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NIH spending battle's ripple effect

FOLLOW THE MONEY Cuts to the National Institutes of Health's budget would have sweeping implications for the broader economic and biomedical ecosystems, MIT and Harvard researchers argue. To reach that conclusion, published Friday in JAMA Health Forum, the researchers analyzed potential NIH budget cuts and 37 studies and reports on NIH funding, biomedical innovation and economic impacts, as well as news coverage from January to April 16, 2025, to show the cuts' effects. They used that data to develop a causal loop diagram, which illustrates how variables in a system are interconnected, to show the effects. While budget reductions in the loop appeared straightforward, innovation, personnel and health care costs would be impacted by decreased funding. Among their key findings: — Reducing the fundamental research that drives discoveries could slow future innovation. — Fewer NIH-funded trainings and career opportunities for scientists could shrink the future biomedical workforce. — More private-sector research and development would likely increase medical innovation costs and drive higher health care spending. 'Reducing NIH budget doesn't just mean fewer grants; it means fewer trainees entering the pipeline, slower progress on treatments, more reliance on expensive late-stage care and weakened capacity for public health,' co-authors Mohammad Jalali and Zeynep Hasgul told Erin in an email. 'These changes build on each other, creating ripple effects that may not be obvious at first but can grow quickly.' The authors described several limitations in their analysis. It simplifies complex relationships among NIH funding, scientific progress and economic outcomes and might not fully capture whether private-sector investment can compensate for reduced public funding. It also doesn't account for global health impacts, such as the Trump administration's cuts to the World Health Organization. 'Washington has thrown billions at NIH for decades with little accountability and few measurable outcomes,' HHS spokesperson Andrew Nixon said in a statement to Future Pulse. 'Cutting waste isn't the same as cutting science — it's how you make room for real innovation. We're focused on doing more with less, funding what works, and delivering results the public can actually see.' Bottom line: The White House has proposed a roughly 40 percent budget cut for the NIH. And while it doesn't appear likely that the House or Senate bills will contain such a drastic cut, Jalali and Hasgul have a suggestion for lawmakers. Before making large-scale funding cuts, they should ask themselves: What else do these cuts affect? 'Even if the goal is fiscal discipline, it's worth distinguishing between cuts that reduce waste and those that undercut long-term capacity,' Jalali and Hasgul said. 'It's worth remembering that NIH is not just a funding line,' they added. 'It's the backbone of the nation's research infrastructure. Like roads or energy grids, research systems take time to build and are costly to repair once broken.' WELCOME TO FUTURE PULSE This is where we explore the ideas and innovators shaping health care. African universities risk being left behind in the artificial intelligence era, Semafor reports. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@ Ruth Reader at rreader@ or Erin Schumaker at eschumaker@ Want to share a tip securely? Message us on Signal: CarmenP.82, RuthReader.02 or ErinSchumaker.01. INFLUENCERS Online privacy and harassment expert Danielle Citron sat down for a conversation with our colleague Aaron Mak and revealed which technologies she thinks are underhyped and which are overhyped (we're looking at you, AI). Citron is a University of Virginia School of Law professor and has received the MacArthur Foundation's 'Genius Grant' for her work on sexual privacy on online platforms. She's convinced that 'we're underleveraging where it most matters, and we're overleveraging on fake promises.' She also had some advice for the government on what it could be doing about tech right now that it isn't. As tech companies have dismantled many safety features in their systems, the government is missing the mark by not implementing the precautionary principle, she explained. 'I thought we'd learned our lessons. We built cars without seat belts, and a lot of people died. And then the car industry faced liability. They then had to internalize the costs.' Read Citron's full conversation with Mak in Digital Future Daily.