The Trump administration has proposed significant reductions to federal research funding, which would weaken components of the world's public health infrastructure. National Institutes of Health (NIH) Director Jay Bhattacharya has requested $27.9 billion for the NIH's 2026 fiscal year (FY) budget [PDF], a roughly 40% reduction from the nearly $48 billion budget for the previous year. This reduction includes an across-the-board cut to research project grants, research centers, research and development (R&D) contracts, and intramural research.
NIH research-grant funding has been invaluable in the development of numerous medical technologies to treat and prevent diseases. One prime example is lenacapavir, a twice-yearly injection that prevents nearly all new HIV infections. Science Magazine recognized it as the 2024 Breakthrough of the Year, and the therapy could transform the global HIV response.
Lenacapavir's story began in an academic lab at the University of Utah. In 1996, biochemist Wesley Sundquist mapped the HIV capsid, the shell that protects the virus's genetic material, and discovered that even the smallest disruptions to this shell could cause the virus to stop replicating. This research caught the attention of Gilead Sciences virologist Tomas Cihlá, who launched lenacapavir's development in 2006. Nearly 20 years later, under Moupali Das's leadership, Gilead's PURPOSE-1 and PURPOSE-2 clinical trials demonstrated 100% and 99% efficacy, respectively, in preventing HIV infection. The approval by the Food and Drug Administration (FDA) in June 2025 could mark a turning point in the global fight against HIV if the drug is distributed equitably.
Given basic science's years-to-decades-long time horizon and focus on the production of public goods, the public sector is uniquely equipped to invest more heavily in basic science
Breakthroughs such as lenacapavir depend on years of publicly funded basic research, work that is essential for identifying therapeutic targets but too uncertain to attract sustained private investment. Both public and private sectors invest in basic science research; however, private investment is heavily concentrated in applied research and experimental development, where the financial return is more immediate. Given basic science's years-to-decades-long time horizon and focus on the production of public goods, the public sector is uniquely equipped to invest more heavily in basic science. Additionally, the private sector relies greatly on public sector funding: every drug approved by the FDA in the 2010s involved research funded by the NIH, proving basic science's foundational role in the U.S. research and development enterprise. Sundquist's lab was funded by the NIH for 12 years, during which time his team made these significant discoveries.
Without this funding, lenacapavir may not exist. Last May, the National Institute of Allergy and Infectious Diseases (NIAID) notified researchers at Scripps Research and Duke University that they will no longer be renewing grants for HIV vaccines research once current funding expires, in June 2026. Dennis Burton of Scripps Research explained that projects that have finally begun to pay off will be terminated or splintered, putting years of work in jeopardy.
The lenacapavir story illustrates the crucial role of NIH funding in driving breakthrough biomedical innovations—advances that are far less likely to emerge without sustained federal support. Both chambers of Congress agree: last July and September, the Senate and House Appropriations Committees approved NIH budgets in the neighborhood of $48 billion for fiscal year 2026, a small increase over the previous year and a bipartisan signal of congressional priorities. On February 3, Congress passed the appropriations package for the Department of Health and Human Services, including for NIH, and the president signed it into law the same day.
Legislators face many economic and political pressures on Capitol Hill. But reducing investments in biomedical research—an area that has long timelines, high uncertainty, and substantial downstream returns—risks trading short-term savings for long-term financial and human costs.
Investing in the NIH delivers significant returns beyond biomedical innovation. Economists estimate that each dollar of NIH-funded research generated $2.56 in economic activity during the 2024 fiscal year, representing a 156% return on investment. Beyond the balance sheet and more critically, NIH investment advances health equity by supporting research on diseases and conditions that disproportionately affect underserved communities—and the private sector rarely invests in these areas.
For example, NIAID supports research on neglected tropical diseases such as Chagas disease and leishmaniasis—diseases that are prevalent among impoverished communities in tropical areas and in multiple regions throughout the United States. Additionally, in 2023, the NIH launched a community-led research program to investigate methods of addressing the underlying structural factors within communities that affect health outcomes, including access to safe spaces and nutritious food, employment opportunities, transportation, and quality health care.
Refusing to invest in U.S. basic research is slowing biomedical innovation, dampening economic growth, and widening existing health disparities. The NIH epitomizes one of the greatest values of the United States: the conviction that science, driven by curiosity and compassion, has the power to improve the lives of all. This investment in knowledge has protected the world's population from threats such as pandemics and cancer. Protecting the NIH budget is not only about funding scientists but also about sustaining the scientific capacity that underpins global health security.
Lenacapavir is more than a scientific breakthrough—it's a reminder of what happens when the United States believes and invests in science.
