Conflicts of Interest at the National Institutes of Health

On May 11, acting National Institutes of Health (NIH) director Lawrence Tabak conceded that $350 million in undisclosed royalty payments to Dr. Anthony Fauci, his deputy Clifford Lane, former NIH director Francis Collins, and hundreds of NIH employees presented “an appearance of a conflict of interest.” Tabak, deputy ethics counselor of NIH since 2010 and in 2009 acting principal deputy director, seemed unaware of developments at his own agency. 

Francis Collins received 14 royalty payments, Dr. Fauci 23 payments, and his deputy, Clifford Lane, eight payments, but the NIH heavily redacted the information. Adam Andrzejewski of Open the Books told reporters, “these are not the files the AP received in 2005 where everything was disclosed, the scientist’s name, the name of the third-party payer, the amount of the royalty paid by the payer to the scientist.” 

According to a 2005 report by the British Medical Journal, patients who took part in NIH drug trials were not told that NIH scientists receive royalties from pharmaceutical companies and device makers. Had they known about that potential conflict of interest, patients might have reconsidered the risks of the trial.

At the time, the NIH held 1200 pages related to Dr. Fauci’s financial information and conflict of interest payments but no plans to put that information on its website. One of the few journalists to follow up was John Solomon in “Profit Motive Hidden From Patients.” 

Fauci and Lane were “collecting royalties on an AIDS treatment they’re testing on patients using taxpayer money. But patients weren’t told on their consent forms about the financial connection.” As Solomon learned, “more than 900 current and former scientists at the National Institutes of Health legally collected $8.9 million in such royalties last year for drugs and inventions they discovered while working for the government.” 

Fauci and Lane acknowledged that they were “unwilling to tell interleukin-2 patients about the royalties on consent forms” until the NIH developed a disclosure policy. As Solomon noted, their case “illustrates the gulf between what the government promised nearly five years ago in the midst of controversy and what actually has been done.” The payments are now much bigger, and the disclosure gulf much wider. 

As Andrzejewski explains, the NIH doles out $32 billion in grants to some 56,000 grantees, and over 11 years, approximately $350 million is “flowing back to NIH scientists and leadership.” With the NIH blocking requests for information, the payments are receiving no scrutiny, “on its face a conflict of interest.” Taxpayers and unwitting participants in medical trials might dial back to Dr. Fauci’s first “treatment” for AIDS. 

Fauci promoted trials of AZT (azidothymidine), marketed as Zidovudine, a DNA chain terminator rejected for cancer treatment because of cytotoxicity, and lethality to cells. In 1987 the FDA approved AZT at lightning speed, which disturbed molecular biologist Dr. Harvey Bialy, who was the scientific editor of Biotechnology. 

“I can’t see how this drug could be doing anything other than making people very sick,” said Dr. Bialy, but at the time, AZT was making some people very rich. After FDA approval, Burroughs Wellcome stock went through the roof. At $8,000 per year per patient, AZT was the most expensive drug ever marketed. As the BBC showed in “Guinea Pig Kids,” Fauci also conducted trials of AZT and other dangerous drugs on black and Hispanic foster children in New York City. 

In her 1995 book, The Search for an AIDS Vaccine, Fauci’s wife Christine Grady said children and pregnant women were suitable subjects for drug trials and touted “the availability and effectiveness of AZT.” As the couple had to know, it was anything but.

In 2012, the NIH named Christine Grady, a specialist in the recruitment of human subjects, and chief of the NIH bioethics department. The NIH announcement did not disclose that Grady is Fauci’s wife, and Grady hasn’t disclosed whether any of the human subjects would have held back from drug trials if they knew her husband got a piece of the action. 

If NIH deputy ethics counselor Lawrence Tabak saw anything unethical about concealing the Fauci-Grady relationship, nothing emerged in the record. As Tabak had to know, Fauci’s wife as NIH bioethics boss was a conflict of interest, not just the appearance of one. 

The NIH inspector general explored that theme in a 2019 report titled “NIH Has Made Strides in Reviewing Financial Conflicts of Interest in Extramural Research, But Could Do More.” So NIH ethics counselor Lawrence Tabak had to know that actual conflicts of interest were going on.

Andrzejewski’s organization, Open the Books, is taking NIH to court to get information that should have been made public from the start. Lawrence Tabak is part of the problem, and the NIH requires reform.