Not even a year after crossing the finish line at the New York City Marathon in November 2022, Jeffrey Reynolds, then 56, underwent a routine colonoscopy. Waking up, his doctor had news: They’d removed several polyps — and found a significant mass.
“Well, how significant?” he recalls asking his doctor. “Very significant,” the doctor informed him.
It was Stage 3B colorectal cancer.
But Reynolds’ cancer journey started before that. The year before, not long after completing the Ironman Florida triathlon, he was diagnosed with prostate cancer. Healthy, active and relatively young, the news came as a shock. But after undergoing treatment, he made a full recovery. The experience turned him into, in his words, “somewhat of an evangelist” for prostate cancer awareness, urging other men to get screened. Taking his own advice, he scheduled other preventive tests, including the colonoscopy that may have saved his life.
Reynold’s care team told him he was eligible for a clinical trial. He was placed in the experimental treatment group, and partway through the first phase, his doctors delivered another life-changing update: “The tumor’s gone.”
“I believe that this three-drug trial has made a big difference in my outcome,” Reynolds says — a trial made possible by federal funding from the National Institutes of Health and the National Cancer Institute.
Stories like Reynolds’ are a testament to the power of medical research, and to what’s truly possible when promising ideas move from lab testing to real patients. But behind every scientific breakthrough lies a complex web of funding, much of which is driven by our federal government. What happens when those funds disappear? Here’s what to know about the health risks associated with federal funding cuts.
[READ: What Is Chemotherapy and How Does It Work?]
Who Pays for Research?
If you’ve ever taken a medication, received a vaccine or been screened for a disease, chances are you’ve benefited from federally funded research. Those breakthroughs don’t just happen; rather, they’re the results of years of federally funded work by scientists, doctors and public health professionals.
Federal research and development dollars primarily flow to academic institutions, federal agencies and labs, nonprofits and hospitals. Cuts to federal research funding disproportionately affect academic research and development — often a collaborative effort between several institutions — similar to Reynolds’ clinical trial aimed at improving colon cancer treatment.
Although academic research and development are funded by various sources, for the past 70 years — since 1953 — the federal government has been the largest contributor. As of 2021, federal funding accounted for 55% of spending in academic research and development. Several federal agencies provide this support, with the majority coming from the National Institutes of Health, which is part of the Department of Health and Human Services.
Beyond that, academic research may also be supported by:
— Academic institutions
— Businesses
— Nonprofits
— State and local governments
— International and other sources
However, the research isn’t just about labs at elite universities; it’s about the treatments available at your local hospital, the speed of detecting disease and doctors who care for you and your family.
[READ: How Do You Know If a Clinical Trial Is Right for You?]
How Is Federal Funding Administered?
Federal research funding is typically administered through competitive grants, awarded by agencies such as the National Institutes of Health and the Centers for Disease Control and Prevention. While government agencies may conduct some in-house research, much of their funding supports projects carried out outside the agency at universities, medical centers, nonprofits and other institutions.
NIH grants review process
The NIH Office of Extramural Research oversees the grant process, which involves several stages:
1. Planning. Grant opportunities don’t just fall into researchers’ laps. Researchers must identify funding opportunities, which requires them to often start planning months in advance.
2. Application preparation. Developing a grant proposal can take anywhere from weeks to months. It requires a detailed project plan, budget and alignment with NIH priorities.
3. Application submission. Once they’ve gathered their application, researchers take steps to complete the formal submission process.
4. Scientific review. Once NIH receives an application, proposals undergo two levels of review. First is a peer review led by experts in the field, followed by an Advisory Council Review to evaluate public health relevance and funding priorities.
5. Award notification. Finally, applicants are notified whether they will receive funding.
6. Post-award monitoring and reporting. After receiving federal funding, projects must comply with reporting requirements, audits and reviews to ensure researchers are in compliance with federal laws, regulations and policies.
Researchers invest a significant amount of time preparing proposals. The process is competitive, time-consuming and, as of late, more unpredictable than ever.
Dr. Lara Zibners, co-founder and chair of Calla Lily Clinical Care, where she leads initiatives in women’s health innovation, experienced this firsthand. Her team was preparing for a crucial NIH review meeting on January 23 of this year.
“I put hours and hours and hours — three straight days — into a slide deck for this,” says Zibners, who is also a board-certified pediatrician and pediatric emergency medicine specialist with over two decades of experience in clinical practice and medical education. “And we had practiced, and we had met every day leading up to that meeting.”
But despite the preparation, things fell apart at the last minute. Checking her email merely 3 hours before the meeting was scheduled to begin, Zibners was notified that all meetings had been canceled without warning.
A lengthy process
Securing and receiving research funding takes time, and a lot of it.
This process is “painfully slow,” as Zibners describes it.
Preparing a grant proposal can take months or even years to complete. Then comes the delays: waiting to schedule a meeting for the research proposal to undergo review, followed by more waiting to hear whether they’ve been awarded funding.
“You set up a meeting, and then you might have your meeting a couple months later. And then you might hear about your meeting a couple months after that — and all the while, you’re trying to pay your bills,” Zibners says. “Making it that much harder when you have a meeting canceled day of.”
Even winning a grant doesn’t mean the money is in the bank the next day, or even the next month.
For example, Zibners — who felt fortunate to receive a grant from the U.K.’s National Institute for Health and Care Research — made a press announcement 14 months after learning they got the grant. Yet, the first round of funding didn’t arrive until several months after that.
[READ How AI Is Transforming Medicine and Patient Care]
Where Federal Funding Goes: The Breakdown
In the 2024 fiscal year alone, NIH awarded $36.94 billion in extramural research — that’s research conducted at academic and research institutions — funding that spanned the United States and abroad.
Federal research grants typically don’t fund entire projects, however, and they don’t go nearly as far as most people think. In reality, especially in the world of innovation, Zibners says, research teams are constantly stretching dollars, applying for additional grants and waiting for the next check to come through.
“Rarely does this money fund an entire project,” she emphasizes.
Where does that money actually go? Most federal research funding isn’t spent on flashy experiments or new, high-tech breakthroughs; it’s largely used to keep the lights on and the research moving. Generally, about 75% of that funding goes toward salaries for the professional scientific staff, students and trainees — those who actually perform the work and advance the field, says Daniel Flynn, who serves as Of Counsel for the academic medicine practice of the executive search and leadership advisory firm WittKieffer, and has decades of experience as an NIH-funded researcher.
Typical research costs include:
— Staff salaries
— Basic infrastructure, including a facility to conduct research with running water, electricity and internet
— Specialized equipment
— Filing fees, which can cost millions for Food and Drug Administration approval
— Regulatory compliance, to meet federal safety and ethical standards
“You can’t just run a study in your backyard,” Zibners says. “They have to do it in a certain way that it will meet the requirements of the FDA. Those steps are there to protect people.”
Just because you have a great, safe new idea and would “love people to have it tomorrow,” doesn’t mean you can, she says. “We have to go through the appropriate steps.”
At many universities, the institution typically fronts the money for grant-funded projects, says Flynn, who previously served as vice president of research for Florida Atlantic University for nearly a decade, where he oversaw the university’s research enterprise. Then, they’re reimbursed by the federal government.
[Read: What to Do If Your Child Is Diagnosed With a Rare Disease.]
How Federal Funding Cuts Affect the Public
When federal funding for research is suddenly drastically reduced or eliminated, the impact ripples far beyond the academic community. Even if that funding is later reinstated, the damage can be long-lasting.
These cuts don’t just affect scientists and institutions, but patients, their friends and families, progress in public health and disease treatment, trust in government institutions and the broader economy.
Here’s why you should care, even if you’re young, healthy and have never participated in a clinical trial.
1. Research programs can’t restart overnight.
When funding stops, ongoing projects don’t simply pause — rather, they can collapse. You can’t suddenly “hit play” and pick back up months later, like you’re watching a Netflix show.
“You can’t just reinstate those programs with the next administration,” Zibners says. “Most of these academics have been working on things for years. And when you disrupt their funding, it stops — and it will take years to rebuild that.”
2. Patients may lose access to life-saving clinical trials.
Clinical trials depend on consistency and timing. When funding disappears, so may opportunities for patients ready to participate in a clinical trial.
“Let’s say there was a patient who was scheduled to come in tomorrow,” says C. Daniel Mullins, a professor in the Department of Practice, Sciences, and Health Outcomes Research (P-SHOR) and executive director of the PATIENTS Program at the University of Maryland School of Pharmacy in Baltimore. “All of a sudden, we said we can’t bring you in to be in our research because our research just got shut down.”
Even if the trial is back up and running six months later, it may be too late.
“By now, you’ve had to decide what treatment to do,” says Mullins, who had federal funds paused earlier this year. “And because you already started one treatment, you may no longer be eligible.”
Mullins recently received a Notice of Award, which enables his team to proceed with an initiative to build infrastructure for patient-centered research by engaging patients and communities as partners in study design, thereby helping ensure that research is relevant, inclusive and feasible for real-world participants.
3. Everyone loses access to future life-saving treatments.
For people like Reynolds, who are actively participating in a clinical trial aimed at improving colon cancer treatment, funding cuts aren’t theoretical — they’re personal.
“I’ve talked to my doctors about, so what happens if it goes away?” Reynolds says. “And they’ve said, ‘Look, it’s a pretty big clinical trial — we hope that won’t happen.'”
But Reynolds isn’t just thinking about himself.
“It’s always in the back of my mind,” Reynolds says. “Not so much for me — but because this trial potentially changes the standard of care for this disease for everybody else that comes behind me.”
Even if you don’t need a life-saving drug or treatment today, you may one day. Or someone in your circle — your coworker, friend, neighbor or family member — might need it tomorrow.
“It may not be you or your child that has a condition for which there’s not an effective treatment,” Mullins says. “But the person who’s in that situation may be your neighbor, may work with you, and that person or their kid has a disease and the current treatments aren’t working.”
“That should matter to you,” he emphasizes. “Celebrate that your family is healthy, but you should still want that other families have access to the best available treatments. And when those treatments don’t work, we need to have research to find new ways of treating patients who don’t benefit from current therapies or maybe benefit but not enough.”
4. The public health workforce takes a hit.
Cuts in research funding can result in significant job losses for those working in labs, at universities, government agencies and start-ups.
“If you suddenly slash employees, those employees leave,” Zibners says. “They have to feed their families.”
Once they leave, they may not return. And hiring qualified replacements can be a very lengthy process.
“It takes years to recruit the right person for some of these positions — these aren’t things you can just fill in somebody who walked in off the street,” Zibners says. “There are very specific skill sets, and there’s very specific understanding of the systems that are carefully curated. And now those people are gone, so you can’t just pick back up.”
5. It undermines trust and, in turn, workforce recruitment.
Federal research jobs may not always pay as well as private-sector roles. But, “the trade off is job security and a trust that you are doing something good,” Zibners says.
However, when abrupt changes from the federal government disrupt that trust, people may not be so willing to work hard for less money without job security. This creates a long-term problem: Talented researchers may not enter or stay in public health careers if the ground keeps shifting beneath them.
6. There are nationwide economic consequences.
A recent report from the Association of Schools & Programs of Public Health details the widespread economic fallout that occurs when major sources of federal funding are cut, including:
— Job losses and hiring freezes. In the 2024 fiscal year alone, NIH grants supported over 400,000 jobs nationwide. Cuts not only lead to widespread job losses and hiring freezes, but also loss of career pathways for early-career researchers.
— Local economic consequences. In cities and towns with a large university presence, such as Johns Hopkins University in Baltimore or the University of Michigan in Ann Arbor, reduced research revenue can have a significant impact on local economies. According to ASPPH’s report, every $1 of NIH funding generates approximately $2.56 in overall economic activity.
— Reduced community health services. Funding cuts don’t just affect labs; they also impact community health centers, public outreach programs and preventive care efforts. In turn, this weakens the health care safety net that many Americans rely on, especially in underserved areas.
Long-Term Implications of Federal Funding Cuts
For long-time researchers, navigating the ups and downs of research funding is a familiar experience. But what’s happening now feels different.
Andrew Bean, a Principal for the academic medicine practice at executive search and leadership advisory firm WittKieffer, who has decades of experience in research, points out that these are very large, sustained cuts to the NIH, National Science Foundation and more, and they don’t seem to be going away.
Previously, Bean served as dean of the graduate school and vice provost for research at Rush University, where he was responsible for the university’s research portfolio and the graduate school’s educational portfolio. Prior to that, he was a basic and translational researcher at UT Health MD Anderson Cancer Center, where he worked in neuroscience and cancer research.
“These huge cuts that are happening are wiping out really important programs,” Zibners adds. “And it is not something that just gets flipped back on.”
Fewer dollars mean fewer grants, and that has cascading effects. Instead of 1 in 10 grant proposals being funded, Bean warns, it may soon be even fewer. That could drive both early- and mid-career scientists out of research entirely.
As Mullins puts it, “My biggest concern is that the assistant professor who has not seen a difficult time before might stop being a researcher.”
“They’ll think, ‘There’s just too much uncertainty,'” he adds, leading them to take jobs outside of research.
And it’s not just the scientists who are affected.
The impact stretches far beyond the lab. Universities are facing their own financial pressures, from enrollment declines to funding uncertainty, Bean says.
Flynn adds that many are university instructors. “They teach our medical students, they teach our future dentists,” he says. “And so that pipeline is going to be affected without the continuity of research training that is required to keep these people moving forward and helping to advance our educational mission.”
Research has grown out of the university’s mission to generate new knowledge, Bean explains. Faculty discover and pass on new knowledge to trainees, which helps advance the field.
This is part of a broader conversation about how higher education and scientific discovery are funded.
“You may not see the effects this year, but they’re going to become more obvious as the years go by,” Flynn says.
For patients like Reynolds, the consequences are personal. As someone benefiting from a clinical trial, he sees firsthand what’s at stake if funding continues to decline.
“I just went for follow-up testing the other day,” he says. While he sat in the waiting room, feeling healthy and wearing his work clothes, he looked around the room at people who looked exactly like he did a year and a half ago: very sick, frail and toughing it out. He couldn’t help but wonder what would happen to them if the funding for their treatments were slashed.
Why It Matters
This isn’t just a funding issue: It’s a national debate about what kind of future Americans want to invest in. The question isn’t whether we can afford to fund research; it’s whether we can afford not to.
“Research creates scientific, societal and economic value,” Bean says.
It drives discovery, fuels innovation, educates future professionals and, ultimately, saves lives.
“You have to spend some money to make some money,” Zibners says. “If you want to be a global leader in research and science and health care, then you have to be funding the programs to get you there.”
More from U.S. News
How to Take Care of Your Mental Health While Using Dating Apps
Navigating Insurance and Costs for Ambulatory Surgery: A Comprehensive Guide on How to Pay
How to Get Enough Protein: Best Protein Sources for Vegans, Vegetarians and Plant-Forward Eaters
How Federal Funding Cuts to Medical Research Can Hurt Your Health originally appeared on usnews.com
