The National Institutes of Health is ripe for an overhaul after Republicans’ victories in Tuesday’s election. Republicans are slated to control the White House and the Senate and well-positioned to win the House. A trifecta next year would enable them to advance their existing proposals to overhaul the NIH, the world’s leading funder of health research. And then there’s Robert F. Kennedy Jr., who has his own ideas and whom President-elect Donald Trump says he’ll put in charge of a broader health agency rethink. The NIH, with its $47 billion budget, funds crucial biomedical research at universities and institutions nationwide. Any overhaul could affect thousands of researchers and potentially reshape biomedical innovation. In the Senate: The likely chair next year of the committee in charge of health care, Bill Cassidy (R-La.), could use the gavel to push his own agenda for the NIH, which includes redirecting focus on basic research that doesn’t yet have clear applications for patients. In addition to maintaining a balanced research portfolio of early- and late-stage research, Cassidy wants to change the NIH’s process for evaluating research proposals, currently led by experts in related fields, by staffing peer-review committees with more generalists. In the House: Energy and Commerce Chair Cathy McMorris Rodgers (R-Wash.) proposed a plan to remake the NIH that House Republicans included in their version of the NIH’s as-yet-unresolved fiscal 2025 spending bill. While Rodgers will retire from Congress at year’s end, the Republican appropriator Robert Aderholt (R-Ala.), who oversees the agency’s funding, shepherded her plan. Key to the framework: five-year-term limits for NIH directors, consolidation of the NIH’s 27 centers to 15 and integration of the Advanced Research Projects Agency for Health, the high-research, high-reward research funder created by President Joe Biden. RFK Jr.: After running a campaign light on health policy details, Trump endorsed Kennedy’s “Make America Healthy Again” platform in his Wednesday morning victory speech. Kennedy’s MAHA policy suggestions for addressing the chronic illnesses plaguing Americans include reallocating NIH’s research budget toward “preventive, alternative and holistic approaches to health” and cracking down on conflicts of interest among NIH-funded scientists.
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