[Congressional Record Volume 172, Number 99 (Thursday, June 11, 2026)]
[House]
[Pages H4103-H4105]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CUTS TO U.S. BIOMEDICAL RESEARCH
(Mr. AUCHINCLOSS asked and was given permission to address the House
for 1 minute and to revise and extend his remarks.)
Mr. AUCHINCLOSS. Mr. Speaker, I ask unanimous consent to include in
the Record a few portions of the editorial written by Steven Khan and
his colleagues regarding the Trump administration's cuts to U.S.
biomedical research.
The SPEAKER pro tempore (Mr. Self). Is there objection to the request
of the gentleman from Massachusetts?
There was no objection.
Misguided Brushes of a Pen Continue To Dismantle and Destroy Biomedical
Research in the United States: We Can No Longer Afford Complacency and
Fear. We Must All Act Now!
Just a year ago, in these very pages, we highlighted the
many threats the current U.S. administration posed to the
health of our nation. Since then, there have been actions by
the administration that have caused grave health
consequences, and their current approach will continue to do
so. The numerous measles outbreaks and associated avoidable
deaths have resulted in part from hyping disproven theories
of harm rather than publicizing the effectiveness of the
measles vaccine. Plugging the concept that diabetes is
curable by ``changing the food source'' simply ignores the
large body of work that has demonstrated that it is not
merely a disease of poor nutrition and the immense challenges
of reinventing the food industry. Peddling conspiracy
theories represents failures by officials of the Department
of Health and Human Services (HHS), whose primary goal is to
protect our health. These two examples represent just two of
the broken promises made by the current HHS leadership during
their confirmation hearings. And, despite promising
oversight, representatives on Capitol Hill have shirked their
responsibility and have allowed the country to continue along
misguided paths that even they recognized as irresponsible.
We are not only naysayers; we do wish to give credit where
credit is due. Both Republicans and Democrats loudly and
firmly rejected the White House's proposed nearly $18 billion
reduction in National Institutes of Health (NIH) funding for
fiscal year 2026. The result was a 1% increase in the total
appropriation over that of fiscal year 2025, amounting to
$47.5 billion, This signaled that the value of biomedical
research is not lost on our elected representatives. We
appreciate their steadfastness and resistance to surrendering
to what would have destroyed decades of American advances in
biomedical discovery and translation.
While one would think that this congressional action to
preserve the NIH budget was a clear repudiation, it has not
stopped President Trump from requesting a 2027 budget that
now seeks a $5 billion reduction to NIH. These proposed cuts
would eliminate the National Institute on Minority Health and
Health Disparities, which they claim ``is replete with DEI
[diversity, equity, and inclusion] expenditures,'' the
Fogarty International Center, which is responsible for
funding degree programs in foreign countries that benefit the
health of all, including Americans, and the National Center
for Complementary and Integrative Health, whose charge
includes supporting research and offering information about
complementary health approaches in the setting of whole-
person health. Other vital cores of the NIH that would be
scaled back are the National Institute of Allergy and
Infectious Diseases and the National Library of Medicine; the
latter's charge includes providing searchable access to the
worldwide medical literature for scientists, clinicians, and
patients around the world.
Threats to the U.S. biomedical research infrastructure are
easy to understand when they involve reductions in
appropriated dollars and cents. However, serious negative
consequences arise when administrative changes are made
without congressional approval or oversight. We have been
witnessing significant changes imposed on NIH since the start
of this administration. The changes seem to be accelerating
and occurring across the whole of NIH, without exception,
thus impacting biomedical innovation in diabetes care and
across every disease. From our perspective as investigators
who have received federal research funding, these changes
have and will continue to have detrimental effects on the NIH
research infrastructure, with significant adverse trickle-
down implications for universities and investigators. These
radical modifications have included a marked reduction in the
NIH workforce, changes in medical advisory councils, a
reduction in published notices of funding opportunities, and
an ill-advised multiyear funding policy.
Early in 2025, the new administration implemented unplanned
and haphazard ``reductions in force'' that targeted not only
NIH scientific staff but also many behind-the-scenes
personnel in each institute who were responsible for policy,
compliance, and communications. It is very clear to many of
us that this reduction in key staff has fractured the NIH
infrastructure, leaving a huge void such that the NIH is
failing to communicate with the general public, universities,
and the investigators they serve.
At an administrative level, each NIH institute has a
medical advisory council responsible for providing oversight
and guidance to its staff. Each institute's advisory council
represents a second level of peer review and acts as the
ultimate arbiter for the agency's scientific and legal
integrity. Each institute's advisory council also provides
approval for ``concept clearance,'' which is required to
launch new research initiatives. Further, these medical
advisory councils have a fiduciary responsibility to ensure
the American public's tax dollars are properly expended by
reviewing and approving each institute's grant funding pay
plan, thereby ensuring funding of the most innovative and
impactful basic, clinical, and translational research.
Membership on these committees, which comprise subject matter
experts from academia and nonprofit organizations, has finite
terms, after which members are either reappointed or
replaced. In the past year, neither has occurred, allowing
the Trump administration to impose its political agenda with
few questions asked. Since mid-2025, observations suggest the
appointment process, which has included traditional
nonpartisan vetting, is taking a worrisome turn and is now
transitioning to more direct oversight by HHS leadership.
This transition is leading to significant and likely
intentional delays in appointments, resulting in some
institutes' councils operating at only one-third capacity and
many councils with massive backlogs in completing their
responsibilities. In addition, the administration appears to
be shifting membership expertise away from an academic and
scientific focus to reflect broader administration priorities
and including political appointees who frequently have no
subject matter expertise. A consequence of these changes is
that the grant cycle is significantly slower and oversight of
grant funding is no longer a required administrative step; it
is now a deliberate policy alignment tool to ensure new
research closely mirrors specific administrative political
interests. As a result, meritorious scientific projects that
aim to improve the lives of all Americans are not being
funded. All of this is in line with what Dr. Francis Collins
recently said: ``Mix politics and science, you get politics.
You kind of lose everything else.''.
Another new tactic is starting to severely hamper the
ability of the NIH's institutes to
[[Page H4104]]
foster high-impact science. The plan, which is currently
being instituted, reduces the number of Notices of Funding
Opportunities (NOFOs) being issued. Over the first 13 months
since Donald Trump's return to the White House, NIH has
issued only 84 NOFOs, compared with 787 the year before; this
represents an 89% reduction. Examination of funding activity
using NIH RePORTER data from the start of the current fiscal
year on 1 October 2025 to the end of February 2026 reveals a
truly troubling trend, This report, issued by the Association
of American Universities, compared this fiscal year 2026
period to that of each of the first 5 months of 2021-2024. It
identified that the current number of grant awards has been
reduced by about 66%, from nearly 3,000 to less than 1,000.
In turn, this has reduced the research money provided to
investigators by 54%, from just over $1.3 billion to about
$600 million.
Why is this consequential for science overall and for
diabetes research? NOFOs, an umbrella term that includes
Program Announcements and Requests for Applications,
encourage investigators to submit applications for a
particular subject matter determined to be high priority by
an institute's scientific staff. Aside from the impact of the
concerns of reduced grant funding laid out above, there are
other significant core issues and implications for fewer
NOFOs that include efficient oversight and scientific
progress as prime examples. Further, and enormously
important, while these calls for NOFOs used to be approved by
each institute's medical advisory council, approval now rests
in the hands of the NIH Director's office and HHS, the NIH's
parent agency, resulting in severe delays or even
disapprovals. Furthermore, with fewer specific NOFOs being
approved, more researchers are funneled into general pools,
providing fewer opportunities to focus on specific gaps and
needs identified by NIH. This is critical, as NOFOs have a
variety of purposes, including 1) encouraging applications on
specific topics ripe for discovery, generally supported by
R01-type applications, 2) supporting large programs,
including clinical trials, that involve investigators with
particular expertise generally across multiple institutions,
and 3) supporting a group of scientists with different areas
of expertise who manage a center that provides specialized
services to numerous investigators at their institution.
Therefore, by moving away from specific funding opportunities
identified by NIH through workshops, from prior research, or
from published data, the agencies lose the ability to
cultivate expertise in emerging or rare fields or to address
research gaps to improve overall health and reduce morbidity
and mortality. What follows are examples of how this new
approach to reducing NOFOs will affect diabetes research.
In the area of requested applications on specific topics in
important areas, a good example is the Restoring Insulin
Secretion (RISE) study. This request for applications
followed the SEARCH for Diabetes in Youth (SEARCH) and
Treatment Options for Type 2 Diabetes in Adolescents and
Youth (TODAY) studies, which respectively highlighted the
increasing incidence and prevalence of type 2 diabetes in
youth and the inability of standard interventions to control
glycemia in adolescents with type 2 diabetes. Using the R01
mechanism, in which applicants each proposed their own study
designs, the worthiest applications were identified by peer
review and funded by the National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK). Thereafter, the seven
selected sites developed a common protocol that employed
sophisticated physiologic measurements to directly compare
the pathophysiology and effect of interventions in youth and
adults with prediabetes and recently diagnosed type 2
diabetes. The study provided important new insights into the
disease process in the two age groups, and its findings have
been incorporated into the American Diabetes Association's
``Standards of Care in Diabetes'' and are modifying clinical
practice. As a result of this work, NIDDK is now supporting
the Discovery of Risk Factors for Type 2 Diabetes in Youth
(DISCOVERY) study, a major, multicenter research project that
is enrolling children and adolescents with obesity into a
study to identify early indicators of the rapid, aggressive
progression of youth-onset type 2 diabetes during puberty.
Over the last few decades, NIDDK has supported numerous
high-impact multicenter clinical trials. Two large ones were
the Diabetes Control and Complications Trial/Epidemiology of
Diabetes Complications (DCCT/EDIC) and the Diabetes
Prevention Program (DPP) and its follow-up, the Diabetes
Prevention Program Outcomes Study (DPPOS). These studies have
directly changed the lives of people with diabetes and those
at high risk of developing the disease. DCCT/EDIC
revolutionized the approach to treating people with type 1
diabetes, establishing standards for glucose control and
resulting in improved quality of life along with clinically
significant reductions in the risk of diabetes complications
and major adverse cardiovascular events. After 44 years, it
continues to provide new insights, including showing that in
adults with type 1 diabetes, neurodegeneration is likely the
result of non-Alzheimer disease mechanisms. DPP/DPPOS, which
enrolled people with prediabetes, demonstrated the benefit of
intensive lifestyle intervention and metformin in reducing
the risk of developing diabetes. These findings led Congress
to approve an amendment to the Social Security Act to
establish the Medicare Diabetes Prevention Program and
provide lifestyle intervention services for eligible
individuals (17). Aside from the primary outcome, numerous
additional insights have been gained from these data,
including the impact of diabetes prevention on macrovascular
and microvascular disease as well as the cost-effectiveness
and cost savings of the interventions. The study is now
primarily supported by the National Institute on Aging and
examines the impact of aging on diabetes and cognitive
outcomes. In addition to these clinical trials that tested a
single protocol, TrialNet is a consortium of clinical trial
sites undertaking smaller clinical studies, each aimed at
identifying an intervention and its mechanistic underpinnings
for slowing or preventing the progression to or of type 1
diabetes. Out of this approach has emerged teplizumab, which
was demonstrated in TrialNet to delay progression to clinical
type 1 diabetes in first-degree relatives of individuals with
type 1 diabetes. This CD3-directed monoclonal antibody has
been approved by the U.S. Food and Drug Administration to
prevent type 1 diabetes in people aged 8 years and older with
stage 2 type 1 diabetes. As a result, we are a major step
closer to a cure for type 1 diabetes. With the potential to
prevent the disease, screening programs for type 1 diabetes
are being initiated worldwide.
NIDDK also supports multicenter initiatives that focus on
basic science. Two examples are the Human Islet Research
Network (HIRN) and the Integrated Islet Distribution Program
(IIDP). HIRN aims to advance our understanding of how b-cells
are lost in human type 1 diabetes and to find inventive
strategies to protect or replace b-cells in people with the
disease. It currently supports 126 investigators and has
contributed to nearly 1,200 publications, including many
collaborations in the United States and internationally. The
IIDP supports the isolation and distribution of islets from a
consortium of ten centers across the country to investigators
all over North America. Since its inception, it has performed
2,639 isolations that have supported 634 studies and led to
1,126 publications. In 2025 alone, IIDP performed 90 human
islet isolations, resulting in the distribution of over 7.84
million islet equivalents for research. The result of work
supported by these resources has driven a greater
understanding of b-cell function, loss, and regeneration in
both type 1 and type 2 diabetes.
The NIDDK ``center grant'' programs have also been hugely
successful. This mechanism provides support to a group of
investigators, typically at one or more academic
institutions, to provide cutting-edge resources to
investigators at their institution and in their region. Those
center programs focused on diabetes include the Diabetes
Research Centers, Centers for Diabetes Translation Research,
Cystic Fibrosis Research and Translation Centers, Nutrition
Obesity Research Centers, and Mouse Metabolic Phenotyping
Centers. Applications for these centers require the inclusion
of scientific cores, a pilot and feasibility program, and an
enrichment program. Thus, aside from the value to the
individual researcher who wants to use a core to incorporate
into their work methodologies that their own group cannot
deliver, they also help support 1) new ideas, particularly
from early-career investigators, that provide the necessary
preliminary data for larger grants and more discovery and 2)
presentations by internal and external speakers that foster
dissemination of scientific knowledge and, importantly,
result in the establishment of new collaborations. The seeds
of numerous scientific advances have been planted through the
science supported by these centers.
The actions of the Trump administration are reducing
opportunities for NIH to implement and fund multicenter
consortia, specialized research centers, and large networks
and to conduct long-term, sustained programs to address
complex issues, including those in diabetes. If this policy
continues, it will greatly reduce the number of funded
programs or even eliminate them. Will the reduction and
elimination of these major programs be in the best interest
of science and improve the health of the American public in
general and individuals with diabetes in particular? What
problem(s) are we trying to solve? Aside from the concerns
regarding the reduction in force, changes in advisory council
practice, and reduction in NOFOs that are dismantling the
ability of the NIH to function effectively, another major
concern, and perhaps the most worrisome, is how the NIH is
being forced to spend its money with the practice of
``multiyear forward funding'' (MYF). In late 2025, NIH was
required by the Office of Management and Budget to start
funding for the entirety of a multiyear grant (e.g., a 5-year
project) up front in year 1, rather than paying for it, as
has been customary, year by year. Should this approach
continue, the implications are quite dire for investigators
and science. As an example, if an institute has $10 million
to spend on grants, and an average award is $500,000, it can
support 20 awards for that year. However, if required to
spend 50% on MYF, that means it can use $5 million to support
ten grants at $500,000 each while using the other $5 million
to support two grants each funded for 5 years. Thus, with a
request for each institute to spend 50% of its allocation as
MYF each year, a 40% reduction in the number of grants funded
from the prior year will be the outcome. Thus, MYF
[[Page H4105]]
clearly is a tool being used by the administration that will
markedly and quickly deplete congressional appropriations,
put at risk available funds for innovative science in future
years, and limit vital research funding for current
investigators. The net result will include the unthinkable:
researchers being forced out of science and fewer people
considering biomedical investigation as a career. Are we
ready to watch the crippling of scientific advances in
diabetes and all other diseases?
Given the proposed budget cuts and the reduction in
opportunities for scientists with appropriate expertise to
continue their work and drive new science, we as clinicians,
scientists, and U.S. citizens call on members of all
communities in our country to make their thoughts known.
While we have focused this editorial on diabetes, the threat
is not limited to this disease. The proposed changes could
affect progress for every disease and every American. There
is an urgent need for all of us to bring attention to these
destructive processes and halt them before the ongoing and
proposed dissolution and destruction of critical components
of our biomedical research infrastructure are completed.
Enough is enough! We call on all concerned citizens of our
beloved country to contact their congressional
representatives to declare their alarm about what is
happening at HHS. We also request that all organizations
established to ensure the health and welfare of U.S. citizens
clearly and loudly make their voices heard and declare their
alarm about what is happening at HHS. It is no longer enough
to stand idly by or work behind the scenes with lawmakers.
Moreover, it is no longer appropriate to fret about political
backlash. Now is the time to recognize and fight to reverse
the spiraling fall of the United States of America's status
as the foremost nation in health care innovation. As a
nation, we must continue to believe in ensuring better health
for all.
A few brushes of a pen, some clearly visible through budget
requests, others less so through internal machinations, are
rapidly destroying what generations have built. We can no
longer afford complacency and fear. We must all act now!
Mr. AUCHINCLOSS. Steve Khan and his colleagues were removed from the
American Diabetes Association's annual meeting, where NIH Director Jay
Bhattacharya was set to speak, while passing out copies of their
editorial.
Attacks on science always become attacks on scientists. This leads to
policy by fear and favor, not evidence.
The editorial said: ``Just a year ago, in these very pages, we
highlighted the many threats the current U.S. administration posed to
the health of our Nation. Since then, there have been actions by the
administration that have caused grave health consequences, and their
current approach will continue to do so. The numerous measles outbreaks
and associated avoidable deaths have resulted in part from hyping
disproven theories of harm rather than publicizing the effectiveness of
the measles vaccine.''
While one would think that this congressional action to preserve the
NIH budget was a clear repudiation, it has not stopped President Trump
from requesting a 2027 budget that now seeks a $5-billion reduction to
the NIH.
Mr. Speaker, we call on all concerned citizens of our beloved country
to contact their congressional Representatives to declare their alarm.
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