NIH cuts have doomed my research in Bangladesh — but US citizens will pay too

Boston Globe

6 days ago

For more than 15 years, I have conducted studies in Bangladesh, a country that has extremely high levels of arsenic in its drinking water supply — meaning the population is routinely exposed to a lot of arsenic. My collaborators are pediatric neurologists like me, as well as neurosurgeons, medics, nurses, and community health workers, all professionals dedicated to understanding how arsenic affects the neurological development of children.
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We have received generous support from US taxpayers through their investments in the NIH. When I submit a grant application, the NIH asks me to justify why taxpayer dollars are being spent outside the country. It is easy for me to provide this justification. Arsenic affects many areas of the United States, including here in New England. But the widespread high levels of arsenic in Bangladesh, and the much larger number of people exposed to it, make conducting studies there more efficient and less expensive. Our studies have led to changes in Bangladesh's health policy, including recommendations to establish dietary standards for folate, a vitamin that counters the toxic effects of arsenic. This work also has helped us develop solutions that are relevant to US families, such as setting regulations for acceptable levels of arsenic in public water systems.
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There are many examples of research conducted abroad that benefit people in the United States. Oral rehydration therapy, the standard treatment for childhood diarrhea, was developed by scientists in India and Bangladesh who worked with US partners funded by the US government. Collaborations with researchers in Colombia led to the identification of a rare genetic variant associated with a delay in dementia onset; this finding provides potential targets for therapies for Alzheimer's disease.
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NIH-funded studies in Africa led to the development of self-collection swabs for cervical cancer screening. And just this month, the Food and Drug Administration
Our recent experiences with COVID-19, Zika, and Ebola confirm that there are no borders to infectious diseases and that global scientific cooperation can lead to faster and more effective responses to them. To address climate change, an even greater health threat, research with foreign collaborators aids knowledge-sharing and innovation. Earlier this year, I participated in a simulation of a heat emergency in Arizona that was conducted by a research team who drew lessons from their work in western India — which taught them more about how extreme temperatures affect human physiology.
It hasn't always been necessary to invoke US health interests to justify scientific research abroad. In 2003, the global HIV/AIDS epidemic led to the President's Emergency Plan for AIDS relief (PEPFAR). Over the past 20 years, PEPFAR, together with NIH funding, has expanded what we know about HIV/AIDS and turned what was once a death sentence into a manageable condition for millions worldwide.
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The NIH states that the motivation for its new policy is 'to improve the tracking of federal dollars and the security of the US biomedical research enterprise.' These are goals that no one can argue with. In 2023, the NIH began requiring foreign collaborators to provide copies to their US partners of all lab notebooks, all data, and all other documentation that is produced as part of research projects. In my own program, this has meant more frequent site visits to Bangladesh, a transition to electronic record-keeping, and more detailed monitoring of expenses and receipts. It must be possible to further strengthen these efforts to provide oversight without stopping the collaborations altogether.
I submitted an application to the NIH in November 2024, just days before the presidential election, that had the words 'global partnerships' in the title. It has not yet been reviewed. When I wrote those words, I believed they would be viewed as a strength of the proposal. That is no longer the case. But I am not deterred. Like many in my position, I am looking elsewhere — foundations, philanthropy, industry, other countries — for new sources of funding. If the United States will not lead the world in scientific research, I hope others will step up. So if you're a foundation or industry leader reading this and you're interested, I have a research grant proposal ready for you.