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This issue examines the NIH's recent and unprecedented termination of LGBTQ+ research projects, which signals a concerning shift potentially guided by political motivations rather than scientific merit. We also explore the tense negotiations around a pivotal funding bill, which teeters on the brink of passing through Democratic concessions or resulting in a government shutdown. Our call to action this week centers on defending the integrity of NIH research grants, urging engagement and advocacy for fair and unbiased research funding.

In today’s issue:

  • NIH Halts LGBTQ+ Research Funding, Raising Alarms
  • Shutdown Looms as Democrats Hold Firm Against Funding Bill
  • Featured Blog: The Threat to Science Is Real. Here’s What Researchers Can Do.
  • What We’re Reading

NIH Halts LGBTQ+ Research Funding, Raising Alarms

The NIH has issued termination letters to investigators working on a range of LGBTQ+ health studies, stating the research was “incompatible” with agency priorities. Reports indicate that at least 23 termination letters have been sent thus far, with hundreds more cancellations likely. These cancellations have already impacted a wide range of studies on aging, dementia risk, health disparities, and HIV prevention. 

In the termination letters, the NIH cites Uniform Guidance—a government-wide framework for grants management--allowing for grant termination “if an award no longer effectuates the program goals or agency priorities.” While these mass terminations targeting LGBTQ+ research are a perceived threat to academic freedom and self-governance, some researchers are also alarmed by the unprecedented scale and extent to which political priorities are influencing cancellations. These terminated awards had already undergone peer review to prove scientific merit and potential to impact public health. However, the notification letters state “Research programs based on gender identity are often unscientific, have little identifiable return on investment, do nothing to enhance the health of many Americans. Many such studies ignore, rather than seriously examine, biological realities. It is the policy of NIH not to prioritize these research programs.”

The letter is particularly concerning as it suggests a political review process is being used not only to assess alignment with the administration’s policy priorities but also to conduct scientific merit review that overrides the peer review process.

The NIH guidance also mirrors rhetoric used in recent executive orders redefining sex strictly based on reproductive function (Executive Order 14168) and limiting DEI-related initiatives (Executive Order 14151). These cancellations also come amid new internal NIH guidance instructing staff to identify and eliminate grants involving transgender populations, DEI, environmental justice, and climate change—further reinforcing concerns these terminations are driven by politically motivated actions rather than inadequate scientific merit. 

Unprecedented Move in NIH History 

The NIH awards grants based on rigorous peer review of scientific merit, and, to date, retroactive grant termination of previously approved research has been an uncommon occurrence. While federal agencies can and often do shift funding priorities, these changes usually impact future grant cycles. The abrupt termination of ongoing, multi-year grants mid-cycle is usually not pursued unless there is clear evidence of scientific misconduct, non-compliance with grant terms and conditions, or financial mismanagement—none of which were justifications cited in this wave of terminations. 

While the notification letter acknowledged that grant recipients typically can “take appropriate corrective action” before termination, the letter also declared that “no corrective action is possible here.” The abruptness of the termination without the opportunity to adjust projects stunned researchers, who were not expecting ongoing projects to be affected without the possibility for modification. 

Impact on Health Services Research 

Beyond the immediate impact on affected researchers—who now face layoffs and project shutdowns—these terminations reinforce the growing concern that researchers will be restricted in the scope of what they can study and that political views will become the arbiters of what qualifies as scientific. Political priorities to decenter DEI may limit abilities to learn how to address pressing health inequities. As noted in previous editions, HSR relies on stable funding to improve health care outcomes, particularly for vulnerable populations, so this shift poses concern about the future of the field’s evidence base as a whole. 

Building an evidence base takes time because establishing causal relationships between actions requires collecting and analyzing data consistently over an extended period. Terminations of long-term studies, such as the LGBTQ+ longitudinal study of older adults in the South, undermines the infrastructure that was being built to map long-term trends that would have generated meaningful insights about health outcomes over time. Ultimately, these premature terminations create more waste because front-end investments associated with infrastructure build and initial data collection have been made, but the benefits of having all of the data needed to answer the scientific questions have not yet been realized. Systematically targeting research focused on the LGBTQ+ population undermines the ability to understand and address substantial health disparities among socially marginalized sexual and gender minority communities.

Ultimately, this situation creates a chilling effect that could deter future studies on the LGBTQ+ population and studies addressing health inequities. If politically motivated funding cuts continue, key areas of health services research (HSR) could be systematically undermined. Such actions send a message that research focused on these communities is being deprioritized, which will exacerbate existing inequities. HSR requires robust support for a wide range of scientific inquiry to fully understand and address the health needs of all populations.

The Reaction and Considerations for Researchers

While the termination notifications declared no opportunity for corrective action, reports show that some letters state that award grantees can appeal the NIH’s decision within 30 days. On March 6, a federal judge imposed a preliminary injunction on the NIH, preventing the cuts on indirect medical research costs from taking effect after a lawsuit was filed by a coalition of 22 states. At this time, it remains to be seen whether this injunction will have an effect on investigators that received award termination letters. 

As noted by Stat, researchers are expecting these terminations to move to the courts as an attempt to violate the temporary restraining order federal courts previously  imposed on the gender and biology executive order. Recommended actions for affected researchers include: 

  1. Review termination notices and file appeals. While outcomes may vary, formally contesting the decision ensures your objections are recorded.
  2. Consider engaging with your institution’s legal teams to assess institutional support and potential collective responses.
  3. Maintain comprehensive records of your work to facilitate continuity if funding is restored or alternative support is secured. 

For others in the community not directly affected who wish to express support, it is recommended that you: 

  1. Express solidarity by publicly supporting affected colleagues via social media posts, letters to the editor and other publicly available channels.
  2. Educate stakeholders including policymakers and the media about the importance of LBGTQ+ and DEI-related research, funding stability, and research funding guided by scientific merit.
  3. Monitor funding trends and legal developments affecting research funding.

Here is a sample message you can use to express your concern: 

As a researcher committed to advancing scientific knowledge, I am concerned by the recent termination of NIH grants focused on LGBTQ+ health, gender identity, and DEI. Research should be guided by scientific merit and the pursuit of knowledge that benefits society as a whole. I urge the NIH to restore support for these projects, as the integrity and independence of research are essential to addressing the complex health challenges we face.

AcademyHealth continues our work communicating with congressional leaders and the media about these important issues.

Shutdown Looms as Democrats Hold Firm Against Funding Bill

In a 217-213 vote largely split along party lines, the House passed a controversial seven-month funding patch, securing a tactical win for House Speaker Mike Johnson. The bill, supported by Democrat Jared Golden of Maine and opposed by Republican Thomas Massie of Kentucky, proposes cutting nondefense funding by $13 billion while increasing defense spending by $6 billion. As the focus shifts to the Senate, the requisite bipartisan support seems unlikely, with Democrats poised to resist demands to slash nondefense budgets. This steadfastness could result in a government shutdown, reflecting a strategic stand by Democrats against extensive funding cuts.

Featured Blog: The Threat to Science Is Real. Here’s What Researchers Can Do. 

In a new AcademyHealth blog post, Dr. Aaron Carroll and Dr. Elizabeth Cope emphasize the importance of defending the core values of scientific inquiry and academic freedom amidst recent challenges. With recent policies impacting researchers through funding freezes, restricted data access, and constraints on certain research areas, the integrity and advancement of science face unprecedented risks. Recognizing that researchers may feel apprehensive about speaking out, the authors suggest constructive ways to engage while maintaining neutrality. They advocate for active participation in public advocacy, membership in professional associations, and strategic communication to amplify voices and protect scientific inquiry. Dr. Carroll and Dr. Cope underscore that strategic engagement, instead of silence, is essential for preserving science's foundational role in shaping a future based on evidence and innovation.

What We’re Tracking and Other Resources 

NIH Halts Vaccine Hesitancy Research

The National Institutes of Health (NIH) is abruptly ending 33 research grants investigating vaccine hesitancy, reflecting a shift in agency priorities. In addition to terminating these grants, which include studies on encouraging vaccine uptake and understanding hesitancy in diverse populations, NIH is also scrutinizing research projects related to mRNA vaccines, driven by unfounded concerns over their safety. Affected scientists, like epidemiologist Denis Nash, argue that halting such research could exacerbate underlying issues of low vaccine uptake, and are voicing their concerns that this move discourages future public health science investigations.

New Tool Assesses Nonprofit Reliance on Government Grants

The Urban Institute has developed a data tool to assess the impact of potential losses in government grants on nonprofit financial sustainability. In 2021, over $267 billion in government grants were awarded, greatly surpassing foundation giving. The tool allows users to explore how reliant nonprofits are on government funding by state, county, and congressional district. Researchers highlight that government support is critical, especially for larger nonprofits, with significant portions of their revenue tied to these grants. A loss or freeze in government funding could jeopardize the financial stability of many nonprofits across the U.S. Access detailed information by region and nonprofit size through this new resource.

Guide to Federal Executive Orders' Impact on Public Health

Act for Public Health, a non-partisan initiative that provides legal technical assistance and policy support to strengthen public health, provides an overview of federal executive orders (EOs), their purposes, limitations, and their impact on public health practice. This explainer also includes links to up-to-date trackers of EOs being challenged in court.

DEI Resource Library Available

American Pride Rises, a network of organizations dedicated to promoting diversity, equity, and inclusion (DEI) across the United States, hosts a DEI Resource Library, which offers data, messaging, reports, and analysis on DEI efforts. Resources include insights on making the business case for DEI, FAQs for higher education champions, and information to counter false claims. 

Previous Updates

This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here

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