NIH Leadership Crisis Deepens as NINDS Director Departs

The National Institutes of Health (NIH) is facing a growing leadership crisis as Walter Koroshetz, M.D., director of the National Institute of Neurological Disorders and Stroke (NINDS), becomes the latest high-profile departure from the agency. This exit, slated for January 24, 2026, marks a significant blow to the stability of the NIH, leaving more than half of its institutes under interim leadership.

Mounting Instability at NIH

Koroshetz's departure comes after the NIH rebuffed his request for reappointment, according to an internal email obtained by Stat. With this latest exit, 14 of the NIH's 27 units will be led by interim directors, underscoring a period of unprecedented turnover at the nation's premier biomedical research agency.

The American Academy of Neurology (AAN) expressed "significant concern" over the abrupt decision, highlighting the lack of consultation with key stakeholders and the absence of a clear succession plan. The AAN emphasized NINDS's vital role in funding and directing research into the brain and central nervous system, stressing the importance of strong, committed leadership for the continuation of critical work in neurology.

Broader Implications for Biomedical Research

The leadership vacuum at NIH is part of a larger trend of instability in federal health agencies, including recent turmoil at the Food and Drug Administration (FDA). In November, hundreds of biotech leaders voiced concerns that ongoing volatility at the FDA could discourage investment in biotech innovation or drive it to other countries.

John Crowley, CEO of the Biotechnology Innovation Organization, warned that the "constant turmoil is undermining America's leadership in biotechnology." This sentiment was echoed by an mRNA alliance, which demanded steady FDA leadership, arguing that the lack of stability is eroding public trust and threatening public health.

HHS Restructuring and Its Impact

The current state of affairs at NIH and other health agencies can be traced back to significant changes implemented by the Trump administration. The Department of Health and Human Services (HHS) has seen a deep alteration and shrinkage of most agencies under its umbrella, including the NIH.

This trend of denying reappointments to institute directors is not isolated to Koroshetz. In March 2025, Eric Green, M.D., Ph.D., who led the National Human Genome Research Institute, was also denied reappointment, further contributing to the leadership void at NIH.

As the pharmaceutical and biotech industries grapple with these changes, the future of American leadership in biomedical research hangs in the balance. The ongoing instability at key federal agencies threatens to undermine decades of progress and innovation in the life sciences sector.