When President Donald Trump took office in January, he directed the Department of Government Efficiency, or DOGE, to reduce the federal government. The National Institutes of Health, the world’s largest funder of biomedical research, has since laid off 1,300 employees and canceled more than $2 billion in federal research grants.
Dr. Francis Collins, who led the agency for 12 years under three administrations, warns that aggressive downsizing will have long-term consequences for Americans’ health.
“When you’re talking about medical research, when you’re talking about people’s lives, when you’re talking about clinical trials for Alzheimer’s disease or cancer that may take three or four years, you can’t just go in and decide, ‘I’m going to shut those down and maybe I’ll try something else.’ Those are people’s lives at risk,” according to Collins.
Work on child cancer therapies, dementia, and stroke has slowed or stopped, according to NIH employees, due to the layoff of critical lab and support staff.
NIH the largest supporter of biomedical research in the world
The NIH is a massive agency with a budget of $47 billion. The agency is made up of 27 institutes and centers and is located on a 300-acre campus in Bethesda, Maryland. The National Institutes of Health (NIH), the world’s largest funder of biomedical research, has made significant contributions to biomedical breakthroughs.
According to Dr. Collins, the National Institutes of Health has reduced heart disease deaths by 75% over the last four decades. The agency is also responsible for life-saving antiretroviral drugs for HIV and AIDS, as well as stroke treatments.
“Every dollar that the NIH awarded to a grant in 2024 is expected to return $2.46 in just one year. “That’s a pretty darn good return on investment,” Collins stated.
According to a 2023 study published in the Journal of the American Medical Association, 99% of drugs approved by the FDA between 2010 and 2019 had ties to NIH-funded research or work.
According to Collins, universities and research institutes other than the NIH receive more than 80% of the NIH budget.
“They’re the ones that do the work, but they get the funds from NIH by writing very compelling grant applications that go through the most rigorous peer review system in the world,” Collins told reporters.
What happened at NIH after President Trump returned to the White House
In the weeks following the inauguration, the Trump administration acted quickly to reduce federal spending. According to Dr. Collins, employees at the NIH were told not to start any new projects, and the ability to order supplies was temporarily suspended.
“But then they set a $1 limit on what you could order. Collins said, “There isn’t much you can order for $1.”
Insiders at the NIH told 60 Minutes that even after the agency lifted a six-week spending freeze, some shelves and refrigerators containing supplies for trials and patients remained empty because many of the staff who procured those supplies had been fired.
Some employees at the agency, including one physician scientist who requested anonymity, are afraid of losing their jobs if they speak out.
“A complex organization like the National Institutes of Health cannot function without a support system. Doctors, nurses, and scientists cannot function without a wide range of other resources, according to an NIH insider. “They need a complete support infrastructure. And that has since been decimated.”
Morale at the NIH declined beginning in February, when more than 1,000 probationary employees were placed on leave, according to an NIH employee. Workers immediately began assessing the damage and determining whether they could continue to care for patients and research participants.
“This didn’t come from within NIH, it came from outside, they don’t know what these people do,” the employee said.
Some fired employees have been reinstated. Others are still paid but not permitted to work.
Earlier this month, the press learned of a Trump administration plan to cut the NIH budget by more than 40%, or $20 billion. The preliminary budget sent shockwaves through the NIH and the larger scientific community, which depends on the NIH to fund research.
It is the administration’s largest proposed budget cut to the National Institutes of Health, but it is not the first. Most recently, Presidents George W. Bush and Barack Obama made minor cuts to the agency.
Dr. Jay Bhattacharya, a former Stanford professor who studied the economics of health care and opposed widespread lockdowns and mandates during the pandemic, was confirmed as the NIH’s new director late last month. He declined an interview request from 60 Minutes, but outlined his vision for the National Institutes of Health during his Senate confirmation hearing.
“If confirmed, I will carry out President Trump and Secretary Kennedy’s agenda of committing the NIH to address the dire chronic health needs of the country with gold standard science and innovation,” he said at the time.
According to Bhattacharya, one way the NIH will carry out that agenda is to create a new comprehensive database for chronic disease research. In addition, in response to a request from US Department of Health and Human Services Secretary Robert F. Kennedy, the NIH will invest $50 million in autism research, a topic on which Kennedy has long disagreed with researchers.
“Scientific progress on this has been slow because scientists are frankly scared to ask the question,” Bhattacharya said at a news conference. “The goal of my leadership, the NIH is going to make it so those questions are no longer taboo among scientists.”
He recently informed agency advisers that he is working hard to reverse some of the recent “disruptions” at the NIH. He referred to the proposal to reduce the agency’s budget by more than 40% as “the beginning of a negotiation.”
The leaked budget draft proposes consolidating the institutes and centers into eight and eliminating four others.
The potential “brain drain”
Kristin Weinstein, a University of Washington doctoral candidate, lives in Seattle with her husband and 10-month-old son. She’s been studying cancer and autoimmunity for the past decade and hopes to continue her research in the United States after graduation. However, Weinstein and her family are considering leaving the United States.
“It’s in some ways bleak,” Weinstein said. “Nationwide there is a hiring freeze at virtually every major academic university.”
She is not alone; a Nature survey of 1,600 scientists revealed that 75% are considering leaving the United States to work abroad. Australia, Europe, and China have already increased recruitment efforts in an attempt to capitalize on the potential brain drain.
Researchers impacted across the U.S.
Confusion at the NIH has paralyzed many of the 2,500 universities and institutes that rely on the agency to fund their research.
Scientists say projects on HIV and AIDS, trans health, and COVID-19 research were canceled after researchers were informed that their work “no longer effectuates agency priorities.”
Last week, the NIH hinted at further cuts, stating that any university with a DEI program or that boycotts an Israeli company may not be awarded new NIH grants and may have existing grants terminated.
Beth Humphrey, 68, a grandmother, was diagnosed with Alzheimer’s disease last year. She participated in an NIH-funded study run by Duke University and the University of North Carolina.
“It has made me feel a little more empowered against the disease,” she told me. “It is sort of my way to fight back.”
But now, that research could be jeopardized. In an effort to reduce waste, the Trump administration intends to limit the amount of grant money that higher education institutions can use for “indirect costs” or overhead, which include administrative and facility expenses.
Critics argue that indirect costs are a slush fund for universities. However, universities argue that the funds are critical, as they are used to pay for facilities such as brain banks and the staff who monitor them.
Universities have warned that the proposed cut will cost them billions of dollars and have a “dire impact” on “life-saving” trials and research. Twenty-two states, including North Carolina, have filed legal challenges to the proposed policy. For the time being, NIH shakeups are causing concern among patients such as Humphrey.
“When that hope of a possible treatment is taken away, you’re left with nothing but the disease,” Humphrey pointed out. “And there really needs to be hope.”