NIH Leaders Discuss Rebuilding Public Trust at MAHA Roundtable

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A physician-researcher participated in a Make America Healthy Again Institute (MAHA) roundtable discussion with NIH Director Jay Bhattacharya and other NIH agency heads, MAHA activists and community members. The discussion focused on rebuilding public trust and improving the future of the National Institutes of Health. While the author did not align ideologically with many in the room, they decided to engage constructively, aiming to understand where critique reflects real dysfunctions that scientists have acknowledged. The author was surprised to hear NIH leaders acknowledge issues like how institutional prestige and entrenched networks can influence funding decisions, the need to rethink peer-review processes, and the challenges of replicating experiments. The discussion around equity was more nuanced than typical public debates, with an emphasis on accountability and measurable impact. Overall, the author found the dialogue to be more complex and constructive than expected, with a focus on practical ideas to make biomedical research systems more efficient, rigorous and supportive.

Why it matters

This roundtable discussion highlights a growing recognition within the scientific community that public trust in institutions like the NIH needs to be rebuilt through open dialogue, acknowledgment of systemic issues, and a commitment to practical reforms. As an NIH-funded researcher, the author brings an insider's perspective to this conversation, underscoring the importance of scientists engaging directly with critiques rather than avoiding them. Addressing challenges around peer review, replication, equity and funding allocation could strengthen the credibility and impact of biomedical research.

The details

The roundtable discussion covered a range of issues facing the NIH, including the need to rethink how peer-review functions in practice. NIH leaders acknowledged that institutional prestige and entrenched networks can influence funding decisions, not due to misconduct but as a structural issue when many proposals are strong. To address this, the process could be modernized by engaging targeted experts and using technology to evaluate certain elements. There was also discussion about fragmentation across research, with a goal of enabling better collaboration and shared infrastructure for improved interoperability. Agency heads recognized that failure to replicate can often be misread as misconduct, when it more accurately reflects the inherent difficulty of science. Strengthening incentives for replication work could bolster the credibility of biomedical research. Concerns about concentration of funding also resonated, with the example that cost-effectiveness should matter more in funding decisions, not just institutional affiliation. NIH leaders emphasized the need to create a legitimate pathway where negative findings are valued, not buried, as our current system rewards positive results and publication counts at the expense of risk-taking.

• The roundtable discussion took place last month.

What they’re saying

What’s next

The NIH plans to continue exploring ways to improve peer review, promote collaboration and shared infrastructure, and incentivize the reporting of negative findings to strengthen the credibility and impact of biomedical research.