Deep cuts to federal funding for health agencies, including the National Institutes of Health (NIH) and the National Cancer Institute (NCI), have raised significant concerns regarding the future of cancer research and care in the United States. Following these reductions, research institutions are experiencing widespread layoffs and hiring freezes, which threaten to undermine oncology research programs and biomedical advancement.
Since the beginning of the current administration in January 2025, several measures have been implemented to reduce workforce and budget allocations for the U.S. Department of Health and Human Services (HHS). In February, the NIH imposed a 15% cap on grants for indirect costs such as infrastructure and maintenance, a stark contrast to previously negotiated rates that ranged from 25% to 70% at many universities. According to estimates from the Senate Health, Education, Labor and Pensions Committee, as much as $2.7 billion in research grants were cut from the NIH within the first three months of 2025.
The repercussions of these decisions are evident. NIH grant rejections have more than doubled, with over 2,500 applications denied so far. Furthermore, a report from the Association of American Medical Colleges revealed that the NIH terminated 777 grants as of May 5, 2025, leading to a loss of over $1.9 billion in medical research funding.
On March 27, HHS Secretary Robert F. Kennedy Jr. announced 10,000 termination notices, including 1,000 at the NIH, though 20% of these were later identified as errors. Additional layoffs in May resulted in the loss of 250 NIH employees, including approximately 50 staff at the NCI. These layoffs coincided with the release of the administration’s Fiscal Year 2026 budget on May 2, which proposes nearly 40% cuts to NIH funding and consolidates the agency’s 27 institutes into just 8, although the NCI is expected to remain intact.
Experts warn that the impact of these cuts will vary based on the structure of individual health systems. Dr. Daniel Spratt, chairman and professor of radiation oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University in Cleveland, Ohio, noted in an interview that significant federal cuts could affect not just universities but the health systems themselves. He stated, “Health care is extremely complex, and the impact is going to be very different based on the structure of a given health system.”
Despite assurances from federal officials that operations at the HHS would not be compromised, reports indicate otherwise. Scientists at the NCI campus in Bethesda, Maryland, have experienced delays in obtaining essential supplies due to staffing cuts, and contracts to maintain biological research specimens are reportedly being reduced. An article by KKF Health News, informed by interviews with over 20 current and former NCI employees, highlighted these concerns.
The potential ramifications of these disruptions could extend throughout the cancer research ecosystem. While Dr. Spratt does not anticipate an immediate reduction in the oncology workforce, he emphasized that the cuts could shift research priorities and the types of studies being conducted. Some colleagues at the NIH are already transitioning to industry roles, which may influence the questions being asked and who benefits from the findings.
“There’s anxiety because there’s uncertainty,” Dr. Spratt remarked, especially for those managing large research portfolios. He added, “If there is a clear reduction in federal funding for cancer research, then there will need to be commensurate increases in foundation support, philanthropy, and industry partnerships.”
The escalating costs of conducting clinical trials in the U.S. further complicate the landscape. “Clinical trials have become exceptionally expensive in the U.S.,” Dr. Spratt observed, attributing this to high regulatory standards. He suggested that innovative approaches may be needed to reduce costs while maintaining safety.
Research focused on equity is also at risk. Some researchers have shifted their attention from race-based investigations to broader analyses of socioeconomic and environmental factors influencing health disparities. Dr. Spratt noted that while some programs continue, they are now under greater scrutiny, with some funding completely disappearing.
To address these challenges, experts are advocating for strategic solutions, including reducing regulatory burdens without compromising safety, improving clinical trial efficiency, and reallocating funding towards projects with the highest potential impact on patients. Dr. Spratt emphasized the importance of collaboration among academia, government, and industry to create new funding pipelines.
“The system we have for biomedical research in the U.S. has many strengths, but there are opportunities for improvement,” he stated. “We must navigate the current climate by aiming for a more cost-effective, robust ability to perform research that helps people, not just for the sake of maintaining funding.”
Looking ahead, Dr. Spratt expresses cautious optimism regarding the stabilization of federal funding. However, given the scale of proposed cuts, the research community must remain adaptable. “This is an awakening moment,” he concluded. “Individuals must now think critically about the sustainability of their programs and whether their research is truly designed to translate from bench to bedside.”
While uncertainty looms, Dr. Spratt maintains hope that researchers focused on high-impact science aimed at benefiting patients will still find avenues for success, reinforcing the potential of the scientific community in the U.S. to continue advancing human health.