The Un-civil War at HHS

Posted on | August 29, 2025 | 1 Comment

Mike Magee

The Health and Human Services department (HHS) includes in its dominion the Food and Drug Administration (FDA), the Center for Disease Control (CDC), and the National Institutes of Health (NIH). It is fair to say that their new leader, RFK Jr. is not a wallflower.

In June, the FDA led the news with its assault on food coloring. On August 7th, it was the CDC with new child and adolescent vaccine schedules. And two weeks ago, the HHS crown jewel NIH hit a raw nerve among the nation’s top medical researchers by grandstanding on the loosely defined term “scientifically justifiable” to declare war on the use of gender data in comparative NIH funded research.

The NIH is housed in 75 buildings on 300 acres in Bethesda, Maryland. It consists of 27 different institutes and centers that together awarded $37 billion in U.S. grant funding in 2024. Reports have documented a 250% return on investment for every dollar in NIH funded research. That includes over 400,000 jobs created and $94.58 billion in new economic activity in 2024.

Jay Bhattacharya M.D., Ph.D., the new NIH Director, assumed his new role as the 18th Director of the NIH on April 1, 2025. As former professor of medicine and economics at Stanford, he has attracted criticism inside and outside the campus boundaries of governmental, academic, and corporate medical science; criticism like this: His attacks on the NIH research partners “seem at odds with the administration’s stated goals of fighting censorship in science at the NIH and liberating public health from ideology.”

This rancor could be considered par for the course in this age of social media and with a president who lives on Truth Social. But when it comes to the NIH, it is not so unusual. Complexity, controversy and intrigue have lived side by side at the organization since its wartime informal beginnings 75 years ago.

Whether it was materials, logistics, or coordinating laboratory studies themselves, the effort to put research on a war footing at the outset of WW II required a group of wily and innovative businessmen-scientists. Primary among them was the bespectacled gentleman who appeared on the April 3, 1944, cover of Time, leaning forward into the lens, tanned, in a light gray suit, with a crisp, white shirt and steel-blue tie, next to a ray-emitting radio microphone. The caption read, “Vannevar Bush: General of Physics.”

As overall head of President Roosevelt’s Office of Scientific Research and Development (OSRD)—also known as the fifth branch of the military general staff, or G5—Bush coordinated 6,000 scientists working in some 300 laboratories, both university-based and commercial. He had plenty of help at the top. Among others in his management team was one George W. Merck, a close friend and confidant since 1933. After Pearl Harbor brought the US into the war, Merck, who had already moved aggressively to centralize his own pharmaceutical company’s research operations, became head of the US Army Biological Warfare Laboratories within Vannevar Bush’s OSRD.

Born March 11, 1890, in Everett, Massachusetts, the only son of a Universalist preacher and the grandson of a whaler, Vannevar Bush earned a math degree from Tufts, followed by a PhD in engineering from MIT. From the beginning of his career he straddled the academic and the industrial in a way that anticipated the future of almost all scientific research.

In 1917, he became head of the experimental laboratory for Tufts University’s new radio station, owned by the American Radio and Research Corporation (AMRAD). His work focused on wave disturbances in magnetic fields, which Bush and the US Army felt might help identify submerged German submarines.

After World War I, he joined MIT’s electrical engineering department, but he continued his affiliation with AMRAD, all the while codeveloping a thermostatic switch with another company that would be acquired 30 years later by Texas Instruments. By 1924, he was working with AMRAD physicist Charles Smith, who invented the S-shaped gas rectifier tube to increase the efficiency of radios and eliminate the need for batteries. In 1925, its Metals and Controls Corporation was renamed Raytheon. Obviously, Bush was well positioned to benefit from the long tail of his academic-industrial efforts.

In time, Bush left MIT to become head of the Carnegie Institute in Washington, DC, the most powerful philanthropic science organization in America, but he was already leading a shadowy second life helping design code-breaking automated machinery for the predecessor of our modern National Security Agency.

In 1939, with the Second World War consuming both Europe and Asia, Bush and James B. Conant, president of Harvard University, met with Frank B. Jewett, president of Bell Labs and of the National Academy of Sciences, to map out a strategy for overcoming our lack of scientific preparedness. Out of that small meeting came a short, four-paragraph proposal for a centralized science operation—outside the control of the military—which Bush placed before President Roosevelt on June 12, 1940.

The president read the report, seized his pen, and scratched at the top, “OK-returned- I think you had best keep this to your own self. FDR.” With that stroke, the National Defense Research Committee (NDRC) was created, and with it, the fully codified and institutionalized era of academic-industrial partnerships in research.

By early fall 1944, the Allies had gained the upper hand on the battlefield, and President Roosevelt had the luxury of thinking about how the US could translate its now thriving wartime-research structure into a postwar world. On November 17, 1944, he wrote to Bush: “There is no reason why the lessons to be found in this experiment cannot be profitably employed in times of peace . . . for the improvement of the national health, the creation of new enterprises bringing new jobs, and the betterment of the national standard of living.” Roosevelt went on to speculate about how the experience gained through OSRD could be adapted “to the war of science against disease.”

By the time Bush had formulated his response in July 1945, Roosevelt was dead of a cerebral hemorrhage at the age of 63. As a consequence, Bush submitted his report, Science: The Endless Frontier, to the newly sworn-in President Harry S. Truman.

Truman agreed that the government needed to support science in the postwar period not only to boost the economy, but also as a bulwark of national defense in the Cold War that was then taking shape, a war in which East and West would become rivals in everything from nuclear weapons to piano competitions. (And today, AI.)

Where Vannevar and Truman parted ways was on the precise role of government. The president saw Washington as being much more engaged, and the new organization allocating America’s treasure under White House directed, government management. Bush leaned heavily toward a more independent, business-oriented venture relying on cooperation among independent scientists, subject to arms-length government oversight and funding.

In the immediate postwar period, the United States fully embraced the idea of a nationally led war against disease. Energized by a healthy business climate and fueled by federally funded American ingenuity, control over our national research enterprise was transferred to a mid-20th-century version of today’s dynastic venture capitalists committed to eventually turning a budding meritocracy into a stable and everlasting aristocracy. Meanwhile, general public health planning and execution was massively decentralized down to the state and county levels. In 1950, more than 6,000 county health departments served nearly 90 percent of the US population and employed 35,000 workers nationwide. Their outputs varied widely in funding, priorities, training, and execution, and their influence steadily diminished over the next half century.

The spigots for research and development were now wide open. In 1940, the US government funded less than 7 percent of the nation’s scientific Research and Discovery. By 1950, that share had grown to 50 percent of a much larger total. Most assumed that Vannevar Bush would be director of the OSRD’s peacetime equivalent, the National Science Foundation, and many were surprised when Truman did not appoint him. However, Bush was ready to move on. He joined the Board of Merck in 1949, and on George Merck’s passing on November 10, 1957 from a cerebral hemorrhage, became Chairman of the Board.

Who’s to know what Vannevar would have thought about RFK Jr. with his 100 Push-His and 50 Pull-Ups, or what he might advise Jay Bhattacharya to do to calm the choppy waters in Bethesda. Four years before his death on June 30, 1974, he was asked what advice he might have for younger leaders.

He wrote, “My conclusion is that things are not so bad as they seem. We need a revival of the essence of the old pioneer spirit which conquered the forest and the plains, which looked at its difficulties with a steady eye, labored and fought, and left its thinking and its philosophy for later and quieter times. This is not a call for optimism; it is a call for determination.”