Science on Pause

Some of the consequences of recent executive actions and some things you can do

Hi friends,

I am writing this from my hotel room. I have made it to NY, and tomorrow night I will start flying to Tanzania. I stepped off the plane to hear reports from friends that they received notifications their NIH study sections have been paused due to Trump’s team wanting some sort of review. How long this will last is unclear. This follows his executive order to withdraw from the World Health Organization and may be related to his silencing of all external communications from DHHS agencies, including the FDA, CDC, NIH, and EPA.

I am angry, worried, and scared in general right now. So, I am coping by writing this to help you have some information and context about why these things are concerning and what you can do to try to help. These are not the only things Trump has done this week that concern me, but they are the ones I am best equipped to write about. Please do not take my silence on other topics to mean I do not care. I do—deeply. But right now, it feels like drinking from a firehose, so I am focusing on where I have direct expertise and impact.

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The World Health Organization (WHO)

The WHO is an agency under the United Nations that has 194 member states, which currently includes the USA. Trump issued an executive order for us to leave the WHO this week.

The WHO oversees and deals with global health issues, including global vaccine equity (which I wrote about here), public health, pandemic preparation, emergency preparedness, monitoring outbreaks, and more.

The amount each state contributes is based on the country's GDP. The USA is currently the largest contributor, providing 18% of its budget. This may seem small, but it corresponds to a significant amount of money the WHO needs for its critically important work.

Our withdrawal from the WHO will not only impact their budget. USA scientists collaborate on research projects with the WHO, and we work with them for disease surveillance to detect new pathogens or other concerning outbreaks.

Overall, this is not good—particularly for a party that claims to want to improve health. It is easy to take a country-only view of health, but infections do not respect borders. An outbreak anywhere can quickly impact us. This will make us less safe while also harming lives that deserve better and need our support across the world. You can read more about the WHO and the impact of this decision here and here.

What can you do? Contact your representatives. The USA joined the WHO based on an act of Congress, and it is unclear if an executive order like this is enough to withdraw (I see people saying yes and people saying no, so only time will tell). Perhaps if enough of us call and complain to our representatives, they will act. You can use this link to send a letter or use the letter as a template to call your representatives directly. You can find your federal representatives here.

Pausing DHHS Communications

A memo leaked to The Washington Post outlines that there is a temporary pause (through at least Feb. 1) on all external communications from DHHS agencies—including the NIH, CDC, FDA, and EPA.

This includes reports from the CDC on issues like bird flu (see my last update about that here), seasonal flu, and more, as well as FDA reports on food recalls. This also applies to all other types of external communications.

This is concerning. Professionals and everyday people need access to this information to make decisions for themselves and their families. Preventing communications for even just two weeks could lead to harm—particularly given the fact that bird flu is circulating so much in dairy cows and that food recalls are happening frequently right now.

What can you do? Follow your local and state health department pages on social media. They can still send out alerts with the data they have. This is not as helpful for looking at nationwide trends, but it is something. You can also keep following and sharing trusted science and public health communicators online, such as Those Nerdy Girls, Your Local Epidemiologist, Two Dusty Travelers, Beyond the Noise by Paul Offit, Unbiased Science (see my Instagram highlight for accounts).

The News on NIH: What Does NIH Even Do?

Tonight, news broke regarding a freeze at NIH, you can read more here.

The National Institutes of Health (NIH) is composed of 27 research centers, each with a specific research focus. For example, the National Eye Institute focuses on research related to eye health, and the National Institute on Aging (NIA) focuses on aging.

The NIH has researchers who conduct research at their site, but their biggest role is to send funds to institutions around the country by awarding grants. The money for these awards comes from Congress, which sets their budget through a process called appropriations.

Researchers write grant proposals and submit them to the NIH to be considered for funding. The proposals outline what researchers want to do, why, how, and who will do the work. They are massive—often hundreds of pages long when including all supporting materials (like budgets).

Once submitted, the grant is reviewed by scientists nationwide who work in related areas. These scientists do not work for NIH, but sometimes receive a small honorarium for their work and it is a lot of work (reading lots and lots of pages). For example, I have reviewed for another federal agency before and was given $200 total for hours of work reading and scoring proposals and attending a 5 hour meeting.

Once the proposals have been reviewed some of the grants are discussed during study sections. A study section is a meeting where reviewers discuss and debate proposals. Proposals that are not discussed are not scored and are not funded. Those that are discussed are given a score. A “good” score can result in funding, though what constitutes a good score depends on the budget year and other factors. A ""bad” score is not funded.

This NIH process, in addition to external communications, has now been paused. How long and exactly why is unclear. This is concerning though—if grants cannot be reviewed, they cannot be funded. This will stop scientific progress on many important issues like childhood cancers, dementia, kidney disease, infectious diseases, and more. This will NOT make us healthier, which is ironic coming from the team claiming they want to make America healthy again.

This also has ramifications for the economy. For example, according to United for Medical Research:

“In Fiscal Year 2023, the $37.81 billion NIH awarded to researchers in the 50 U.S. states and the District of Columbia supported 412,041 jobs and $92.89 billion in economic activity.”

Many people depend on these jobs for their livelihoods—from PhD scientists to support staff who may or may not hold bachelor's degrees (did you know about 60% of people in STEM-related fields do not have a bachelor’s degree?). A long freeze could lead to loss of jobs, will hurt the economy and scientific progress and will weaken our ability to compete on the global stage.

Side note: The National Science Foundation (NSF) also funds research, but this research is not as tied directly to human health. It is unclear if similar issues are happening there, but they are also funded by Congress and critically important to the scientific enterprise.

What can you do? Contact your representatives again and tell them you support NIH and NSF funding for scientific research. Hug any scientist you know. We, like many others, are not okay.

With that I sign off and will return once I am back from Africa. Stay safe. Do what you can even if that is as small as sending an email. Action leads to hope. Please also consider sharing the work of myself and others, we do this in our limited spare time in addition to full time jobs and lives. <3

Photo by Jaron Nix on Unsplash