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Brian Lehrer: Brian Lehrer on WNYC. One of the things we've committed to doing on this show during Trump's first 100 days is a Health and Climate Tuesdays section of the show. This builds on and expands the climate story of the week that we had been doing on Tuesdays the last two years. Our thinking right now is that there are so many headlines coming from the new administration.

We were just speaking about some of them with Andrew Weissmann, things that are pretty monumental on a daily basis, that health and climate ones risk getting lost in the shuffle. Today, we'll talk about the attacks on the National Institutes of Health, and their implications for Americans' health in the space we've carved out for these issues.

Then, later what Ezra Klein and Derek Thompson argue for in a new book, which is a climate policy based on abundance, rather than scarcity, they'll explain, but the NIH first. The National Institutes of Health is the world's single largest public funder of biomedical research. The agency spends most of its $47 billion annual budget on developing new drugs and vaccines.

Here are just some of its accomplishments according to its own website and other sources. The American Cancer Society estimates improvements in cancer treatment, many of which were funded and driven by the NIH, resulted in a 33% drop in the cancer death rate since 1991. NIH research has driven HIV testing and preventive interventions, resulting in a more than 90% decrease in the number of US babies born with HIV.

The agency played a major role in working to address the national opioid crisis by working to develop safe, effective medicines for chronic pain. On average, the agency awards 60,000 research grants each year for these kinds of works, and much more. In a typical year, around 20 grants might receive a termination letter, but only after a rigorous review process, and usually, because of serious problems. Again, around 20 grants out of 60,000.

The Trump administration, however, is now targeting certain grants for termination, most recently, those that make mention of gender, DEI, or vaccine hesitancy, just based on those broad brush categories. Number of cancellations so far this year, therefore, is thought to be well over a hundred already. Within a matter of weeks, our next guest writes, "It could exceed the total number of cancellations the NIH has executed in the past decade, all for seemingly political reasons."

Joining us now to explain how NIH agency officials are being forced to terminate certain active research grants by the administration, is the writer of that article, Katherine Wu, Staff Writer for The Atlantic. Her latest is titled: The NIH's Grant Terminations Are 'Utter and Complete Chaos'. Katherine, always good to have you. Welcome back to WNYC.

Katherine Wu: Thanks for having me back.

Brian Lehrer: Listeners, we know some of you out there are probably working in scientific research funded by the NIH, so help us report this story. 212-433-WNYC, call or text. Have you been impacted firsthand by a grant termination? Have any of your friends, or colleagues received a termination? What was the justification of the termination? If you can share, 212-433-WNYC, 212-433-9692, or other pressures on federally funded scientific research, 212 433-WNYC, 433-9692. Help us report this story with a call or a text.

Katherine, when you were on last about a month ago, we talked about the Trump administration freezing funding, and slashing budgets, but this termination of active research projects by the NIH is new since then. Can you just put it into context for us? How big of a deal is this?

Katherine Wu: It's a very big deal. I think I differentiate this from frozen funding in one really important way. This is basically cutting off funding to projects that have already been started. It's basically the equivalent of hiring someone and then firing, versus never hiring them in the first place. These studies have already started. They've already started animals, or people on treatments.

They've already recruited subjects. They've already invested the work. They've hired research staff. They've invested sometimes years of work. All of a sudden, they're getting these very abrupt emails, absolutely no warning, and saying, "Stop work immediately. You're getting no funds, even though you budgeted for this for maybe another 5 to 10 years." That's just gone. That's huge.

That means people have to lay off research staff. That means they have to halt their studies. There may be animals or people with drugs in their bodies still, now being told, "Well, we can't help you anymore, this is over, and your sacrifices have been for nothing." That is wildly disruptive, and it's part of the reason that the NIH normally goes to all lengths possible to avoid this kind of termination, or cancellation.

Brian Lehrer: There have been two rounds of these cancellations. I see. The first began on February 28th targeting one set of grants. The second began on March 10th targeting a second set, both political targets of the Trump administration. Can you break them down for us?

Katherine Wu: Yes. It's been a little bit difficult to keep track of these waves, because they happen so very abruptly. It seems like there has been a continuous trickle ever since, so the waves are really starting to bleed together at this point. Yes, the first one, end of February, this big wave that targeted grants that seem to make mention of some sort of DEI, or involves transgender participants.

The second wave seemed mostly targeted on grants that mention vaccine hesitancy, or uptake. Though, I'm using some couching terms here, because in both cases, it seemed like a lot of grants were caught up in collateral damage here. Some grants were targeted, even though they don't focus very heavily on the key words I just mentioned. They just happened to make mention of them somewhere in their description.

Brian Lehrer: What are some of the public health issues that these studies were actually addressing?

Katherine Wu: Yes, I mean, it's a massive range, right? I mean, you think of all the subfields that these topics can touch. You can imagine HIV epidemiology being impacted, frankly, by [chuckles] both sets of grant targets here. Patterns of sexually transmitted infection transmission with vaccine hesitancy. That is basically any vaccine, but there were also mathematical modeling studies caught up in that wave that just mentioned vaccine uptake as a factor that contributes to how diseases transmit in the modern world.

Really, I saw grants being canceled from, basically, across most of the NIH's 27 institutes and centers, which cover basically all of biomedical research. Definitely clear, though, that certain institutes such as the National Institutes for Allergy and Infectious Disease were hit harder than some others.

Brian Lehrer: Let's take a phone call. Here's Andrew in Jersey City. Hi, Andrew, you're on WNYC.

Andrew: Hi, how are you? Can you hear me?

Brian Lehrer: I can hear you.

Andrew: Yes. I'm a former liver transplant surgeon. I do a lot of public health research, and early diagnosis of preventable cancers. My frustration is twofold. A, I've written R21s, R01s, KOA grants to the NIH, haven't been funded, but I think there's a big disconnect between what we actually need, and what we actually do. I mean, as a liver transplant surgeon for a dozen years, and even now, 85% of patients who get a liver transplant, get a transplant for something that's absolutely preventable, if you think about that.

If you look at colon cancer, lung cancer, liver cancer, we do an abysmally poor job of early diagnosis for those cancers. I mean, it was basically almost impossible to get meaningful grant funding for those disciplines prior to the Trump cuts, and it's going to be even harder. I'm very concerned that we have basically lost our way in terms of what we need to prioritize in health care.

Brian Lehrer: Why do you think, Andrew? I mean, if this number is really correct, that there are 60,000 NIH research grants given out every year, and you're talking about what sounds like very mainstream, as well as serious public health prevention concerns, disease prevention concerns. Why isn't the money, in your opinion, going to some of those right places, important places?

Andrew: I think the problem is the structure of our healthcare system. Our health care healthcare system has devolved into everything has to be revenue driven. I think the big problem with that is, I think we're one of the only industrialized countries in the world that doesn't have a nationalized healthcare program. I do liver cancer, and I spend a lot of time trying to find people with Hep C and B metabolic liver disease with cirrhosis, to impact on decreasing their likelihood of needing a liver transplant, or developing a cancer.

The unfortunate truth on that is, that's not a moneymaker. Hospitals have devolved to, basically-- Even whether they're "nonprofit", or "for profit", it's all about revenue. Programs that seek to improve health, and decrease the rate of cancer, or early diagnosis are not moneymakers.

Brian Lehrer: Andrew, you raise really important issues. Thank you very much for chiming in. Katherine, what are you thinking as you listen to Andrew?

Katherine Wu: Yes, I think there are a lot of great points being raised here. Certainly, there is just a general funding crisis. I think one of the most important things to consider is just how much political ideology is now, I think, interfering with the grant making process. Certainly, the funding system was absolutely not perfect before, I will say that a million times over, but it was very much premised on the idea of scientists, experts making expert decisions about what science got funded.

There are a lot of redundancies in that sentence. Exactly, because it was supposed to be that way, science doing science. You disrupt that system, and the system just gets ever more problematic.

Brian Lehrer: Do I even have the number right? 60,000 research grants per year from the NIH?

Katherine Wu: Yes.

Brian Lehrer: How can they even review that many grant applications, and put that many public health research projects into the pipeline every year?

Katherine Wu: It's a really complicated system, but I mean, you think about that number, and it is staggering. That's tens of billions of dollars going out to universities, and other institutions across the US, and really around the world. They have 27 institutes and centers. They are filled with experts. They bring in outside experts from outside the NIH to vet those proposals that come in to compete for those grants.

There are multiple rounds of review that make sure only the best grants are funded. It's a really complex system, but this has operated as a decently well-oiled machine for decades, and there have been enormous returns on investment. Exactly as you mentioned at the top of the segment, pretty much all the major medical breakthroughs we've had in the past few decades can be, at least, partly attributed to NIH funding.

Brian Lehrer: Yes, but here's a pushback text on whether things need to be shaken up. Listener writes, "If you're saying that the status quo of the NIH has been so productive." Listener writes, "What's going right? The health of the nation is now failing, as evidenced by lowering of life expectancy. The epidemic of young adults getting cancers, the unexplained spike in deaths after the pandemic, and the poor performance of government agencies during the pandemic. Things need to be shaken up."

Katherine Wu: Yes, I think that's a great point. I would not pretend that anything about this country is perfect, but I do think it's important to distinguish between driving biomedical innovation, actually doing the, the basic and translational research that is making discoveries, and then there's the whole other step of operationalizing that research, and making sure the fruits of that labor actually reach the people, the American public, in a fair and equitable way.

Our previous caller made a great point that we don't have very well-structured health care in this country. It's not a nationalized system. Not everyone is guaranteed good access to good care. Everything is privatized, it's still a heavily capitalistic society. I think that is part of the reason we still have these massive disparities, and that a lot of the health issues are concentrated in highly vulnerable populations.

I worry that's going to get even worse though, if we dismantle what has been working fairly well about our system here, which is, I think, very premised on innovation.

Brian Lehrer: On the basis of political enemies lists, like targeting anything that mentions DEI. We should probably say out loud that there's a real public health risk, and public health cost to not measuring racial and other disparities in life expectancy, and particular diseases and healthcare outcomes. Right?

Katherine Wu: Absolutely. I think there is a massive concern that is being realized already that a lot of the grants that are being cut, that are being terminated, and a lot of the projects that aren't going to be funded in the future, are going to concentrate especially on research that would have otherwise focused on reducing health disparities, bringing care to marginalized populations.

We have to consider that over the past few decades, we only just started making strides and progress and bringing some of those populations into research itself. Now, all of that work is being undone in an instant, effectively. I think you also have to consider that it took a lot of work to get those populations to even have a little bit of trust in the medical establishment. You break that again, I don't know how it's going to go the next time.

Brian Lehrer: Katherine Wu, who writes about health and science for The Atlantic, with us. The immediate hook, the termination of many NIH public health research grants, and the implications of those, and how it fits into the political agenda of the new Trump administration. We're inviting calls from scientists who are being affected by this. Mary Beth in Boston, you're on WNYC. Hello, Mary Beth.

Mary Beth: Hi. Can you hear me okay?

Brian Lehrer: Yes, I can.

Mary Beth: Great. Thank you so much for doing this episode. I am a professor of epidemiology at Columbia University, and also at our Herbert Irving Comprehensive Cancer Center. I'm also the executive director of Silent Spring Institute. We lost a number of grants last week. I want to speak to one of them, because it really is about training the next generation.

This is the first time ever that the different institutes in NIH allowed you to work across outcomes, so five centers in New York City came together to put together a large center grant that funds junior scientists, as well as offers pilot awards for training in multiple chronic diseases, because this is one of the big issues in health inequities in New York City.

When that grant got canceled, it canceled a partnership that took many years to establish, as well as hurt many junior faculty who have these pilot awards to this. Many of our doctoral students also lost their grant funding. In order to get this grant funding, it was incredibly difficult to get in the first place. Many of them had an award notice the same night it was canceled, so I really worry most about the loss of this generation. If they can't stay in science for this.

Brian Lehrer: Why do you think this in particular was targeted, Mary Beth?

Mary Beth: Well, I can tell you, not all of the grants that were cancelled, but many of the grants that were canceled, were canceled because they had an equity component, which meant that we do training across different groups of people, particularly, people that are underrepresented in science, because we do know, and there's substantial data to support that the best answers in science come from people across disciplines, and across different lived experiences, in particular, the NIH.

These are all signed contracts that were awarded. These are not grants that we're trying to get now. This is the first time we've ever had grants canceled, at least in my 26 years of research. Also, we had them canceled for things that the government asked us specifically to put into the grants. Again, this includes our major centers across the campus, like our cancer centers.

Brian Lehrer: Mary Beth, I don't know if you're comfortable going here, because it's so hot, but this cancellation of $400 million in grants to Columbia by the Trump administration over antisemitism concerns, are you aware of that impacting public health research at Columbia?

Mary Beth: The Public Health School is one of the most affected schools. Again, it's a combination, because most of our work is in health disparities and health inequities, and it's this conflation between DEI and health inequities, which are totally different. Also, most of our programs are dealing with the most marginalized populations. Like the previous speaker talked about, without these kinds of grants, and without counting data this way, we'll never be able to describe the health inequities. If you can't describe them, you can't fix them.

Contrary to what most people think, we've only just started over the last couple decades in getting more diversity in terms of the areas of health that are being represented. To this date, there's only been 8.8%, the National Academy's estimated 8.8% of grants specifically on women's health, and so, there's huge gaps that need to be addressed in this research, and the research is [crosstalk] being targeted. Sorry.

Brian Lehrer: Well, I was just going to say, even women's health, for people who haven't thought about it in these terms as an area of scientific study, public health study is being eliminated under the attack on DEI, not just racial minorities?

Mary Beth: That's absolutely right, yes.

Brian Lehrer: Mary Beth, thank you very much for your call. Let's keep going. Another scientist, Miriam, in Brooklyn. You're on WNYC. Hi, Miriam.

Miriam: Hello. Good morning, Brian. I just wanted to let you know, so I will just call myself Dr. XYZ to represent all the doctors and all the molecular biologists that are seeing this right now, and hearing it, that we are not supposed to mention mRNA in any of our report, or any projects, or any submissions. We are totally under attack here. We cannot mention mRNA for molecular biology.

Brian Lehrer: Just so for some people who may not know what you're referring to, the COVID vaccine, for example, was an mRNA vaccine based on that technology, right?

Miriam: Yes, sir.

Brian Lehrer: That's probably the exact reason that mRNA is being politically targeted, right?

Miriam: Absolutely. Yes, sir. Yes, Brian. I also want just to follow up on what your previous caller said. Where is this new generation going? Well, the same way we came all from Europe to America, to United States, because there is the money here for research, and there is flowing money for research, for proper research, to advance medical research, and that's why we-- Many, many, many brains came here, and participated in a wonderful group work.

To respond to your previous caller, I am feeling that there will be a [unintelligible 00:21:30] a migration of all these resources, and all these brains towards Europe, towards wherever they will be offered, because we come here as postdoc, and then we establish our life in this country, and the new generation, they are already being told on campuses, Brian, "Go look for another postdoc somewhere else. Look in Europe."

Brian Lehrer: Miriam, thank you very much for your call. Katherine Wu from The Atlantic. I mean, there are at least two big topics just in that last call that we could discuss. One, the attack on the mRNA vaccines, or research on developing new ones, or continuing to develop existing ones. Then, this idea of a brain drain. It used to be that the brain drain was from autocracies around the world, people who all wanted to come to the United States, or many of them did. Now, it may go exactly the other way. That would be so the opposite of US history.

Katherine Wu: Yes. I think both topics are incredibly important to consider. I think for a couple weeks now, there has been this growing fear that mRNA vaccine-focused grants, as well as grants that send any funding to projects in South Africa are going to be among the next ones to be culled. I think that is quite likely to happen based on recent events.

I think people are very understandably wary of trying to continue their research careers in this country. A lot of the people I'm talking to are struggling to picture even what next week will look like, much less five years from now. I think that's a really toxic environment to be working in. Certainly, even within the NIH, people are feeling how suffocating and toxic the environment is, and wanting to leave that space.

I can't imagine what it's like to be an academic researcher right now in the biomedical sciences, or really any other field of research. Frankly, the funding cuts have affected everyone. I think there's going to be serious implications for the future of the workforce in this country, and by extension, the future of American health.

Brian Lehrer: You write the quote, "Recent directions to terminate in all these grant terminations in mid-flight arrived without warning, or the usual steps of deliberation, and they instructed grants management officers to issue letters by the end of the day they received them." You wrote, "The email directives also handed NIH officials pre-written justifications for termination." Pre-written justifications that the new NIH officials could use. What are these pre-written justifications? Do you have an example?

Katherine Wu: Yes, there are a couple. Basically, the gist of it is, "Your work no longer aligns with agency priorities, and it's basically not valid/" Especially, in the case where grants touched on DEI, or had a component that involved transgender participants. There were even these really insulting bits about how their research didn't align with biological realities.

In general, these letters are saying that the research being targeted here, is not a good use of taxpayer dollars, and is not advancing American health. All of that, I think, is very clearly refutable looking at how important some of the topics covered here are, including infectious disease research, reducing health disparities, all of these really important topics in public health.

I think the weird vagueness and weird ideology mentioned in these letters, really speaks to the fact that these are politically motivated terminations. These are not typical termination coming out of the NIH, which are rare, and usually, because somebody has not complied with the scientific objectives laid out in their grant, or involved some sort of research misconduct.

That is absolutely not the case here. This is a new administration meddling in the affairs of a federal agency that, otherwise, grants funding to the best science. Now, that is being worked towards funding only what the administration feels is politically palatable.

Brian Lehrer: We're going to take Pat in Hillsborough, New Jersey, as our last caller in this segment. Pat, hang on for just one second. I just want to say, Katherine, we have so many scientists calling in with so many different stories as we come to the end of our time for today. We're going to have to do this again, because this is just the beginning, or so it seems, of a long story during this Trump administration of the impact on science, and scientific research, never mind public health outcomes. Right?

Katherine Wu: Absolutely. I would encourage the scientists to keep speaking out. Your stories are so important, and I think, the public has struggled to understand how research operates under the best of times, under the most normal of times. It's essential that they hear from you now.

Brian Lehrer: Our last scientist for today, or maybe it's, I think, spouse of a scientist in this case, Pat. right? Hi, you're on WNYC.

Pat: [chuckles] Yes, I'm a spouse of a scientist. My husband was dean of research at Rutgers Medical School for a number of years. Was very involved in getting the cancer center going in New Brunswick, and so I've been a participant from fairly close. One of the major things I wanted to say is that, people really don't understand how basic science actually affects health over the years.

For instance, I was a good friend with the person who actually-- One of the people who actually ended up founding Genentech. The work was done in '73. Then, they were able to figure out how to make insulin without just getting it from animals. Can you imagine a major difference that, that made? It's a long time ago, folks. It takes a long time for some of these fundamental things to make their way into things that are immensely useful.

Your guest just said that people don't understand how science works. I would really hope, Brian, that you could actually bring scientists doing this kind of work into the kind of work you do, because one of the problems about viewing it continually through the narrow version of health, is that it means that people really just don't understand how asking basic questions can lead to answers that 50 years later, can make a difference in people's lives, an immense difference in people's lives.

I'm just begging you. For instance, there were scientists who signed a letter against Kennedy's appointment, and you didn't have one of them on. You talked to--

Brian Lehrer: No, we talked to--[crosstalk]

Pat: You've covered this very, very well, but I think you need to broaden very much, because I think it's also an attack on the universities, actually, because Vance has said,-

Brian Lehrer: There's no question.

Pat: -"The professors are the enemy."

Brian Lehrer: Yes, Pat, thank you very much, and a very worthy suggestion. In our last minute, Katherine, to her main point about how long things take to really come to fruition, and actually help save people's lives, and improve their health. I think you wrote about this in your article, that terminating grants to match political priorities, creates a fundamental instability in the government's approach if this just changes from administration-to-administration depending on their politics, right?

Katherine Wu: Right. I mean, science progresses by definition incrementally. Findings build on one another and. Exactly to the caller's point, it's not always the grants that are titled, clinical trial, like testing XYZ drug, that are going to be the most important things. Sometimes these kernels come out of really basic research, just trying to find out more about the world around us.

If those discoveries don't have a chance to blossom, and get picked up by other researchers, and translated into other contexts, there's not going to be this incremental buildup that results in advancement of knowledge. It's going to be a series of fits and starts. There's going to be funding given, funding pulled back, and no one's going to want to work in an environment like that, and no progress is going to be made in an environment like that.

Brian Lehrer: Certainly, we are having scientists on this show, Paul Offit recently, the vaccine expert Daniel Griffin, who comes on with us on a pretty regular basis from This Week in Virology and others. Pat, to your point, but could we be doing more? Absolutely. It's our commitment that we're going to keep our eye on what's happening in health and the environment, no matter what else may also dominate the headlines on a given day, or on a given week.

That, in fact, is part one of today's Health and Climate Tuesday section. We're going to do part two coming up, but we thank Katherine Wu, staff writer for The Atlantic. Her latest is titled: The NIH's Grant Terminations Are 'Utter and Complete Chaos'. Katherine, thanks as always.

Katherine Wu: Thanks so much for having me.

 

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