Health research under Trump’s microscope

The ideas and innovators shaping health care

Nov 07, 2024 View in browser   By Erin Schumaker, Carmen Paun, Shawn Zeller, Daniel Payne and Ruth Reader AROUND THE AGENCIES Trump's getting a lot of advice on overhauling the NIH. | AP 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. WELCOME TO FUTURE PULSE Washington, D.C. | Getty Images This is where we explore the ideas and innovators shaping health care.  Nine countries promised to ban corporal punishment of children at a gathering in Colombia, the World Health Organization said. The U.S. was not among them. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, or Erin Schumaker at eschumaker@politico.com . Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.  AROUND THE NATION California voters are in a tough-on-crime frame of mind. | Getty Images Californians approved a tough-on-crime ballot initiative Tuesday that would strengthen penalties for some drug-related crimes. It wasn’t close. Some 6.5 million California voters — slightly over 70 percent — voted in favor of Proposition 36, which would increase penalties for repeated theft and some drug crimes, including involving illicit fentanyl, according to the Associated Press. It would also create a drug court treatment program for people with multiple drug possession convictions. The measure, supported by a coalition of prosecutors and retailers like Walmart and Target, rolls back part of a 2014 ballot measure seen as emblematic of a progressive shift in California on drug policy that voters have now rejected. Progressives had sought to reduce drug penalties’ disproportionate toll on people of color and prioritize rehabilitation of drug users over punishment, POLITICO’s Emily Schultheis reports. But Proposition 36 gained traction with voters amid a spike in crime during the pandemic. Why it matters: The measure’s passage marks further momentum for tougher-on-drugs policies in some West Coast states. The Oregon legislature earlier this year repealed the state’s three-year-old law decriminalizing drug possession for personal use after a surge in fatal overdoses and public drug use in Portland. The decriminalization was a result of a 2020 ballot measure that passed with 58 percent of the votes and came amidst protests demanding racial justice following the killing of George Floyd, a Black man, by a white police officer. DANGER ZONE Watch the THC in that joint, a California commission suggests. | AFP via Getty Images California policymakers must do more to warn consumers of the health dangers of high-potency marijuana and deter its use, according to a new report by scientists convened by the state Department of Public Health. Why’s that? Most of the cannabis sold in California is high potency, with a concentration of the active ingredient, THC, or tetrahydrocannabinol, five to 10 times greater than the pot of the 1970s and 1980s. And high-potency cannabis, according to the report authors, is more likely to be addictive and cause serious health problems, like psychosis or cannabis hyperemesis syndrome, in which users can’t stop vomiting or feeling nauseous. What to do? The authors, including scientists from Stanford, Johns Hopkins, the University of California and other institutions, say legal pot is here to stay, but policymakers should take lessons from successful campaigns to reduce smoking and drinking. Among other ideas, they recommend: — Restricting pot advertising, packaging and marketing — Barring flavored products that appeal to kids — Limiting THC content — Raising taxes on high-potency products — Launching a public education campaign about high-potency pot’s health effects What’s next? The authors say they’re lobbying the California Department of Public Health, the state Department of Cannabis Control, the state legislature and other state agencies to boost regulation.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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