Big reforms in the NIH: Significant changes under Trump 2.0 for biomedical research

Big reforms in the NIH: Significant changes under Trump 2.0 for biomedical research

The world's largest public funding agency for biomedical research will be faced with significant restructuring in the coming years.

suggestions from both chambers of the US congress and statements of the Future government of US President Donald Trump show that there is a significant need for reform for the National Institutes of Health (NIH) and its 47 billion US dollar research. However, it remains unclear how this transformation will be precisely; The proposals range from the halving of the number of institutes to the replacement of some of the agency employees.

In order to take the increased control of the government into account, the NIH launched a number of meetings on November 12, in which an advisory group from internal and external scientists will check various suggestions and express its own reform recommendations.

Jennifer Zeitzer, who leads the office for public affairs of the Federation of American Societies for Experimental Biology in Rockville, Maryland, says: "There is definitely movement on Capitol Hill to discuss how the NIH can be optimized and reformed. Now the agency is also participating in this discussion."

reduce and shorten

The NIH-advisory meeting takes place after the Republicans' victory in the 2025 congress elections. This year, two separate legislative proposals were brought in to the reform of the agency of Republican Congress members-one by MP Cathy McMorris Rodgers from Washington and the other by Senator Bill Cassidy from Louisiana. These suggestions are partly due to dissatisfaction with the reaction of the agency to the Covid-19 pandemic and The perception that supervision for research into potentially risky pathogenic lax was .

McMorris Rodgers NiH from 27 to 15, allowing the mother agency to cancel every grant that is seen as a threat to national security to introduce a 5-year term of office for institute heads that can only be extended once and to enforce a strict monitoring of research into risky pathogenic. Cassidy, who will probably take over the chair of the Health Committee of the US Senate in 2025,

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The NIH was often the target of Trump and his Republican and other allies. Robert F. Kennedy Jr., whom Trump has chosen as head of the US Ministry of Health (HHS)-the Mother Agency of the NIH-explained in 2023 that he would strive for an eight-year break for research on infectious diseases at the NIH so that the biomedical sponsor can instead concentrate on chronic illnesses such as diabetes and obesity. He also said on November 9 that he wanted to replace 600 employees at the NIH. (Neither Trump nor his appointments can currently be released from the agency, the positions of which are legally protected, but this could be Change his promise to re-classify the federal workers.)

Harold Varmus, a cancer researcher at the Weill Cornell Medicine in New York City and former head of NIH, told Nature that Kennedy's statements "worry". "We may need the support of congress republicans and even from Democrats who traditionally support the NIH to stand up for the agency and its importance for public health."

final sprint

At the meeting of the NIH advisory committee, the Scientific Management Review Board (SMRB), the members exchanged themselves for the first time since 2015 on the structure of the agency and the research spectrum and developed recommendations for the NIH director and the HHS. The agency had asked the congress to initiate this process.

The NIH officials hope that the group will meet five times in the coming calendar year to create a report on their findings and recommendations by November 2025. This ambitious schedule indicates that “there is recognition that the SMRB has to act quickly to keep up with the congress, or the risk of congress is making decisions that they do not make,” says Zeitzer.

In fact, several committee members said during the meeting on November 12 that the congress could act before the group's reporting. Kate Klimczak, the head of the NIH legislative Politics and Analyzes Office, tried to calm the body: "The authors of the various [congressional] suggestions obviously wanted this body to be set up and that it does its work," she said. "We have to believe that you are looking forward to receiving [a report] from you."

NiH director Monica Bertagnolli , which will probably withdraw before Trump's taking office, expressed her rejection of the suggestions for reducing the institute. She emphasized that the current system enables people with diseases and patient groups to work with a certain institute for their concerns, for example the National Institute of Mental Health or the National Institute on Aging. "If we were downsized, we would definitely lose something in relation to our commitment to the public," she said.

It is unclear in which direction the SMRB will go with its recommendations, but there were indications during the meeting. Several participants were surprised by the legislative suggestions. For example, McMorris Rodgers' white book says that "decades of non -strategic and uncoordinated growth have created a system that is susceptible to stagnating leadership, research duplication, gaps, misconduct and inappropriate influence". James Hildreth, President of the Meharey Medical College in Nashville, Tennessee, described this language as "almost insulting". He added: "I know that we should not allow politics to penetrate what we do, but how couldn't that be the case?"