Originally published by our sister publication Infectious Disease Special Edition

By Marie Rosenthal, MS

Federal funding cuts will hurt today and tomorrow, according to two infectious disease researchers who spoke at a recent media briefing sponsored by the Infectious Diseases Society of America (IDSA). Programs that are already benefiting patients, as well as future medical developments, are at risk from federal cuts being made by the White House’s Department of Government Efficiency (DOGE).

However, they are not the only victims of DOGE. Communities that support many healthcare institutions and universities will also suffer, according to Stephen Carpenter, MD, PhD, FIDSA, an assistant professor, Division of Infectious Diseases and HIV Medicine, at Case Western Reserve University School of Medicine, in Cleveland.

In many cities and states, institutions that deliver medical care and provide biomedical research are among the top employers in the area. “Medical care and biomedical research are one of the top five industries in the Cleveland area. University hospitals, the Cleveland Clinic, Case Western, these are top institutions in the world and are locally impacted by the investment the government makes in biomedical research,” said Dr. Carpenter, who called the funding a good investment. “For every dollar spent by the U.S. government, $2.50 are returned on that investment” to the local and national economy, he noted during the IDSA media briefing.

This 2025 annual analysis of the economic impact of National Institutes of Health research funding was done by United for Medical Research (UMR). The analysis found that $36.94 billion awarded to researchers in the 50 U.S. states and District of Columbia in fiscal year 2024 supported 407,782 jobs and $94.58 billion in new economic activity nationwide—or $2.56 for every $1 invested.

“There is no better investment than one that saves lives, supports local economies and drives America’s global leadership in biomedical innovation. When Congress invests strongly and consistently in the NIH, all three of those things happen,” said UMR President Caitlin Leach in a statement from the group.

Most of that grant funding comes from the federal government, and every state benefits from NIH research funding because the money supports employment and the purchase of research-related goods, services and materials. The income generated from these jobs and purchases cycles through the economy to produce new economic activity, benefiting local businesses, according to the report.

Since fiscal year 2015, the NIH budget has grown by more than $17 billion, thanks to strong bipartisan congressional support and a commitment to making medical research a critical national priority, according to the report. Over the past decade, NIH research funding has driven more than $787 billion in new economic activity and supported an average of more than 370,000 jobs per year.

One example is the University of Alabama at Birmingham, a research university and academic medical center, which is the state’s largest employer, with more than 28,000 people employed by the university and its medical centers. UAB has a positive economic impact of more than $12.1 billion, according to a 2022 report. In addition, UAB supports 107,687 jobs throughout the state.

And that is outside the value of the research that can improve or save the lives of countless people both here and abroad, Dr. Carpenter said. “This investment generates lifesaving discoveries in cancer, infectious diseases, autoimmune disease, heart disease and obesity. We’ve seen many [treatments] developed by drug companies—both small and large—that have come from the basic research that is done [in] NIH-funded studies.”

Dr. Carpenter, who researches the immune response triggered by chronic infectious diseases such as Mycobacterium tuberculosis, HIV and cytomegalovirus, said he was directly affected by DOGE actions. His study received a fundable score last fall, but with current funding pauses, he does not know whether the government will fund the grant. Just in his laboratory, this puts seven jobs on the line. In addition, indirect funds from the grants go to the university, which pays support and administrative staff, as well as sponsors other programs at the school, according to Dr. Carpenter.

Because of similar cuts, John Hopkins University said it will lay off 2,000 workers in May, and other institutions are following suit. 

Institutions Feeling ‘Chaos’ of Funding Cuts 

At the same briefing, Colleen Kelley, MD, the chair of the HIV Medicine Association, as well as an HIV clinician-scientist and a professor of medicine at Emory University School of Medicine, in Atlanta, called the situation “chaotic.” 

“The chaos we have experienced—and there’s no better word than chaos—in the last several weeks in the research enterprise has had significant impact on medical science and has halted progress in so many areas. 

“We have colleagues and we’ve seen institutions that have had large numbers of terminated research grants and contracts.”

In addition, the communication from these agencies has been contradictory. “No, then yes, then no again. We’ve experienced frozen funds, proposed cuts in indirect costs that we literally depend on every day to turn the lights on and to do our research. These are all imminent threats to the future of research and could lead to the total collapse of research infrastructure at academic institutions,” she said. 

The Trump administration claims that the indirect NIH funding that Dr. Kelley cites as being so critical to day-to-day operations must be cut to address “administrative bloat” and save more than $4 billion annually. In a Feb. 7 post on X, the agency said the cuts would also free up more money for scientific research.

But according to Dr. Kelley, if the administration wants to “improve efficiency,” it is going about it the wrong way. “We all accept that we live in a world of limited resources. This is true, very true in research. It’s true in medicine; it’s true in science worldwide. What is happening right now is the exact opposite of efficiency.” 

For example, limiting the language that can be used means that people who might benefit most from prophylaxis or treatment might not be found. “If we cannot target those interventions at the right populations, we waste time, we waste resources and, most importantly, we waste money,” she said.

If these cuts result in layoffs and elimination of graduate degree programs and positions, the United States will lose “the next generation of researchers,” she said. 

“People are not going to enter a field that they cannot see a future in,” she said. “And the damage that’s been done thus far will likely be felt for many years and decades to come as the pipeline of future researchers turns away and doesn’t enter research.” 

In addition, this defunding will have significant global implications, “ceding U.S. leadership in medicine and science to other countries,” she added.

A Well-Vetted Funding Process

The irony, according to Dr. Carpenter, is that getting research funding from the federal government is an arduous process that is well vetted. He discussed the process for his grant that was recently approved, but has not yet been awarded.  

“Less than 10% of research grants are currently being funded on average nationwide. And so a grant like this is not only an achievement and recognition of the importance of the work that we and other researchers are doing in immunology and infectious diseases, but it affects the jobs of people in my lab,” he said. 

“A grant process looks something like this: A researcher will write a research plan, [which includes] a budget for the direct costs of conducting that research. And we’ll outline the institution, the investigators and staff that contribute to the research and the protection of human subjects and animals that may be used,” he said, adding that the grant application totals about 150 pages.

That research grant then goes through the NIH and is reviewed by staff and gets distributed to peers who are scientists who review the grants anonymously and provide their feedback at study sections and at NIH Councils. Only a certain percentage of these grants pass muster enough to be voted on for funding.

“So, the very top grants that are the most impactful as judged by numerous scientists are those that are being funded. Now, the process is onerous—takes about nine months from start to finish before grants are funded,” Dr. Carpenter said. 

He admits the process could be streamlined, and researchers are willing to be part of this process. “We want to be part of the solution.”

However, indiscriminate cuts to research funding without understanding the consequences both for local communities that depend on that funding, as well as long-term unintended consequences on the impact of biomedical research in the United States is short-sited, he explained.

“When funding for a lab dries up, there’s usually no coming back from that. For a researcher, it takes more than a decade for researchers to establish themselves after their training, and continuously publish and obtain grant funding, train students, and make new discoveries. When that lab has to close and there’s a gap in those careers, it’s very difficult for that researcher to then get on track in their research area again. And so these funding pauses have large consequences,” he said.

Most of the drugs approved in the United States today resulted from “basic science research started in an academic institution before it was taken forward by a biotech or pharma company to further development,” Dr. Kelley said. “It is that funding that comes from the federal government that funds that very high-risk basic science research that then leads to drug discovery and vaccine discovery and intervention discovery, [which] starts in academia and starts with federal funding generally from the NIH or CDC that goes on every day.”

“These impact biomedical research in our country as a whole. These cuts can delay lifesaving discoveries, can cost the jobs of many in our communities,” Dr. Carpenter added.