Year: 2025
Type: article
Abstract: For nearly 15 years, I served in leadership positions in extramural divisions of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH). I started as deputy director of the Division of AIDS and later became director of the Division of Microbiology and Infectious Diseases. During that time, I witnessed transforming advances in treating and preventing infectious and immunologic diseases, all supported by NIAID-funded research. Successful human immunodeficiency virus (HIV) treatment saved lives and prevented HIV transmission [1]. Elegant structure-based vaccine design led to highly effective vaccines that prevented severe acute respiratory syndrome coronavirus 2 and respiratory syncytial virus infection and disease, leading to countless saved lives [2, 3]. Introduction of peanut consumption early in life significantly decreased peanut allergy in children at risk [4]. Nearly every major medical advance was built on foundational knowledge gained through NIAID's support of basic science. Even when a primary scientific goal proved elusive—an efficacious HIV vaccine, for example—discoveries made along the way transformed our thinking about the immune system and provided a foundation for progress in other areas [5]. The NIAID program staff with whom I worked with were smart, diligent, and extraordinarily committed to the NIH mission of turning scientific discovery into positive health outcomes and to the NIAID mission of combating infectious, immunologic, and allergic diseases. It was not uncommon for a scientist to leave the private sector and take a pay cut to work at NIAID. After 20 January 2025, my federal colleagues put their heads down and kept working hard, even as they were characterized by public figures as “parasites” and part of a “criminal cartel.” The explicitly stated intention of these public officials was to inflict trauma on federal workers so that they would leave the government workforce [6]. It was demoralizing. On more than one occasion, I had colleagues shedding tears in my office as they voiced their psychological pain and frustration. In the first hundred days of the current administration, the Department of Health and Human Services took actions to rapidly implement the flurry of executive orders. Extramural programs designed to attract, build, and retain a diverse scientific workforce in a country with an increasingly diverse population (diversity, equity and inclusion [DEI] programs) were rapidly dismantled. There was no precise definition of DEI given. This meant that projects that might have focused on a particular demographic group but had nothing to do with the concept of DEI (ie, building a diverse scientific workforce with consideration of characteristics beyond merit) were swept up onto a spreadsheet of grants to be terminated. For example, a project focused on preventing chlamydia transmission among Black youth (who are at much higher risk of this infection) was terminated. Even when reinstated on appeal, these unprecedented actions based upon ideology have had a chilling effect on involved parties ranging from senior scientists to junior trainees to deans at research institutions. Equally chilling were the actions taken to target for defunding certain academic institutions—their medical schools, cancer centers, schools of public health—all because of their response to student protests on campus in 2024. Every time that a new spreadsheet of grants at risk for termination landed in my inbox, I felt heartsick. The claim was that the new administration was fighting “waste, fraud, and abuse.” In no instance was evidence presented of either fraud or abuse. The definition of “waste” seemed to be projects not aligned with the new administration priorities, though those priorities were never articulated clearly to program staff, and those of us directing extramural programs were never asked to provide a scientific justification for a project's value. Reports are now emerging that staff of the Department of Government Efficiency (DOGE) were empowered to order terminations of NIH grants based solely upon their understanding of the abstract associated with the grant [7]. At the program level, we had no idea who was making these decisions. Every day brought more chaos. It remains unclear how much “savings” these terminated grants and contracts will bring back to taxpayers. Scores of grants were terminated in the middle of the project period; thus, initial productive years of work funded through taxpayer dollars will go uncompleted and be wasted. No mention is made of these losses. Nor was there discussion of the negative consequences of terminating K- and F-series grants that supported the early career development of promising young scientists. Certainly, these terminations cannot be considered as savings. It would be more accurate to characterize the terminations as an intentional choice to lose a generation of scientists. Recovering from the negative consequences of these actions will take years and probably decades. A bipartisan commission on the future of biotechnology convened by the United States Congress concluded that national security, economic power, and global influence rest on continued scientific achievement and innovation in biological research. With funding cuts and other barriers to biomedical research constructed in the first 100 days, scientists may well leave the United States for better opportunities elsewhere. Some are already moving in that direction. Several countries such as Canada, Australia, and those in the European Union are actively recruiting disenfranchised American scientists. Foreign entities, both friend and foe, will stand to gain. China, in particular, has increased its spending on biotechnology research and development over 400-fold in the past decade and is moving quickly toward global dominance in this realm [8]. The dismantling of the NIH since 20 January 2025 will only serve to accelerate China's rise to a position of dominance. We can make a positive difference. Scientists whose work has been impacted by these rapid changes may feel powerless and numb right now. Their instincts might lead them to keep their heads down and grind away at planned experiments, if they still have funding to complete them. The media is flooded with terrible news that goes far beyond threats to biomedical research: impending tariff wars, the assault on universities and law firms, an expanding war in Europe, and unlawful deportations—it's a lot to take in. However, the story of the negative impact on the future of infectious disease research will only become part of public discourse if scientists speak up loudly and impress the public with the value of their research. These are some recommendations for action: Learn to communicate to nonscientists the value of scientific advances in your field. Data presentations might impress some, but folks are moved more by stories of real people who suffer from real diseases, especially if they benefited from a scientific breakthrough. Learn to work with colleagues who have expertise in communications. Ask them to help you tap into the best media format to amplify these stories. Professional societies might provide extra help and extend the reach and impact. Cultivate relationships with your congressional representatives. Meet with them regularly. Make them aware of how threats to funding might impact your laboratory, your staff, and the economy including that in their own districts and states. I have visited many labs funded by NIAID, and I know that the NIAID presence is significant in locations covering the whole political spectrum. Remember that, in normal times, the executive branch of government is expected to respond to queries from members of the legislative branch on how federally funded programs are implemented. Talk to the press—loudly, frequently, and on the record. If you are not comfortable doing this, ask a trusted colleague in communications to help you with talking points and a rehearsal. Remember that even though the media is flooded with bad news right now, these important stories on the future of infectious disease research will only get out there if you speak up. Disclaimer. The viewpoint expressed is that of the author and not of the National Institute of Allergy and Infectious Diseases or the National Institutes of Health. Financial support. There is no financial support to cite for this work.
Author: Emily J Erbelding
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,763
Funder: National Institutes of Health
OpenAlex ID: W4411224544