My Reflections on Research Cuts

If you’re like me, you may be feeling a little disheartened lately. Seeing colleagues’ grant funding seemingly pulled for attempting to answer critical questions about how we address structural racism, climate change and socioeconomic inequities, for example, is more than heartbreaking, especially given how vital this research is for our patients with systemic lupus, rheumatoid arthritis and other chronic conditions.^1-3 Between February and April 2025, 694 grants funded by the National Institutes of Health (NIH) were terminated, and further cuts—amounting to a 40% reduction in the NIH budget—have been proposed.

Dr. Downey

The NIH isn’t the only target: The fiscal year 2026 budget proposes a 44% cut to the Centers for Disease Control & Prevention and a 55% cut to the National Science Foundation, among others.⁴

For decades, the U.S. has served as a beacon to the international scientific community. With these drastic cuts to scientific investment, the U.S. stands to lose not only immigrants considering careers in research, but also homegrown scientists.⁵ A poll of 1,608 U.S. researchers found that 75% are considering leaving the country in favor of Canada and Europe, where grant funding is stable. Cutting research also hurts the economy. A recent report showed that a 25% cut to public research funding would reduce the GDP by 3.8%, comparable to the Great Recession. A 50% reduction is estimated to make the average American $10,000 poorer and would significantly shrink government revenue.⁶

As the chair of the Government Affairs Committee for the past two-and-a-half years and a health policy advocate for the past 11 years, I can relate a bit to Sisyphus. However, there is hope to be found from coalitions of attorneys general, state-led lawsuits, legal action by individual universities and a groundswell of public support for research and the pursuit of scientific advancement.

It can sometimes be difficult to overcome the pull toward a deep well of nihilism when considering the threats to the practice of rheumatology. Consider the ongoing cuts to the Physician Fee Schedule and increasing burnout driven by pharmacy benefit managers (PBMs), as well as deep cuts in research grant funding, the silver linings can be hard to find. However, I saw several recently in Washington, D.C., this May.

I met with attuned Congressional staffers who are fighting for Medicare sustainability, to reform harmful PBM practices and to preserve scientific research of all kinds. I also met with colleagues and patients from 26 different states who are energized and engaged in holding our leaders accountable. It’s easy to forget, but there are still true public servants in Washington, D.C., and many informed, passionate citizens who are committed to preserving what makes America great.

I invite each of you become engaged—there are many different ways that you can do this. Read the weekly updates from ACR advocacy staff delivered to your email. Visit the Legislative Action Center to contact your representatives. Invite patients to participate in the Simple Tasks campaign. Invest in RheumPAC to ensure the needs of the rheumatology community are heard. Make a tax-deductible donation to the Rheumatology Research Foundation to ensure our researchers have the funding they need to begin or sustain their careers and make meaningful contributions to the field.

I couldn’t say it better than American political activist and philosopher Angela Davis: “I am no longer accepting the things I cannot change. I am changing the things I cannot accept.”

Will you accept my invitation to do the same?

Christina D. Downey, MD, is an assistant professor of medicine at Loma Linda University School of Medicine, California.

References

1. Yang S, Santacroce L, Collins JE, Feldman CH. Association of historical redlining and present-day racialised economic segregation with health-care utilisation among individuals with rheumatic conditions in Massachusetts and surrounding areas of the USA: A retrospective cohort study. Lancet Rheumatol. 2025 Jan;7(1):e33–e43. doi:10.1016/S2665-9913(24)00235-2.
2. Yip K, Navarro-Millán I. Racial, ethnic, and healthcare disparities in rheumatoid arthritis. Curr Opin Rheumatol. 2021 Mar 1;33(2):117–121. doi:10.1097/BOR.0000000000000782.
3. Liang MH, Lew ER, Fraser PA, et al. Choosing to end African American health disparities in patients with systemic lupus erythematosus. Arthritis Rheumatol. 2024 Jun;76(6):823–835. doi:10.1002/art.42797.
4. Cha AE. Trump’s HHS budget cuts spark concern among scientists. The Washington Post. 2025 Apr 16.