Trump's NIH Cuts Send Shockwaves Through the Science World

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2:30Hello, and welcome to another episode of the Odd Lots podcast. I'm Jill Weisenthal. And I'm Tracy Alouette. Tracy, we're recording this February 25th, and we're just a little bit over a month into the new Trump administration. And setting aside how one views the long-term goals of the administration from the outside, it's chaotic. And there have been a lot of cuts and it doesn't look like scalpel types of cuts. Many things have been shut down or frozen completely in some respect. And you see a lot of people talk about the implications of these moves. But I find it hard to wrap my head around. There's a lot happening.

3:10That's for sure. And I think one of the struggles of everyone who's trying to follow this at the moment is that you have new executive orders coming out almost daily. Then you have the legal challenges to those. And then you have the administration itself. sometimes arguing within itself about whether or not certain orders should be followed, certain emails should be replied to. It does feel very chaotic. One area that I think has caught a lot of people's attention in particular has been immediate moves at the NIH, the National Institute of Health. And there are multiple moving parts here. But from what I've been understanding that when there are grants awarded.

3:50Some of the money goes to direct costs and some of it's indirect. And there has been a change in what's allowed on the indirect. And then I've also seen, and it's almost hard to believe, but I've now seen it in enough places that there have been like whole programs that got hit with an immediate freeze, which I have to imagine in science creates all sorts of problems. I imagine there are lots of endeavors that can't just be stopped started on a switch. And so understanding what's actually happening right now in science funding. And the implications of some of these moves is obviously something we need to discuss, especially given the broader thing of like, we want to be, I think, a country at the leading edge of science and technology.

4:30Yeah, this is exactly the tension, I think. So even Elon Musk and Donald Trump will talk about how important it is for the U.S. to be technologically advanced and to beat competitors like China. But at the same time, they're doing this. And I guess their argument is that by capping some of the cost of research, you might make it more efficient, you might make it more monetizable, you might see more breakthroughs. But again, there is this tension to the sledgehammer approach that we've seen, where if you just put in a cap on something like indirect funding, it can affect a bunch of research programs.

5:07So we should talk about it. I also, I must admit, I don't know anything about NIH funding. It seems very sprawling and very complicated. So I want to get into that as well. All right. Well, I'm very excited to say we have the perfect guest, someone who actually is a scientist in the lab working on these things and has been talking about the impact of the moves over the last several weeks. Thrilled to bring on to the show, Carol Laban, Professor of Molecular Biosciences at Northwestern University. Professor Laban, thank you so much for coming on the Outlots podcast. Happy to be here. What's happened in the last month?

5:43Why don't you ask a broad question? We need 40 minutes for just answering that question. So this is fine. Three major things have happened in the last month. One is what you alluded to already, this attempt to cap the indirect cost for grants at 15%. And I'm happy to go into that in more detail. But you can think about it if you pick any area of research that you might care about, let's say pediatric cancer, that basically amounts to a 15 % to 20 % decrease in funding for studying those cancers. And this is an area where NIH has made huge progress. So 40 years ago, if your child was diagnosed with cancer, there was less of a 60 percent of those children that would still be alive in five years.

6:26Today, there's a 90 percent survival rate. So, I mean, these are impacts that are going to be huge. I'm going to actually stop you right there because I think this is important. There is science research that happens outside of the NIH. When you look at that 40-year history. How do you draw the line for someone who, you know, people are aware of big pharma companies exist, that this is like the NIH should get credit for that progress? So the NIH is really sort of two different systems. They have an intramural system. So there are scientists running laboratories at the NIH. And by the way, they have not been exempt from these cuts to probationary people.

7:05I know of young scientists who had started their independent laboratories at the NIH in the last couple of years who a week ago Saturday received an email at night saying that they were terminated and that their access to campus was gone. So there's intramural research. But the vast majority of NIH grant funds go into their extramural program. These are funds that go to grants at universities in all 50 states. and they are incredibly important for all levels of science. Basic research, translational research, clinical trials are going on not at the NIH, but in Iowa and in Ohio and in Florida. And so, you know, it's estimated that these grant monies that come to the universities, they support directly about 400 ,000 or more employees across those 50 states.

7:58But also, they drive more than$93 billion of economic activity each year. And again, that's across all 50 states. That's not staying in Washington, D.C. There's an estimate that for every dollar of NIH grant money that is granted, it generates almost$2.50 worth of economic activity. Just to press on Joe's point, how do you actually measure the success of NIH funding? Is it you produce some new wonder drug that is monetizable and everyone starts using it? Is it just the sort of nebulous concept, I guess, of like advancing scientific research? How do you judge the success and efficacy? So I think that you can look at that on two levels.

8:43So there are the studies that are translational studies that immediately impact human health, and those are very, very important. But just as important is the kind of research that the general public sometimes has trouble wrapping their heads around because you don't necessarily see an immediate advance from that research in human health. But most of the advances that we see today that are being translated and are really making a direct effect on human health, they stem from studies that were done 10 or even 20 years ago that were foundational, that at the time, again, this is called discovery-based science or basic science or fundamental research, but it's these foundations that are built on in the more clinical studies.

9:28And also in industry, in the pharmaceutical industry and biotech, they are building on these basic discoveries that were funded by the NIH. I can give you one really cool example. So you've got to have heard of Ozenpik, right? The semaglutinide that's everywhere these days. Did you know that that came from research, very basic research that was done ages ago on a venomous lizard called a gila monster. A gila monster? This gila monster is native to the southwest of the U.S. And people noticed that, scientists noticed that it had the ability to fast for an incredibly long period of time. So wanting to understand the biological mechanisms of how it did that led them to isolate from the saliva of a gila monster, this what would eventually become Ozenbeck.

10:19Talk to us about the math of direct versus indirect costs, because I think this is just something that was in the headline of the announcement. And I don't think I really have a concrete understanding of what the difference is, why there is this distinct allocation. What do you walk us through a year ago or just in the up until recently, what this allocation was all about? So every grant that goes to, let's say, Northwestern where I am has two components to it. Direct costs that come directly to my research laboratory and indirect costs that are used to support my research. So a lab like mine is analogous to running a small business.

10:57So let's say that business is a restaurant. The direct cost of the restaurant would be the food, the cooks, and the servers. But there are other costs to running a restaurant business. You have inventory and purchasing and upkeep of the kitchen equipment in the building, et cetera. And so the restaurant can't run without those other things. It can't exist with just the food, the cooks, and the servers. And so for a research lab like mine, the direct costs are the chemicals and the reagents and the salaries of the scientists who are carrying out the studies, but there's also indirect costs. And those, again, include maintenance and replacement of equipment, ordering, bookkeeping, handling hazardous waste, compliance with government regulations, all of which are absolutely essential to doing the research.

11:41And the reason it gets separated out like this is actually to save money, because while the direct costs are specific to my particular research, most of those indirect costs are for most, if not all, research labs at a given university. And so you get economies of scale by lumping those together. Does that make sense? Yeah. So going back to your restaurant analogy, I guess it's kind of like you're funding a food court, right? So each individual restaurant within a food court might have their own direct costs, but then the cost of actually maintaining the space, renting out the space is sort of shared by everyone doing different things.

12:22Sure. I think that's a great advance on the analogy. And it would be particularly so if they had a pooled, let's say, central billing so that they didn't each have to handle the finances individually. So one thing that I was wondering is how the NIH cap on indirect funding currently, or I guess up until a month or two ago, actually compares with other medical research organizations. Because I'm thinking specifically about organizations like the Gates Foundation. And I think in the announcement, the NIH talked about aligning with other types of research organizations like the John Templeton Foundation.

12:59So how do private research organizations manage to keep their own indirect costs down? And why do their indirect costs seem lower than the NIH's? Oh, I mean, they are lower and there are, in fact, some types of small foundations that have no indirect costs. I remember back when I was a graduate student at Harvard, Harvard wanted to stop letting their researchers take those grants because they were not paying for the other real costs of doing research. But in general, over time, what's come out of it is in the research ecosystem, universities admit that these smaller foundations and even something like the Gates Foundation, you know, they're directing money at very specific things and they can do more with their work if they lean on the NIH and universities for covering more of those indirect costs.

13:51So they don't cover the indirect costs. It's just that it's understood that they can't. So your assertion here is that what appears to be a financing mechanism with lower indirect costs is capable of existing because, I don't know if free riding is the right word, but because there is also the indirect costs that come from the NIH to aligned or the same labs. Absolutely. They're like a loss leader.

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15:35To learn more, visit easycater.com slash podcast. So one of the arguments is that a lot of NIH funding goes to a handful of extremely well-endowed universities. It's skewed. That also, and it's something you hear a lot, including from people academia, that there is a tremendous amount of bureaucratic bloat that exists. And I think setting aside the science, it does not surprise me that the current administration wants to take aim at bureaucratic bloat within America's universities, etc. Why shouldn't we be skeptical of the degree of costs that these labs have borne? I mean, I think you shouldn't be skeptical because these are negotiated between health and Human Services and the universities through a very thorough process where they sit down and really have to lay out what the costs are and show proof that that's what the costs are.

16:33So this isn't somebody picking a number out of the air. This has been the result of negotiations to really figure out what the costs are. And, you know, most universities would tell you that even the negotiated indirect cost rates don't cover all of the costs of research. This is a very wide ranging question, but going back to Joe's point about the administrative burden, could you maybe walk us through the process of getting an NIH grant? Like, how does it actually work? How long does it take? How many steps do you have to go through? Yeah. So NIH runs three funding cycles a year. Each of them take more than half a year to complete, almost three quarters of a year.

17:12So basically, there will be one date where grants are submitted, another date where grants are reviewed by a panel of experts from around the country, usually a panel of 25 to 30 scientists with subject matter expertise in the area of the grants. And those are called study sections. And then finally, they'll be reviewed by an advisory council that will basically okay grants for funding. So here's an example. I have a really talented postdoctoral fellow working in my research group who applied for a career transition award back in the summer. His grant was reviewed in October by a study section.

17:49It got a phenomenal score that should have been funded. His counsel was supposed to meet at the beginning of this month in February. But because no study sections or counsels have been allowed to meet, his grant can't be approved for funding. So there are three of those cycles a year. And right now, I mean, I'm not sure that if your listeners are aware of this, but besides the kinds of things that we're talking about with indirect costs and direct costs, HHS has blocked NIH from posting in the federal register. And why that matters is in order to hold one of these study sections, these grant review sections, or hold one of these advisory councils, they have to be posted in the Federal Register at least 15 days ahead by law.

18:33So when a judge put a restraining order on the freeze to grants, HHS got around this bureaucratically by just simply not letting NIH submit those notices. So the whole system has been ground to a halt. Grants that were reviewed, like my postdocs last fall, can't get approved at council. Grants that should have been reviewed this month can't be reviewed. And who knows whether their councils will meet coming in May when they should. So right now, labs are really in sort of an existential crisis. I mean, so again, going back to this small business model, labs are businesses that run on very tight margins.

19:12And so if I'm going to be running my laboratory on one of these NIH grants, which let's say is four years long, in year three, I would be applying for a renewal of that grant to continue that research. And remember, research that the NIH has already invested in, if that grant can't get reviewed or funded, then I'm turning around to the people in my lab and saying, I don't want to have to do this, but I'm going to have to let you go. So not only is that a real cost in terms of jobs for people who are, again, experts in what they're doing, but you're damaging research that you've already invested in.

19:49The whole thing is kind of senseless. That's certainly not government deficiency. Can you talk more about what's being frozen right now? So you've just described the stopping of the review process. So theoretically, if this freeze is in place by the time you need your next tranche of funding and it can't happen, then you could have layoffs. What's happening operationally in labs that you know of right now as a result of the overall freeze? Are there specific trials or tests or I guess experiments is what a layperson might call them that had been going on in January that aren't happening right now?

20:23So I think there are some clinical trials out of NIH that have been affected directly. For most of us, it's damaging things, but we could still pull back from it being absolutely disastrous if things get turned around very, very soon. But otherwise, the layoffs are going to include people who take care of research animals. It's going to include the people that make sure that hazardous waste is supposed to safely. And right now, it really depends on each university. A lot of universities have begun to either rescind offers for graduate students for the coming fall or basically decide not to have the next class of graduate students who are cut it down by 20 to 50 percent.

21:08And I think this is something that's important to bring up. So NIH research really does three things, right? It funds the science that we've been talking about. So making drugs like Ozenpik or pediatric cancer research. it funds money in the economy, as I mentioned. So hundreds of thousands of jobs,$93 billion a year in economic activity. But the other thing it does is to train the next generation of research scientists. And I can tell you that the trainees right now, graduate students and postdoctoral fellows, are completely scared and demoralized and wondering whether there is a future for them and science.

21:48And if we lose the next generation of scientific researchers, it's not just going to affect academic research. We train the workforce for the pharmaceutical industry and the biotech industry. This is going to decimate U.S. scientific biomedical research broadly. So just on that note, one thing you hear from the Trump administration continuously is this idea that we need to compete with China. And it's certainly true when it comes to electronics technology like semiconductors, and they say also in the realm of scientific funding. Can you maybe talk a little bit about how the Chinese research model stacks up against the U.S.

22:27research model? And I guess how much competition there is currently between the two countries for that younger generation of talent? Yeah, no, absolutely. As I'm sure you're probably aware, federal investment in science like at NIH and the National Science Foundation after World War II was what drove the U.S.'s enormous growth in the 50s and 60s and really boosted America to the forefront of the world in technology development and science. And we barely keep pace. I mean, to say that we spend too much money on science is so far from being true that it's crazy. On the other hand, China recognizes what these investments do, And they have been upping and upping the kinds of investments that they make in biotechnology and other technology, because that is what's going to drive the economic growth of the future.

23:20The investments that the U.S. has made in science to date have driven the formation of entire industries, not just innovations in medicine, but also in engineering and technology. We are going to lose that leadership. You've given these examples of talented postdocs being unsure if they're going to get their funding or the prospect that the next generation of talent who will go into private sector labs is going to be devastated because their education trajectory is off. One of the arguments for NIH reform is that a lot of NIH grants actually go to established professionals, that there is this hierarchy that it's very hard or very rare to get grants for people under 40.

24:05Setting aside the Trump-Elon reforms, do you believe that there are flaws within the existing NIH regime causing money to not go into the most promising areas? So I would take issue with what's going on being termed that, but the problem is that there's not enough money in the system. And so those grant cycles that I just mentioned, right? So one of the study sections is going to be evaluating many, many dozens of grants in each cycle. and then there are many study sections that are evaluating different areas of science, at current funding levels, less than 10 % of those grants are going to be able to be funded.

24:50Where is the line that I could draw where I could clearly say that these ones are absolutely should be funded and these ones maybe need more work or more thought? That line is more around the 25 to 30%. So we are really underfunding research. And you're right. When you are underfunding research, there is going to be, if you will, a competitive advantage to established researchers versus junior researchers. But the NIH recognizes that. And so they have put in place a number of different mechanisms to try to alleviate that. So there are score boosts for early career investigators that help more of them get funded.

25:31There are special granting programs that are aimed at those early career investigators. So, I mean, one of the things about NIH is that it's really conscientious about trying to course correct. They are constantly looking at what they're doing and what the outcomes are, and then consulting with the broader scientific community about where they could find deficiencies or how they could solve particular problems. It's not like all of this is going on in a vacuum and nobody's paying attention. That makes a lot of sense to me. I'm just looking at stats. The median age for researcher designated NIH award for the first time had increased since 1995 and is now, according to something that was reported in 2021, over 40 years old.

26:19Like government, corporate processes, whatever, there's always, as you say, there's course correcting, there's awareness of the issues, but awareness is not the same thing as addressing them. And I'm just trying to press on whether there are reasons to be skeptical about the efficacy of the existing system or the ability of the existing system to course correct, or is this not a number that we should care about at all? Does that not mean anything that the average age of a first-time awardee has gone up? Maybe that's not necessarily a bad thing. Yeah. So, you know, one thing you can say about almost anything this large is it's the best flawed system that we have.

26:55The U.S. scientific research enterprise is the envy of the entire world, hands down. The reason for the increase in age has nothing really to do with the NIH itself. And so that's more on science and scientists to some extent. The time to degree for graduate students has been creeping up, how long it takes them to earn their PhD, and also the time that faculty spend as postdoctoral fellows. And when I was first starting out as a graduate student in the 90s, there were people who were hired into faculty positions that never did postdoctoral fellows. Then that became almost non-existent. And now there are some programs like the Whitehead Fellows, where you have mentored postdoc positions where they are independent faculty member like people, but with a little bit more safety net than a typical assistant professor would have.

27:46And so I'm going to swing back to those people that get fired from their laboratories at the NIH two weeks ago. So each one of those people will have spent more than 10 years training for their jobs, generally more than 12 years training. but between graduate school and their postdoctoral fellowship. Each one of those people was almost certainly supported by NIH funding through those dozen years, whether it be independent fellowships to them personally or funding from their PI's research grants. So these are people who the U.S. has already made an enormous investment in, and they were successful at getting research laboratory positions at one of the top places in the world, the NIH.