NIH funding cuts imperil lifesaving drugs and US prosperity

The Hill

23-02-2025

In 1972, testicular cancer was a leading killer of young men — almost uniformly fatal. Today, it has a 90 percent survival rate.
The drug responsible for this miraculous reversal, Cisplatin, would never have been discovered without 'indirect funding' from the National Institutes of Health — resources used for all the essential services needed to support clinical studies.
Like Cisplatin, every groundbreaking cancer treatment you've ever heard of started the same way — not in a corporate boardroom, but in a university lab where NIH indirect funding pays the staff, keeps the computers humming, and medical equipment functioning.
All of this may abruptly end, given the Trump administration's plan to retroactively slash NIH indirect support to 15 percent of grants. For decades, research institutions have negotiated the rate with NIH, ranging between 25 to 70 percent.
This drastic cut will deter universities from accepting NIH research awards. Universities, including my own, often supplement NIH grants by more than two times the amount with their own institutional funds, and that is at the more generous negotiated rates.
It's clear that the administration's characterization of indirect costs as 'waste,' 'bureaucracy' or mere 'overhead' reflects a dangerous misunderstanding of the value of scientific research.
The NIH funds basic 'high-risk and pre-commercial research' that no private capital venture or pharmaceutical company would invest in due to the long horizon for finding cures. Across the board — from Alzheimer's disease to cancer and heart disease — NIH's funding of basic research has turned out to be a spectacularly successful investment.
NIH spurs awe-inspiring scientific breakthroughs and powers our economy. A recent study found that NIH supported 354 of 356 drugs approved from 2010 to 2019. That means that most of the lifesaving medications we take for granted today would not have been possible without the NIH.
It is estimated that every dollar in publicly funded basic research yields $8.38 after eight years. There are few government investments that can match the health and economic benefits of NIH funding.
Capping indirect funding will decimate biomedical research, which has been the engine of the U.S. economy and the envy of the world. This rash overreach will cost the jobs of thousands of highly trained researchers and those who support their work with little prospect for relocation or retraining. It will leave patients enrolled in clinical trials without access to the cutting-edge treatments already supported by their tax dollars.
This myopic decision, ostensibly made to save costs, will endanger our country's health, safety and prosperity.
What's more, the White House plan is flagrantly unlawful. NIH has existing contracts with 2,500 hospitals, medical institutions and universities in all 50 states. These are binding contracts that cannot be revoked without proof of violation and absent due process.
A basic principle of contract law is that contracts cannot be changed or rescinded retroactively. In fact, when the first Trump administration tried to do the same thing in 2017, Congress enacted specific protections for NIH-funded contracts.
The partnership between the federal government and a decentralized network of research universities has its origins in the Manhattan Project which had to rely on foreign-trained scientists. Insufficient scientific expertise became even more concerning in the 1960s after the Soviet Union's launch of the first satellite to orbit the Earth signaled that we were falling behind in the space race.
The response was to develop the current system: supporting universities to develop independent research capacities, rather than having all projects run out of Washington.
Our decentralized network of research universities is a vital component in driving scientific innovation and safeguarding our national security. Not only does our ability to train our own scientists make us self-sufficient, but it also provides a tremendous resource for the Department of Defense, which directs 50 percent of its basic research to universities.
By reliably supporting a consistent state of scientific readiness, our research network is able to pivot quickly towards addressing new threats, whether occurring naturally or a biological attack.
A federal court issued a temporary restraining order pausing the new rate cut in litigation filed by 22 state attorneys general. Universities and national academic associations just filed another lawsuit.
The ongoing litigation is likely to succeed, but the damage caused by this capricious and reckless action is immediate and devastating for medical centers across the country, which have already budgeted for (and incurred obligations based on) the specific indirect cost rates that have been negotiated and formalized with the NIH.
The NIH funding model has made the U.S. the world's science superpower and our universities the premier destination for students from every nation. Slashing NIH funding will not save money, but it will unravel a biomedical system that has powered our economy and protected our population for generations.
Congress stopped these dangerous cuts to NIH in 2017 and needs to hear scientists' voices again to protect medical research today and in the future.
Lawrence O. Gostin is a distinguished professor of Law at the O'Neill Institute for National and Global Health Law at Georgetown University and Director of the World Health Organization Center on Global Health Law. Jennifer S. Bard is a professor of Law at the University of Cincinnati.