From the first week of his administration, President Trump has targeted medical and academic research, cutting research funding to universities and slashing the workforce and budget for the National Institutes of Health (NIH). Concerns about the future of medical research in the United States began on January 22, just three days into the new administration, when all meetings to review grant submissions at NIH were cancelled with no plan for rescheduling.

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Within days, NIH abruptly cut off funding for research projects that incorporated principles or language associated with diversity, equity, and inclusion (DEI) in any form, such as clinical trials focused on populations underrepresented in past research. In early February, NIH announced drastic reductions in the indirect costs rate, the percentage paid to universities for administrative and overhead costs of funded research studies. NIH funding of new grants fell precipitously; an analysis in STAT found a 28% reduction in new grant funding in the first three months of the administration. Then in March universities got hit, most notably Columbia and Harvard, with the Trump administration threatening to terminate all federal funding if universities did not comply with the administration’s policy demands. The loss of federal funds abruptly ended groundbreaking biomedical and behavioral research in areas from cancer to chronic illness to infectious diseases, including some longitudinal studies that had been following participants for years and even decades.

Damaging the ‘entire pipeline’ of innovation and discovery.

The impact of loss of federal funding goes beyond one or two targeted universities. An Association of Health Care Journalists article explains that, “when the government pulls the plug, it’s not just Harvard or Columbia University that feels the pain—it’s the entire pipeline of innovation, discovery and health equity.” Large research projects are conducted by a network of universities, and funding cuts at Columbia and Harvard are felt throughout that network. The loss extends to the next generation of scientists as graduate students and postdoctoral fellows have lost their funding and positions and the NIH has canceled a decades-old research internship program for college students. And, though elite institutions are the ones in the news, research at smaller universities, which don’t have the large endowments of a Harvard or Columbia, is being disrupted as well.

National Institute of Nursing Research under threat.

Now the National Institute of Nursing Research (NINR) is on the chopping block. The proposed budget Trump submitted to Congress in early May eliminates NINR entirely. In the 40 years since Congress established NINR, the institute has led and funded research that has improved patient outcomes, advanced health and quality of life, and addressed health disparities. Since 1997, NINR has been the lead institute for end-of-life care research across NIH institutes and other federal agencies. Shuttering NINR and cutting off funding for in-progress and future nursing research will have wide-ranging and harmful effects across all populations, hampering or halting further improvements in direct patient care, public health, and health care delivery.

In a statement after a draft of the budget was leaked, American Nurses Association president Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, stating:

“ANA firmly believes that NINR plays a vital role in ensuring that research guided by nurses’ education, experiences, and clinical training continue to enable our overall health care system to improve and be driven by evidence . . . . Nurses are concerned about the ability of a restructured HHS, without the NINR, to pursue nurse-specific approaches that answer the challenges and demanding needs of our healthcare system and the patients we serve.”

Multiple health care institutes and centers face elimination.

Nursing is not the only NIH institute that will be eliminated with the proposed budget. With the stated purpose to “reform NIH and focus NIH research activities in line with the President’s commitment to MAHA” (Make America Healthy Again), the proposal also eliminates funding for the National Institute on Minority and Health Disparities, the Fogarty International Center, and the National Center for Complementary and Integrative Health. The proposal states that these changes would align NIH research “with the President’s priorities to address chronic disease and other epidemics, implementing all executive orders, and eliminating research on climate change, radical gender ideology, and divisive racialism.”

Overall, the budget slashes NIH funding by $18 billion, nearly 40% of the 2024 budget. In a press release, Research!America president and CEO Mary Woolley called for Congress to reject the budget, stating that, “[i]f enacted, the president’s proposed cuts will dramatically slow U.S. medical research and innovation, taking away health and hope from Americans. Childhood cancer, Alzheimer’s, lupus . . . name a health threat, and this budget would neglect it.”

Health care professionals and people in general are alarmed and voicing deep concerns about the state of medical research in the United States as President Trump’s policies and cuts take effect. In a survey published in April in the journal Nature, 94% of readers responded that they were worried about the future of science in the United States, and over 90% thought Trump’s policies would have negative effects on the U.S. and the world. The survey authors note that science policy experts warn that “damage caused by the Trump administration…could set the United States back for decades.”

AJN news director Karen Roush, PhD, RN, FNP, will be providing regular updates on AJN Off the Charts about the details and implications of rapid and potentially momentous changes being made by the Trump administration to the public health system in the United States. Her previous post is “The Harm Done by Dismantling USAID.”