What It Would Mean To Lose the National Institutes of Health
In this piece, we provide readers with an in-depth explainer of what the NIH does and how its mission is being threatened by current political interference.
Introduction
In one of our last posts, Science Under Attack, we threw a lot of headlines at you about recent executive orders and their effects on the U.S. research ecosystem. However, as these situations have continued to evolve, it has become clear that a general awareness of the issues at hand isn’t necessarily sufficient towards building a response to it. For most members of the public, this is probably their first time being exposed to the inner workings of scientific research and the funding schemes that support it. Wrapping your mind around these things is difficult even for those of us who are a part of the scientific community–we can only imagine how disorienting or amorphous these concepts may seem to those outside of science.
In this post, we’ll be giving you much needed context as to what the National Institutes of Health (NIH) actually does, both in terms of its independent function and its contributions to research nationwide, and why the current administration’s actions are jeopardizing our country’s research, healthcare, and public health systems. Then, we’ll take you through how these situations have changed since our last post and provide an outlook of what the next months may bring. If you take anything from this post, however, it should be this: U.S. science is in danger, and we will all be affected–regardless of whether we are scientists, doctors, or members of the general public.
What Is The NIH?
Let’s start with the basics. Originally founded in 1887 as the Laboratory of Hygiene, the National Institutes of Health (NIH) is the primary federal agency dedicated to conducting biomedical and public health research in the United States. In its nearly 140 years, the institute has grown to encompass 27 institutes and centers (ICs), each focusing on a particular disease or aspect of human biology. Importantly, the research performed by these institutes encompasses both basic and translational research–in other words, exploratory, discovery-based science as well as studies aiming to translate these findings into medical treatments or therapeutics, respectively.
Before we get into the specifics of how the NIH works, though, we would be remiss if we didn’t emphasize just how special it is. Often called the crown jewel of biomedical research, the National Institutes of Health represents the forefront of innovation and cutting-edge research not only within the U.S., but across the world. To give you an idea of just how much NIH-supported research has achieved, here are some (key word being some) of the major highlights: the sequencing of the human genome, breakthroughs against multiple diseases including cancer and Alzheimer’s, and vaccines for multiple major diseases such as COVID-19 and rubella. Not only that, but of the 356 medications that have been approved by the FDA between 2010 and 2019–including recent heavy-hitters like Ozempic–354 of those medications were developed thanks to NIH-funded research. And, if you needed further proof, over 150 Nobel Prize winners performed their award-winning research thanks to funding from, you guessed it, the NIH.
Evidently, the NIH supports a substantial amount of the country’s most critical research, producing incredible medical breakthroughs that cure numerous diseases and advance our knowledge of human health. But how exactly does NIH carry out its life-saving and important research, and how is this mission being put at risk?
The NIH & Its Relationship To The Economy
The NIH has two main branches of research activity: an intramural branch and an extramural branch. The former encompasses the 27 ICs and supports the research of scientists on its campus, which covers the gamut of diseases, from Alzheimer’s and cancer to more basic research on development and cellular and molecular biology. The extramural program, on the other hand, supports the research activities of universities across the country and forms the backbone of the U.S. research ecosystem. Of the funding it is appropriated by Congress, the majority goes to the extramural branch–according to 2019 numbers, only 10% of its funding that year was applied towards the intramural program.
The nature of this funding structure means two things: the NIH is a major force for economic growth and research activity in the United States, and it is a crucial contributor towards the development of the next generation of scientific talent in our country. Let’s start with the economic side of things. Current estimates have reported that for every dollar invested in the NIH, the agency returns $2.56. Scale this up to the budget it receives, and the NIH rapidly becomes the source for billions in economic returns; in fact, according to a 2025 report by United for Medical Research, the agency drove 95 billion in economic output last year alone. Additionally, compared to the rest of the world, it is the biggest investor in biomedical research, easily outpacing similar agencies and funders in other countries by the billions.
If you recall from Science Under Attack, the Trump administration attempted to put a freeze on federal funding, which included funding through and by the NIH. As you can imagine, this presents several issues not just for scientists and the state of research, but the economy itself. If an agency that generates billions in economic output is suddenly unable to generate any output, the resulting economic impacts become incredibly severe. A recent analysis by STAT is already reporting a 2.3 billion plummet in new grants issued by the NIH–with only 3 million issued for new and competitive renewal grants so far compared to 15 million this time last year.
Not only that, a recent study covered in The New York Times from researchers at American University’s Institute for Macroeconomic and Policy Analysis claimed that even the mildest scenario–a budgetary cut of 25 percent–of reduced investment in research would result in a 3.8% decline in U.S. gross domestic product (GDP) over time, similar to the decline seen during the 2008 economic recession. This hypothetical cut would also leave the government with 4.3% tax revenue, reducing overall stores of federal funding. And, again, this is the mildest scenario. Larger cuts–like the ones rumored to be under consideration–will have even more disastrous long-term economic effects.
Of course, while federal funding makes up the bulk of economic investment in biomedical research, there are also private and philanthropic sources of contribution that contribute towards science in the United States. That being said, it would be an error to assume that these sources alone can fill the void that will be left in the wake of budgetary cuts. In an article for Nature, policy experts like Pamela Herd, a sociologist at the University of Michigan, warn that this is not a plausible scenario; Herd says, “No one has the capacity of the federal government. You’re producing research, but you’re also training the next generation of scientists. Private industry can’t do that.” University of Chicago economist Ufuk Akcigit also noted that investors often invest in something once its application becomes clear, whereas basic research is more focused on building knowledge without a set application in mind.
While the funding situation is still fluid, with policies surrounding indirect rates and funding continuing to be fought in the courts, it is already becoming clear just how disruptive these cuts will be not only to the economy, but to other areas of science as well.
Grantsmanship & NIH Funding
Before moving into the NIH’s role in supporting the next generation of researchers, though, let’s take a second to get into the weeds of the grant mechanisms that the agency supports and how they are being affected by recent funding cuts and executive orders. The NIH has multiple types of grants that support researchers and training programs at different levels; some examples include the K99/R00 grant, which supports postdoctoral fellows in the midst of applying to faculty positions and beginning their own labs, as well as the F31 grant, a prestigious award that supports graduate students in the later stages of their Ph.D. research. These grants not only directly fund the research of the recipient, but also provide valuable training and professional development opportunities that serve as the stepping stones of a successful career in science.
Currently, administration actions are threatening both sides of the grant application process–in other words, not just those applying to grants, but also the scientists responsible for reviewing them. In terms of the former, the administration has begun to eliminate diversity tracks for grants like the F31 (which, if you recall from our last post, are meant for scientists who come from underrepresented backgrounds but are in every way identical to the usual application track), in addition to outright canceling others meant to increase diversity in science. The gravity of these actions shouldn’t be underestimated–preparing a grant can take weeks, if not months, out of a scientist’s research efforts and having a grant cancelled outright (especially in the middle of its disbursal) means not being able to make rent or afford groceries.
If these actions weren’t concerning enough, the administration has also begun to take aim at the other side of grantsmanship: the reviewers. When a grant is submitted to an institute like the NIH, the agency brings together experts from that particular field to assess applications and determine several parameters, such as the feasibility of the research and what it contributes to the field. These reviews, also known as study sections, occur regularly throughout the year and are essential to determining what research to fund and why. In NIH’s case, the Boards of Scientific Counselors act as their reviewers, a group of expert scientists in a field that convenes every four years to assess the progress and quality of intramural research.
Recently, however, certain reviewers serving on NIH’s Boards began receiving dismissals from then-acting NIH director Dr. Matthew Memoli, effectively terminating their tenure as reviewers. Usually, experts who are appointed to this board serve for five years, but in the case of those terminated, these notices came in the middle of their terms–a turnover that individuals familiar with the Boards claim is “not routine.” Of particular concern, however, is the fact that many of those terminated–38 of 43 individuals–were women or minorities, implying a bias motivating their dismissal. Though the Department of Health and Human Services (HHS) was quick to deny any biases, the likelihood of these firings happening to occur in this pattern by chance was calculated to be 1 in 300, or 0.33 percent. In the past week, the NIH has also gone on to completely dismiss the Board of Scientific Counselor for the National Cancer Institute, indicating that they’re not planning on stopping these dismissals–targeted or not–anytime soon.
In addition to grant applicants and reviewer boards, political interference from the current administration has now extended towards what grant solicitations get to be released by the NIH. Usually, the agency periodically releases Notices of Funding Opportunities (NOFOs), which invite researchers to apply for research and training grants. These notices have been frozen since January following the communications blackout instituted by the Trump administration, which was recently lifted. However, in order for a NOFO to be posted, it must now be approved both by an individual from DOGE and an individual from the Department of Health and Human Services (NIH’s parent agency) to ensure that the notice aligns with the priorities of the current administration. An NIH official quoted in the article described this development as “chilling” and indicative of a higher level of political interference in the agency’s scientific priorities.
This overreach can also be seen in what institutions are allowed to receive NIH funds. Recently, the NIH announced that institutions must certify that they do not have diversity, equity, and inclusion (DEI) programs and that they are not limiting their commercial relations with Israel in order to receive funds. This edict applies not only to new grants, but to all existing grants, meaning that the NIH can decide to retract already awarded funds if it deems that the institution is not in compliance. Let’s be clear: in canceling grants and attempting to assume control over the process of grantsmanship, the administration is deciding not only what science gets done, but also who gets to do it, signaling a concerning turn towards censorship and increased political interference of research in the United States.
Trainees & Brain Drain
In addition to supporting research at an economic level, the NIH is also responsible for training and giving rise to the next generation of scientists in the United States. On campus, the agency offers two major training programs: the NIH Summer Intern Program (SIP) and the Postbaccalaureate Intramural Research Training Program (IRTA), the former of which provides high school students with their first experience in scientific research and the latter of which serves as a stepping stone for recent college graduates to successfully apply to graduate and medical programs. In a given year, thousands of high school and college students flock to the NIH’s labs to receive scientific training and mentorship from some of the country’s foremost researchers in their fields. This year, however, will look very different: NIH SIP, in addition to similar programs, have been cancelled, while the IRTA program suffered a months-long hiring freeze that was only recently removed. As a result, students across the country have found themselves without valuable research experience or a full-time job at a critical time in their academic careers. Labs feel this loss too–much, if not all, of NIH’s research is driven by research fellows including postbaccalaureates and summer interns.
The agency dedicates itself to the mentorship of the next generation of scientists not only on its own campus, but on the campuses of universities across the nation as well. Through its Postbaccalaureate Research Education Program, also known as PREP, the NIH funds one to two-year postbaccalaureate programs at multiple universities, allowing students to gain additional research experience and supporting them in applying to graduate programs and fellowships such as the NSF Graduate Research Fellowship Program. PREP is one of many examples of the ways in which the agency’s funds are used to build the careers of the nation’s future scientists; other grants like the Maximizing Access to Research Careers (MARC) and the Undergraduate Research Training Initiative for Student Enhancement (U-RISE) help universities–particularly those with less research resources and funding–to broaden participation in the sciences by granting undergraduate students the support they need to pursue careers in research and medicine.
Seeing the large number of ways in which NIH supports trainees and universities is what makes it so difficult to hear that many of these grants and programs have been unceremoniously cancelled. Directors of these programs across the country received letters from the NIH claiming that these grants “no longer effectuate agency priorities.” To give you an idea of the scope and nature of these cancellations, take a look at the map below, courtesy of scientists who have been tracking and reporting these events. The institutions affected aren’t your Ivy Leagues or major public universities–these are rural and minority-serving institutions that fill an important gap in access to higher education. While universities like Harvard have the resources to fend off political challenges, these institutions do not. Without grants like these and without programs like these, we will inevitably lose talented scientists–a phenomenon otherwise known as brain drain.
In fact, brain drain is already beginning in the United States. According to a recent poll by Nature, 75% of respondents were interested in continuing their scientific careers elsewhere due to political interference. Not only that, but scientists from other countries (who contribute significantly to U.S. science) have lost interest in pursuing their careers here–a dual loss to the country’s scientific workforce. The bigger risk, however, is not merely that scientists will move to other countries, it’s that they’ll move out of science entirely.
Recall the figure we showed you earlier comparing the NIH’s investment in biomedical research to other global funders. While there are multiple global funders of research, none are operating at the scale of the NIH. Put simply, there isn’t enough economic infrastructure to sustain U.S. levels of research intensity anywhere else in the world. This means that, while some will have the fortune of pursuing their careers elsewhere, many will be pushed out of science completely due to a lack of accessibility to research opportunities and a lack of economic investment in research. Importantly, once these talented scientists leave, we will likely never get them back—an untold loss not only for science, but for all of us who rely on it.
Layoffs & Clinical Trials
Outside of academia, interruptions to NIH funding have had widespread reverberations across the scientific workforce, healthcare, and local economies. Beginning with the agency itself, the start of April saw approximately 1300 federal workers laid off from the NIH. These workers occupied positions throughout the 27 ICs and ranged from directors of institutes to individuals involved with human resources, communications, and IT departments. As a result of these layoffs, the NIH has been thrown into further chaos–everything from delays on purchasing crucial reagents to an inability to send out valuable samples for analysis.
While blanket bans on communication, travel, and purchasing have been recently lifted, scientists have found themselves unable to return to normalcy; the individuals who would normally perform the administrative work associated with registering and traveling to a conference or putting in purchasing orders for reagents, for example, were dismissed in the layoffs. Now, scientists are being forced to take on more administrative work to be able to perform their research. Importantly, roadblocks like these have real consequences on life-saving research—just listen to this PBS interview with NIH scientist Dr. Steven Rosenberg about how a rollout for a promising cancer immunotherapy treatment is at risk of being delayed. The scale and urgency of this moment is perhaps best captured by one NIH scientist‘s response to The Atlantic: “How I lost my job is trivial compared to the fact that people will die because of this.”
These disruptions to life-saving research are not only happening on the NIH’s campus, but at the campuses of universities, medical schools, and hospitals across the nation. Funding freezes, cancellations, and a lack of new grants are collectively leading to the pausing or termination of over one hundred clinical trials spanning a range of diseases and treatments. For some, such as a study assessing the effects of organ transplant on vaccine efficacy, the dismissal from the NIH claimed that, since the pandemic was “over,” “the grant funds are no longer necessary.” For others, such as a study assessing efficacy of HIV/AIDS prevention in women, the NIH claimed, “research programs based primarily on artificial and nonscientific categories … do not enhance health, lengthen life or reduce illness.”
It’s important not to underestimate just how damaging these pauses and cancellations will be towards advancing the way we think about and treat some of the most challenging diseases we face today; without them, we will be unable to develop new treatments or assess whether these potentially life-saving treatments can be successfully applied to patients. It’s also important to emphasize that universities will not be alone in suffering the consequences of lost NIH funding. In the case of Harvard University, for example, an analysis performed by the Harvard Crimson found that hospitals would suffer the most from the Trump administration’s $9 billion review–not the university. Indeed, cancellations and pauses have already sparked layoffs at hospitals, such as the University of Massachusetts’s Chan Medical School, which recently laid off two hundred employees.
Conclusion
What’s next
There’s a lot to take stock of, but let’s briefly rewind and review the major points: federal layoffs, clinical studies cancelled, political interference in what science gets done by who, an entire generation of scientists lost, and an untold loss for the development of life-saving research and treatments. Clearly, the first one hundred days of the Trump administration have already wrought plenty of disruption to U.S. research. In the face of so much chaos, you may be wondering: what now?
First, it’s important to keep our eye on the ball; tracking political interference (such as terminated grants or training programs) will be crucial towards understanding the immediate and long-term impacts of executive orders and federal policies. Equally important is to call a spade a spade and to hold the administration accountable for its actions. Take this recent opinion piece published in The New York Times, which questions why the NIH is being targeted by the government without any conclusive line of thought. This kind of naïveté only serves to occlude and shield the administration’s actions, creating the illusion that no one really knows why science is being targeted when, in fact, the game plan is appallingly clear. It’s for the same reason that drove the administration to defund research on misinformation–to control the spread of information and to silence any opposing voices or data that refute their own ideological beliefs and priorities. Additionally, by gutting our federal research agencies, the administration will point to their lack of output and efficiency as a sign that we no longer need them–allowing them to privatize public services and increase their own profits at the expense of the American public.
How do we prevent this from happening? By looking ahead and gleaning what we can about what may be coming down the line–both for the purposes of anticipating future interference and for preparing to resist it. Already, there are some concerning developments to keep an eye on: the Trump administration’s 2026 budget proposal aims to cut NIH’s budget nearly in half–from its current 48 billion to 27 billion–in addition to reducing its 27 ICs by eliminating certain institutes and consolidating others. If the cuts described earlier in this piece were damaging, such a sweeping reduction in funding will be the killing blow to many aspects of biomedical research in the United States–training programs, clinical trials, graduate programs, you name it. Importantly, however, while the Trump administration can suggest these changes, Congress ultimately holds the power of the purse—meaning these changes aren’t set in stone just yet. Regardless, this proposal sets a worrying precedent for the future ahead.
Additionally, while we’ve only discussed the effects of losing biomedical funding within the U.S. in this piece, it’s also important to note that the U.S. has recently cut USAID funding to health programs in low and middle-income countries. A recent paper published in The Lancet estimates that, if this funding is not replaced or reinstituted, these cuts will result in an estimated 25 million deaths from diseases like AIDS and tuberculosis as well as unplanned pregnancies and unsafe abortions. Not only that, the NIH has recently announced that it will not renew or issue foreign subawards, or funding that is given to an international collaborator working with US researchers, effectively cutting off scientific collaboration with experts around the world and isolating scientists further.
What to do about it
Reading the headlines, it can be easy to feel buried under the sheer magnitude of everything taking place–both in science and outside of it. The scale of political interference is unprecedented, and the effects extend well beyond our country alone. That being said, as futile as it may seem, we are not powerless. Take the recent cancellation–and subsequent reinstitution–of the NIH’s Women’s Health Initiative (WHI). Started in 1991, the WHI has enrolled thousands of patients over three decades in the pursuit of preventing conditions like heart disease and cancer in women. Originally cut by the Trump administration on April 22nd, public outrage over the cancellation was so overwhelming that it forced the administration to backtrack and reinstitute WHI funding just three days later. This isn’t the only example of situations in which the administration has had to quickly retract its stance–other recent examples include the reinstatement of the Greensboro Lunch Counter exhibit at the National Museum of African-American History and Culture or the Pentagon’s resumption of gender-affirming care for transgender service members.
If you’re upset by what you’ve read in this piece, you’re not alone. A recent poll taken by The Washington Post shows that 77% of respondents oppose the reduction of federal funding for medical research. Whether you’re concerned about the economy, a young scientist hoping to pursue a career in research, or someone depending on researchers for new treatments to a disease, we all depend on the NIH and we will all have something to lose if these cuts continue. Now more than ever, we need to come together to defend our research institutes and universities as well as the importance of the work they do. While we have already shared action items related to these events in Science Under Attack, let’s briefly reiterate two of the most important things you can do: spread the word about NIH cuts and make your voice heard.
Inform others. As we’ve covered in this piece, loss of NIH funding will affect just about everything from clinical research to higher education, but odds are that most people aren’t aware of the magnitude of these actions or how they will be personally affected by them. This is, of course, on purpose: the more actions to keep track of, the more likely you are to miss them. Thankfully, scientists have compiled resources to help the public understand how their state and county economies may be affected: SCIMaP, which allows you to view the economic loss expected for your county, and United for Medical Research’s NIH In Your State, which allows you to view the current funding allocated to your state as well as the jobs and economic activity this funding supports. Lastly, Our Health ROI allows you to see the contributions that NIH-funded research has made towards understanding and treating a particular disease. Share these resources on social media. Talk to your family, your friends, and your neighbors about what’s happening. Without awareness, we cannot move towards concrete action.
Make your voice heard. In addition to informing others, it’s crucial that we reach out to our representatives in the House and the Senate about these issues. Calling or emailing might feel like a drop in the bucket, but together, we can truly make a collective impact–just look at the examples we cited earlier of public outrage resulting in a policy change. What most people don’t realize is that convincing you that your voice doesn’t matter, or that your vote doesn’t count, is half the battle. As Cory Booker repeatedly stated during his record-breaking speech on the Hill, “the power of the people is greater than the people in power.” Now is the time to attend town halls, to take part in events like Stand Up For Science, even to run for office–not to give up.
Though the future remains uncertain, we are determined to keep doing our science and to defend the importance of biomedical research. We constantly say it here on How We Talk About Science, but it’s true: we are always stronger together, and we will get through this–together.
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