NIH cuts will devastate US research and communities

A dramatic cut to the National Institutes of Health’s budget for grants that support research institutions will have a seismic impact on science and medicine in the US — and will directly affect local communities and Americans’ access to high quality care. The Trump administration has targeted $4 billion in cuts to “indirect” costs for NIH research grants. Those funds, typically known as overhead, help cover the facilities and support that enable universities and academic hospitals to do world-class research. It pays for things like equipment, maintenance and administrative salaries. These things might not seem essential, but the impact will be crippling to biomedical research in the US Institutions will immediately face hard choices about projects and staff. That ultimately will affect health care for all of us, whether in the form of a clinical trial that isn’t funded, or a lifesaving drug that is never developed, or a facility that doesn’t have the money for state-of-the-art equipment.

Consider the impact on St. Jude Children’s Research Hospital, which develops new treatments for pediatric cancers and diseases like sickle cell. The hospital will lose nearly $40 million a year in research funding, says Charles Roberts, director of the St. Jude Comprehensive Cancer Center. “This will likely mean fewer new treatments will get to children and therefore that more children will die,” he says. Now multiply that loss across all the leading children’s hospitals, academic medical centers and universities in the country. Some institutions stand to lose as much as $100 million in funding, according to Stat. Local economies will also take a hit. The University of Alabama, at Birmingham, for example, is the biggest public employer in the state, and has received more than $1 billion in NIH grants in recent years. The loss in funding is expected to diminish health care access for everyone in the region and affect jobs, whether the people working directly for the university or those at local businesses where its employees and patients shop and eat.

“Research universities are often the largest employers in their region. They are often the primary health care providers to communities,” Alondra Nelson, principal deputy director for science and society for the White House Office of Science and Technology Policy during the Biden administration, explained in a post on Bluesky. “This funding shift will not only reduce U.S. research leadership, it will put working people out of work and reduce healthcare access.”

“Overhead” might sound like a way to just pad a budget but think of the many other situations where we pay the cost. When you go to a restaurant, for example, the prices on the menu aren’t just accounting for the cost of the food and labour to make it and deliver it to your table. Baked into your tab is a share of all the other things that make it possible for you to enjoy your meal — like rent, utilities, garbage collection, and cleaning staff.

Science is no different. A grant covers specific work performed by a research team — some of the salary of a scientist, the cost to make an experimental drug, the nurse who administers it, among other things. But then there’s the chunk of money that accounts for the infrastructure that allows that experiment to happen. “We cannot do cutting edge research to save children’s lives in the middle of a field,” Roberts, from St. Jude, says. Beyond the buildings, labs, advanced equipment, “we need the shared resources that enable scientists to collaborate. We need high performance computing. (We need) the people who wash our glassware, repair our equipment, schedule meetings, and the people who ensure our patients are kept safe in clinical trials so our scientists can focus on doing the research.”

Republicans have criticised the wide variation in what NIH pays different institutions for overhead. Harvard’s negotiated rate is nearly 70%, whereas a state school might get 20% to 30%. In fact, a social media post from NIH directly called out Harvard University, Yale University and Johns Hopkins University, prompting billionaire Elon Musk, who Trump has tasked with excising money from the federal budget, to declare overhead “a ripoff.” (Johns Hopkins Bloomberg School of Public Health is supported by Michael Bloomberg, founder and majority owner of Bloomberg LP, parent company of Bloomberg News.)

But those differences don’t mean Harvard is wasting the money. Rather, it means, in part, that lab space and salaries in Boston are a lot higher than in Columbus, Ohio. And our leading scientific institutions typically have more advanced equipment to maintain and administrative staff to support their vast operations. This doesn’t mean we can’t have a healthy conversation about whether some of those costs should be put back on the universities that can support them, or whether there aren’t places for savings.

If the government said to universities, “‘Hey, you’re spending too much money, can you tighten it up?’ We’d say it’s hard, but we can probably do it,” says Michael Oakes, who oversees Case Western Reserve University’s research enterprise and technology transfer programme. “You can make the system more efficient. But blowing it up? That creates a real problem for America.”

This isn’t the first time the Trump administration has gone after overhead at NIH. In 2017, as part of a broader plan to trim 18% from the agency’s budget, Trump proposed capping indirect costs at 10%. But back then, academic associations had time to make the case to Congress that the move would be economically devastating. Reason reigned. This move caps indirect costs at 15%. The swiftness of the administration’s action — it was announced on Friday night to take effect on Monday — has everyone scrambling. The legality of the order is already being challenged. On Monday, 22 state attorneys general sued the NIH, saying that “Without relief from NIH’s action, these institutions’ cutting edge work to cure and treat human disease will grind to a halt.”

But in the meantime, universities will need to make difficult choices. Sure, some, like Harvard, can dip into their endowments, especially if they believe the situation is temporary. Others might consider raising tuition and passing those costs onto already financially overburdened students. Philanthropic organisations and donors might step in to close some of the gap, though it’s hard to imagine they could come close to covering all of it. Everyone expects some projects to be shut down and people to lose their jobs. Academic science is the substrate for innovation in this country. These cuts risk drastically depleting that precious resource — and put our health and economy at risk.

Earlier, after Trump took office, the US Office of Management and Budget put a hold on federal funding assistance to states. Tong was among a coalition of 22 attorneys general suing to stop implementation of that policy. Tong called the funding freeze a “full assault on Connecticut families — an unprecedented and blatantly lawless attack on every corner and level of our government and economy,” and said “Connecticut is locked arm in arm with states across the nation” in fighting it. US district judge John J McConnell Jr. issued an order in January siding with the attorneys general, and then this week said the Trump administration had violated that order and said the Trump administration “must immediately restore withheld funds” and “immediately restore frozen funding.” That order followed a “motion to enforce” and a “motion for preliminary injunction” filed in the case, after the state Department of Energy and Environmental Protection said detailing $534,464,753 in federal funding remained inaccessible.

Tribune News Service