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On Monday, scores of scientists at the National Institutes of Health sent their Trump-appointed leader a letter titled the Bethesda Declaration, a frontal challenge to “policies that undermine the NIH mission, waste public resources, and harm the health of Americans and people across the globe.”It says: "We dissent."In a capitol where insiders often insist on anonymity to say such things publicly, more than 90 NIH researchers, program directors, branch chiefs and scientific review officers put their signatures on the letter �� and their careers on the line.Confronting a ‘culture of fear’They went public in the face of a “culture of fear and suppression�� they say President Donald Trump's administration has spread through the federal civil service. “We are compelled to speak up when our leadership prioritizes political momentum over human safety and faithful stewardship of public resources,�� the declaration says.Named for the agency's headquarters location in Maryland, the Bethesda Declaration details upheaval in the world’s premier public health research institution over the course of mere months.It addresses the abrupt termination of 2,100 research grants valued at more than $12 billion and some of the human costs that have resulted, such as cutting off medication regimens to participants in clinical trials or leaving them with unmonitored device implants.In one case, an NIH-supported study of multi-drug-resistant tuberculosis in Haiti had to be stopped, ceasing antibiotic treatment mid-course for patients.In a number of cases, trials that were mostly completed were rendered useless without the money to finish and analyze the work, the letter says. “Ending a $5 million research study when it is 80% complete does not save $1 million,�� it says, “it wastes $4 million.”Video below: Hundreds protest against medical research cuts in March The mask comes offThe four-page letter, addressed to Jay Bhattacharya but also sent to Health Secretary Robert F. Kennedy Jr. and members of Congress who oversee the NIH, was endorsed by 250 anonymous employees of the agency besides the 92 who signed.Jenna Norton, who oversees health disparity research at the agency's National Institute of Diabetes and Digestive and Kidney Diseases, recently appeared at a forum by Sen. Angela Alsobrooks, D-Md., to talk about what's happening at the NIH.At the event, she masked to conceal her identity. Now the mask is off. She was a lead organizer of the declaration.“I want people to know how bad things are at NIH," Norton told The Associated Press.The signers said they modeled their indictment after Bhattacharya’s own Great Barrington Declaration of October 2020, when he was a professor at Stanford University Medical School.His declaration drew together like-minded infectious disease epidemiologists and public health scientists who dissented from what they saw as excessive COVID-19 lockdown policies and felt ostracized by the larger public health community that pushed those policies, including the NIH.“He is proud of his statement, and we are proud of ours," said Sarah Kobrin, a branch chief at the NIH's National Cancer Institute who signed the Bethesda Declaration.Cancer research is sidelinedAs chief of the Health Systems and Interventions Research Branch, Kobrin provides scientific oversight of researchers across the country who've been funded by the cancer institute or want to be. But sudden cuts in personnel and money have shifted her work from improving cancer care research to what she sees as minimizing its destruction. "So much of it is gone �� my work,�� she said.The 21-year NIH veteran said she signed because “I don't want to be a collaborator�� in the political manipulation of biomedical science.Ian Morgan, a postdoctoral fellow with the National Institute of General Medical Sciences, also signed the declaration. “We have a saying in basic science,�� he said. “You go and become a physician if you want to treat thousands of patients. You go and become a researcher if you want to save billions of patients.“We are doing the research that is going to go and create the cures of the future,�� he added. But that won’t happen, he said, if Trump's Republican administration prevails with its searing cuts to grants.The NIH employees interviewed by the AP emphasized they were speaking for themselves and not for their institutes or the NIH.Dissenters range across the breadth of NIHEmployees from all 27 NIH institutes and centers gave their support to the declaration. Most who signed are intimately involved with evaluating and overseeing extramural research grants.The letter asserts that “NIH trials are being halted without regard to participant safety�� and that the agency is shirking commitments to trial participants who “braved personal risk to give the incredible gift of biological samples, understanding that their generosity would fuel scientific discovery and improve health.”The Trump administration has gone at public health research on several fronts, both directly, as part of its broad effort to root out diversity, equity and inclusion values throughout the bureaucracy, and as part of its drive to starve some universities of federal money.A blunt ax swingsThis has forced “indiscriminate grant terminations, payment freezes for ongoing research, and blanket holds on awards regardless of the quality, progress, or impact of the science,�� the declaration says.Some NIH employees have previously come forward in televised protests to air grievances, and many walked out of Bhattacharya's town hall with staff. The declaration is the first cohesive effort to register agency-wide dismay with the NIH's direction.A Signal group became the place for participants to sort through NIH chatter on Reddit, discern rumor from reality and offer mutual support. The declaration took shape in that group and as word spread neighbor to neighbor in NIH offices.The dissenters remind Bhattacharya in their letter of his oft-stated ethic that academic freedom must be a linchpin in science.With that in place, he said in a statement in April, “NIH scientists can be certain they are afforded the ability to engage in open, academic discourse as part of their official duties and in their personal capacities without risk of official interference, professional disadvantage or workplace retaliation."Now it will be seen whether that's enough to protect those NIH employees challenging the Trump administration and him.“There's a book I read to my kids, and it talks about how you can't be brave if you're not scared,�� said Norton, who has three young children. "I am so scared about doing this, but I am trying to be brave for my kids because it's only going to get harder to speak up.“Maybe I'm putting my kids at risk by doing this," she added. "And I'm doing it anyway because I couldn't live with myself otherwise.��