The federal government has slashed research sinceDonald Trumptook office – hacking away at the National Institutes of Health (NIH) and its grants, staff and long-held partnerships with academia.
Now, some private companies said they want to pick up strands of research that might have otherwise been funded by the federal government. The effort has stoked little optimism among experts, who caution that private efforts cannot remotely replicate the breadth, depth or public service provided by federal funding.
“We can’t wait four years to do any women’s health research,” said Priyanka Jain, co-founder and CEO of the start-up Evvy. The company sells at-home vaginal microbiome tests – a product the company argues can help women better understand common conditions such as bacterial vaginosis.
Jain said Evvy is funding a small trial to identify biomarkers, or physical indicators, of how the vaginal microbiome can impact in vitro fertilization (IVF) success rates.
“There are companies like Evvy raising venture dollars and doing the work the government is not doing,” said Jain. “Women step up and actually solve this problem.”
In contrast, health policy insiders such as Sean Tipton, chief policy officer at the American Society for Reproductive Medicine, said the many small projects that hope to keep research alive cannot remotely match the retreat of federal government research.
“It is absolutely not realistic to think that the resources of the federal government can be replaced through some combination of philanthropic and for-profit entities trying to fill the gap,” said Tipton.
The NIH is the world’s largest public funder of biomedical and behavioral research. When Trump took office, the agency had a $48bn budget and funded projects into nearly every area of medicine imaginable – including administration bugbears such asfluorideandvaccine safety.
In the first few months of the administration, the health secretary Robert F Kennedy Jr and billionaire Elon Musk’s unofficial “department of government efficiency” have fired1,300 NIH employees, canceled $2bn in grants, and slowed new grant approval by nearly one-third, pumping$2.3bn lessinto research.
Aleaked budget proposalwould further shrink the NIH by 40% – or tens of billions less that will not go into research. HHS has also canceled more than$11bn in state grantsand frozen billions in grants slated for research at Ivy league colleges such asHarvard University. In the latest move, the National Science Foundation, which finances basic research in areas such as astronomy and quantum computing, canceled$2bn more in funding.
“In the research space, my organization is proud because we’re now spending in excess of $3m a year on research grants – that is literally a rounding error compared to what the federal government spends,” Tipton said. “We’re very proud of that, and worked very hard to get it up to that level, and that level is puny and inadequate.”
The federal government’s backing of scientific research has been fundamental to modern drug discovery.NIH research contributedto 354 of 356 of the drugs approved by the US Food and Drug Administration (FDA) between 2010-2019, a JAMA Health Forumstudy found.
That money has gone to advance blockbuster drugs such as Wegovy and Ozempic – first identified by anNIH-fundedresearcher and isolated fromgila monster salivaby Veterans Affairs researchers – and to the hundreds lesser known FDA-approved treatments.
“Tell taxpayers we’re studying gila monsters in a lab – they’ll laugh you out of town, but the first GLP-1 was exenatide, which is a gila monster protein,” said Dr Fred Ledley, the author of the JAMA Health Forum study. Ledley’s favorite example of basic research comes from worms – publicly funded studies of their intestinal development led to the discovery of a trigger of cell death, which now underpins nearly one-third of the new cancer drugs on the market.
His research found that for every “first in class” innovative drug brought to market, the NIH funded roughly $1.4bn in research. If government investment was calculated as industry calculates its investment – to include failure and the cost of capital – it is closer to $2.8bn in public funding, or about the equivalent of what industry spends to bring an innovative drug to market.
Without NIH’s basic research, there is little hope that the private market will pick up the tab, said Ledley.
“It’s too expensive for them,” Ledley said. “What you’ll see industry do is develop more ‘me too’ drugs,’” and “incremental tweaking … This is not what the public wants”.
“The public wants something to treat Alzheimer’s with, they want something to prevent diabetes in the first place, and they desperately need better treatments for cancer and heart disease – still the number one killer,” said Ledley.
Another indicator of the low likelihood of the industry picking up basic research is in job listings. Since 1 January, listings for research and development positions have fallen 25% based on a “before times” baseline of January 2020 baseline, according to data from job hiring site Indeed. Instead, the private health sector is dominated by demand for services – such as nurses and surgeons.
“The government can step in and correct that kind of market failure when something is going to be positive for the society but not necessarily profitable in the market,” said economist Allison Shrivastava, an economist with Indeed. “A lot of this research falls into that category.”
Put another way by the Democratic US Senator Patty Murray at arecent press conference: “Our public health folks who go out and track measles or track whooping cough or track a new pandemic aren’t going to work for a private company … There isn’t a profit-making course in this.”
“In last year’s world we were hoping to get funding” from the federal government for her company’s study, said Jain. She noted thatwomen’s health researchhas been especially hard-hit by cuts, a victim of “diversity, equity and inclusion” cancellations.
“I personally don’t think we should have to raise venture capital money to do this study – that is not the typical use of venture capital money,” said Jain. “Our hope is we survive another four years and the tides turn.”