What Research Funding Cuts Mean for the Future of Health Care

All the health care services we receive today are the result of efforts-over several decades-by researchers determined to make the world healthier. This research has been a major factor in human life expectancy rates jumping from around 40 years in the early 19th century to 72 years in 2020.

At Partners In Health (PIH), research is a critical component of the mission. When health providers around the world believed multidrug-resistant tuberculosis (MDR-TB) wasn't worth the hassle of trying to treat in resource-limited settings like Peru, PIH Co-founder Dr. Paul Farmer set out to prove that it was.

The qualitative research conducted by Dr. Farmer and his colleagues at PIH paved the way for advanced TB care in Peru and, eventually, future clinical trials that would inform MDR-TB treatment worldwide. Even the World Health Organization has used results from research conducted by PIH through the endTB project to update its global TB treatment guidelines.

The Importance of Research in Medicine

Some of the greatest advancements made through research include vaccines, insulin, anesthesia, and treatments for infectious diseases. From laboratory studies to clinical trials and epidemiological investigations, scientists around the world use different methods of research to advance disease treatment, enhance diagnostics, and improve our overall understanding of diseases.

"Research is the key to advancing health on the individual, community, national, and global level," said Cora Cunningham, PIH Engage member, Harvard T.H. Chan School of Public Health student, and research assistant with the Lantagne Group at Tufts University. "Whether about drinking water quality, disease dynamics, health systems, or the patient experience, research in public and global health is what allows us to access, receive, or deliver quality and patient-centered health care."

Without research, there would be no breakthroughs, no clinical advancements, and no new cures. Despite its importance to humankind, biomedical research-particularly research funded through the National Institutes of Health (NIH)-has been targeted by the current U.S. administration. Years of progress have been disrupted through frozen funding, intentional roadblocks to financing, and overly complicated new procedures.

Funding the Cure

With the NIH being the world's largest public funder of biomedical research, suspending payments will stifle progress in disease prevention, diagnostics, treatment, and patient outcomes. A lack of funding opportunities restricts research that otherwise would have helped Americans live healthier lives-and will make it challenging for the U.S. to maintain its position as a leader in health care innovation.

Cunningham was a part of research focused on evaluating water, sanitation, and hygiene (WASH) programs to reduce the burden of infectious disease in humanitarian settings. In early February, her group's work was placed on a stop-work order, and upon the dismantling of USAID, all of the funding for this project disappeared.

"Receiving the email from my Principal Investigator that she had lost 100% of her funding was shattering," Cunningham said. "I was devastated for her, her family, my colleagues, and even more so for the millions of people who benefit from this type of operational research, and for the more than 150 million people around the world still in need of humanitarian aid."

For millions, these funding cuts meant immediate interruptions to their care or treatment. Unlike other projects that receive government funding, the rapid stop work orders in biomedical research can skew results, force projects to start over, and leave patients neglected-sometimes in the middle of a clinical trial or treatment. By halting medical research, the current administration is throwing away millions of dollars with no regard for patient safety.

Carole Mitnick, PIH's director of research for the endTB project, co-principal investigator of the endTB trial, and professor of global health and social medicine at Harvard Medical School, was part of a project researching post-TB lung disease in Peru. This project would be a follow-up to one-which had significant taxpayer investment-that followed a cohort of TB patients and carefully categorized aspects of their disease to see if there were any trends in developing post-TB lung disease.

"With just one single follow-up visit that would have been funded through a grant, we could have completed a whole universe of information that would tell us who is at risk for developing post-TB lung disease, what the characteristics are, and how we can screen people and possibly apply interventions at the beginning of TB treatment," Mitnick said. "This has not only big picture consequences for patients, but also is just a waste of the investment already made. To start this work over will take two or three times as long and cost two or three times as much."

Concerns Across the Aisle

Disruption to NIH spending has received significant bipartisan pushback. In the early days of his presidency, the Trump administration paused specific communications by NIH, preventing them from posting notices of grant review meetings, which are how grants are evaluated and funds are allocated. Without these meetings, the grantmaking process was ostensibly shut down.

Over two months later, meetings were resumed, but NIH funding still wasn't fully stable. On May 1, the NIH announced that American researchers were prohibited from issuing subcontracts to partners at institutions outside of the U.S. According to STAT, this decision is forcing approximately 1,800 health research projects to decide between their international collaborators and their funding.

"There is not a single innovation in treatment, in diagnosis, in prevention, and even in supportive mechanisms in priority populations-in both TB and HIV-that has not relied on, at least in part, research in South Africa," Mitnick said. "We've just completely cut ourselves off to say: you can still do research, you just can't do it there."

In early August, the Government Accountability Office, a Congressional watchdog, concluded that by abruptly canceling NIH grants, the Trump administration illegally withheld funding that had already been approved by Congress. While their findings aren't enforceable, they have caused tension as the Legislative Branch pushes back on the administration's attempts to override Congress' power of the purse.

Long-Term Consequences

It is likely that we may not see the impacts of stalled or suspended research for years-but there is no doubt that their consequences will reverberate for generations. Patients who were part of clinical trials will face health risks due to the abrupt end to their treatment and support. Advancements made on cures and treatments for various diseases will be squandered. Jobs will be lost, and public health will suffer.

"It's hard to estimate, but our best guess is that if you stop research for a year, you're going to have a three-year recovery time. Even if funding was reinstated tomorrow, you've got to find the staff, get approvals, and rebuild trust with the organization and patients," Mitnick said. "If there aren't intentional efforts made to not only restart but also compensate for everything that's been lost, the impact on human lives is going to be really severe."