Russell Vought will reportedly be given veto power over all NIH grants

The Washington Post reported on Friday that a contentious White House meeting pitted the director of the National Institutes of Health (NIH), Jay Bhattacharya, against Russell Vought, who heads the Office of Management and Budget (OMB). At issue was yet another attempt to place the agency's funding decisions under political control.

A draft executive order

The Post suggested that Bhattacharya lost the argument. The leak has since been confirmed and expanded on by The New York Times and Politico, which report that the administration is drafting an executive order giving Vought veto power over every individual grant awarded by the NIH. Under the reported plan, grants would need approval from a committee that includes Vought and Bhattacharya; without a unanimous vote, funding would be rejected.

The money at stake

The NIH is the largest funder of biomedical research on the planet, with a $47 billion budget larger than that of the next ten research funders combined. Its grants to academic researchers support everything from basic biology to clinical trials and have helped the biotechnology industry flourish. Vought contends that the agency has funded a great deal of what he calls "woke" research.

After Trump returned to office, the NIH terminated grants on topics such as pandemic preparedness and health disparities and proposed a budget that would have shrunk the agency by nearly half. Congress rejected the cut, and a court voided the policy behind the terminations. Vought then proposed grant rules that would make political considerations key to funding decisions; Congress put that rule on hold until December.

Harvard and the practical doubts

According to Politico, Vought presented OMB control of NIH grants as an alternative way to target Harvard, which declined to settle and won a lawsuit restoring its funding; Trump later demanded $1 billion from the university as part of any settlement.

How the committee would work in practice is unclear. During the Biden administration the NIH funded more than 64,000 grants a year, and Vought and Bhattacharya have other duties as agency heads. The panel would presumably act only after funding decisions were made, raising the risk that the NIH could not spend all the money Congress allocates.

Previously, the NIH ranked grants by scientific merit scores assigned by expert peer reviewers, a system that also made it easy to redirect money to the best unfunded proposals. Vought has tried to limit peer review as well. Courts are expected to reject the order as arbitrary and capricious, but someone must first show standing to sue.