Science Friday - How NIH Cuts Could Affect U.S. Biomedical Research

Episode Date: March 19, 2025

Former NIH director Dr. Harold Varmus speaks out about what recent budget cuts and policy changes could mean for science.One of the areas targeted by President Trump’s administration for cuts has been the National Institutes of Health (NIH). Cost-cutting actions have included the layoffs of some 1,200 NIH employees, the termination of research grants, a pause in the “study sections” that evaluate and award grant funding, and a cap on indirect costs included in research grants. Some of those moves have been paused following court cases. Dr. Harold Varmus, a former director of the National Institutes of Health, joins Host Ira Flatow to talk about the actions, and the impact he fears they could have on the future of biomedical research in the United States.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Plato. Today on the podcast, checking in on the NIH with a former director. What's the future of the NIH during a time of government cuts? Proposals that were made recently could be deeply, deeply destructive to the enterprise that we built up. And it would take decades, not years, to restore some of that. One of President Trump's targets for cutting has been the National Institutes of Health, including layoffs of some 1,200 NIH employees, termination of research grants, and an order capping indirect costs to grants. Some of these moves have been paused following court cases,

but they are still an ongoing topic of concern. Joining me now to talk about how the NIH operates what the new administration changes could mean for medical research in this country is Dr. Harold Varmus. He was director of NIH from 1993 to 1999, currently professor of medicine at Wild Cornell Medicine, senior associate at the New York Genome Center, and the 1989 Nobel Prize winner in medicine. Welcome back to Science Friday. Thank you, Eric. Good to see you. Nice to see you. Last month, you wrote an op-ed for the New York Times entitled, I used to run the NIH.

Here's what worries me. I mean, tell us how you would characterize what worries you, what's being done to the NIH? Well, there are a number of things that are concerning me at the moment. One is the general threat to science, which is one of the prides of our country and a way to solve some of the biggest problems that face our citizens. The other is the threat to investigators who've spent their lives training to do these jobs, and especially in the public sector, who are now being. threatened with loss of their grant funds, holdups in the way the research is being pursued,

slowdowns in the grant review process at a time when we already have a highly competitive atmosphere in which grants are being awarded. The appointment of leaders who, in my view, are inadequate to the task of running the major agencies, not just the NIH, but also the CDC, and the Department of Health and Human Services itself, which oversees the health research agencies. So there are many ways in which scientists do biomedical research, either clinical research, or basic research, are feeling threatened. They don't feel they get support of the kind that they need from the public and importantly from the industries, but biotech and pharmaceutical industries that are so dependent on the research that's generated by these people.

I mean, as head of NIH for, what, six years and head of the National Cancer Institute, You're sort of watching attempts at dismantling your whole life's work. You know, there is incredible amounts more to be done. A lot has been accomplished, but a lot more to be done. And the one way not to get it done right is to have poor leadership, undue restrictions on what can and can't be done, discouragement to young people who either people growing up in the U.S. or people from abroad who have traditionally brought so much to our science.

If I were thinking about a career in biomedical science today, and I've been brought up in Asia or South America or anyplace else, I would say there are a lot of other places than the U.S. to do this kind of work. And in last month's time's op-ed piece, you said you were troubled that there hadn't been big protests so far, yet last week there were big stand-up for science events. Does that give you some hope? Well, yes. I mean, I definitely was pleased to see, in fact, participated in the event in New York and in Washington Square Park, and it was good to see many of my colleagues and students and other trainees and members of the public out in reasonably large numbers.

Friday's demonstrations were evidence that there is going to be some public outcry. More outcries will be needed, and people need to recognize that we all want America to be successful. And we all want scientists to be able to do their work and the things that are being enforced on our community at the moment through actions taken through the NIH and through the general negativity that is so prominent in public pronouncements is going to damage science over a very long haul. Do you think the public realizes this? Not sufficiently yet.

I mean, it depends a little bit on how you ask the question. People want medical research to produce cures for the illnesses they're worried about, of course. But they need to be able to understand what the significance of some of the budgetary cuts might be and that the kinds of draconian measures that are being proposed by this new organization called Doge are not going to cure the financial ills of the country that, in fact, investments in medical research enrich our economy. Every dollar spent on the NIH produces additional commercial activity of various kinds that help our country become wealthier, not poorer. And you're not going to end the trillion dollar deficits that our country is experiencing by making a million or even billion dollar cuts in NIA spending. It's a very poor thing to cut.

I'm particularly troubled by something we haven't mentioned yet, which is the idea. that America can go it alone. And of course, going it alone while we're cutting back on the support is a problem. But you have to realize that science is an international activity and that public health is done best when we're in communication with many other countries. The attempt to dismantle USAID, the Agency for International Development, and the withdrawal from the World Health Organization, these are devastating steps that are going to be detrimental to health everywhere in the world

and detrimental to our reputation as well. So you view those real possibilities, the consequences, I guess, I should say, when the next epidemic comes around. Well, we're worried about epidemics all the time. There are indications that we may be facing a bird flu epidemic. There's always the possibility of another coronavirus outbreak. There are other diseases. that are much less common, but like Marburg disease and quite a few others that are seen sporadically.

We're trying to bring polio to a halt. And the public is not sufficiently responsive, in my view, to the dreadful effects of having the U.S. pull out of the World Health Organization. Many of the Doge actions have been billed as we need to tighten our belts. We need to cut out the waste. I mean, are there places you think that NIH could operate? more efficiently? Well, look, every organization has room for improvement.

And like everyone I know in the senior ranks of NIH-supported investigators, I've been critical of the NIH for some of the ways it does things. But on the whole, it's an efficient, incredibly successful agency that remains one of the jewels and the crown of U.S. government. Of course, we can save some dollars. but the kind of large-scale economic constraints that we need to take it, we're going to avoid our trillion-dollar, multi-trillion-dollar debt, are not going to be gained by allopping a few million or even a few billion out of the NIH.

What do you think of Trump's pick to head the NIH, Dr. Beretscheria? Well, you know, he's not somebody I know particularly well, and I'm not opposed to him because of his, being fundamentally a health economist. He is an MD, and I think he's an intelligent person. But he's done several things in the past that make me concerned about his ability to run an organization that is so deeply involved in the kind of research that he's really not familiar with. I'm also concerned about the emphasis he's placing on the question of free speech as a criterion

for determining who gets funded. I think what he means by free speech is that he wants to be able to say whatever he pleases without having anybody criticize him. We have to take a quick break, but don't go away. More on this when we come back. People are understandably naive about what it means to have money going into research.

But companies do extremely little in basic research. Do you think that the wounds that NIH and the research community might suffer during this administration would be permanent to take years to recover from? Well, they don't need to be permanent, but I welcome your comment, ARA, because people need to realize that although we now have an incredibly successful, federally supported scientific enterprise in this country, it took a long time to get there. The U.S. was not a prominent player in science until after World War II when Franklin Roosevelt's science,

advisor Vannevo Bush made a plan for how the federal government could support basic science, produce results that would be available for commercial development, and through grants to investigators working at our academic institutions. That had a tremendous amount to do with the tremendous success of our universities in supporting the training of scientists and the conduct of science with federal dollars. Now we are the envy of the world, but for having developed a system that is so highly functional. But over the course of just a couple of years, it's very easy to deplete these institutions

of not just the resources, but the people and the talents that have fueled all of our success. The proposals were made abruptly recently to remove what is somewhat irresponsibly called indirect costs, the absolutely essential funding for facilities and administrative support for science could be in a very short time, deeply, deeply destructive to the enterprise that we've built up. And it would take decades, not years, to restore some of that. Do you think we might be seeing a brain drain, as we used

to call it, of people going, research is going to other countries? Well, you don't even have to go to another country to become a brain drain. That is, the many who have been working in the scientific enterprise and in the not-for-profit sector could very easily find other kinds of occupations that might be in science or outside of science, tremendous loss of talent and waste of investment in training these individuals. And that is part of the destruction of the system that worries made the most. But the job market's already very tight. There are jobs in industry. We have a great need for better science teachers in our public schools. I mean, there are jobs, but I think I'm less worried about where people will go for another job than I am about

the loss of talent in a domain in which not only is the U.S. so successful and dominant, but a place where great science remains to be done and the science is beneficial to society. I do think that people are understandably naive about what it means to have money going into research. But companies do extremely little in basic research, and yet most of the ideas that fuel the dramatic new changes in medical care, for example, on the one hand, dependent on development of those therapies in industry, are fundamentally dependent on the new ideas that arise out of federally supported basic research

at universities. Take, for example, the excitement in my own area, my own field about immunotherapies for cancer. That's the result of investments in scientists working at places like UC Berkeley or Memorial Sun Kettering in a deeper understanding of the immune systems. It was possible to begin to understand how you could develop immunological tools for treating cancer. That's not going to happen And if we disassemble the federally supported machine that's been so effective and deepening our understanding of how bodies respond to the various diseases we call cancers. You don't even have to go that deeply. You can get into something that everybody knows about, you know, OZempic, the GLP1 receptor drugs.

Weren't they all NIH? Well, originally, yes, came from trying to understand appetite, obesity. Absolutely. about there are many, many examples. Ammino therapy for cancer is one of them, but there are many, many others that involve investment in fundamental research. That's the real investment that the federal government makes in industry. It makes this investment that was originally conceived by a man of a Bush during World War II,

that when you make investments in understanding the world, you generate new ideas about how the world works, that the industry is pretty good at, transforming it into practical solutions to our world problems and not just in health, but in security, in arms, manufacturing, and making life pleasurable. This is Science Friday from WNYC Studios. If you're just joining us, I'm talking with Dr. Harold Varma's, former head of the National Institutes of Health, about changes to biomedical research under the Trump administration. So where do you see possible pushback, compromise solutions?

Is it court orders, congressional action, people protesting? Critical question, I'm about getting around to this, because one of the things I've been concerned about is the balance of power between the executive and legislative branch is eroding at the moment. And the legislators are not standing up. Any of the people I see making decisions about who should be confirmed for leadership positions, who should be exerting. their power as members of Congress to say these things are violations of laws we've already passed, for example, laws about how we pay for research through payment of facilities and administrative costs, as well as direct costs of research. Congress needs to step up. Right now, we're getting our, placing our biggest bets on resistance from the judiciary.

branch, which has stood up to several of the efforts that the executive branch has been making to disassemble and undermine research. But that's not enough. We need Congress to be speaking up as well, and people who are experienced and knowledgeable and have been responsive to the needs of the scientific community over the past several decades need to set aside their apprehensions about their own. re-election and stand up for what's right. It's got to come from patients, their families, advocates, from members of industries that are dependent on government-sponsored research

for the kinds of advances they make that are profitable for them in the long run, and from the general public, which sees one of the great virtues of our country, our services a beacon for people around the world, talent in our own country, to participate, in these great adventures of scientific discovery that have been so beneficial to the world and to our own economy. I mean, you've been around a while. I mean, have you ever seen such politicalization? I mean, I've been very pleased as a leader of the NCI or the NIH to have friends on both sides of the aisle and to see Republicans and Democrats supporting scientific activities. That's been a wonderful aspect of being in the government through work on something which is supported by both parties. And right now, the alignment of politicians with these attacks on science is deeply disturbing to me.

It's a long-lasting effort to politicize science that is something that I think will be not so, easy to reverse. No, and I think you've summed it up very well, Dr. Barmus. I want to thank you for taking time to be with us today. My pleasure. Always good to talk to WIRE. Dr. Harold Varmus, former director of the NIH, currently the Lewis Thomas University Professor of Medicine at Wild Cornell Medicine. That's about all the time we have for now. A lot of people help make this show happen. Santiago Flores. Dean Petersmith. Full of Samirs. Emma Gomez.

I'm Ira Flato. Thanks for listening.