President Trump once again oversees billions of dollars of funding for research into pandemics, HIV, cancer, and other fundamental areas of health and science. And once again, his administration seems determined to shake up how that money is doled out.
Federal science agencies, from the Department of Energy to the National Science Foundation, fund research across the country. So far, the agency that the Trump administration has most clearly signaled as a target for changes is the National Institutes of Health, which funnels some $40 billion to 300,000 scientists at 2,500 universities and other research institutions. Trump has nominated the former presidential candidate Robert F. Kennedy Jr. to lead the Department of Health and Human Services, the NIH’s parent agency, and Jay Bhattacharya, a professor of medicine and health policy at Stanford University, to run the NIH.
Public remarks and news reports about their possible plans, as well as other ideas being pushed by influential conservatives, indicate that their leadership would mark a departure from mainstream medical thinking and from the way the agencies have traditionally operated. Kennedy, who over the years has expressed skepticism of vaccines and repeatedly claimed they are linked to autism, has said he’d tell NIH employees to “give infectious disease a break for about eight years.” Bhattacharya, who has said that he was unfairly criticized for condemning lockdowns during the Covid-19 pandemic, is reportedly considering tying universities’ funding to their free-speech climates.
That and other proposed changes to the way funding is administered — such as divvying up the NIH’s grant budget among states — have raised concern among science-policy experts. But there is bipartisan support for other possible changes, like strengthening research reproducibility and overhauling peer review.
Which reforms come to fruition remains to be seen. Kennedy’s first Senate committee hearings will take place by the end of the month, but Bhattacharya’s had not been scheduled as of Thursday. (Neither returned requests for comment.) When Trump repeatedly tried to slash funding to science agencies during his first term, Congress blocked his attempts, and all those agencies’ budgets ultimately grew. Kennedy has talked about firing and replacing 600 NIH employees, and Trump has restored an executive order from his first term that makes it easier to fire federal workers, but that is expected to be challenged in court.
Already, though, many scientists are nervous. This week, the Trump administration directed federal health agencies to pause external communications, including scientific reports and health advisories, through February 1, according to CNN. Meetings of experts to review NIH grant applications — a crucial stage of the funding process — were also paused, according to the health and science news site Stat. (An NIH spokesperson told Stat: “HHS has issued a pause on mass communications and public appearances that are not directly related to emergencies or critical to preserving health. This is a short pause to allow the new team to set up a process for review and prioritization. There are exceptions for announcements that HHS divisions believe are mission critical, but they will be made on a case-by-case basis.”)
Predicting how scientific research will be affected by Trump’s policies is “incredibly difficult,” said David H. Guston, associate vice provost for discovery, engagement, and outcomes at Arizona State University’s Julie Ann Wrigley Global Futures Laboratory. “Fundamental research has been a place of long-duration, bipartisan commitment in the United States. But Trump in his previous term, and in preparation for this term, has really scrambled other kinds of bipartisan commitments,” such as NATO, Guston noted. “And there’s no reason to believe why he might not scramble this one.”
Scientific Fields Under the Microscope
Under Trump’s administration, investment in scientific fields could fall along politicized lines. In an op-ed for The Wall Street Journal, Kennedy declared that he wanted to “devote half of research budgets from the NIH toward preventive, alternative and holistic approaches to health.” Currently, he wrote, “researchers don’t have enough incentive to study generic drugs and root-cause therapies that look at things like diet.”
Some of that message resonates with Mary Woolley, president of Research!America, a nonprofit that represents universities and other health-research institutions. “I and many people would like to see more emphasis on prevention in particular — it’s a no-brainer,” she said. “It’s more cost-effective, it saves more lives. Of course we should do everything we can to find ways to prevent the scourges of our time and those that might come next.”
But Kennedy has also expressed deep skepticism of certain tools proven to prevent diseases — like vaccines and water fluoridation. Before running for president, he was chair of Children’s Health Defense, a group that has campaigned against both public-health programs. He has been blamed for playing a role in a deadly 2019 measles outbreak in Samoa, where he’d met with anti-vaccine activists. (“I never told anybody not to vaccinate,” Kennedy has said.) Shortly after the Covid-19 vaccines were rolled out, he petitioned the Food and Drug Administration to revoke their authorization. (More recently, Kennedy has told reporters that he wouldn’t “take away anybody’s vaccines” and rejected the idea that he’s “anti-vaccine,” and reportedly claimed he’s “all for” polio immunizations.)
In the fall, Kennedy accused the FDA of “aggressive suppression” of “psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma.”
“Some of the most difficult and dangerous stuff comes with the dog’s breakfast of ideas that HHS nominee Kennedy has been circulating,” Guston said. Woolley added that investing in preventing diseases shouldn’t come at the expense of curing and treating them. “We’re very strong proponents of ‘both and,’ not ‘either or,’” she said.
But a key type of infectious-disease research could soon be targeted. In virology, “gain-of-function” experiments engineer viruses with new, potentially more dangerous characteristics, a practice that proponents say is necessary to illuminate how they work. Scientists debate the risks and benefits of such research; the Obama administration paused funding while it developed a policy around it.
Now, it’s under scrutiny again in the wake of the popular but speculative theory that such experiments in Wuhan, China, caused the Covid-19 pandemic. The Heritage Foundation, the conservative think tank that authored the “Project 2025” policy document, has called gain-of-function research “dangerous.” The Wall Street Journal has reported that Bhattacharya wants to pause it, citing people familiar with his thinking.
Trump’s administration may also take aim once again at fetal-tissue research. Many scientists say that fetal tissue and cells derived from it are crucial to studying human development and producing vaccines, but anti-abortion activists oppose this work. In 2019, the Department of Health and Human Services banned NIH scientists from doing research with fetal tissue. Academics seeking federal funding for such studies also had to get their proposals approved by an ethics advisory board, one mostly made up of members opposed to abortion rights. Those restrictions were reversed by President Joe Biden — but could now return.
Gain-of-function and fetal-tissue research “are two good examples of where a helpful political environment could come to healthy conclusions about how sincerely held values, anticipated risks, and benefits of research interact,” Guston said. “The trouble with having them now is that it’s very hard to see what sincerely held values and a solid assessment of risks and benefits really looks like in the contemporary environment.”
At the same time, Trump may be supportive of the kind of innovation that produced the Covid-19 vaccines. Erica Goldman, director of policy entrepreneurship at the Federation of American Scientists, a think tank advocating for science-based policy, noted his first administration pulled off Operation Warp Speed, which was a public-private partnership. “Maybe the fact that the Trump administration did that well and agilely the first time, we could see more of that,” she said.
Remaking the NIH
What type of research is favored under Trump may prove to be less significant than how all research is funded — and what strings may be attached.
The Heritage Foundation has called for dividing the NIH budget into “block grants” for states to fund their own research. (“Funding for scientific research should not be controlled by a small group of highly paid and unaccountable insiders at the NIH, many of whom stay in power for decades,” states its “Project 2025” document.)
Woolley called it “a terrible idea.” To use an analogy, she said, it wouldn’t make sense to parcel out the Department of Defense’s budget across the states, even though military installations, like biomedical research activity, are scattered throughout the country. “The hub — the coordinated direction and real value-add — is in one place,” Woolley said. “So if you’ve got an asset like that in the country, why would you divvy it up and lose the capacity that comes from coordination — and much admired, by the way, around the world?” That said, she added that she is an advocate of giving special consideration to research projects in states that are less science-rich.
Alzheimer’s does not care whether you’re a Democrat or Republican or Tea Party or socialist or Green Party or any other belief.
According to The Wall Street Journal, Bhattacharya is also considering linking universities’ research funding to some measure of academic freedom on campus, such as the Foundation for Individual Rights and Expression’s free-speech rankings. “I think that the FIRE rankings are not necessarily a great approach to figuring out what’s going on on campuses with respect to free speech,” Guston said, “just like I think that the U.S. News & World Report’s rankings are not a great way of figuring out what’s going on on campuses with respect to quality education.”
The idea, according to the Journal, links back to Bhattacharya’s experience at Stanford during the Covid-19 pandemic. In October 2020, he co-authored the Great Barrington Declaration, a document calling for isolating the vulnerable from the virus and allowing young, healthy people to get infected so they could develop herd immunity — a proposal that others said would be dangerous. Bhattacharya later wrote that in response, Stanford “created an environment in which slander, threats, and abuse aimed at lockdown critics could flourish.”
Trump’s determination to nix diversity, equity, and inclusion efforts could also affect universities’ access to research funding. An executive order he signed Tuesday states that recipients of federal grants must certify that they don’t run “programs promoting DEI that violate any applicable federal antidiscrimination laws.” The Wall Street Journal reported that NIH grants would be affected, citing people familiar with the matter. NIH webpages promoting grants for scientists from underrepresented backgrounds were offline as of Thursday. Some large research universities receive hundreds of millions of dollars worth of NIH funding every year.
Some possible changes may prove less controversial. Sen. Bill Cassidy, Republican of Louisiana and chair of the Senate Health, Education, Labor, and Pensions Committee, has proposed a slew of ideas that he says would “strengthen NIH and the U.S. biomedical research enterprise.” Those that would most directly affect outside researchers include funding early-stage research alongside the later-stage, applied research that Cassidy says the agency has traditionally favored; encouraging data-sharing from failed experiments; and using machine-learning tools to predict which proposals “will yield the most transformative science.”
Another change would revamp the peer-review process to include more generalists rather than just specialists, which “can bias [panels] toward the approaches and methodologies favored by such experts,” states a report Cassidy authored in May. Bhattacharya, according to The Wall Street Journal, is interested in funding studies that try to replicate existing research and starting a journal that would run comments from named peer reviews alongside studies.
We are definitely going to see change. We don’t know the exact parameters of that, but we can help shape them.
Stuart Buck, executive director of the Good Science Project, a think tank that advocates for research innovation and transparency, sees promise in some of these ideas, depending on how they’re implemented. Creating a database in which to dump null results, as Cassidy has suggested, could lead to a data deluge, Buck said; a more feasible policy could be to require grantees to write an annual update about a promising idea that sputtered out. Buck said that he’d been in touch with people close to the administration and “trying to spread ideas that I hope would have bipartisan appeal.”
“What I always say is Alzheimer’s does not care whether you’re a Democrat or Republican or Tea Party or socialist or Green Party or any other belief,” Buck said. “We all have a shared interest in making sure that for that and many other diseases, that scientists are on track to find a cure, and that their work is innovative, but also not fraudulent.” Allegedly fraudulent Alzheimer’s research, in particular, is a pressing issue for the NIH: In the fall, Science reported that data-integrity experts had found apparently falsified images in 132 papers by a top Alzheimer’s researcher. The scientist reportedly didn’t challenge any of the examples, and the NIH told Science that it had “made findings of research misconduct” against him in relation to two papers.
While the Trump administration has yet to make any concrete announcements about its vision for research, Goldman said that scientists may benefit from thinking outside the box — or outside of the United States. “There may be ways to encourage international scientific collaboration that’s not government-to-government but academic-to-academic,” she said. “It would be an opportune moment to see international institutions open their arms with invitations to scientists who may be under pressure in this administration to collaborate beyond the borders.”
Woolley said it’s important for the research community to act in unison — and to pick its battles. “We are definitely going to see change,” she said. “We don’t know the exact parameters of that, but we can help shape them.”