The numbers are striking across the board.
New grants for Alzheimer's and aging research were cut in half — from 369 in 2024 to 177, all while the US population is rapidly aging. Mental health research grants fell by 47 percent. And new grants for cancer research fell by 23 percent — even as cancer rates are rising sharply among Gen X and millennial Americans. Across all areas, the NIH went from funding roughly 5,000 new research grants in 2024 to just 3,900 in 2025.
"This is the worst year I've ever seen, probably going back to the 1980s," said Jeremy Berg, who led the National Institute of General Medical Sciences, one of NIH's largest institutes, from 2003 to 2011.
The NIH's funding system was already under strain — too many researchers were chasing too few research dollars. That has always meant that the most ambitious and most unconventional ideas struggle to get funded.
But the Trump administration's policy decisions have made that problem dramatically worse in just a single year.
What went wrong
The NIH funds research through federal grants. Scientists across the country submit their proposals, a panel of outside experts scores and ranks them, and then each NIH institute — each focused on a different area of medicine — funds as many top-scoring proposals as its budget allows. In a normal year, about 5,000 new grants get funded.
Last year, one policy change did more to shrink that number than almost anything else.
In July 2025, the White House Office of Management and Budget required NIH to start paying the full cost of approved grants upfront — all at once, instead of paying year by year, as it has for a very long time. In principle, funding grants upfront makes them less vulnerable to future budget cuts.
But here's the problem: When NIH funds a research project, it's typically a commitment that stretches three to five years. That means in any given year, about 80 percent of the agency's budget is already spoken for — paying for grants it promised in previous years. Only the remaining 20 percent of the budget is available to fund new research.
When the agency has to pay the full cost of every multiyear grant up front, that means each new grant costs several times more than it used to. Michael Lauer, who oversaw NIH's grant-making for nearly a decade before leaving the agency in early 2025, put it simply: "Instead of funding five grants, you now only fund one, and that means four other grants that would've been funded don't get funded."
Berg, the former NIH institute director, estimates this single change wiped out roughly 1,000 new grants.
But it wasn't the only factor. The Trump administration also terminated thousands of existing grants over the past year — something Lauer said he had seen happen only twice in his entire 18-year tenure at the agency. The leftover money from those terminations went to the US Treasury, not back to NIH. Berg estimates that roughly $500 million left the system this way.
On top of that, about 12 percent more grant applications were submitted in 2025 than in 2024, all competing for the shrinking pool of funds.
The Trump administration has been open about wanting a smaller NIH; it proposed cutting the agency's budget for 2026 by 40 percent, though Congress has not enacted that cut. At the same time, the White House has pushed policy changes it says are aimed at restoring accountability at NIH — but the effect of those changes has been to shrink the agency.
"I think it's pretty easy to start to wonder if there is some connection between those two things," Carrie Wolinetz, a former senior NIH official, told STAT News.
The NIH did not respond to specific questions about the institute-level declines, or what happened to the money from terminated grants.
But isn't the best research still getting funded?
With fewer grants to go around, you might think the system is just getting more selective — funding just the best ideas and cutting the rest. But that's actually not how it works.
Philippe Aghion, the economist who shared last year's Nobel Prize, found that past a certain point, more competition actually stifles innovation rather than spurs it. When NIH can only fund the top 5 or 6 percent of proposals, what survives is good but conservative science — established labs extending well-established research.
"The main thing you're giving up there is new ideas," Berg said.
Researchers in the UK recently discovered that people vaccinated against shingles had a roughly 20 percent lower risk of developing dementia seven years later. That finding came from a natural experiment in Wales, where people born before a certain date weren't eligible for the vaccine and those born after were — and the group that got the vaccine had lower rates of dementia.
Understanding why a shingles vaccine works against dementia, and whether it could lead to new ways to prevent dementia, is the kind of exploratory research that would now struggle to get funded.
Katalin Karikó, who won the 2023 Nobel Prize in medicine for the mRNA work behind the Covid vaccines, had her grants repeatedly rejected long before the Trump cuts. The window for unconventional ideas was already narrow. Now it's narrowing even further.
And much of the damage could prove permanent. When funding dries up, researchers leave — for other countries, for the private sector, for careers outside science altogether. "Researchers who leave the field or the country to work elsewhere are unlikely to return," said Joshua Weitz, a University of Maryland professor who tracks science funding.
There are early signs that 2026 could get even worse for medical research. The White House budget office has delayed NIH from spending its 2026 funding, even after Congress approved it, and the NIH has made roughly a third as many new awards as it typically would by this point in the year.
The hardest thing to measure, Berg said, is the research that never got a chance to begin. "It's much more like we set out across the ocean to see what we could discover and the voyage was canceled. There might be some beautiful island out there of incredibly important stuff, but we're never going to know about it."
