Protesters rally at a “Kill the Cuts” demonstration at the University of California-Los Angeles April 8.
Photo by Robyn Beck, courtesy AFP/Getty Images
Pediatrician Doug Opel, MD, MPH, was stunned for a number of reasons when he received a letter from the National Institutes of Health in March abruptly canceling his research grants. But he was especially surprised because it happened just as a measles outbreak was ripping through unvaccinated communities in West Texas.
Opel, a professor at the University of Washington School of Medicine, studies vaccine hesitancy and how to engage parents on immunizations. He was involved in two related studies that got axed during the spree of NIH grant terminations in the early months of President Donald Trump’s new term.
In the cancellation letter, NIH told Opel it is “obligated to carefully steward grant awards to ensure taxpayer dollars are used in ways that benefit the American people and improve their quality of life. Your project does not satisfy these criteria.”
Opel said it was “shocking” to see such language used in reference to vaccines, a scientific advancement that has saved millions of lives, “and from an agency that’s always been a beacon of truth.”
As of April, according to an analysis in Nature, the Trump administration had canceled almost 800 NIH research grants — some experts say illegally — including dozens related to vaccine hesitancy and hundreds related to other critical public health efforts, such as disease disparities, HIV prevention, COVID-19 and health equity.
The cancellations are part of sweeping cuts to federal science funding and staff that have left many key public health efforts in shambles and hundreds of the country’s leading scientists issuing an urgent alert.
“The nation’s scientific enterprise is being decimated,” wrote 1,900 elected members of the National Academies of Sciences, Engineering and Medicine in an open statement to the American people in March. “The administration is slashing funding for scientific agencies, terminating grants to scientists, defunding their laboratories and hampering scientific collaboration.”
Some of the cuts are in response to Trump’s executive orders targeting diversity, equity and inclusion. Agencies reportedly used a long list of search terms — such as “disability,” “minority,” “racism” and “underserved” — to flag federally funded research and initiatives that the administration disagreed with.
Damage to science also comes from the result of mass federal firings, such as the 10,000 layoffs at the U.S. Department of Health and Human Services this spring. The firings gutted research offices at the Centers for Disease Control and Prevention that study HIV prevention, chronic disease, reproductive health, worker safety, tobacco use and more.
Other cuts, such as the termination of NIH’s vaccine hesitancy portfolio, align with HHS Secretary Robert Kennedy Jr.’s longtime anti-vaccine activism.
The damage goes beyond HHS, with scientists swept up in firings and rollbacks across the government: medical researchers at the Department of Veterans Affairs, forecasters at the National Weather Service and climate scientists at NASA have all been impacted. In March, reports circulated that the U.S. Environmental Protection Agency planned to fire more than 1,000 scientists and close its Office of Research and Development.
The Trump administration is also threatening public investments at some universities — such as NIH funding for new disease therapeutics at Harvard — unless the institutions comply with its demands regarding campus activism.
As of press time, the debris from the administration’s sweeping actions had yet to settle — multiple lawsuits over the grant terminations were still in process, including some filed by APHA. But on the ground, scientists have been shutting down studies, patients are losing out on clinical trials and experts are worried about a brain drain of young researchers.
“It will literally cost lives,” said Steven Woolf, MD, MPH, a lead organizer of the NASEM statement and a professor in the Department of Family Medicine and Population Health at Virginia Commonwealth University. “Our top scientists will look to other countries where they can pursue science without government interference.”
For Opel, both of the vaccine studies he was involved in were terminated in the middle of their grant periods. As of April, he was appealing to NIH for extra time to salvage what was left.
APHA has been aggressively fighting back against the administration’s actions to undercut public health, including two legal wins that allowed some fired staff to return to work. On April 2, APHA joined with researchers in a lawsuit against NIH, arguing that staff were directed to eliminate research on “disfavored” topics and populations without clear guidance or justification. Besides jeopardizing medical and public health advancements, the cancellations directly conflict with mandates set by Congress.
Deep impacts for US public health science
HIV and LGBTQ+ health topics were some of the hardest hit in the early rounds of the NIH grant terminations.
Among the nearly 800 terminations, almost 29% were related to HIV/AIDS and 25% to transgender health. Seventeen percent of the cuts targeted COVID-19 research and 3.5% were related to climate. The National Institute on Minority Health and Health Disparities had more grant cuts than any other NIH institute.
Allison Agwu, MD, ScM, immediate past chair of the HIV Medicine Association, said a potential reason for large cuts to HIV/AIDS research is that it often involves marginalized, underserved communities, which could raise flags under the administration’s anti-DEI orders.
Agwu is involved in the NIH-funded Adolescent Medicine Trials Network for HIV Interventions, the first clinical research group focused on HIV among teens and young adults. As of 2022, 1 in every 5 new HIV diagnoses in the U.S. occurred among people ages 13 to 24, CDC data show.
Agwu said researchers with the network, established in 2001, began getting stop-work orders in March. The letter she received called the work’s equity objectives “amorphous and antithetical to scientific inquiry.” Agwu said the entire network is shutting down.
“It feels like we’re going back 30 years,” she said.
HIV science was also impacted at CDC, with about a fourth of staff at its National Center for HIV, Viral Hepatitis, STD and Tuberculosis Prevention fired in the HHS layoffs.
Some of the other critical losses at CDC include the entire team behind the Pregnancy Risk Assessment Monitoring System, which is key to maternal health research, and nearly all staff at the National Institute for Occupational Safety and Health, which researches workplace exposures and responds to work-related hazards.
Linda Rosenstock, MD, MPH, who served as NIOSH director for seven years, said the institute has a track record of science that leads to lifesaving worker interventions, such as better respirators and earlier disease detection in miners. She said it is “hard to imagine” how to replace that lost capacity.
“The idea that we’re basically ravaging the core of everything that makes us be smart about what we do is very troubling,” Rosenstock said.
Not long after Brittany Charlton, ScD, an associate professor at Harvard T.H. Chan School of Public Health, spoke out against the administration’s actions this year, her entire NIH grant portfolio was terminated. Charlton, along with APHA, is part of the lawsuit challenging the terminations.
Without NIH support, Charlton might have to shutter the LGBTQ Health Center of Excellence, where she is founding director. The terminations left her and colleagues sitting on dozens of scientific papers ready for peer review — such as one showing that lesbian women were three times as likely to experience a stillbirth as heterosexual women — but without any funds to submit them.
“Now no one will get to benefit from the investment that’s already been made,” Charlton said. “That is inefficient and that is wasteful.”
For more information and to advocate against the cuts, visit www.apha.org.
- Copyright The Nation’s Health, American Public Health Association
