The main campus for the US National Institutes of Health is located in Bethesda, Maryland. A new policy from the US National Institutes of H...
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| The main campus for the US National Institutes of Health is located in Bethesda, Maryland. |
The NIH, the world’s largest funder of biomedical research, announced on 1 May that by October, it will not renew or issue new 'foreign subawards’, which are NIH funds that a US researcher can give to an international collaborator to help complete a project. The agency typically spends about US$500 million on these awards each year.
The announcement states that the agency is establishing a new award structure for foreign researchers, which has not yet been released. As part of this, foreign researchers will now likely have to submit a grant application and undergo review much in the same way as any other researcher soliciting funding from the agency. The document cites national security and a lack of transparency as the rationale for the change.
“These decisions will have tragic consequences,” says Francis Collins, a geneticist who led the NIH, based in Bethesda, Maryland, for 12 years under three US presidents. As part of its effort to reduce federal spending, the administration of US President Donald Trump has already effectively shuttered the US Agency for International Development, which funded research, prevention and care for diseases worldwide. Combined with that action, Collins says, halting NIH foreign subawards means that “more children and adults in low-income countries will now lose their lives because of research that didn’t get done about diseases like malaria and tuberculosis”.
Agency staff members have already been instructed to hold funds for foreign institutions that are part of both new research grants and grants coming up for renewal, according to multiple NIH employees who spoke to Nature under the condition of anonymity because they are not authorized to speak to the press. Spokespeople for the NIH and its parent organization, the US Department of Health and Human Services (HHS), based in Washington DC, confirmed the policy change to Nature on 30 April but could not be reached for comment on 1 May.
Broad implications
The policy targets all subawards to institutions outside the United States, regardless of whether they are located in US-designated ‘countries of concern’ such as China or North Korea, or in an ally nation such as the United Kingdom. It states that research projects will be terminated if they are no longer viable without the foreign subaward.
Unless foreign researchers secure funding directly from the agency by October — a tall order for any researcher — funding for ongoing clinical trials with sites abroad and other research will likely lapse, says a former senior NIH employee, who requested anonymity out of fear of retribution. If the administration’s goal is to end funding of research abroad, “but they don’t have the law to do that, this is a way they can do it”, they say, “by making the bureaucracy much more difficult.”
The policy’s implications will be wide-reaching: in 2024, the agency issued about 3,700 subawards to institutions abroad, compared with fewer than 900 direct awards to foreign institutions, according to the US government website USASpending.gov.
Much US-backed research that is conducted abroad is on global-health topics such as cancer, maternal and child health and infectious diseases such as AIDS, Ebola and tuberculosis. “Disease outbreaks that start anywhere in the world can reach our shores in hours,” Collins says. “To just pull the plug is short-sighted and self-defeating.” If the United States pulled back all of its global health funding — which was US$12 billion in 2024 — roughly 25 million people could die in the next 15 years, according to models.
Amy Bei, a malaria specialist at the Yale School of Public Health in New Haven, Connecticut, who collaborates with researchers in Senegal, says, “we can’t do cutting-edge malaria research from the United States”, because the disease is not prevalent in the country. “If you want to move the needle on the most pressing global-health problems, this requires pulling from the best minds in the field” across the world, she says.
Cancer research could be heavily impacted too, says Yu Chen, a chronic-diseases epidemiologist at NYU Langone Health in New York City, who helps to lead a massive consortium of cancer researchers in 20 countries. For rare cancers, it’s crucial to pool data from cohorts all over the world, Chen says. “Together, we can have larger sample sizes and do meaningful research.”
