Letter to the Editor / Funding for NICHD

By John Hobbins MD

Donald Trump was elected because voters thought he would lower taxes and curb rising inflation. After less than 100 days his zany approach to the economy has resulted in a massive hit on the stock market and, not surprisingly, has caused voter’s remorse, or even voter’s ire. However, one of his post-election activities has not received enough attention. To improve “efficiency” he and his demolition team have thrown a Molotov cocktail into the government’s Division of Health and Human services (HHS), the agency dedicated to saving lives, improving delivery of health care, and preventing the spread of communicable diseases. Ironically, it is now lead by a renegade vaccine-denier.

While aiming to cut the present HHS budget of $47 billion to 27 billion, they have reduced the workforce by 20,000 (25%) and interrupted/terminated 700 research projects. Just one example: A branch of HHS, the National Institutes of Childhood Health and Development (NICHD), has recently lost 1300 employees, including the highly respected Director of the agency who learned of her firing by e-mail. Among many responsibilities, this agency has funded large multi-center trials to guide evidence-based clinical care and has launched innovative research projects in prenatal diagnosis and in utero gene therapy to prevent disease before it starts.

The agency has operated according to guidelines that have been developed by respected scientists over the years. Studies are not funded on a whim. A typical grant proposal (RO-1) usually takes two to three months to prepare and only runs a 10% chance of surviving rigorous review. This has resulted in funding for the highest quality studies that have yielded many breakthroughs.

So now a group of IT-savvy youths with no background in science, has been gathered by an unhinged obscenely wealthy guy, to ferret out “waste” in the government (Department of Government Efficiency—DOGE)) and the NICHD has been among those targeted. The DOGE team’s mission is to selectively gut an agency staffed by dedicated scientists and civil servants. Round two likely will be to fashion a new system from scratch based on ideas from a President who once suggested drinking bleach might be a good way to treat Covid.

A more measured approach would be to thoughtfully identify, with evidence, where the existing system can be improved without messing with the ongoing studies whose missions have been to make life better. Arbitrarily stuffing a study in midstream is devastating but even pausing it can set back progress for months or even years. A similar Covid-related pause in a study involving fetal growth restriction at the University of Colorado delayed important results from being aired for two years.

These massive cutbacks also will permanently damage the infrastructure of the agency. Replacing the laid off scientists and staff will not be easy. How do you recruit new scientists when their fates will be at the fancy of an administration whose MO is “ready-shoot-aim”?

Since January there have been many issues to be upset about but this one will affect the health of you, your family and the nation for years to come. Protest can work. Please let your local and national representatives know how you feel about this!

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