Jaime Slaughter-Acey was taken aback when she received an email in March from the National Institutes of Health implying that her $2.4 million research grant focused on Black maternal health was being terminated because her work could be used to back racist policies.
The granddaughter of a New Orleans civil rights activist, Slaughter-Acey has devoted her career to improving maternal and infant health in marginalized communities. But here was the NIH informing the University of North Carolina at Chapel Hill associate professor that studies informed by diversity, equity, and inclusion—like her research on socioenvironmental impacts on Black women and their babies—“are often used to support unlawful discrimination on the basis of race and other protected characteristics, which harms the health of Americans.”
It was as if the NIH took everything civil rights leaders stood for and threw it back in her face, Slaughter-Acey said.
“If you strip away race, what we’re doing matters for every mom and baby in this country,” she said of her research.
The Trump administration’s decision to cut roughly $2 billion in NIH grants, some of which were later reinstated, affected a wide range of projects, but its anti-DEI push means marginalized communities will be disproportionately excluded from medical research. Those groups face high prevalence rates of certain conditions, like Black people with sickle cell disease and LGBTQ+ youth with mental illness.
But the scope of damage is wider than that. While a June court ruling led the government to pause its cancellation of grants and reinstate some, the cuts already made and others proposed for the future have jeopardized future research, forcing scientists to think about how they’ll operate without the US government as a reliable partner and denting economic activity.
“We are most likely going to lose a generation of scientists, of young researchers,” said Nadir Weibel, a professor of computer science and engineering at the University of California San Diego. He’s the co-leader of a yearslong research project on artificial intelligence in health-care settings that’s supported by one of the recently reinstated grants.
“They are not going to get into research and become the workforce in research that will solve the problems we will have to face.”
‘Not Good Science’
Grant-cutting decisions are coming from higher-ups in the Department of Health and Human Services, with little consultation from those in the institutes, said a staff member for the NIH, who asked to be anonymous due to the sensitivity of the topic. They added that the agency’s plan is to enact new policies effective in the fall that officials believe will allow them to terminate reinstated grants.
HHS Director of Communications Andrew Nixon said in an email that the “NIH remains fully committed to supporting research aimed at improving the health and well-being of every American, regardless of their sexual identity, race, religion, or socioeconomic status” by shifting away from “politicized DEI and gender ideology studies” to research on chronic conditions like cancer and diabetes.
The National Institute on Minority Health and Health Disparities ranked near the top for the value and number of terminated grants, according to an analysis by researchers at Harvard Medical School and Yale University published in the Journal of the American Medical Association. But narrowing study populations by focusing on specific racial, ethnic, and sexual minorities is a standard aspect of health research, practitioners argue.
“Doing sort of everything in the general population is not good science,” said Brian Mustanski, a Northwestern University professor and director of its Impact Institute. The agency suffered $8.9 million in federal cuts in the current fiscal year, though some of the money was later restored.
“It’s not good public health, and it’s not good economically,” he said.
Emily Dworkin, an associate professor at the University of Washington School of Medicine who specializes in trauma recovery research, said looking at specific populations “can generate findings that are relevant to all Americans beyond just that population.”
But Robert Redfield, who led the Centers for Disease Control and Prevention in the first Trump administration, said he remains confident that the United States will remain the global research leader even if scientists leave for other countries because “the engine for biomedical research in the world is the NIH.”
“The reality is other countries don’t invest in biomedical research to any degree,” Redfield said.
Shrinking Departments
Without guaranteed government financial support, universities have already cut graduate school admissions at biomedical science programs, leaving faculty members concerned about their future employment.
Shelly Sakiyama-Elbert, vice dean of research and graduate education at the University of Washington School of Medicine, said school programs slashed their graduate admissions for the next academic year by 25% to 50% due to the recent grant cuts.
Quickly getting new grants can be difficult, said Dworkin, noting it can take at least a year to apply and receive funding. The NIH restored Dworkin’s funding on July 2 in response to a federal judge’s order invalidating hundreds of grant terminations. HHS is challenging the decision, though the US Court of Appeals for the First Circuit on Friday declined to halt the ruling ordering the reinstatements.
The court ruling offered at least temporary relief for Dworkin, whose grant for her study on trauma recovery among sexual minority women is intended to cover half her salary for the next three years. She had just 30 of 2,400 study participants left to enroll when she learned her federal funding was terminated in March.
“Because my position is completely grant funded, I was weeks away from losing my job when my grants were reinstated,” Dworkin said. Now, she said, “I’m sleeping with one eye open, professionally speaking. It’s an unprecedented level of uncertainty for one of America’s most solid economic and intellectual investments.”
Uri Manor, an assistant professor in the University of California San Diego’s Department of Cell and Developmental Biology, had his five-year NIH funding stream for studying gene therapy for hearing loss abruptly canceled, leaving him on the hook to quickly amass the money needed to continue his research.
His lab is about to go into deficit, and is beginning the layoff process for several people, he said.
“Nothing will kick you into higher gear than the bottom falling out and suddenly you’re in free fall,” said Manor, whose own hearing loss made him eligible for his diversity-focused NIH funding. He noted that “even in the best of times,” researchers spend a considerable amount of time applying for grants.
After the NIH stripped his funding, however, his efforts have “been amped up to 11,” Manor said.
‘Crux’ of the Economy
The current and promised cuts directly undermine the government-backed US research infrastructure developed since the end of World War II that led to breakthroughs in vaccines, cancer therapies, and more, health experts say.
“That’s really been the crux of what our economy has been built on,” Sakiyama-Elbert said.
An analysis published in March by United for Medical Research found that fiscal year 2024 NIH grants supported more than 407,000 jobs and contributed to roughly $94 billion in new economic activity nationwide.
The economic loss is likely to be felt most in more rural states like Nevada, Idaho, and Wyoming, according to the analysis, which draws on data from the US Bureau of Economic Analysis.
“There’s just no replacement for the scope of science that the NIH can fund, through foundations or industry,” Mustanski said. “We’re going to be talking about a radically different way in which science does or doesn’t happen in our country if this approach continues.”
The NIH helps pay for the research behind the vast majority of new pharmaceuticals—354 of 356 approved by the Food and Drug Administration from 2014 to 2019, according to a 2023 report by the Journal of the American Medical Association.
One breakthrough lost without continuing NIH funding is highly active antiretroviral therapy, which suppresses HIV replication. NIH researchers continue to study new drug cocktails, though studies related to the delivery of HIV treatments were among those with grants cut over the past several months.
“It’s not some abstract thing,” said Alonzo L. Plough, vice president of research, evaluation, and learning and chief science officer at the Robert Wood Johnson Foundation, a health-focused philanthropic organization in New Jersey. “And it is also the research that incubates the next health miracle, technological breakthrough that will provide early detection, treatment, and potential cures for the kind of chronic diseases that affect everyone in our population.”
Use of AI in the health field is another area where the US could fall behind, said Andrea Hartzler, co-director of the University of Washington’s Clinical Informatics and Patient-Centered Technologies Program.
Hartzler co-leads the decade-long project with Weibel, which temporarily lost a grant for 20% of its funding, focused on testing AI technology to detect situations when hidden biases may influence how a provider communicates with a patient. The NIH restored this grant on June 27 to comply with the court order.
Funding Flaws
Critics of the current funding system say US medical researchers’ dependence on the federal government is flawed, and that the government should prioritize studies that typically don’t attract large investments by the pharmaceutical industry.
The government-backed research was based on the idea that federal investment would propel national economic growth, win the Cold War, and extend overall life expectancy, said Terence Kealey, an adjunct scholar at the libertarian think tank Cato Institute.
But the data hasn’t borne this out, Kealey said, citing moderate gross domestic product growth rates over time and an average life expectancy that falls behind other high-income countries.
“The premise should be governments shouldn’t fund science and that should be left for industry, and the government only steps in when you can show the industry has failed,” Kealey said.
Still, private sources like foundations can examine and fund some already-vetted proposals, but it “would be pure fiction to say that philanthropy” can fill the gap left by fewer NIH dollars, Plough said.
Some researchers are already bracing for a world where the NIH takes a back seat in scientific research funding.
The future of research requires “diversifying your portfolio,” said UCSD’s Manor. He pursued investors and foundations, some of which—like the Chan Zuckerberg Initiative and The Mathers Foundation—have “been instrumental” in his lab’s survival, he said.
As someone who holds patents on AI technology, therapeutic hearing loss approaches, and more, he’s also trying to start a company to profit off of his ideas.
“‘I really see a hybrid between academia and industry as the right way to go. And now that I lost this grant, I’m even more motivated,” Manor said. “I’ve really got to make sure the other parts of my portfolio are solid if I’m going to keep doing this, because I really want to.”
Slaughter-Acey, the UNC researcher, said she’s fortunate that her project hasn’t completely shut down. Michigan State University, where her co-researcher works, gave the project money to keep a recruitment center open and pay staff until the end of summer. But if her federal grant isn’t reinstated or she doesn’t find an alternative, “that would be devastating,” she said.
But even if her grant isn’t restored, it meant a lot that the judge in the recent ruling said he saw discrimination in the way funding was cut.
“I think it is a victory, even if I don’t ever get my grant back,” Slaughter-Acey said. “To me, my grant isn’t lost in vain.”
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