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How Toxic Are Trump's Cuts to the NIH?

The president wants to cut $5.8 billion from the budget of the largest public funder of biomedical research in the world. Brace yourselves: We're all about to get a lot sicker.
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It’s hard to believe that this is real news, but our current president and his cabinet of horrors hate science and reject facts to such an alarming and dangerous degree that hundreds of thousands of outraged scientists and other science-loving, fact-embracing Americans gathered together to participate on Earth Day this past Sunday in a March for Science in over 600 cities across the world. The marchers expressed outrage at a White House that perpetuates alternative facts, denies the dire reality of climate change, promotes anti-vaccine falsehoods, seeks to deny women’s rights to their bodies, and is willing to trade public health for corporate loopholes. Cutting back on its scientific research arm is like removing your spine because you have a headache.

While the Affordable Care Act has received a reprieve for the time being, it’s only one of many of the Trump administration’s attacks on health and science, and the most vulnerable populations of Americans. Given this climate, so to speak, it may come as little surprise that the National Institutes of Health (NIH), the largest public funder of biomedical research in the world, is on the budget chopping block, with a proposed $5.8 billion cut in Trump’s budget plan for 2018.  If you take medicine, have or will ever need surgery, and believe in evidence-based policy-making, you should be alarmed, downright terrified and enraged by Trump’s proposal to cut the government’s own research arm. Without the research and science that underpins healthcare, medical breakthroughs, and public health, this administration seeks to drag the United States back to a time when the common cold could kill you, formerly disappeared diseases claimed the most vulnerable, and a viral outbreak could prove deadly.

For a greater sense of scope: The NIH invests more than $32 billion of our taxpayers’ money every year into projects that benefit everything from physical to mental to public health.  As the NIH website itself states, more than 80 percent of the NIH's funding is awarded “through almost 50,000 competitive grants to more than 300,000 researchers at more than 2,500 universities, medical schools, and other research institutions in every state and around the world.” Only about 10 percent of the NIH's budget funds projects conducted by its own laboratories, approximately 6,000 scientists, on the NIH campus in Bethesda, Maryland.

Cuts Herald The Death of Innovation

NIH grants are already incredibly competitive in the best of times. Rick Domann, a professor at the University of Iowa and President of the Society for Redox Biology and Medicine, is concerned that further cuts will not only mean fewer applications for grants funded in 2018 and coming years, but worse, “As a result fewer people will go into science, fewer discoveries will be made, and society will benefit less because of it.” This particularly galls him. “We’re at a point right now where the last forty years of biomedical research is really starting to pay off.” 

In the past year alone, researchers have made breakthroughs in stem cell therapies to treat paralysis; immunotherapies to treat cancer without toxicity; radical improvements in the treatment of Type 1 Diabetes, and so many others whose budgets rely upon the NIH.

One such NIH-funded researcher, Meghan May, Ph.D., an associate professor of microbiology and infectious disease at the University of New England, Maine, is alarmed, “If you disrupt [funding] you disrupt an ecosystem of for-profit research at universities, and research institutions. We are going to lose a generation of scientists.” 

Losing a generation of scientists at a time is a chilling enough thought, but when climatologists are warning us we’ve tipped past the point of no return with carbon emissions, it’s diabolical and dangerous to our health.

The Cost to Public Health

If you think these cuts won’t affect you personally, since scientific breakthroughs take a long time anyway, May has more bad news; NIH also funds physician and scientist training grants. “If your physician had their training grant cut off all of a sudden, they won’t have the expertise they would have had. That’s a very short-term consequence.”

Worse, if you think America enjoys a particular quality of public health, hygiene, and protection against disease, that too will be under threat. May’s lab is one that studies infectious agents and pathogens, like the Zika virus, the flu, and bacterial infections. These are not labs you want losing their overhead funds, and laying off staff.  

Domann echoes her concerns. “The public should be fearful of these cuts because they are going to eliminate a layer of defensive mechanism that our country enjoys in the realm of public health, because of the structure of the NIH and the CDC (Centers for Disease Control).” 

If Trump and Price also get their way for a larger restructuring of the HHS department, May says it could be “catastrophic overnight” because HHS cuts would include cuts to the CDC, which monitors outbreak response teams and related research.

Trump claims to be tough on terror, but we need scientists, not just a military, to stay ahead of such scenarios as biological warfare—the release of pathogens and toxins against civilians in an act of war—like the chemical attacks on Syrian civilians that Trump used as a reason to bomb their already war-torn country. 

It’s Not Saving Money If It Means Losing Jobs

For a man whose biggest campaign promise turned talking point is to “create more jobs,” Trump’s cuts will do the opposite. “I have employees in my laboratory who would lose their jobs. That’s not good for our skilled workforce. That’s not good for economics,” May says. 

Tom Price, Secretary of Health and Human Services (HHS)—whom Democrats opposed for a number of reasons, not least of which, including “actively trading shares of medical and pharmaceutical companies while shaping health policy in Congress,” according to the New York Times—is trying to sell this cut to Congress, as Republicans often do, by claiming that it’s just cleaning up “inefficiencies.” Price claims the budget will carve that badly needed 18 percent off in the form of “overhead” and other “indirect expenses.” 

From a scientist’s perspective, those funds mean the difference between taking a project to completion or not. May calls these cuts “downright reckless.” In fact, so crucial are these funds, she says, most universities and research centers work them into any grant to make sure these essential costs get paid. “It’s all well and good to give somebody exactly the money they need to accomplish a project, but you still need to keep the lights on and the heat on. You have to pay the housekeeping staff, acquire the space and pay the Internet bills,” she says.

May is frustrated by this administration’s resistance to facts. “I have not seen a whole lot of evidence that the administration operates in an evidence-based reality,” she says. She cannot fathom how a medical doctor like Price can be so cavalier about these cuts. “He’s not a scientist, and we are not interchangeable.” She wants to make it very clear that he does not speak for scientific researchers, many of whom who are against these cuts.  

It’s hard not to draw the conclusion that a sicker, less educated population can be more easily manipulated, and more likely to accept legislation that lines billionaires pockets over making life better for everyone.

Domann points out that NIH grants also provide jobs to numerous graduate students and post-docs, who get paid training to become the leading researchers of tomorrow. 

Not to mention that these cuts will increase inequity in under-funded areas of scientific research. Particularly since another area that is slated to be cut in these alleged “inefficiencies” is the IDeA (Institutional Development Award)Program, which May describes as, “Earmarked money that goes to states that are traditionally underfunded in terms of biomedical research and science.” This includes her own state of Maine.

Meanwhile, May says she is “scrambling to find some foundation money” to keep her lab manager, who she will have to let go if the cuts go through. “It really tears me up; this is a person who doesn’t deserve to lose their job and they need to pay their rent and eat and everything else.”

Domann’s only speck of optimism is that these cuts may not hold when Congress has to approve the budget. “The NIH budget has typically been a bipartisan thing, because many of them are aging Americans, may have health issues and it concerns them.”

However, he fears an inevitable “showdown over the budget.” This could lead to a disastrous government shut down.  “If the government shuts down that means everybody’s grants and grant reviews and pending grants go into a holding pattern, and that always causes delays, shutdowns and stoppages,” he says. 

If Trump is so eager to run the government like a business, as he claims, May says the best thing he could do is keep the NIH running at full steam. After all, drug companies base their products on research, and that research comes at a steep price. “Research into new treatments and new cures is exactly the role for government in science,” May says.

 

Jordan E. Rosenfeld has written for: The Atlantic, the New York Times, New York Magazine, Ozy, Pacific Standard, The Rumpus, Salon, Scientific American, The Washington Post, Stir Journal, and more. She lives in California with her husband and son. Find more of her writing at www.Jordanrosenfeld.net, and follow her: @JordanRosenfeld