Opinion | I Was an NIH Program Official. Here's What a Peer Reviewer Doesn’t See.

In a June 18 opinion piece in MedPage Today, Anthony LoSasso, PhD, a health economist who served on NIH study sections for 12 years, took issue with a recent New England Journal of Medicine (NEJM) editorial that criticizes the Office of Management and Budget (OMB) proposed Federal Financial Assistance rule.

His complaints against the NEJM editors were threefold. First, he argued they romanticized NIH peer review, ignoring that funding decisions have always involved judgment, discretion, and imperfection. Second, he accused them of hyperbole for invoking the Soviet agronomist Trofim Lysenko, implying the comparison to politicized science crowded out the opportunity to argue for a more balanced middle ground. Third, he cites the "Unified Strategy" from NIH Director Jay Bhattacharya, MD, PhD, as an example of thoughtful reform, calling on the NEJM editors to approach this issue with humility as Bhattacharya has done. But his characterization of what the Unified Strategy actually is and what has been happening at NIH is incomplete.

Each of these complaints deserves a direct response. But taken together, his argument inadvertently obscures rather than illuminates what the administration is actually doing.