Trump Administration Cuts Put Medical Progress at Risk, Researchers Say

The nation’s universities and academic medical centers were reeling on Saturday from a directive by the Trump administration to slash funding for medical research, a decision that doctors and scientists said would have a devastating effect on studies aimed at finding treatments for diseases such as cancer, diabetes and heart disease.

The change is aimed at reducing the amount of tax dollars that universities spend on overhead costs. The National Institutes of Health, which announced the move Friday evening, said $9 billion of $35 billion — or about 26 percent — of grant dollars distributed last year had gone to overhead.

The new policy, which takes effect on Monday, will cap “indirect funds” for costs like buildings, utilities and support staff at 15 percent and is aimed at saving $4 billion.

Dr. David J. Skorton, president of the Association of American Medical Colleges, said the policy would sharply cut funds to universities and medical centers that do N.I.H.-funded research, likely limiting the number of studies that could go forward.

“These are real consequences, longer waits for cures and for diagnosis, slower scientific progress, losing out to competitors around the world, and fewer jobs,” he said, adding: “Those who are facing any health challenges will suffer from less biomedical research.”

Dr. Robert Lefkowitz, a Duke University professor of medicine who won the Nobel Prize in Chemistry in 2012, said that indirect costs pay for the purchase and maintenance of highly sophisticated microscopes that enable him to examine the structure of molecules.

That fundamental research, he said, has made it possible to develop lifesaving medicines for cancer and other diseases. No single researcher, or even a group of researchers, could afford the upkeep on the equipment without the federal dollars tacked onto their grants to support it, he said.

“I think the American people need to understand how devastating it would be if this goes through,” Dr. Lefkowitz said. “A lot of research would just have to stop; I can’t imagine that the shortfall could be met from other sources.”

The N.I.H. funding also supports about 412,000 jobs, from research assistants to grant managers to people who dispose of toxic chemicals, according to United for Medical Research, an organization of universities and health advocates.

The leading category of study at the National Institutes of Health is cancer research, an area that has produced breakthrough drugs that have significantly extended survival for people with certain blood cancers and skin cancers. Close behind is infectious disease research, an area that produced the mRNA technology that rapidly produced vaccines against Covid in 2020.

Advances in sequencing the human genome supported in part by the institutes also led to therapies for people with cystic fibrosis who expected to die in their 30s, but are now living into their 60s.

Still, the Trump administration has been sharply critical of what it derides as “woke” policies and cultures at universities, which have been bracing for a hit to their budgets. Project 2025, the Heritage Foundation’s policy blueprint for a Republican presidency, called for capping research funds, saying they were sometimes used to fund diversity, equity and inclusion initiatives. Cutting such costs would “reduce federal taxpayer subsidization of leftist agendas,” Project 2025’s authors said.

Elon Musk, who is running President Trump’s government efficiency program, hailed the announcement of the cuts on social media. He suggested that some elite universities devote much more than 30 percent of their grant dollars to administrative costs.

“Can you believe that universities with tens of billions in endowments were siphoning off 60% of research award money for ‘overhead’?” Mr. Musk wrote on X, his social media platform. “What a ripoff!”

While some elite universities do have large endowments, Lawrence O. Gostin, an expert in public health law at Georgetown University, said indirect costs are a lifeline for smaller academic institutions, including historically Black colleges, that depend on federal dollars and conduct medical research on tight margins, often losing money.

“This would be catastrophic,” Professor Gostin said. “It would mean that, at the most extreme, universities wouldn’t be able to even take N.I.H. money, and would have to stop doing essential research, including research on pediatric cancer and heart disease and dementia and a whole range of other things. At the very best, they would be hemorrhaging money.”

He called the policy “literally the opposite of the mission of the N.I.H., which is to advance research, not to make it difficult or even unaffordable.”

The administration has said the changes taking effect Monday will apply to existing grants. That will be jarring, said David A. Baltrus, a University of Arizona associate professor whose lab is developing antibiotics for crops.

“I think it’s going to destroy research universities in the short term, and I don’t know after that,” he said. “They rely on the money. They budget for the money. The universities were making decisions expecting the money to be there.”

Dr. Baltrus said that his research is focused on efforts such as keeping E. coli bacteria out of crops like sprouts and lettuce. He said the policy change would force his university to make cuts to support staff and other overhead costs.

An N.I.H. social media post said the change could save the federal government as much as $4 billion and sharply cut payments to Harvard, Yale and Johns Hopkins, which have overhead rates above 60 percent of their grant sums.

The institutes are currently supporting about 11,000 research projects in cancer research. Infectious disease research is a close second, with nearly 9,000 projects underway. Much of the research the institutes fund is meant to discover how diseases work — in the interest of finding cures.

Dr. Skorton, a cardiologist and the president of the medical school association, said the N.I.H. has helped drastically change the fate of people with congenital heart disease, the most common birth defect. He said when he was born in 1949, 80 percent of people with the condition died before adulthood. Now, 90 percent of them survive.

The N.I.H. funds also support medical equipment suppliers and janitorial services nationwide, with $6.8 billion going to California, $5 billion to New York, $4.5 billion to Massachusetts and $3.8 billion to North Carolina.

The proposal may tee up a potent test for Republican lawmakers who have largely avoided direct challenges to the Trump administration.

Republican-leaning states reap millions from the institutes, including about $1 billion each to Florida, Missouri and Tennessee, according to N.I.H. data. North Carolina researchers were awarded $3.7 billion in grants last year.

Senator Patty Murray, Democrat of Washington, said in a statement late Friday that the move could “dismantle the biomedical research system, stifle the development of new cures for disease and rip treatments away from patients in need.”

“Just because Elon Musk doesn’t understand indirect costs doesn’t mean Americans should have to pay the price with their lives,” Ms. Murray said in a statement. Her state gets about $1.5 billion in N.I.H. funds.

The institutes spent about $35 billion in 2023 on about 50,000 competitive grants to about 300,000 researchers at 2,500 universities, medical schools and other research institutions nationwide, according to the Trump administration. Of that, about $26 billion directly funded research and $9 billion covered indirect costs.

The indirect costs pay for buildings, utilities, lab equipment, cleaning costs and “research administration,” which includes the work of safety and regulatory committees that are mandated by the federal government, as well as animal caretakers and other support staff.

One study found that every dollar the institutes spend generates $2.50 in additional spending economic activity.

Dr. Norman Sharpless, a former director of the N.I.H.’s National Cancer Institute, said he expected a forceful response from universities.

“I think it’ll be a very swift legal response from the university counsels across the country,” Dr. Sharpless said. “I do think it will get enjoined, but hopefully it will lead to a discussion of what indirect costs ought to be. And that’s a healthy discussion to be having.”

He said 15 percent in indirect costs would be too low in high-cost cities with key research centers such as New York City, San Diego and Boston. “Because you’re effectively saying you can’t do science in Manhattan,” he said.