Photo: NIH
Overview
In a candid conversation with Cure, Dr. Jay Bhattacharya talked about affordable manufacturing, gaps in today’s research system, rebuilding trust in science, and where he hopes entrepreneurs will step in.
One of the biggest opportunities for life science entrepreneurs isn’t developing new treatments, it’s figuring out how to make them affordable, according to Dr. Jay Bhattacharya, director of the National Institutes of Health.
In an exclusive conversation with Cure's CEO Seema Kumar, Dr. Bhattacharya discussed his approach to managing the agency, the need to build trust in science, and how to spur innovation. He pointed to sickle cell gene editing treatments as an example. These medicines, which seemed like “science fiction” when he was in medical school, are now available, but at a cost of $3 million per patient. Lowering the manufacturing cost to $30,000 could eliminate the condition.
The key advance needed is "not new cures for sickle cell anemia," he said, but "reducing the price of the manufacturing of the cell-based therapies."
He called it "a huge opportunity for entrepreneurs."
Click here to view the full 60-minute conversation titled Healthcare at a Crossroads, only accessible to Cure Members.
How NIH plans to help founders
Dr. Bhattacharya praised the Small Business Innovation Research program, or SBIR, which provides grants to help companies develop investigational products through a peer-reviewed application process. But he wants to find ways to improve it.
"It's often really slow," he said. "It's also often very conservative, we're not often investing in the cutting edge."
Speeding up decision-making and orienting the program toward "companies that are trying to go from zero to one," is one way to solve that.
Unlocking dormant intellectual property funded by the NIH that sits unused at universities is another priority.
"A lot of that intellectual property essentially just dies there because they don't have the expertise to make the leap," he said. "A patent that no one uses is a useless patent."
Beyond speed and access, Dr. Bhattacharya wants to fix what he called a crisis of incentives in science. The current system rewards publication in top journals rather than reproducible results, he said. That creates problems for companies trying to build on published research.
"If you don't have reliable published literature, then you can't make decisions about investments.”
Why trust matters for new therapies
For any new therapy to gain traction, the public has to trust it, according to Dr. Bhattacharya. In his view, the government’s response to COVID-19 eroded that trust, citing vaccine mandates, school closures, and silenced dissenting points of view.
He was at the center of many of these conversations. In 2020, he co-authored an open letter known as the Great Barrington Declaration, which argued against COVID-19 lockdowns and for pursuing “herd immunity” instead—an approach that mainstream health officials widely denounced.
“The fundamental problem we had during COVID was that it was impossible for people who thought differently inside science and in public health to express their ideas in ways where it could be heard and engaged with,” Dr. Bhattacharya argues. “It's in times of greatest uncertainty where that kind of scientific discussion, debate, and process is most needed.”
A shift on DEI
Dr. Bhattacharya says he has removed diversity, equity and inclusion (DEI) as a formal priority at the NIH. He framed the change as part of a broader effort to refocus the agency on health outcomes rather than political goals.
"I'm still deeply committed to funding research and supporting research that advances the health of minority populations,” he said. “To solve the structures of racism is not within the DNA of the NIH. We don't have the capacity to do that.”
That doesn’t mean disparities in health outcomes don’t exist or aren’t worth addressing, he said. Improving representation of diverse patient populations in clinical trials is one way to provide better guidance to clinicians and potentially improve outcomes.
“The NIH’s mission is research that advances the health and longevity for Americans,” he said. “That includes minorities, includes women. If we do not improve the health of women, if we do not improve the health of minorities, then we have failed in our mission.”
“If you want all of the American people to support the investments in biomedicine, you shouldn't be alienating people with controversial political ideas that don't actually translate to better health.”
Disruption across the board
Dr. Bhattacharya sees a need for new ideas and funding in several areas. He said AI has already transformed basic science and is reshaping clinical care. He called for expanded investment in women's health, including research on menopause, as well as more focus on root causes of depression, anxiety, and Alzheimer’s.
“We need to unleash the power of American ingenuity, and so there should not be taboo questions. We should be checking each other's work with replication efforts. We should be thinking big because the problems are big.” he said. “A decade and a half of stagnation on life expectancy, that's reason enough to disrupt things.”
