Pediatric cancer. Diabetes. Long COVID. Postpartum depression.
Those are among the conditions being investigated by studies that were stopped this year by federal freezes on research grants at medical schools and university hospitals.
The grants were swept up in efforts by the federal government on several fronts: to reduce spending by the National Institutes of Health (NIH), which is the primary funder of medical research in the United States; to require universities to remove programs and language in their curricula, hiring, and admissions that appear to align with “diversity, equity, and inclusion”; and to push back on campus protests last year that opposed Israeli actions in Gaza.
The funding suspensions affect not only the research itself but also the trial participants who might benefit from the experimental treatments, and patients who might benefit in the future from those treatments that are federally approved.
“There’s a lot of thought that the canceled grants are just punishing these rich elite institutions,” such as Ivy League universities, says Paula Castaño, MD, MPH, associate professor of reproductive science and principal investigator of two contraceptive trials that were halted at Columbia University Vagelos College of Physicians and Surgeons in New York City. “This impacts people” who might benefit from the research.
“Real humans are being affected.”
In some cases, funding was initially frozen and then released, but the uncertainty about future funding has created widespread concern. Clinical trials cannot be restarted like a car. Supplies of drugs and devices have to be restocked, participants drift away, and researchers move on to other projects that pay.
“Trials are hard to carry out,” Castaño notes. “They require a lot of work and a lot of commitment, both from the research team and from the participants.”
Last week the AAMC submitted a brief to a federal court in Massachusetts in a lawsuit opposing the grant terminations, saying that “the impact grows each day as promising research is halted, patients in clinical trials face the discontinuation of care, researchers lose their jobs, and graduate students have their admissions offers rescinded.”
Clinical trials are essential
“Clinical trials are essential to biomedical research,” notes Elena Fuentes-Afflick, MD, MPH, chief scientific officer at the AAMC. “Halting or terminating them hurts the advancement of scientific knowledge.”
Using voluntary participants, human clinical trials test new drugs, treatments, medical devices, and behavioral interventions to determine their safety and effectiveness. The federal website that tracks clinical trials lists 45,000 active trials as of April 2025.
The NIH is the largest funder. In 2024, more than 80% of the agency’s $47 billion budget went to support research (including lab and clinical trials) at over 2,500 scientific institutions. Sixty percent of this extramural research occurred on academic medical center campuses.
Aside from testing treatments for future patients, the trials also offer hope for the participants that the intervention will work right now. One of those participants was Katie Doble. In 2013, at age 31, Doble was diagnosed with uveal melanoma, a rare form of eye cancer. It later spread to her liver, and she was told she had 16 months to live.
That set off a series of four clinical trials to stave off death: at Memorial Sloan Kettering Cancer Center in New York City, two at UCHealth in Colorado (the state where she lives with her husband), and another at the University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center in partnership with the University of Pittsburgh. At various times along the way, Doble had to leave the studies because of the progression of her disease (at one point it had spread to her brain) and the requirements of the trials.
The last trial, at UPMC, used her body’s own T cells to fight the cancer. It worked. “We were seeing tumors disappear,” says Doble, who has been cancer-free for more than three years.
No one can pinpoint the impact of each experimental treatment, but Doble suspects that some of them enabled the others, slowing the spread of cancer to a degree that a subsequent therapy could become available and work.
Doble has a strong reaction to the cuts that are affecting clinical trials today.
“I’m terrified. I’m devastated,” says Doble, who now guides other cancer patients toward finding help, including clinical trials and specialists. “I think about so many people that I know who are still in the fight for their lives — mothers, fathers, sons, daughters. The continuity in research is crucial, and we’re going to lose that. It’s shortsighted and selfish.”
Below is a sampling of the trials that have been affected by the cuts.
Postpartum depression
In March, 21 new mothers were cut off from calls from doulas who had been trained in cognitive behavioral therapy to stave off postpartum depression and improve heart health. The Living Healthy for Moms program — a collaboration between Weill Cornell Medicine, Columbia University, and several community health organizations, all in New York City — set out to enroll 600 women to see if the specially designed intervention with doulas could help reduce maternal depression and heart ailments.
“Mental health conditions and cardiovascular health conditions are the leading causes of death in the first year postpartum,” says Lauren Osborne, MD, vice chair of clinical research in the Department of Obstetrics and Gynecology at Weill Cornell.
The federal administration froze $400 million in funds to Columbia University because of protests at the campus over Gaza and alleged failures to combat antisemitism. That cut off the funds to Weill Cornell Medicine, which then provided money to continue the work with the women already enrolled.
“We felt very strongly that it was unethical to just leave those patients in the lurch,” Osborne says.
The project’s future, though, is uncertain, because recruitment halted far short of the goal. Several enrolled women “dropped out because they thought we were unreliable,” she adds.
“The impact on research is huge. We would have known whether an intervention like this could help us reverse those appalling numbers, and now we won’t have that information.”
“This has an impact on people who are at the most vulnerable time of their lives,” Osborne says. “We were enrolling women right after delivery. They’ve given birth a day before.”
Diabetes and dementia
In March, the federal administration canceled funding for a 30-year, nationwide study — the Diabetes Prevention Program Outcomes Study — that was tracking 1,700 people with prediabetes and diabetes. The observational study is managed by Columbia University and its participants include more than two dozen research sites around the country, such as Jefferson Medical College in Philadelphia; the Albert Einstein College of Medicine in the Bronx, New York; and Johns Hopkins University School of Medicine in Baltimore.
The study looks for factors that might reduce the risk of complications among people developing diabetes and prediabetes, as well as risk factors for dementia that are associated with the disease.
“People with diabetes have a higher risk of dementia,” says José Luchsinger, MD, MPH, director of the Center for Research on Aging and Quality of Life at Columbia University Vagelos College of Physicians and Surgeons.
“We were notified to stop all data collection,” he says. “There’s no funding to continue the interaction” with patients.
The study includes brain imaging of participants and blood tests to monitor brain health, going back decades. Researchers believe that the changes in those blood test results over time will provide insights about the progression of diabetes and dementia.
“The project was terminated at a time when we don’t have the means to put together the data that can meaningfully answer important scientific questions” about diabetes and dementia, Luchsinger says. “Whatever we found was going to have an impact on public health.”
Pediatric cancer
In January, federal grant funding was paused for countless studies, including those carried out through the Children’s Oncology Group (COG), a member of the National Cancer Institute (NCI) National Clinical Trials Network — the world’s largest organization devoted exclusively to childhood and adolescent cancer research. Funding has been restored while administration staff and lawmakers review budgets, but the COG organizations — including academic medical institutions — remain uncertain about their funding.
“About 60% of all of our funding that supports our group and our member institutions comes from the NCI,” says Douglas Hawkins, MD, chair of COG, which includes numerous institutions that study pediatric cancer.
One issue behind the pause is an administration proposal to cap indirect costs for grants at 15% of the grant total, a big drop for compensation that can be 50% of each grant. Institutions use that compensation to help offset costs, such as the purchase and maintenance of scientific equipment that are necessary for studies, Hawkins says.
The reduction “would be devastating to institutions” that carry out pediatric cancer research, he adds. “Without support to our institutions, we simply could not exist. We would simply stop doing that research.”
The AAMC led a lawsuit that halted the indirect-cost cuts. The administration appealed the judicial order, which remains in effect.
Federal funding is essential, Hawkins says, because pediatric cancer is so rare that pharmaceutical companies have less financial incentive to invest in therapeutics for those cancers than for more common adult malignancies. About 15,000 children are diagnosed with cancer in the U.S. every year, according to the NCI.
As for the prospect of continued funding, Hawkins says, “we’re worried.”
Long COVID
In late March, the NIH temporarily terminated funding for dozens of projects that study long COVID, a group of health problems that persist for months or years after someone has had the disease. The pause included parts of the largest federal funding pool for long COVID: Researching COVID to Enhance Recovery (RECOVER), which takes place at dozens of institutions.
RECOVER combines data from four different types of studies to understand what long COVID does to the body over time.
“It’s a huge effort that spans the country, involves many medical schools, many hospitals. There are about 20,000 enrollees in this trial,” says David Warburton, MD, a pediatrician at the University of Southern California (USC) Keck School of Medicine.
Warburton is a principal investigator for two RECOVER-funded studies at Children’s Hospital Los Angeles: One looks at whether genetic factors made some patients more susceptible to the condition. The other, involving teens and young adults, examines brain fog — cognitive difficulties that include short-term memory loss, concentration troubles, and confusion.
The funds were restored within days, after protests from patients, researchers, and lawmakers.
“It turned out to be a case of throwing out the baby with the bathwater,” Warburton says. “Luckily, we were able to collect the bathwater and put it back in the tub.”
Birth control
The Contraceptive Clinical Trials Network oversees two studies, sponsored by the NIH: to test long-acting, injectable contraceptives and to test vaginal rings. The reason for these studies, Castaño explains, is that many women “have tried different types of contraception and have found that they’re not a good option for them,” either because of effectiveness, ease of use, or medical conditions. For instance, some women cannot use hormone-based contraception.
The studies are carried out at more than a dozen institutions. They test:
Long-lasting injections: Many people are averse to injections, and current birth control injections require women to come to an office every three months to get them. That discourages them. The longer-lasting injections are required less often, putting less of a burden on the recipient.
“Someone who is needle-averse says, ‘If it’s only a few times a year, that’s better for me,’” Castaño says.
A vaginal ring: Unlike other insertable rings, the one in this trial does not use hormones, such as estrogen, which some women cannot or prefer not to use, Castaño says. The ring blocks sperm from entering the cervical canal and releases an agent that impedes sperm motility.
It can be inserted by the patient and works for one month. That requires less interaction such as using condoms and spermicides, for each incidence of intercourse.
For both approaches, Castaño says, “the purpose is to find good alternative contraceptive options for patients.”
When the federal administration cut off grants to Columbia University, these clinical trials at Columbia University Irving Medical Center were included in the freeze. Aside from the loss of data about the effectiveness of these contraceptive methods, Castaño worries about the impact on participants.
“There’s a risk that someone is unprotected” from pregnancy, she says.
What comes next?
Even for those trials whose funding was restored, researchers are deeply concerned about the effect of future funding cuts on their labs and their patients.
At the long-COVID study, for instance, uncertainly persists among researchers and the community representatives who communicate with and advocate for the participants. “They’re very concerned, reasonably so,” Warburton says.
What’s also lost is trust. One of the ongoing challenges for clinical and observational studies is enrolling participants willing to entrust their health to a scientific research system that can seem disconnected from their lives and unreliable.
“It’s really hard to engage the community in research,” Osborne says. “We involved community health organizations. We were able to gain their trust, as somebody who proactively partnered with them to improve the health of the community.
“It causes damage to the relationship between the community and medical research. That’s an impact on the research, but it’s also an impact on the participants, and their willingness to trust science and trust research.”
