Image above: Courage is Contagious. Credit: Dr. Rabbithole, anonymous 27 UNIHTED member
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Sylvia Chou had been with the National Institutes of Health for 18 years when she decided to resign in January 2026, 1 year after the second Trump Administration took office. At the time of her resignation, she was serving as a program director at the NIH’s National Cancer Institute, and her specialty was health communication. One of her areas of expertise, health misinformation, became a topic that was more relevant than ever at the end of her career at NIH.
Over the course of 2025, top–down directives brought significant changes to NIH’s grant funding policies and infrastructures, curtailing the independence and integrity that had long defined the institution. These directives dictated what kind of science was deemed acceptable, how funding decisions were made, and how health information could be communicated to the public. They also brought significant disruptions to NIH’s workforce. Since January 2025, NIH has lost over a fifth of its workforce because of layoffs, resignations, and early retirements, causing generational expertise to disappear.
Along with a group of her colleagues at NIH, Chou helped to organize the Bethesda Declaration, a letter signed by nearly 500 NIH employees in June 2025 that advocated for the protection of scientific integrity, academic freedom, and restoration of politically disrupted research funding. One year later, the same group issued a follow-up to this declaration, writing that “the chaos of 2025 has been replaced with coordinated, systematic, institutionalized destruction in 2026.”
Chou was one of roughly 90 people who signed the Bethesda Declaration by name and has chosen to speak publicly about her experience as a federal worker navigating this turmoil. From this vantage point, the Observer’s Managing Editor Hannah O. Brown talked with Chou about her experience on the frontlines of a historic disruption of scientific research.
Brown and Chou spoke on July 15, 2026. Edited excerpts of their conversation follow.
Your recent research has focused on health misinformation. How did that expertise inform how you interpreted what was happening around you at NIH before you resigned?
“To this day, most people are living in fear and dread. And I’m not exaggerating.”
When the new Trump administration took over and started becoming very muscular in dictating what needs to happen in the space of science, I felt like I already knew the playbook. I knew where things were headed, maybe a little bit ahead of a lot of people who were earnestly and honestly wanting to just do their jobs. That awareness was painful but was also very illuminating for how to make decisions for personal lives and as a whole. On the personal side, I made a decision to speak out. But on a societal level, I had certain ideas about [what we] as a group, as people who want our science to thrive, would need to do in the face of all these things happening.
It sounds like you saw the writing on the wall and could anticipate what was going to happen. Did you already know what your steps were going to be? Or was it more of a “buckle up and ride it out” feeling?
Absolutely not. I did not know. And even though we could anticipate certain things, I think everyone was still taken by surprise by how fast, relentless, lawless, and senseless a lot of the ensuing actions were. My own personal homework was to be very alert and always listen and learn and keep an open mind. I had to keep asking questions like: Am I able to speak safely? Am I able to still do this research? Am I able to help people? I had to keep asking these questions almost every day as a temperature check on where things were.
That sounds very nerve-wracking, like you had no sense of felt safety.
Yes, yes. The biggest shock is how fearful everyone has gotten. To this day, most people are living in fear and dread. And I’m not exaggerating.
Are people staying at NIH with the experience of that fear because they have to? Or are they staying because they feel like they can make a difference from the inside out? I understand the answer to this may be nuanced and hard to provide.
Very, very nuanced. That’s the question that had been keeping me up at night precisely because the answers are so nuanced. But I can break it down pretty simplistically: Nobody’s OK. People are very concerned about the future of science and our pursuit of academic freedom. That’s where the commonality ends. And then you have people who feel they have no other option, whether it’s a livelihood issue, insurance issue, or other life burdens. Even for those people, the lines are constantly moving. Some people will tell themselves, “As long as I’m still doing this, it’s OK.” Others are saying, “As long as I’m not being asked to do that, it’s OK.” But then those goalposts keep shifting. Sometimes what we tell ourselves does not match what is actually happening, and we are all at risk of that. That’s where the nuance comes in.
Can you share how the Bethesda Declaration came about?
I talked about the beginning of these attacks and the soul-crushing nature of the work. People were starting to murmur either through signal chats or in parking lots: What is this? What can we do? How do they get away with this? Who can you trust? You’re looking over your shoulder. It reminded me of predemocracy, like when I lived under martial law before Taiwan became a democratic society. There was that feeling of, “Can I say this?” Never in my life had I experienced that except for when I was in elementary school in Taiwan in the early 1980s.
We started organizing and, through a friend, I found out about the larger effort across NIH, because NIH has 27 institutes. My friend told me that this group is thinking of issuing a letter that calls out some of the most harmful policies, so that’s how I got connected.
I remember calling the lead organizer at the time, and I asked her, “What makes you think you can take this on?” I had a very good personal conversation with Jenna Norton, and I could see that the group was very levelheaded and well informed. They knew what they were doing. I joined the organizers, and it took us a few weeks of intense revisions and recruiting other people. And finally, I think we had 91 named signers and several hundreds of anonymous signers when the letter was first issued on June 9, 2025. After it was issued, many thousands more signed the support letter, including a bunch of Nobel laureates. I believe our declaration was covered by close to 100 media outlets.
So many atrocities were happening that it’s possible a lot of people still haven’t heard of it. I’m really aware of that. But most people have heard about different groups of civil servants speaking out. I think more than 10 other federal agencies have also issued similar dissent letters.
I would say the number one contribution is that we have kept that conversation going today. We issued the Bethesda Declaration One Year Later. We’ve been documenting systematically what’s happened inside the NIH, and we found that a lot of what seemed arbitrary and senseless and illegal has now been formalized and normalized and systematically applied in the way NIH does business. We think that’s an important alarm to sound.
Can you describe the experience of organizing with a group of colleagues rather than going about it on your own?
Without my group of comrades, we wouldn’t have survived emotionally, none of us. I really mean it, both in terms of the soul-crushing nature of being inside and the desire to let the world know what is happening to raise awareness. I think just getting by day-to-day and getting our voices heard would have been impossible.
I also learned that an authoritarian government intends to isolate people. There is a lot of work built into stopping you from connecting and forming dialogues and engaging in difficult conversations. It is really critical that we came together, and our motto is courage is strength, courage is contagious, and there is strength in numbers. I have internalized these sayings because they are really true.
Because we have a community, we can each do things that fit our risk tolerance and our values. We also can challenge one another. We have had disagreements and internal conversations about best strategies. We learned so much from each other. I am just so grateful that we have this community.
Looking back at your time at the end of being at NIH, is there a version of the story where you could see yourself staying and kind of pushing from within the system? Could you talk about what that would have cost or what that would have taken from you personally?
The short answer is no; I really couldn’t have seen a way to stay past the time I did. But I have to bring up my privilege when I answer that question. I do have a spouse who has health insurance. If I didn’t have that, I don’t know whether I would have leaned in on the survival mechanism and stayed and how I would have handled my life if I had stayed.
Has your research funding been disrupted by federal policy changes? APS wants to hear from you. Please share your story here.
Health insurance is a huge constraint in this country because it’s an employer-based program that makes it very hard for people to leave their jobs. But besides that, I really felt like what I saw was compliance because of fear and paralysis. Every day I was crying, saying, my life is too short to live like this. That’s when I knew I had to take the next step. The grand scheme of humanity, it’s so tiny. Our time of working and trying to do something, it’s tiny. And I just couldn’t live with myself if I couldn’t feel free to think and speak and write and engage with people like you.
Can I ask, what are you doing now? Did you take another position?
I have never been busier. I am writing, speaking, and organizing. I have already published many op-eds and have a few more coming, and I have a book to write about our Bethesda Declaration. I’ve been working hard on it but it’s a daunting project. It started out as just my desire to bear witness, because I really do think history will look at this time in ways that future generations will be astonished by. But now I’m thinking it is so important before we can rebuild, and that’s my other project right now—really thinking about the future of academic research. I am collaborating with like-minded voices to ponder: How do we build a system that will be protected and insulated from political whims? Answering this question requires us to look at what’s happening now. That’s a prerequisite before you can bring any skillful experts into the space. We have to learn from what is happening to our infrastructure right now.
Can you talk a little bit about the cost for research and the cost for society of what you were seeing at NIH, beyond the dollar figures? What do you think gets lost when research is not funded or when it gets interrupted midstream? Are those research programs just delayed, or are they sometimes lost for good?
I see at least three main areas. First is broken trust. There was an implicit trust that researchers and the federal government as funders have built to understand the shared rules of the game. It was never perfect—there was always going to be that grumpy reviewer that never understood my work, and there were turf wars. But we still had a parameter where we knew how to play by the rules and do our best and thrive. I worry that all this destruction is breaking that long-held trust between funders and the researchers.
My second area would be a broken pipeline. I worry about younger investigators coming from a trainee role to an investigator role. How do they sustain their research program? How do they not despair and either move away or find something else to do?
And lastly, the reason most of us do research is that much of NIH’s work is aiming to improve the health of everyone. I think there’s going to be downstream impacts on healthcare, services people get, innovation, and general population-level health outcomes. And these damages are not going to hit people equally. The marginalized, the immigrants, the sexual and gender minorities, and English-as-a-second-language folks are going to be disproportionately negatively affected by the censored and stopped research.
For readers whose health depends on research that’s been stalled or defunded, what would you like them to know about the stakes of what’s happening? Especially with your understanding of their playbook, what will happen next?
They should realize that science is incremental, and so many people are dedicating their scholarly pursuit to some version of truth seeking. We need all of that work to eventually grow into life-saving care and treatment options. It takes patience, trust, and public commitment for academic pursuits. These are people who devote a whole career or a series of grants to understand some small aspect of this larger mystery.
The idea that scientists are just elitists is not accurate. I think most researchers have good intentions. But I do think on the flip side, as an academic research enterprise, maybe we did not do enough in thinking and articulating why our work matters to the well-being of society. That’s where I think science communication and advocacy work that actually connects to patients and communities is going to be critically important. Not just to tell people, “You should trust us because we do good work.” We want you to be engaged, to tell your experience, and to teach us how to better position our research to help you. The broader community needs to be part of a larger reckoning, a larger discussion about why as a society we care about the pursuit of science and research.
The last thing I would say is that I think everybody can find their voice. I really want to stress that the idea, “Let’s wait for some people to go and talk to Congress or talk to the media,” can be damaging. The whole reason we got organized as the Bethesda Declaration is that we looked around and wondered: Where are the adults? Who is coming to save us? How can this destruction just happen like this? Where are the leaders? We realized if nobody’s coming to save us, we better stand up. We have to learn and be very humble, but very courageous.

It seems almost like a muscle to exercise when you talk about courage and how it’s something that’s contagious. Has it gotten easier to take those stands over time and to be confident that you’re doing the right thing?
I love this question because you talked about muscle memory.  My muscles could be strengthened, but I know that we never build muscles overnight. It is a practice. And even though I just told you that our motto was “courage is contagious,” I don’t know how many times I’ve been told by people who are not involved in our movement that it is NOT contagious. They tell me that fear is contagious. Self-preservation is contagious. Apathy and silence can be contagious.
The night before we issued the declaration, I’ll never forget that video call. I hadn’t met most of these people. I didn’t know 95% of the people who signed. On that call, there were talks of fear of arrest, fear of being kicked out of our computers, all kinds of things that I hadn’t even personally reflected on. And it was getting really scary. But we had this image of holding hands and jumping off together, like “We are scared, but we’re doing this,” and it was very comforting.
I definitely think I have learned how to listen to my inner voice. Listen to my heart. But always be clearheaded, and be safe, and be cautious. I think a lot of it is finding that deep listening and reflection and intentionally not allowing fear to be the dominating driving force for your everyday life. And it is a deliberate decision. It’s not just circumstance.
What kind of impact do you think the Bethesda Declaration has had so far?
The jury is still out on the longer-term future of both science and the NIH. But I think that our main impact is in continuing the honest conversation about reality, because there are a lot of people who want to tell you something that’s either a half-truth or wishful thinking, or people who are so exhausted, they just don’t even want to look at the reality. I think we’re holding each other accountable to the facts and the reality on the ground. And we also hopefully have articulated that an attack on science is an attack on truth and attempts to seek that truth, and that is a threat to our democracy and our fundamental values.
I think people in the Bethesda Declaration and people who we work with recognize that this is not just about getting another grant funded or picking up another project. It is about how we ensure that this country is one that respects academic freedom, freedom of speech, and freedom of thought so that people can pursue their academic research without fear or censorship. I’m holding out hope for more people to join us. Universities and professional associations are realizing they have a critical role to play, even if it may potentially put them at elevated risk. The risk of not doing something or capitulating is bigger.
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