NIH turmoil risks reciprocal EU-US access to health research funding

A clampdown on diversity-related projects at the US National Institutes of Health (NIH) is causing uncertainty and fear among European grant recipients, raising questions over whether the EU should continue a reciprocal arrangement that allows reciprocal access for US scientists to its €93 billion Horizon Europe research programme. 

An executive order issued by US president Donald Trump taking aim at diversity, equity and inclusion (DEI) has rippled through US science, with the NIH reportedly cancelling previously approved projects that include forbidden terms, such as research into LGBTQ+ people’s health. 

Rooting out DEI-related projects has also meant a freeze on some NIH funding, despite court orders, gumming up money for grants. And nearly 1,200 NIH staff have been laid off in a cost-cutting drive, risking further administrative paralysis. 

This turmoil at the NIH has created deep uncertainty, not just for US-based scientists but also for Europeans and other foreign researchers who also receive agency funding. In 2024, 121 projects involving Europe-based researchers, with a combined value of more than $62 million, won funding from the NIH. 

“The current climate and potential restrictions will make applying for US funding less attractive,” said Mathilde Richard, a virus researcher based at the Erasmus University Medical Center in Rotterdam. Richard holds several NIH grants, and is waiting to see whether they will be affected. 

The NIH has long funded researchers outside the US and, in 2008, the EU reciprocated, allowing US-based researchers to receive funding from the health cluster of its research Framework Programmes. 

The idea was to make transatlantic collaboration easier, speeding up new health treatments. Under the current programme, Horizon Europe, US researchers have received €26.4 million from the EU for health projects. Still, despite the reciprocal arrangement’s high ambitions, it has often been criticised for the heavy bureaucratic overhead that comes with trying to reconcile the very different US and EU funding systems.

Watching carefully

But with access to NIH funding now in a state of confusion, the European Commission says it is closely watching the impact on European grantees. 

“The Commission is following the developments very carefully to assess the consequences of NIH reorganisation with respect to the funding of European researchers,” a Commission press spokesperson told Science|Business.

The reciprocal arrangement has “benefitted numerous European and American researchers in collaborative health research and innovation projects,” they stressed. 

“For the time being, no decision has been taken as to restricting Horizon Europe Cluster 1 health research funding to US legal entities,” they added. 

Some worry the NIH disruption could scupper reciprocal access. "It's not unusual or unexpected that there would be a consequence to one country's decision to curtail access,” said Cole Donovan, a former official at the US’s Office of Science and Technology Policy.

For now, it’s too early for European researchers to know whether their NIH funding will be cut off. US researchers are only just finding out themselves. 

“The honest (and also slightly scary) answer is that we don’t know,” said Stefan Pfister, a division head at the German Cancer Research Center, who last year won a NIH grant worth more than $500,000 to investigate new cures to childhood tumours. 

“We live with uncertainty regarding the [annual] funding renewal,” said one Switzerland-based NIH grant recipient, who asked not to be identified. 

“We've seen grants being cancelled even after they've been awarded, so that worry is hanging over us,” said one UK-based researcher, who also declined to be identified in case speaking out made them a target. The UK, while not part of the EU, since last year pays into Horizon Europe as an associated country.

“We have to make long-term plans for our staff and our research, and for all we know the money we've spent so much time securing is going to suddenly disappear,” he said. 

NIH less attractive

But regardless of what happens with their own grants, several European researchers said the turmoil at the NIH had made it much less attractive to apply. 

The uncertainty “makes planning funding applications to the NIH almost impossible. Is there any point putting in an application if we don't know whether the NIH is actually going to fund anything?” said the UK-based researcher. 

Restrictions on addressing issues like gender disparities would be "particularly difficult in health," said Donovan. "If you're unable to study those types of biological phenomena then that inherently is going to have consequences," he said. 

Aside from the ongoing funding freezes, cancellation of projects and firings, the NIH, which has annual budget of $48 billion, could be in line for enormous cuts later this year as Trump negotiates an annual budget with Congress. 

During his first term, Trump tried to slash science budgets, but the cuts were reversed by Congress. However, he now holds far greater sway over the Republican party. 

Russell Vought, director of the White House Office of Management and Budget, and one of those leading drastic cost-cutting measures at federal agencies, called in a 2023 policy paper for a 21.5% cut in the NIH’s budget. 

He argued the cuts were necessary to “curb the agency’s increasingly weaponised posture toward the American public,” accusing it of having a “woke bureaucracy” for example, and attacked its “support for morally and medically dubious gender transition procedures on minors and adults.”

The new Trump administration has already drastically scaled back the amount of money for overhead costs that come with each NIH grant, although these changes do not affect grant winners outside the US, who have always received relatively low overhead costs of 8%. 

Fundamental changes

“Even if current grants may not be affected, future funding will be for sure reduced, both for domestic and foreign awards, perhaps for the latter even more,” said Richard, at the Erasmus University Medical Center.

"It's clear that the new administration has a view toward adjusting the way the NIH operates at a pretty fundamental level,” Donovan said, “from overhead costs, the types of activities that they fund, in addition to the emphasis that they place on certain research subjects. He lost his position at the National Oceanic and Atmospheric Administration in the recent round of agency layoffs. 

The US National Science Foundation (NSF) could be in line for even bigger cuts. Ars Technica reported last month that a budget reduction of two-thirds was being discussed. Vought has called for NSF funding to be more than halved, to “eliminate the leftward march of the agency and its funding choices.” 

The NIH’s Fogarty International Center, which handles overseas grants, did not reply to queries, but referred to other officials in the agency. Science|Business has requested a response from them.