As the Trump administration slashes and transforms the National Institutes of Health (NIH), minority health researchers are walking a tightrope, trying to maintain funding without crossing the vague line into “diversity, equity and inclusion” (DEI) projects.
Researchers told The Hill they are facing unclear research directives, increasingly competitive grant awards and politicized peer review processes as they battle to sustain their work improving health outcomes for minority populations.
“The rules are being changed all the time. The communication is not clear. Study sections [are] getting paused,” said Samira Asgari, a tenure-track assistant professor at the Institute for Genomic Health at Oakland School of Medicine at Mount Sinai. “This brings just an environment of lack of stability and uncertainty.”
While many minority health research projects have seen their grants terminated, others managed to scrape by with funding intact. But to financially sustain their research, scientists have sought alternate funding sources or changed their grant application strategies entirely.
“This is going to basically harm science, because getting a grant becomes a lot more competitive,” Asgari said. “It’s already a numbers game, and even the best of the proposals, for all sorts of reasons, may not get funded.”
Trump terminations target minority health research
The Trump administration directed agencies to terminate DEI programs and grants earlier in the year, resulting in the cancellation of several hundred NIH grants.
“There was no specific type of institution that was spared,” said Michael Liu, a resident physician at Massachusetts General Hospital. “We saw public and private institutions affected across the United States.”
However, Liu and other researchers found certain NIH institutes had more funding terminated than others. The National Institute of Allergy and Infectious Diseases, and the National Institute on Minority Health and Health Disparities, endured the most cuts during the initial round of terminations — more than $505 million and $223 million, respectively.
The Supreme Court greenlit the Trump administration’s continued termination of NIH funding in August, though separate legal challenges managed to disparately preserve some grants.
Though the Senate rejected the administration’s proposed cuts to the NIH and preserved the agency’s $48 billion budget, the White House instated a forward funding policy throughout the NIH’s 28 institutes.
Under the new policy, institutes now offer multiyear funding for a project up-front. According to researchers, this means the agency doesn’t have to build out year-long infrastructure for multiple grants, resulting in less funds being awarded.
Timi Adediran, a research postdoctoral fellow at the University of Michigan’s Department of Microbiology and Immunology, said forward funding will make grants more competitive. She added that it could make planning projects more difficult.
“It can be harder to understand what your budget is going to look like, and it’s going to be hard to figure out how to employ the necessary people,” she said.
Changes to the peer review process have also made researchers increasingly nervous of political appointees deciding who gets awarded grants, rather than long-standing panels of scientists.
Nathaniel Tran, an assistant professor of health policy at the University of Illinois-Chicago School of Public Health, is a researcher for a federally funded project researching health in older LGBTQ+ adults. They said the project had passed a previous peer review project in President Trump’s first term.
“It was scored and awarded, and at that time, pure scientists said that it was good science. It was high-quality science asking important questions, and it happened to include LGBT people, or uses a sample of LGBTQ people to ask scientific questions,” Tran said.
Though Tran’s group application to renew the project scored well again, the original project’s funding was terminated earlier this year. Following a lawsuit, the project’s funding was restarted, and its renewal funding was eventually rewarded.
The White House has taken steps to reduce the power of NIH peer-review boards — which usually consist of credentialed scientists — and allow political appointees to exert more influence over which grants are funded.
“How that actually is going to play out is unclear, but it certainly would be different to have much more of a political layer over each grant to make sure that these grants comply with the administration’s priorities,” said Ellie Mahoney, a senior vice president of policy and advocacy at Research!America, a medical and health research advocacy alliance.
“The Trump administration is committed to federal funding of the cutting-edge biomedical research that can save lives and improve our quality of life – not indulging in ideological pet projects,” White House spokesperson Kush Desai told The Hill in a statement.
Shifting research priorities
Though the Trump administration has declared outright that it would root out DEI from the government, NIH Director Jay Bhattacharya has taken a more measured approach to describing which projects the NIH will and won’t fund.
“NIH has invested substantially in health disparities research, focusing mainly on identifying and documenting worse health outcomes for minority populations,” Bhattacharya wrote in an August NIH directive.
While he acknowledged the research’s importance, he also wrote that it hadn’t translated to “measurable improved health” for minority communities. Moving forward, he wrote, the NIH would instead prioritize research that focuses on “solution-oriented approaches” to address poor health outcomes in minority communities.
“I think anyone working in health equity … would agree that no one enjoys being a professional critic,” said Kushal Kadakia, a resident physician at Massachusetts General Hospital who researched grant terminations alongside Liu. “Everyone hopes to one day move from diagnosis to treatment, which is the same as what we would do in the hospital as doctors. There’s not a lot of joy about only telling someone what’s wrong without offering a solution, because that’s always the next question.”
But he said “diagnostic equity research” — research identifying disparities in health care or health outcomes — is still important.
“It’s very difficult to tailor solutions or design them if you don’t know where the problem is,” Kadakia said. “So I think that research agendas need to prioritize both, which I think was true before 2025 and is true in 2025 as well.”
In a statement to The Hill, an NIH spokesperson said Bhattacharya and Trump were “in full alignment in advancing truth-based science that serves all Americans, regardless of background or status.”
“At NIH, producing evidence-driven, gold-standard research—free from ideological influence—is our highest priority,” the spokesperson said. “We’re bringing the focus back to real science.” The spokesperson added that the agency would “leave no stone unturned in identifying the root causes” of America’s “chronic disease epidemic.”
The administration continued to target DEI programs throughout the summer. In August, the NIH’s parent agency, the Department of Health and Human Services, terminated an NIH program that sought to diversify the biomedical workforce, in compliance with Trump’s executive orders targeting DEI.
“HHS remains committed to ensuring equal treatment under the law throughout its grant programs,” the notice announcing the program’s termination reads.
The program’s termination followed the NIH’s termination of a grant program earlier this year that allowed research teams to hire researchers from minority backgrounds, according to Prakash Nagarkatti, director of the NIH Center of Dietary Supplements and Inflammation at the University of South Carolina. If he didn’t have financial resources of his own, Nagarkatti said he would have had to remove people from his team.
Both Namratha Kandula and Alka Kanaya, principal investigators for Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, said their project is entirely federally funded.
Through around $19 million in grants from the NIH in the past decade, the project has made discoveries that changed national screening guidelines for heart disease and diabetes in South Asians and other Asian American groups.
Kanaya said there’s a lot to lose if their study — which fits under diagnostic equity research — doesn’t continue. “We’ve sort of described the problem, but now it’s really a deep understanding of, what exactly is causing risks? And then, what can we do about it?”
Asgari, the assistant professor at Mount Sinai, said the NIH contacted her to make changes in the language of her grant. Through funding from two NIH institutes, she and her team have conducted research into the spread of infectious diseases among minority communities.
“We just changed the language to remove certain language about diversity, about health disparity, about equity,” Asgari said. “It was not fun at all, because these words were basically at the core of the project.”
“When we study a minority population, it does not mean that what we find is not applicable to other population groups,” Asgari said. “Some of our discoveries are fundamental genetic discoveries that may be identifiable through study of genetic variants that just happen to exist in one population and not another population.”
Changing funding strategies
Anticipating difficult upcoming grant cycles, researchers have begun strategizing how to secure funding to move forward.
The MASALA study’s researchers and Asgari expect to continue inquiring for federal funding — but will apply for more grants to increase their chances of securing funds.
Asgari said it would be a huge time suck, but felt it was necessary. Still, she believes the process may discourage others from research if they don’t have the time or energy to aggressively pursue these grants
“MASALA is now also seeking donations from private donors, since it might look like federal funding might not come through,” Kandula said.
Meanwhile, Adediran — who considers herself to be an early-career researcher — said moving forward, she would focus on clearly communicating the stakes of her work and how her findings could be generalized.
“I just think often the word ‘disparity’ is just kind of used as a blanketed term, but I think being more specific on what you mean by you’re doing ‘disparities work’ can be [helpful],” Adediran said. “I’m trying to be very clear about what I am looking at and how I feel like it could better help us understand how infectious disease acquisition and transmission occurs.”
Other researchers’ concerns have centered on how to keep their already awarded funding, as the threat of it being yanked away looms large.
“To have a large research project that focuses on LGBTQ health and effects of social networks and policy, particularly anti-LGBT policy, right now, to have it be funded right now as a multiyear award, it’s a double-edged sword,” Tran said.
Tran also said no organization could replace the NIH — meaning scientists need to be able to rely on it for research or continue trying to seek funding from it.
“There is no one, their philanthropy cannot fill that gap. There’s no foundation that has enough money to put out $45 billion worth of science,” Tran said. “That’s the unfortunate, really uncomfortable truth to come to terms with.”
