Observers See Healy Tenure At NIH Helm In Jeopardy If Clinton Is Elected President

Officials, scientists, and others agree that her close ties to Bush policies could cost the agency director her job More than ever before, the future direction and leadership of the National Institutes of Health will hinge on the outcome of a United States presidential election. There is strong feeling among many key congressional staffers and other Washington observers that NIH director Bernadine Healy, because she appears to be inextricably linked to the Bush administration and its policies, will be removed if Arkansas Gov. Bill Clinton is elected. Although early in her tenure, Healy was widely thought of as someone who would have remained at the agency's helm no matter who might be elected in the fall of 1992, times have changed. Congressional aides, who are generally constrained from making attributed comments, were able to speak off the record for this article. According to one well-placed aide, Healy "had a halo" when she was first appointed, enjoying a reputation as an assertive and highly qualified woman who was an advocate of increased attention to women's health issues. "She had the potential to outlast a Clinton victory," says the aide. But the issue that most seriously eroded her support from both male and female House members was a June 3 letter from Healy addressed to Sen. George Mitchell (D-Maine), which defended President Bush's expected veto of the NIH reauthorization bill. The bill not only would have removed the Bush administration ban on fetal tissue research, but also would have mandated attention to women and minority health issues. In the letter, Healy said, "I would concur with the recommendation to the President to veto the Bill." She wrote that the bill "micromanages some of NIH's important research programs." Healy also objected to the bill's language requiring attention to women's health issues when that initiative was already under way. Another sore point for many in Congress and the biomedical community was her assertion in the letter that a fetal tissue bank depending on ectopic pregnancies, instead of elective abortions, as a source was feasible and should be tried out for a year. Those voting against the bill used the letter to justify their "no" vote, and that angered bill supporters, who on June 24 failed, by a slim margin, to override the Bush veto. Rep. Louise Slaughter (D-N.Y.) says that following the letter, "it's so hard to trust her now." Slaughter says she will not support Healy's retention as NIH director if Clinton is elected. "I think a scientist is a scientist, and if a scientist is so hamstrung by political considerations, they shouldn't be heading up the National Institutes of Health." Rep. Patricia Schroeder (D.-Colo.), who is cochairwoman of the bipartisan Congressional Caucus for Women's Issues, is apparently still upset over the letter incident. However, Schroeder and other congressional representatives, including caucus cochair-woman, Rep. Olympia Snowe (R.-Maine) declined to speak on the record concerning their degree of support for Healy. But, at the time of the letter-writing incident Schroeder was quoted in a June 10 article in the Chronicle of Higher Education (S. Burd, page A21): "We felt double-crossed. She [Healy] has come for help when [Rep.] Dingell has been on her case; she has come to us for more funding, and we always did it; and she has told us how great all these women's-health goals are; and the next thing we know everyone was running around with this letter." A staffer with the House Subcommittee on Health and the Environment, says that nowadays, "she doesn't have a great many allies here." When one combines Healy's previous position as deputy director of the White House science office during the Reagan administration with the letter, which "showed where her loyalties lie," he says, it would be inconceivable for her to stay on if Clinton is elected. But Healy is by no means bereft of congressional support, especially in the Senate and even among Democrats. "On this end, [Sen.] Barbara Mikulski is a very strong supporter of Dr. Healy," says a spokesman for Mikulski, a Democrat from Maryland. The aide will not speculate, however, on whether Mikulski would support Healy in a Clinton administration. And, says one Senate Labor and Human Resources Committee staffer, "I think everyone is impressed with what Healy is doing at NIH." His prediction is that, even if Clinton is elected, Healy will "stay in place." The staffer acknowledges, however, that there is lingering ill will over the letter. "There's a feeling that she turned her back on people who supported her," he says. "But she really has made an effort to address the concerns that people have had about the NIH." He particularly lauds her leadership on women's health issues and efforts to produce a strategic plan. The strategic plan is being developed by NIH staff and incorporates comments from some of the hundreds of biomedical researchers. The plan is intended to set forth a clear mission and prioritized goals for the institutes gathered under NIH and, in doing so, act as a kind of marketing tool with Congress. Hundreds of pages of reports from the series of meetings that went into the plan's formulation were gathered, but the final product of that process will be a 100-page document due for release in October after being cleared by the Department of Health and Human Services, NIH officials say. Just as congressional sentiments are divided, Healy's forceful style has apparently divided the biomedical community into opposing camps of supporters and detractors. Among issues that have stirred strong sentiments in the past have been Healy's support of the NIH effort to patent partial DNA sequences, and the forcing out of James Watson as head of the Human Genome Project. Lately, it's been the strategic planning process that's been roiling the waters. Among those providing accolades is Dani Bolognesi, director of the Center for AIDS Research at Duke University Medical Center, who has been involved in formulating the strategic plan for NIH. "I think she's doing a great job and will get better and better if she stays in the job longer," he says. Many researchers have expressed strong reservations about the strategic plan on grounds that it was at first a chaotic process and that it potentially imposes too much top-down management (B. Metheny and S. Haley, The Scientist, May 11, 1992, page 1). But Bolognesi, who is part of a panel of researchers working with NIH on the plan's formulation, thinks the strategic planning process is a great way of focusing and defining NIH to itself and to Congress. "You can't go to Congress and say you just want to support good science," he says. "You do have to have a plan. NIH has to stand for something." The process of drawing up a plan for the future direction of NIH research has been a valuable contribution by Healy, says George Abraham, an immunologist at University of Rochester School of Medicine. "You have to give Healy credit for trying to do something like this," he says. "To be quite frank, something like this should have been done sooner." Abraham unabashedly likes the assertive director. "Can you remember any NIH director that's gotten such notoriety? She's given NIH a new face and a new identity," he says. And that "new face" has been showing up outside the usual science venues, in such places as Working Woman magazine, which features Healy on its September cover. Sid Gilman, chairman of the department of neurology at University of Michigan Medical School, also on a panel involved in drawing up the strategic plan, has nothing but praise for Healy. "She's done a great deal of innovative work, and she has vision and insight," he says. He adds that it would be "a real pity" if she were asked to leave office following a Clinton victory. But not everyone involved in the NIH strategic planning process has good things to say either about the plan or about Healy. One researcher from a prominent East Coast institute, speaking on the condition of anonymity, says the strategic planning meetings were hardly the open forums for discussion they were billed as. "I felt it was a complete waste of time," she says. "I felt unfree to say what was on my mind. And virtually everyone I have talked to had the same experience." As for NIH director Healy: "I'd be happy to see her go." Philip Sharp, head of the department of biology at the Massachusetts Institute of Technology, is not pleased with the over-politicization of the office of NIH director. And Sharp sees Healy as the ultimate expression of a process that's been under way ever since the directorship became a presidential appointment in the 1970s. "I find Dr. Healy a purely political person and very much identified with the political aspirations of this administration, and that has made it a more political position," he says. While he favors the strengthening of the director's position--as Healy has helped achieve--he would like to jettison the political baggage that's been loaded on board. So what does Clinton have to say about Healy's future? "There's no answer to that," says a campaign spokesman. He says decisions on who would be requested to submit a pro forma letter of resignation in the event of a Clinton victory are "not even on the map yet." Healy's press aide, Johanna Schneider, when asked what might happen under a Clinton presidency, says, "I don't think there's any way to respond to that question." But as for the strategic plan, she says, "No matter what happens, the strategic plan will be of value to the next director." One troublesome issue for some in the science community is whether a Clinton victory would equate to another long period of interim leadership for NIH, as happened after the Reagan-appointed James Wyn-gaarden stepped down following Bush's election. Robert Rosen-zweig, president of the Association of American Universities, says that's not probable. Two things led to the 20 months of vacancy before Healy was appointed, he says: For one, the Bush administration was generally slow in filling posts and did not make the search for a new NIH director a high priority. In addition, many quality potential candidates were excluded because they would not take or could not pass the "litmus test" on opposition to abortion and the use of fetal tissue in research and treatment, he says. But if Healy were to step down, "there's no reason to panic," he says. "I think there are people out there who can fill that job quite satisfactorily." Of course, similar confidence in the ease of filling the post was expressed by White House science office director Allan Bromley back on June 27, 1990, almost a year after Wyngaarden left the post (Jeffrey Mervis, The Scientist, July 23, 1990, page 10). "There is a clear recognition throughout the administration that [the NIH directorship] is a position we must fill and fill quickly," he said. And Healy was not confirmed by the Senate as the new director of NIH until nine months later, on March 21, 1991.

Observers See Healy Tenure At NIH Helm In Jeopardy If Clinton Is Elected President

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