In her parting words to the National Institutes of Health’s scientific management review board on Friday, Director Monica Bertagnolli advised the group of scholars and top government health officials to carefully examine plans in Congress to overhaul how the agency awards billions in health care research funding. The advisers shouldn’t believe as fact claims from eager GOP lawmakers seeking NIH restructuring and increased oversight nor automatically accept the premise of Congress’ recommendations, she cautioned. “You dive in and decide,” Bertagnolli advised the group. Congress created the board in the 2006 NIH Reform Act, charging it with reviewing the agency’s structure and research portfolio and making recommendations to the NIH director. The board fell dormant under former NIH Director Francis Collins, sparking criticism from House and Senate Republicans interested in increasing NIH oversight and a directive in the 2024 omnibus appropriations law to restart it. Reviving the review board was a key part of the GOP proposals to overhaul the NIH released last year by Sen. Bill Cassidy (R-La.), then-ranking member of the Senate Health, Education, Labor and Pensions Committee, and Rep. Cathy McMorris Rodgers (R-Wash.), then-chair of the House Energy and Commerce Committee. Rodgers also proposed imposing five-year term limits for NIH directors who oversee key research areas and consolidating the agency’s 27 centers to 15. Bertagnolli described the board, which includes both NIH institute and center heads and non-government members, as a chance to offer outside perspective to Congress on its overhaul proposals. “This is an opportunity for us to respond to Congress by having a very careful thought process with you all from the external community, so that it's not just me writing a letter back to Congress saying, ‘Well, no, I don’t think what you asked us to do is such a good idea,’” Bertagnolli said. Even so: The board has no power to affect Congress’ plans beyond offering advice, and its future is unclear. While Republicans advocated for reviving the board, Robert F. Kennedy Jr., President-elect Donald Trump’s choice to lead the Department of Health and Human Services, could replace its members with his own picks. What’s next: Republicans are in a better position to advance their plans now that they control Congress and the White House, but Democrats retain the ability to block legislation in the Senate when 60 votes are required. And GOP plans could change, Bertagnolli noted. “These recommendations came from a different Congress under a different administration,” she said. Rodgers retired after the last Congress, though Rep. Robert Aderholt (R-Ala.), chair of the Appropriations Committee panel that sets the NIH budget, backed her proposal and remains atop the panel. Cassidy has more power to advance his plan now that he’s chair of Senate HELP. Trump has tapped Stanford University economist Jay Bhattacharya to replace Bertagnolli at NIH. | 
