Following the confirmation of Robert F. Kennedy Jr. as Secretary of the Department of Health and Human Services (HHS) in mid-February, federal health agencies, including the National Institutes of Health (NIH), have been devastated by staff layoffs and directives to terminate certain research programs and grants that do not align with the values of the new administration. The federal government has largely abandoned the deliberative and transparent process for policy changes, and so FABBS is working to keep our members informed of the developments most relevant to our sciences. This week we are reporting on the leaked HHS budget and Monday’s NIH Council of Councils meeting.
FABBS is building on our advocacy tools and urges scientists to communicate with elected officials in the service of helping them understand the real-world consequences of these actions. If you are interested in joining the FABBS database of researchers eager to engage with Congress, please submit the form here.
HHS Budget Draft Leaked
An April 10 draft of the HHS Fiscal Year 2026 (FY26) budget, as proposed by the Office of Management and Budget (OMB), was leaked to the press last week. This document offers the first detailed look at the Trump administration’s plans for federal health agencies. The reported goal of the budget is to have HHS fulfill its legal obligations in the most cost-effective way possible. Overall, OMB has proposed a 40 percent decrease from the FY25 HHS budget, i.e., from $116.8 billion to $80.4 billion. Many programs have been flagged for elimination, including those that align with Kennedy’s priorities. Even causes championed by Republican senators, such as rural health programs, are on the chopping block.
The leaked budget also reveals that major changes are planned at NIH. The proposal cuts its current budget by nearly half, down to just $26.7 billion. Many of the savings are expected to result from a 15 percent cap in facilities and administration (F&A) rates. NIH proposed this change in early February, but it was not included in the FY25 continuing resolution, which maintained FY24 funding levels and language to protect current F&A levels. The administration proposing cuts at NIH is not surprising – many presidents have done the same – but the sheer size of the cuts has stakeholders deeply concerned. Congress typically pushes back against cuts to NIH – during Trump’s first term, legislators rejected his proposed 20 percent cut in 2017 – but it is unclear how a Republican-controlled Congress will respond.
The OMB draft also includes significant reorganization of NIH, reducing the number of institutes and centers (ICs) from 27 to just eight by eliminating, consolidating, and moving some to other areas of HHS. This plan differs from former House Energy & Commerce Committee Chair Cathy McMorris Rodgers’ proposed restructuring – she proposed reducing the ICs from 27 to 15 – but there is some overlap. Unlike McMorris Rodgers, OMB proposes completely eliminating four ICs: the National Institute of Nursing Research (NINR), the National Institute on Minority Health and Health Disparities (NIMHD), the Fogarty International Center (FIC), and the National Center for Complementary and Integrative Health (NCCIH). In late March, the directors of NINR and NIMHD were placed on administrative leave. Two programs would move to the new Assistant Secretary for Innovation office within HHS: Advanced Research Projects Agency for Health (ARPA-H) and the National Center for Advancing Translational Sciences (NCATS). The National Institute of Environmental Health Sciences (NIEHS) would move to the new Administration for a Healthy America (AHA) office within HHS.
Three ICs are not mentioned in the draft: the NIH Clinical Center (CC), the Center for Information Technology (CIT), and the Center for Scientific Review (CSR). Given the proposed centralization of NIH’s grant review process, CSR should remain as is, if not expanded to some degree to take on the expected extra work. NIH leadership has also recently acknowledged the importance of clinical trials, making it likely that the CC will also be relatively safe.
OMB proposes reorganizing the remaining ICs as follows:
| Proposed Institutes | Current Institutes |
| National Cancer Institute (NCI) | National Cancer Institute (NCI) |
| National Institute on Aging (NIA) | National Institute on Aging (NIA) |
| National Institute of Allergy and Infectious Diseases (NIAID) | National Institute of Allergy and Infectious Diseases (NIAID) |
| National Institute on Body Systems | National Heart, Lung, and Blood Institute (NHLBI) |
| National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) | |
| National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) | |
| National Institute on Neuroscience and Brain Research | National Institute of Dental and Craniofacial Research (NIDCR) |
| National Institute of Neurological Disorders and Stroke (NINDS) | |
| National Eye Institute | |
| National Institute of General Medical Sciences | National Institute of General Medical Sciences (NIGMS) |
| National Human Genome Research Institute (NHGRI) | |
| National Library of Medicine (NLM) | |
| National Institute of Biomedical Imaging and Bioengineering (NIBIB) | |
| National Institute of Disability Related Research | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) |
| National Institute on Deafness and Other Communication Disorders (NIDCD) | |
| National Institute of Behavioral Health | National Institute on Alcohol Abuse and Alcoholism (NIAAA) |
| National Institute on Drug Abuse (NIDA) | |
| National Institute of Mental Health (NIMH) |
Although the proposed budget calls for major changes, stakeholders have questioned whether the administration can legally do so. Many of the ICs were established by acts of Congress, therefore it is possible that only Congressional authorization can eliminate, consolidate, or move them. Additionally, lawmakers such as Senator Bill Cassidy (R-LA), Chair of the Senate Committee on Health, Education, Labor, and Pensions (HELP), have previously indicated that they want to see a thoughtful, deliberative NIH reauthorization process that would also tackled reorganization.
NIH Council of Councils Meeting
On April 21, the NIH Council of Councils met for the first time since Jay Bhattacharya’s confirmation as Director. (See this previous FABBS article for an overview of the Council of Councils, including its purpose and membership.) Most relevant to FABBS members is his NIH update, in which the new director discussed his vision for NIH and answered questions from council members. The meeting also included votes on four concept clearances as well as very brief updates on NIH’s Science of Science initiatives and a proposal for a Council of Councils Working Group on High Risk, High Reward research.
Dr. Bhattacharya began by acknowledging the tumultuous changes NIH has faced over the past few months. Notably, he committed to a “normal process” for replacing IC leaders who have retired or been reassigned. He also introduced two new initiatives: Understanding Autism Spectrum Disorder (ASD) and NIH Real-World Data Platform. For the former, he envisions 10 to 20 groups of researchers around the country employing diverse approaches to understanding the causes of autism and improving treatments. For the later, he argued that existing data sources are fragmented and difficult to obtain, thus he wants to see a platform where all researchers have access to high quality data from a variety of different sources. NIH will unveil this platform as part of the autism initiative, but it will eventually be available for other areas of research.
The new NIH Director next offered five building blocks for improving Americans’ health, which he had already outlined during his confirmation hearing and in his first email to NIHH staff:
- Improve population health by focusing on prevention, scaling, accessibility, and diseases that afflict the most people.
- Ensure reliable results by centering replication and reproducibility in NIH research.
- Make big advances by transforming the NIH portfolio and relying more heavily on early career researchers.
- Maintain safety and transparency by eliminating research that might pose a risk to the human population (e.g., gain-of-function research).
- Encourage academic freedom by allowing NIH researchers to make their own decisions about publication.
After his presentation, Dr. Bhattacharya answered questions from council members. Dr. Monica Gandhi (University of California, San Francisco) asked the question on everyone’s mind: what does the new Director think of the leaked budget? Dr. Bhattacharya said that he could not comment on the leaked HHS budget draft, but emphasized that he continuously hears bipartisan support for NIH on the Hill. He also acknowledged that not all of the recent changes at NIH have been good for science and his current focus is “turning the lights back on” to ease disruptions. He noted that study sections should be back on track in May.
In response to questions about terminated grants and academic freedom, Dr. Bhattacharya held firm that the health needs of all must be included in the NIH portfolio, regardless of race, gender, and so on. He believes that Trump’s executive orders related to diversity, equity, and inclusion (DEI) have been misunderstood, i.e., they are not meant to stop research on the health and wellbeing of minority populations. Dr. Bhattacharya went so far as to say he would not have taken this job if that were true. He does, however, see a distinction between what researchers can study and what research NIH funds with its limited resources, with the latter having to directly serve the NIH mission (i.e., improve the health and longevity of the American people). One council member said that additional clarification on this issue is needed.
(After meeting ended, NIH announced a new policy requiring colleges and universities to certify that they do not have any DEI programs, even if unrelated to research, in order to receive NIH funding, contradicting Dr. Bhattacharya’s earlier claim.)
Finally, Dr. Linda Chang (University of Maryland) asked about NIH reorganization. Again, Dr. Bhattacharya did not comment on anything in the leaked budget, but he did say that the budget is the start of reorganization negotiations, not the final decision. He himself has no specific plans at the moment and his intention going forward is to work closely with the administration and Congress, possibly leveraging the Scientific Management Review Board (SMRB) process if that is what Congress wants to see. The director appeared to echo the thoughts of many in the stakeholder community when he emphasized the need for a thoughtful reorganization process, arguing that there cannot be reorganization just for its own sake; instead, there must be clear benefits that enable NIH to best fulfill its mission.
The Council of Councils next meets on May 29-30. The terms of several council members expire at the end of April, but it is unclear if there will be any new appointments before the upcoming meeting.
