The outside of UCSF Health in San Francisco. (Smith Collection/Gado/Getty Images)
Dr. Adil Daud, a cancer researcher, is scrambling to keep a critical clinical trial afloat.
His team is developing a treatment for mucosal melanoma, a rare and aggressive cancer. In December, they submitted a proposal to the Department of Defense to test a novel checkpoint inhibitor for patients who don’t respond to current immunotherapies.
“If I can’t secure alternative funding in the next few months, I don’t know if these patients will get a chance,” Daud said. “If you only have a few months to live, a pause in research could mean the difference between accessing a potentially life-saving trial and not having that option at all.”
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Daud and other researchers are caught in the crosshairs of a dizzying number of directives pouring out of the White House.
Since taking office, President Donald Trump has announced plans for the U.S. to withdraw from the World Health Organization, suspended public reports from the Centers for Disease Control and Prevention and abruptly halted grant review panels at the National Institutes of Health — all without explanation.
Then, on Monday night, the administration sent further shockwaves through federal agencies, issuing a memo that halted all federal financial assistance. The order was accompanied by a spreadsheet listing about 2,600 initiatives now under review. A federal judge has temporarily paused the directive. By Wednesday morning, the administration rescinded the freeze, according to the New York Times.
U.S. President Donald Trump signs an executive order in the Oval Office of the White House in Washington, D.C., on Jan. 20, 2025. (Jim Watson/Pool/AFP via Getty Images)
The disruption coincides with this week’s Senate hearings evaluating Robert F. Kennedy Jr.’s nomination to lead the Department of Health and Human Services, which oversees the NIH.
Dr. Pamela Munster, a cancer researcher, said she has never seen anything like it.
“I’ve been here since 1992, through multiple presidents — Clinton, Bush, Obama. This is completely new territory,” she said. “Scientific meetings aren’t just paused, halted or delayed like this. Even during COVID, we found ways to continue virtually.”
At institutions such as UCSF, where NIH funding supports grants, the consequences could be devastating. In 2023 alone, UCSF received $789 million in NIH funding — more than any other public university in the nation, a distinction it has held for 17 consecutive years.
UCSF, the nation’s top public recipient of NIH funding for 17 years, received $789 million in 2023 — vital support that could face serious consequences if funding is cut. (Thomas Hawk/Flickr)
“It’s almost like PTSD,” said Dr. Peter Chin-Hong, an infectious disease expert. “I’m really activated because it’s all so uncertain. I think it’s leading to confusion, a decrease in morale and chronic stress because you don’t know what’s coming.”
Securing NIH funding is grueling, even under normal circumstances. Researchers spend months crafting grant applications that can span hundreds of pages, undergoing rigorous reviews by numerous expert panels. The entire system depends on intricate scheduling and coordination.
“It’s not easy to just postpone them,” Munster said. “I’m not sure how we make up for these delays.”
Adding to the chaos, NIH staff were reportedly instructed to cease communication with external scientists, halt travel to scientific conferences and cancel meetings between researchers and NIH program officers.
The University of California is evaluating the deluge of orders issued by Trump and the subsequent agency guidance to understand their potential impact, according to a statement from the Office of the President.
For physician-scientists who split their time between treating patients and conducting research, the instability is particularly concerning. Munster said she and her colleagues translate discoveries from the lab into treatments for patients and bring insights from patient care back to the lab.
“We’re somewhat of an endangered species already,” Munster explained. “I bring a lot of bedside-to-bench expertise. That will be lost if people like me don’t see academic medicine as a viable career path.”
Munster predicts more scientists will abandon academia for the private sector, where salaries are often significantly higher.
“We put our hearts and souls into medical research,” she said. “Don’t get me wrong — I make a decent salary as a physician-scientist. But I could make a lot more money if I went into industry.”
Kennedy has publicly stated his intent to fire and replace 600 of NIH’s 20,000 employees and shift half of the NIH budget toward “preventive, alternative and holistic approaches to health.” While experts agree lifestyle changes are important, they stress that exercise and nutrition won’t be enough for terminal cancer patients who need breakthrough treatments.
Dr. Elad Sharon, an oncologist at Harvard University, likens the current situation to a government shutdown.
“The reason why there is so much confusion in the scientific community is that there is no purported end date associated with this decision to stop some aspect of grant review and public communication,” he said.
While he acknowledges that a short pause may not immediately derail scientific progress, the broader implications of these disruptions raise serious concerns.
“Public health agencies like the NIH play a critical role not just in supporting researchers but in addressing the needs of vulnerable populations,” Sharon said. “Without federal support, many critical questions, especially those affecting individuals overlooked by commercial interests, simply won’t be answered.”
He said the more federal health agencies are restricted, the greater the impact on people’s lives.
“We serve the public regardless of political ideology,” Sharon said. “Cancer research shouldn’t be turned on and off based on politics.”
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