Emma Bascom , 2025-05-16 15:11:00
Key takeaways:
- Experts said important academic research has been stalled after the NIH pulled federal grants.
- Cuts to institution funding may force researchers to leave their university jobs for work with private investors.
President Donald J. Trump’s administration has announced major federal cuts in the name of efficiency, but this has massive repercussions for academic medical researchers and the patients who rely on their work, according to experts.
The NIH has canceled hundreds of grants in the past few months, prompting public outcry and litigation.
In fiscal year 2023, NIH spent more than $35 billion to provide more than 300,000 researchers with nearly 50,000 competitive grants, according to the agency. As Healio previously reported, NIH grants include additional money for indirect costs, which cover expenses related to facilities, equipment, faculty, utilities, security and maintenance. In most cases, institutions charge the government a 30% indirect cost rate, though some institutions charge more than 50%.
The updated NIH policy immediately caps the indirect cost rate at 15%, which translates to potential annual savings of more than $4 billion. The cuts will differ at each university, but at the University of Pennsylvania, for example, the cuts would reduce federal funding to the by nearly $250 million per year.
Firsthand experience
Jack Iwashyna, MD, PhD, a critical care physician, health services researcher and Bloomberg Distinguished Professor of Social Science and Justice in Medicine at Johns Hopkins Medical School, told Healio that he has personally seen how academic research has made “incredible progress in treating diseases that would have killed my patients just a few years ago.”
The kind of success that Iwashyna has seen comes from “decades of sustained investment” in these institutions, he said. The cuts to funding, he added, have disrupted research efforts, leading to “months of turmoil and chaos and distraction — months that could have been used to learn new things.”
Junior faculty — “the upstarts with brilliant new ideas, the classic Hollywood movie young geniuses” — have had “to rewrite their grants, and face unprecedented delays in evaluating their grants, just totally stalling their work,” Iwashyna said.
“We might well have had progress on important problems in, for example, pneumonia, or in the detection of low blood oxygen levels, had these avoidable delays not slowed these brilliant young people down,” Iwashyna said.
Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers University School of Public Health, said he has seen several NIH grants with Rutgers-affiliated researchers get the axe, and that the cuts have “incredibly affected” these researchers.
“Every day that passes now, without this work being done, without this knowledge being developed, is diminishing the health of people,” he said.
Responsibilities to patients
One of the key issues stemming from the funding cuts is how they may affect patients who rely on institutions conducting research or who are in the middle of a clinical trial.
“Honestly, this is an unprecedented problem. Some complex treatment regimens require months to be enacted. They can’t be stopped in the middle,” Iwashyna said. “These ham-handed executive orders provide no nuance or guidance.”
Halkitis said the impact on patients will vary based on what stage the study was in, so some studies will never start and others will “become frozen.”
“None of our studies have those situations where people suffering from these illnesses are not going to be able to access the care that they need, but there are studies out there that are definitely affected in that way,” he said. “There are the day-to-day realities of research teams being dismantled that has everyday people implications separate from the science that’s being undermined.”
DEI-targeted cuts?
One of the most polarizing stances from the current administration has been its anti-DEI policies.
Much of the research that Halkitis has seen cut falls “under the umbrella of ‘science that is not in line with how the federal government defines science’ — which means science that has diversity, equity and inclusion at its center.”
“This is what we’ve been experiencing, and the primary target of our grants at our school have been around HIV and sexual minority populations,” he said.
Halkitis said he is seeing pointed cuts for research regarding transgender health, LGBTQ+ health and vaccination.
“In this very insidious way, there are attacks on areas that have created a lot of debate and divisiveness in the country,” he said. “But that’s just the beginning. There’s an overall attack on science that’s taking place. And the question I have for all of us as we’re facing this is, ‘do we just roll over and let this happen?’”
He mentioned the snowball effect, and said reproductive rights, for example, could be up next. Not fighting back now, when highly marginalized groups are targeted, “opens the door to the possibility of” disrupting other areas of science, so “it is incredibly important that individuals are proactive and not reactive to these efforts to undermine DEI,” he added.
“We all should be making the case for and providing examples for how DEI has enriched not only the lives of people who are members of minority groups, but also all Americans,” Halkitis said.
“As an activist, I would be remiss not to say that protesting in a calm, civil, and intelligent way is the strongest tool we have right now,” he continued.
Shikha Jain, MD, FACP, an associate professor of medicine in the division of hematology, oncology and cell therapy, and associate director of oncology communication and digital innovation at the University of Illinois Cancer Center, told Healio that “health care has become politicized.”
“At the end of the day, health care should not be a political topic. It should really be about taking care of patients,” said Jain, who is also the host of Healio’s Oncology Overdrive podcast, a Healio | HemOnc Today associate medical editor and consulting medical editor for Healio | Women In Oncology.
The future
Looking to the future, there are other major repercussions to consider, like recruitment. For “every day we need to worry about this, it makes future recruitment for research even harder,” Iwashyna said.
“Research has never paid well; we offer the fun of discovery and the dull stability of university jobs in exchange for doing work in the public interest, rather than for private investors,” he said. “So, I find people are asking: without stability, why not go into something for private gain instead of the public good of scholarship? This chaos is losing the most important ingredient in science: talent.”
Iwashyna said this is especially an issue where DEI-focused work is concerned.
“The slashing of DEI work means that many of the most exciting new voices who were recruited in part with the support of those DEI initiatives are particularly finding their work threatened, right as we need them the most,” he said.
Halkitis also mentioned how much future science will be set back. He said it is not long before the stalled trials will need to start back from day 1, which puts the U.S. behind.
“How long will it take for the U.S., after these months of attacks on research, to rebuild itself? It’s not going to happen overnight,” he said. “It’s going to take years.”
Halkitis recalled a decade-long study he worked on that followed young gay men, “and that was a big lift to try and get them back every 6 months to do the work, to look at the development of sexually transmitted infections and HIV.”
“Once you undo that, once you stop injecting the medication you’re testing, you are going to start from scratch,” he said. “Science takes 24-hour, 7-days-a-week attention. It’s not like we can just pick it up and start it again. Every day that passes … is a day that damages the scientific integrity of the work that’s happening in the U.S.”
Despite the uncertainty, Iwashyna is holding out hope.
“The success of those who would destroy science, scholarship and universities is not inevitable — and we need to keep pushing back against bad ideas to defend these institutions that do so much good,” he said. “Americans deserve to continue to have the best science in the world working for them.”
HHS did not respond to Healio’s request for comment.
For more information:
Perry N. Halkitis, PhD, MS, MPH; Jack Iwashyna, MD, PhD; and Shikha Jain, MD, FACP, can be reached at primarycare@healio.com.
