A year into funding cuts, where do NIH researchers stand?

It’s been over a year since the Trump administration began cutting $32 billion in National Institutes of Health (NIH) funding, leaving researchers with fewer resources and often also without jobs.

In a recent Stat survey of nearly 1,000 US-based NIH grantees, 35% saw all funding return after initial cuts, but 27% reported that none of their funding was restored and 26% said only some was.

“A lot of people have been defunded. A lot of young people have gotten out of [research] or decided not to go into it,” Eric Perakslis, chief science and data officer at health tech Pluto Health, told us. “And all of these things add up.”

‘Deeply damaged.’ Perakslis, who also previously worked at the FDA as chief information officer and chief scientist of informatics from 2011 to 2013, said the research ecosystem has been “pretty deeply damaged” by these cuts.

For biomedical research, he said NIH is “Fort Knox,” funding studies through lab space as well as salaries and rent that make doing the job possible. Without NIH funding, it’s more expensive for universities to conduct research and house grantees, he said.

“Universities aren’t going to support researchers if they’re going to lose money on grants,” Perakslis said.

This has several long-term implications for the healthcare industry, experts told us. For one, researchers are seeking out other areas of employment, particularly in the private sector. They’re also moving out of the US to continue their studies abroad, where they can find funding.

“We’re not signaling to this next generation of early-career researchers that there is a stable, predictable opportunity for careers in science that are based on government funding,” Karen Knudsen, CEO of the Parker Institute for Cancer Immunotherapy, told Healthcare Brew. “Talent follows stability.”

Some researchers are also turning to philanthropic organizations or the private sector for funding. But nongovernmental organizations often have specific goals or reasons for funding that can limit a researcher’s opportunities, like needing to focus on a certain disease.

Additionally, getting funding for early-stage research from the private sector can be difficult, Marcel Botha, CEO of venture firm 10XBeta said, as the work is riskier compared to the commercial stage because it’s not yet proven to work.

“Those funding cuts will affect the US’s ability to compete with global research and global innovation—not today, not tomorrow, but over the next decade,” Botha said. “If we don’t restore that with a competent alternative—if not the same mechanism—then that will hurt us as a nation.”

Care cost. But it’s not just a loss of jobs or money. NIH cuts could also mean a loss of lives, experts told us.

“It’s very difficult to restart those programs for the obvious reasons that you’ve lost the talent,” Knudsen said. “When it comes to cancer research, in particular…I worry greatly about it, for what it means for the health of the US public.”

Since 1991, there’s been a 34% decline in cancer mortality, according to the American Cancer Society, which Knudsen directly links to NIH funding. The problem, she said, is that when there’s a lack of funding, money often goes to “safer science,” and “bold projects are also likely to fall by the wayside.”

For cancer, that is especially impactful, as clinical trials are often “the most advanced form of care,” she said. Fewer clinical trials could lead to more lives lost.

In need of a reset. Experts have also made it clear that NIH has had trouble in the past proving that funding was going to meaningful projects or wasn’t sufficient to meet need.

Botha said he’s looking at these cuts as a “reset” to ask what the government is funding, how it benefits the public, and if it’s modernizing the US health system over other countries.

“With Covid and with the trust in medicine and science dropping, I think there was a lot of the public that was challenging the billions of dollars running through NIH and what they were getting for it,” Perakslis said.

Still, he said the way the government went about the cuts was “reckless.”

“I don’t believe you can build something as fast as you can break it,” Perakslis said. But because the systems are already broken down, it’s a “clean slate to try to build some of this back better,” he added.

“We don’t have a choice anyway,” he said.