical perspective, noting a long-standing tension between presidential administrations seeking greater political control and civil servants resisting perceived incursions. He explained that administrations often argue that increased political control ensures the agency is responsive to the electorate and promotes transparency and accountability. However, he also cautioned about potential downsides, including short-term thinking, unstable budgets, and the loss of expertise.
Mark Richardson, a political scientist at Georgetown University, observed a correlation between the level of partisan disagreement over an agency’s role and the degree to which administrations seek to exert control through appointments. He noted that NIH has historically been aligned with agencies enjoying broad bipartisan support, but that the Trump administration appears to be expanding political conflict to these traditionally stable institutions.
The ongoing power struggle at NIH represents a critical juncture for the future of biomedical research in the United States. The balance between political oversight and scientific autonomy will undoubtedly shape the agency’s priorities, funding decisions, and ultimately, its ability to address pressing health challenges. The situation demands careful monitoring and a commitment to preserving the integrity and independence of scientific inquiry.