Last year, Washingtonian spoke to an anonymous manager at the National Institutes of Health about the turmoil there during the Trump administration’s first 100 days. Describing a mood of “absolute despair,” the manager discussed how layoffs, funding cuts, and the targeting of studies and programs believed by the administration to be connected to diversity, equity, and inclusion were demoralizing workers and sending the nation’s biomedical science and research “down a pathway to destruction.”
Today, that same manager says, threats to science remain—particularly through Notices of Funding Opportunities, called “NOFOs,” which are public announcements posted by the NIH to solicit grant applications from scientists for specific types of research the agency wants to fund.
Traditionally, NIH and independent advisory scientists with relevant expertise have been in charge of NOFOs, a key part of a grant-making process that disburses much of the agency’s $48 billion budget to research. However, the Trump administration has repeatedly attempted to exercise control over NOFOs and other parts of that process through a variety of mechanisms: delaying, freezing, and eliminating grants; writing executive orders; changing internal guidelines; and even attempting to create a new commission that would be able to block NIH spending that does not support the administration’s political goals.
Congressional opposition recently forced the White House to table its commission plans, and some of the administration’s other efforts to dictate NIH funding have been stymied in federal court and on Capitol Hill. However, the anonymous manager tells Washingtonian that damage to biomedical science is ongoing. The following conversation has been lightly edited for clarity and brevity:
Has it always been the case that NOFOs had to be approved by presidential appointees?
No. Prior to the Trump administration, no president was monitoring what’s being funded. That was being controlled by scientists and researchers. We have a mechanism in place to determine what gets funded.
With this new administration, they want to have their hands in everything so they can control the narrative, so they can control what type of research is being done based on their political affiliation.
NOFOs are now reviewed by the Department of Health and Human Services. Who’s ultimately in charge of that, HHS Secretary RFK Jr.?
Not him personally, but all of the NOFOs have to be approved by HHS. Never did they do this before. As a result, there’s been a reduction in the number of NOFOs that can go out, there have been delays in the approval of NOFOS, and some NOFOs have not been approved at all.
In March, Science reported that while 787 NOFOs were published in 2024, only 84 were published in the first 13 months of 2025/2026. That is a dramatic drop.
That is a dramatic drop. Just to better understand what these NOFOs do, these are opportunities—what we are saying is, “there is a need to study this disease. There’s the need to study the epidemiology. We don’t know how this virus transfers. We have a need to understand it, so we are releasing this NOFO, which means we have set aside money for experts. Submit your proposal to study this.”
Because those NOFOs were not [published], we may not get the quality of information that we need to better manage that disease.
What you can say is that, and this is true across the NIH, that the number of NOFOs that can be issued has been substantially reduced, and that there are these presidential appointees reviewing them [which] slows down the timing for releasing them.
Speaking of delays, here’s what a recent New York Times article said about funding delays for HIV/AIDS research: “Delays to medical research spending have become a chronic issue during the second Trump administration, and funding for the networks may yet be renewed. But some scientists warned that any delays could jeopardize the safety of participants in clinical trials, derail time-sensitive studies and disrupt staffing and resources.”
What’s your reaction to those warnings?
Those fears are real. Delays can damage resource infrastructure. It can put patients at risk because the resources to monitor their safety are not there. It can cause clinical trials to shut down. It can cause staff to leave because, you know, if you are working in a lab, that’s your job, that’s your 9-to-5, you got kids to feed, a mortgage to pay, and then suddenly there’s a delay in funding. You can’t wait and sit around and say, “Oh, we’ll get our funds back in two, three months.” No! You’re gone.
In a resource-limited setting, that is absolutely catastrophic. Because there aren’t unlimited numbers of laboratory technologists, and clinical trials experts—there just aren’t—so if you lose those people, even if they restore the funding, you may be screwed because you may not be able to get anybody.
And this is true more broadly than HIV/AIDS research mentioned in this article?
Yes, it is broader than HIV/AIDS research. You could say the same thing for cancer, you could say the same thing for any of these clinical trials they are studying. In some instances, they are studying investigational agents, so the monitoring of patients enrolled in the study is important. If you disrupt that study, the whole study design is suddenly disrupted.
Imagine if we are given a drug, and we have to administer this drug every month for free, and then suddenly the trial stops because the funding is cut. Those patients are not going to get their drug administered every month, so what happens to them? Can you include them in the analysis?
There are safety issues. And with cancer, that requires a dosing, and if [patients] don’t get it, they could die!
This is also affecting ALS research, right?
It’s affecting all kinds of research where people have diseases that are potentially life-threatening, or many diseases like lupus or arthritis, these diseases wax and wane through cycles, so you may get the disease in remission, then you may get a flare-up. So you don’t want to monkey around with interrupting something unnecessarily.
Following up on our last conversation, has the administration’s obsession with DEI removal from any language in grants continued to impact the NIH’s work?
Many grants were terminated because they were accused of being DEI when they are really health disparities research. Health disparities look at racial differences, gender differences, ethnic differences, socioeconomic differences, and aging differences. What we are trying to look at is why these differences exist, and how do we eliminate them and give the same quality of care?
That is not DEI, that’s science.
By labeling health disparity research as DEI it has allowed the administration to terminate very important research. Then, you know, they were sued, and the court said you have to reinstate those grants. But as we discussed, if you shut down my grant and a year later you say, “Ok now we can refund it,” I lost all my staff! The equipment maintenance contracts have expired! You know, my lab is shut down! And now you are telling me I can continue? It’s really disruptive.
Has the NIH experienced a decline in interest by scientists abroad to carry out biomedical research in the US due to the administration’s polices to restrict international collaboration?
Yes. Yes. It is a loss of interest. So many of my colleagues who are in academia—the folks doing biomedical research—applications to these graduate research programs have declined. This is really serious because we are threatening the pipeline of future scientists, and what this administration doesn’t understand is we don’t pop out new researchers in six months—this is not, you know, you get three months of training and get a certificate for like phlebotomy or something like that. These are intense programs. Training is intensive and long term. The graduate programs seeing a reduction is going to have far-reaching implications.
Is there a way to quantify any effect the administration has had on getting established researchers from abroad to come here?
That’s created an absolute nightmare because that’s not how science works. We collaborate, we share data. You could have a clinical study, this is one of the things I do, and it’s a nightmare—I’m processing a grant, and I have to log all of the foreign collaborators to get the State Department approval, and you could have as many as a dozen different collaborators, and everybody is contributing to a different piece.
Just to be clear: there was a directive that you all were not supposed to share what you were doing? Or what specifically are you referring to?
There was a policy change that we could no longer allow foreign research and specifically centered around the way these grants were being paid in that a US investigator gets a study, has collaborators, and they issue these sub-awards.
[Say] I have a collaborator in Uganda helping me recruit patients. That site, they get money, so they have a sub-award under my award. And the problem they [the administration] said was such a big deal was, “we don’t know how they are spending the money. We need to be able to directly quantify the money and see how they are managing funds.’”
This led to restructuring in how these foreign awards could be done, and people had to figure out how to do it. There were only limited tools that could be used to allow collaboration to continue.
Is there a degree of collaboration now? Are they back to letting you do that?
It has opened back up, and very importantly because—this really makes my blood boil—they had shut down all of the research in South Africa, and South Africa has the highest concentration of people living with HIV and also living with tuberculosis, so if you want to study those diseases, South Africa is a good place to do it.
What do you fear most as the administration continues to insert itself into the business of the NIH?
What I fear the most is the damage that ultimately gets done by this administration. That assumes we are able to stop it in the next couple years, or maybe by the time his term ends. My concern is that it will be irreversible, that we will not be able to recoup what we lost or it will take a very, very long time, and that the United States will no longer be the leading country in biomedical research.
Do you think we still are?
We are, but we aren’t producing students [as we once did] who can do a STEM curriculum, and so [if] we don’t have international students coming into our PhD program—were it not for them, excuse my language, we would be up shit’s creek without a paddle. Now the policy of international students who want to come and study here is, “let me go to Europe, let me go to Canada.”
