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NIH director Jay Bhattacharya didn't aggressively push back and defend Trump administration budget cuts and grant freezes when senators grilled him for 90 minutes last week about plans for his agency.

• An $18 billion cut in the 2026 NIH budget request was just a starting point for negotiations, he told lawmakers.

Why it matters: The former Stanford professor has tried to deflect controversy over the administration's health agenda while others on President Trump's health team under HHS Secretary Robert F. Kennedy Jr. have leaned into their roles as disruptors.

• That's raising questions about who has the final say over the government's biomedical research hub.
• Bhattacharya is "in a difficult position with limited influence," Capital Alpha Partners analyst Rob Smith wrote in a note on Friday. "RFK appears to be running the show at the subagencies he oversees as HHS Secretary. It's our understanding that very little happens without his input."

What they're saying: An HHS spokesperson told Axios that NIH and Bhattacharya are fully committed to advancing research, improving health outcomes and supporting scientific discovery. Constructive criticism pushes this innovation forward, they said.

State of play: Bhattacharya tried to find a middle ground during the Senate Appropriations Committee hearing, taking credit for fighting what he called "politicized science" while telling lawmakers he didn't accept the job to terminate grants.

• "This is my first time through this budget fight, and so I'm still learning, but I'll tell you what I understand is that this — the budget — is a collaborative effort between Congress and the administration," Bhattacharya said.
• Meanwhile, Kennedy defended the cuts strongly when he appeared in front of the same panel last month.

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Use of the 988 national suicide prevention and mental health hotline remains uneven across states, a new analysis finds.

Why it matters: The service was launched nearly three years ago to help address America's mental health crisis — but gaps persist.

Driving the news: Alaska (45.3 contacts per 1,000 people), Vermont (40.2) and New York (38.8) had the highest 988 contact rates among states in 2024, per new research published in JAMA Network Open.

• Delaware (12.5), Alabama (14.4) and Florida (15.6) had the lowest.

The big picture: The 988 service fielded more than 16.3 million calls, texts and chats between July 2022 and the end of 2024.

• The national contact rate was 48.9 per 1,000 people during that period, and 23.7 in 2024 alone.
• What they're saying: Several factors may be contributing to the state and regional differences in 988 use, says study author Jonathan Purtle, associate professor and director of policy research at New York University's School of Global Public Health.
  • That includes differences in how 988 is being advertised by states and cities, as well as political attitudes.

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The FDA will miss a Tuesday deadline for deciding whether to approve a drug for a potentially life-threatening disorder because of "heavy workload and limited resources," manufacturer KalVista Pharmaceuticals said.

Why it matters: It appears to be the first time an FDA review had to be extended because of DOGE-directed cuts to staff at the agency.

The big picture: Health industries pay billions developing and shepherding drugs, devices and tests through the regulatory process, including user fees that help ensure there's enough staff to evaluate products on a predictable timeline.

• Drug companies previously expressed concerns that the timeframes for these sorts of decisions would begin slipping because of staff and budget cuts.

KalVista said the FDA notified the company it would miss its decision date of June 17 for a new drug application for the oral drug, called sebetralstat, that targets hereditary angioedema.

• The condition is a rare genetic disorder in which patients can experience experience painful and debilitating attacks of tissue swelling.

What they're saying: "One delay does not a trend make," wrote Chris Meekins, a Raymond James analyst and health official in the first Trump administration.

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Ineffective policies are limiting access to critical compounded drugs — patient-specific therapies prescribed when an FDA-approved drug is inappropriate or unavailable.

What you need to know: Our Blueprint outlines 14 targeted reforms to protect patient care.

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President Trump's first-term surgeon general thinks people shouldn't be focused as much on who HHS Secretary Robert F. Kennedy appointed to the expert panel that advises the CDC on vaccine policy as the way he purged all 17 of the sitting members.

What they are saying: "Everyone jumped so quickly from 'they fired everybody' to 'let's talk about these new people' that we stopped talking about the fact that they fired everybody," said Jerome Adams, an anesthesiologist who's now a professor at Purdue University.

• If a new administration doesn't like the panel members or their recommendations, "they can just throw them all out and start over again," he said.

Between the lines: Since the 1960s, the ACIP has served as a highly vetted advisory group that's informed the government through public debate on the safety and effectiveness of vaccines, Adams said.

• The system operated for decades largely free from outside interference, he said, allowing doctors to safely rely on it to make recommendations to patients. ACIP recommendations also heavily influenced which shots insurers would cover.

"If ACIP begins dropping recommendations for COVID-19 vaccines and other shots, it would disrupt the process by which vaccines are paid for. Then you're indirectly taking away vaccine access from people," he said.

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