How far could Trump’s NIH funding cuts set medical innovation back? By decades, UW researchers warn

On a dark night in November 2023, Andrea Gilbert was driving home from Costco in Kirkland, when she realized she had no idea where she was.

She had driven the route dozens of times, but suddenly found herself in a forested area, totally disoriented and unsure whether her electric car had enough charge to make it home.

“There were all these trees around me, pitch black, just my car lights to show me where I was,” she said. “I was like, ‘Where the hell am I?’”

At an appointment with her primary care doctor at UW Medicine a few days later, Gilbert shared the story, not because she was worried, but because she thought it was an amusing anecdote about getting older. At the time, she was 78.

After a battery of tests, Gilbert was diagnosed with early Alzheimer’s. She was one of the first patients to receive a new drug designed to reduce plaque in the brain that doctors believe causes cognitive decline. Researchers at UW Medicine say her diagnosis and treatment would not have been possible without long-term support from the National Institutes of Health, which now faces an uncertain future.

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The Trump administration has cut funding levels and paused new and existing grants from the agency, which totalled $35 billion in 2023. That’s left critical studies of various illnesses and drugs that could help treat them on pause. Doctors, researchers, and scientists who have spent years and often decades studying chronic diseases worry the cuts will have long-lasting consequences for public health and medical innovation.

If NIH support is eliminated or drastically reduced, it could leave UW Medicine without hundreds of million dollars.

“If we stop investing in this research now, 10 years from now or 20 years from now, we won't have this pipeline of amazing new drugs to help people, to treat cancer, to treat Alzheimer's, to treat diabetes, to treat heart disease,” said Dr. Shelly Sakiyama-Elbert, vice dean of research and graduate education at the University of Washington School of Medicine. “We're working on these therapies of the future. Cutting that off will have a negative impact way down the line.”

President Trump signed an executive order Jan. 22 that effectively halted the annual grant-approval process at the NIH, stalling about 50,000 grants nationwide, including 100 from UW Medicine.

Less than a week later, the Office of Management and Budget paused federal grants, loans, and other financial assistance programs. That pause continues despite a court order blocking the Trump administration from freezing federal funds.

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Meanwhile, the NIH has threatened to cap “indirect costs” that pay for facilities maintenance, utilities, equipment, IT, purchasing, accounting, and safety measures at 15%. The standard UW charge for indirect costs is 55.5%.

If the lower rate had been in place in 2024, it would have cost the university $91 million, Sakiyama-Elbert said.

The proposed cut in indirect costs has been challenged in a lawsuit brought by 22 attorneys general, including Washington State Attorney General Nick Brown.

Sakiyama-Elbert said much of UW Medicine’s federal funding goes directly to doctors, scientists, and graduate students. She said more than 3,000 UW employees are supported either fully or partially by NIH grants, including:

• 1,100 faculty members
• 650 doctoral students
• 450 post-doc researchers
• 950 research scientists and engineers

“We’re really in danger of losing an entire generation of really talented researchers who have spent a decade or more preparing for these careers because the opportunities aren’t going to be there,” Sakiyama-Elbert said. “That’s something that’s going to be really devastating to our research and our ability to be leaders in innovation in biomedical research for decades to come.”

Alzheimer’s research

Seattle is a national hub for Alzheimer’s research. The UW Alzheimer Disease Research Center is one of 35 centers across the country that share data and research on the disease, which is the fifth-leading cause of death among Americans 65 or older.

The UW is also home to the National Alzheimer’s Coordinating Center, where data from all the U.S. centers — and thousands of patients — is stored and shared.

Alzheimer’s research requires studies that can last for decades, said Dr. Thomas Grabowski, the center’s director and a professor of radiology and neurology at the UW School of Medicine. Those studies typically end when patients die, and their brains are examined.

“To study this disease seriously, you need to be able to follow research participants over many years, all the way to autopsy,” he said. “NIH funding is what gives the center’s program its longevity and stability to enable it to do that.”

Alzheimer centers are funded in part by non-competing NIH grants that renew every five years. The UW center is one of 14 nationwide whose grant comes up for renewal in 2025.

Some centers have grants that expired at the end of February. The UW center’s request for between $20 million and $22 million must be approved by the end of April to keep critical research going, according to Grabowski.

“This is a very real crisis,” Grabowski said. “We’re one of the older centers and one of the most successful centers, but we’re just one of 14 that are really in jeopardy, which is almost half the program nationally.”

Uncertainty about NIH funding comes at a critical time for Alzheimer’s research. The combination of early diagnosis with new drugs — like the one Andrea Gilbert is taking — is giving doctors and researchers hope that they can limit the progress of a disease that affects 6.9 million people ages 65 and older in the U.S.

Gilbert was diagnosed with early Alzheimer’s thanks to a decade of biomarker research at the UW Alzheimer’s Center. Scientists can now determine through either blood tests or brain imaging whether someone has the disease 10 to 15 years before they start exhibiting symptoms.

Once she was diagnosed, Gilbert became part of the center’s Clinical Core. She was among the first to receive the monoclonal antibody called lecamemab, which she takes in biweekly infusions at the UW Medicine Memory and Brain Wellness Center at Harborview.

Sakiyama-Elbert said cutting-edge drugs like lecamemab are the direct result of federally funded research.

“If we look at the drugs that were newly approved by the FDA between 2010 and 2019, 99% of those drugs had some funding from NIH during their development life cycle,” she said.

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The UW is not the only Washington institution bracing for NIH cuts. The Fred Hutch Cancer Center, the state’s second largest recipient of NIH money, would reportedly lose $125 million if the agency implements a 15% cap on indirect funding.

“We are working vigorously with our peers, partners, legislators, and trade organizations to advocate for Congressional intervention,” Senior Communications Manager Claire R. Hudson said via email. “To date, changes in NIH research funding have not interrupted the care of patients at Fred Hutch.”

Washington State University would lose nearly $5 million a year if the cap on indirect costs is implemented, according to David Wasson, director of WSU News and Media Relations.

Meanwhile, in the other Washington, U.S. Sen. Patty Murray (D-Wash.) has been an outspoken opponent of proposed cuts to NIH funding and delays in the grant approval process.

During a confirmation hearing March 5 for Dr. Jayanta “Jay” Bhattacharya, Trump’s nominee to serve as director of the NIH, Murray expressed outrage about indiscriminate firings and massive cuts that could impact critical research.

“I don’t think it’s an exaggeration to say that right now, President Trump and Elon Musk are really putting a lot of lifesaving research at risk,” Murray said. “We’ve had grant freezes, pauses on advisory meetings, pauses on clinical trials, mass firings being carried out by the so-called DOGE, and it is really threatening our ability to treat childhood cancers, to mitigate the effects of Alzheimer’s disease and other forms of dementia, and to better understand and treat women’s health issues.”

Bhattacharya, a Stanford professor who criticized Covid-19 shutdowns and vaccine policies, defended the cuts.

“I love the NIH but post-pandemic, America’s biomedical sciences are at a crossroads,” he said.

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While the battle over funding and federal cuts continues, the NIH last week resumed public communications and rescheduled the first phase of review for proposed NIH grants for late March and early April.

“The second phase is still held up right now, but the first phase looks like it’s going to start resuming,” Sakiyama-Elbert said. “So, that’s wonderful news.”

For her part, Andrea Gilbert’s verbal test during her most recent appointment with Dr. Grabowski showed that her memory was improving.

“I was one point better than the last time,” she said. “If nothing else, it's possibly making a dent in it.”

In June, Gilbert will finish 18 months of biweekly infusions to prevent her Alzheimer’s from progressing. She said her memory seems better in recent days, but that could be just a “flash in the pan.”

“The whole goal for me is to not get any worse,” she said. “Because I feel like I'm pretty capable of living happily the way I am.”