Medical research depends on government money – even a day’s delay in the intricate funding process throws science off-kilter
- Written by Aliasger K. Salem, Associate Vice President for Research and Professor of Pharmaceutical Sciences, University of Iowa
In the early days of the second Trump administration, a directive to pause all public communication[1] from the Department of Health and Human Services created uncertainty and anxiety among biomedical researchers in the U.S. This directive halted key operations[2] of numerous federal agencies like the National Institutes of Health, including those critical to advancing science and medicine.
These operations included a hiring freeze, travel bans and a pause on publishing regulations, guidance documents and other communications. The directive also suspended the grant review panels that determine which research projects receive funding.
As a result of these disruptions[3], NIH staff has reported being unable to meet with study participants or recruit patients into clinical trials, delays submitting research findings to science journals, and rescinded job offers.
Shorter communication freezes[4] in the first few days of a new administration aren’t uncommon. But the consequences of a freeze lasting weeks or potentially longer underscore the critical role the federal government plays[5] in supporting biomedical research. It also brings the intricate processes through which federal research grants are evaluated and awarded into the spotlight.
I am a member of a federal research grant review panel, as well as a scientist[6] whose own projects have undergone this review process. My experience with the NIH has shown me that these panels come to a decision on the best science to fund through rigorous review and careful vetting.
How NIH study sections work
At the heart of the NIH’s mission to advance biomedical research is a careful and transparent peer review process[7]. Key to this process are study sections – panels of scientists and subject matter experts tasked with evaluating grant applications for scientific and technical merit. Study sections are overseen by the Center for Scientific Review[8], the NIH’s portal for all incoming grant proposals.
A typical study section consists of dozens of reviewers selected based on their expertise in relevant fields and with careful screening for any conflicts of interest. These scientists are a mix of permanent members and temporary participants.
I have had the privilege of serving as a permanent chartered member of an NIH study section for several years. This role requires a commitment of four to six years and provides an in-depth understanding of the peer review process. Despite media reports[9] and social media[10] posts indicating that many other panels have been canceled, a section meeting I have scheduled in February 2025 is currently proceeding as planned.
Reviewers analyze applications using key criteria[12], including the significance and innovation of the research, the qualifications and training of the investigators, the feasibility and rigor of the study design, and the environment the work will be conducted in. Each criterion is scored and combined into an overall impact score. Applications with the highest scores are sent to the next stage, where reviewers meet to discuss and assign final rankings.
Because no system is perfect, the NIH is constantly reevaluating its review process for potential improvements. For example, in a change that was proposed in 2024, new submissions from Jan. 25, 2025, onward will be reviewed using an updated scoring system that does not rate the investigator and environment but takes these criteria into account[13] in the overall impact score. This change improves the process by increasing the focus of the review on the quality and impact of the science.
From review to award
Following peer review, applications are passed[14] to the NIH’s funding institutes and centers, such as the National Institute of Allergy and Infectious Diseases[15] or the National Cancer Institute[16], where program officials assess the applications’ alignment with the priorities and budgets of institutes’ relevant research programs.
A second tier of review is conducted by advisory councils[17] composed of scientists, clinicians and public representatives. In my experience, study section scores and comments typically carry the greatest weight. Public health needs, policy directives and ensuring that one type of research is not overrepresented relative to other areas are also considered in funding decisions. These factors can change with shifts in administrative priorities.
Grant awards are typically announced several months after the review process, although administrative freezes or budgetary uncertainties can extend this timeline. Last year, approximately US$40 billion[18] was awarded for biomedical research, largely through almost 50,000 competitive grants to more than 300,000 researchers at over 2,500 universities, medical schools and other research institutions across the U.S.
Getting federal funding for research is a highly competitive process. On average, only 1 in 5 grant applications[19] is funded.
Consequences of an administrative freeze
The Trump administration’s initial freeze paused some of the steps in the federal research grant review process. Some study section meetings have been postponed indefinitely, and program officials faced delays in processing applications. Some research groups relying on NIH funding for ongoing projects can face cash flow challenges, potentially resulting in a need to scale back research activities or temporarily reassign staff.
Because my own study section meeting is still scheduled to take place in February, I believe these pauses are temporary. This is consistent with a recent follow-up memo from acting HHS Secretary Dorothy Fink, stating that the directive would be in effect through Feb. 1[21].
Importantly, the pause underscores the fragility of the research funding pipeline and the cascading effects of administrative uncertainty. Early-career scientists who often rely on timely grant awards to establish their labs are particularly vulnerable[22], heightening concerns about workforce sustainability in biomedical research.
As the NIH and research community navigate these pauses, this chapter serves as a reminder of the critical importance of stable and predictable funding systems. Biomedical research in the U.S. has historically maintained bipartisan support[23]. Protecting the NIH’s mission of advancing human health from political or administrative turbulence is critical to ensure that the pursuit of scientific innovation and public health remains uncompromised.
References
- ^ pause all public communication (www.science.org)
- ^ key operations (doi.org)
- ^ result of these disruptions (www.science.org)
- ^ Shorter communication freezes (www.science.org)
- ^ critical role the federal government plays (www.nih.gov)
- ^ a scientist (scholar.google.com)
- ^ peer review process (grants.nih.gov)
- ^ Center for Scientific Review (public.csr.nih.gov)
- ^ media reports (www.npr.org)
- ^ social media (bsky.app)
- ^ Center for Scientific Review (commons.wikimedia.org)
- ^ analyze applications using key criteria (www.niaid.nih.gov)
- ^ takes these criteria into account (grants.nih.gov)
- ^ applications are passed (grants.nih.gov)
- ^ National Institute of Allergy and Infectious Diseases (www.niaid.nih.gov)
- ^ National Cancer Institute (www.cancer.gov)
- ^ advisory councils (grants.nih.gov)
- ^ approximately US$40 billion (www.nih.gov)
- ^ 1 in 5 grant applications (grants.nih.gov)
- ^ gorodenkoff/iStock via Getty Images Plus (www.gettyimages.com)
- ^ in effect through Feb. 1 (www.cnn.com)
- ^ particularly vulnerable (www.statnews.com)
- ^ historically maintained bipartisan support (www.statnews.com)
Authors: Aliasger K. Salem, Associate Vice President for Research and Professor of Pharmaceutical Sciences, University of Iowa
