Spending on new medical research by the National Institutes of Health has fallen roughly $1 billion behind the pace of years past, delaying thousands of scientific projects and raising concerns within the agency that it may struggle to pay out the money it was allotted by Congress.<\/p>\n
Instead of canceling grants<\/a> en masse, as the N.I.H. did in the first year of this Trump presidency, it is now vetting them before approval with a \u201ccomputational text analysis tool\u201d that scans for terms including \u201cracism,\u201d \u201cgender\u201d and \u201cvaccination refusal,\u201d according to documents obtained by The New York Times.<\/p>\n That tool was meant to formalize a campaign against \u201cwoke science\u201d that was initiated last year by the Elon Musk-led Department of Government Efficiency.<\/p>\n But the screening system is now exacerbating a slowdown in research spending: The N.I.H. awarded only about 1,900 new and competitive grants from October to late March, less than half the number it tended to give out by that point in the fiscal year during the Biden administration, an analysis by The Times showed.<\/p>\n The protracted government shutdown in the fall delayed grant review meetings by months, significantly setting back medical research spending. The N.I.H. has struggled to catch up, and delays are affecting fields far beyond those ostensibly targeted by the administration\u2019s crusade against diversity, equity and inclusion.<\/p>\n As of late March, for example, the National Cancer Institute had earmarked only about $72 million for new and competitive research grants, less than one-third of the nearly $250 million it had agreed to spend by that point in a typical fiscal year during the Biden administration, according to The Times\u2019s analysis.<\/p>\n \u201cIt means that people get fired because there is uncertainty about whether the grant will come through,\u201d said Dr. Joshua Gordon, a professor of psychiatry at Columbia University and a former director of the National Institute of Mental Health. \u201cIt means budgets get busted. It means research projects get stalled.\u201d<\/p>\n However alarming the canceled grants and spending delays were last year, Dr. Gordon said, \u201cI\u2019m more worried this year.\u201d<\/p>\n The Department of Health and Human Services, which oversees the N.I.H. and is led by Secretary Robert F. Kennedy Jr., has become involved this year in flagging certain grant awards and stopping their release, according to emails reviewed by The Times.<\/p>\n At congressional hearings on Tuesday and Wednesday, Mr. Kennedy faced a barrage of criticism over N.I.H. spending delays, with Senator Susan Collins, Republican of Maine, deploring what she described as the administration\u2019s retreat from health disparities research.<\/p>\n The N.I.H. has fallen behind in part because it lost thousands of workers last year to layoffs and early retirements. In some branches of the agency, what workers remain can barely keep up with renewing existing grants, much less awarding new ones.<\/p>\n One N.I.H. institute has less than half of the workers needed to vet grants for legal and financial compliance, employees were told at a recent meeting, notes from which were reviewed by The Times.<\/p>\n Under the most dire projections, the institute could leave $500 million of congressionally appropriated funding on the table because of difficulties processing grants, N.I.H. officials said at that meeting. They were temporarily deploying career scientists to what were effectively business roles to speed up grant awards.<\/p>\n The N.I.H. director, Dr. Jay Bhattacharya, has said that he is trying to root out ideologically motivated and insufficiently rigorous science. Conservatives accuse the N.I.H. of having fostered such research during the Obama and Biden presidencies by, for example, encouraging grant proposals on sexual- and gender-minority groups.<\/p>\n \u201cScientists will no longer have to mouth D.E.I. shibboleths to garner funding,\u201d Dr. Bhattacharya and his top deputy wrote in an online article<\/a> in December, the day before the N.I.H. outlined the new screening process to its employees.<\/p>\n Andrew Nixon, a health department spokesman, blamed the spending shortfall on \u201cthe Democrat-led shutdown,\u201d which he said \u201cdelayed N.I.H.\u2019s ability to issue grants\u201d at the start of the fiscal year. Since then, he said, \u201ctimelines have returned to typical funding patterns.\u201d<\/p>\n He added that the agency \u201cuses a variety of review tools to ensure alignment with agency priorities\u201d and that it was working to hire additional employees. \u201cThe N.I.H. intends to obligate all appropriated funds, as directed by Congress,\u201d he said.<\/p>\n To understand why spending has slowed so dramatically at the N.I.H., the world\u2019s premier funder of medical research, The Times interviewed 10 agency employees and reviewed internal documents, including spreadsheets of grants flagged by the screening tool and the list of roughly 235 terms it searches for.<\/p>\n The employees spoke on the condition of anonymity because they were not authorized to comment publicly.<\/p>\n The documents painted a picture of an agency whose leaders were seeking to exert greater control over scientific spending by, among other things, deciding whether certain grants were compatible with agency priorities. But in clamping down on the funding process, the N.I.H. created new choke points, leaving some proposals in limbo for days or weeks.<\/p>\n That has frustrated some senior N.I.H. officials, one of whom lamented in an email seen by The Times that it was taking too long to rework grant proposals. The official asked his staff to simply strip the proposals of disfavored terms instead.<\/p>\n The delays have also angered lawmakers. Congress sets the country\u2019s medical research spending levels, even as the administration has leeway to prioritize types of studies. And despite Mr. Trump\u2019s proposing major cuts last year, Congress preserved the N.I.H. budget at roughly $47 billion for 2026.<\/p>\n \u201cIt is very frustrating to understand that this administration can circumvent dollars that were designated for our scientists,\u201d said Senator Angela Alsobrooks, Democrat of Maryland.<\/p>\n Congress\u2019s budget buoyed American scientists. By late 2025, many believed that they had weathered the worst of Trump-era funding problems. The N.I.H. spent aggressively toward the end of the last fiscal year, overcoming earlier blockages and delays.<\/p>\n The Supreme Court also let stand a lower court\u2019s ruling that the policy behind the cancellation of more than $780 million in N.I.H. grants was probably unlawful, a victory for groups that had argued the terminations were arbitrary and capricious.<\/p>\n But the Trump administration was preparing a far more systematic crackdown on what it saw as unreliable research.<\/p>\n