CHAPEL HILL  (January 27, 2025) — Medical and biomedical researchers across North Carolina are used to pondering some of the most vexing questions in health and biology, but a directive issued last week by President Donald Trump left many without answers when it came to the future of their life-saving and life-enhancing research projects.

North Carolina received more than $4.2 billion from the National Institutes of Health over the past two fiscal years — research dollars that are important drivers of economic activity across the state.

Mike Walden, an N.C. State University professor emeritus who has spent more than four decades studying the state economy, told NC Health News that a rule of thumb is to double that base federal grant number to get a handle on the trickle-down economic effect of that money on the state.

The projects generate research assistant jobs, needs for equipment and other capital investments. The people who fill those posts or supply that apparatus then spend money from the grant generating — under Walden’s guiding standard — nearly $8.5 billion in subsequent economic activity for that two-year period.

“If you have a grantee who spends money on equipment or who hires students or hires other people, and their income is augmented, and that gets spent in grocery stores, etc.,” Walden said.

Those are the stakes for North Carolina as researchers, administrators and others try to sort through the larger implications of action taken by the Trump administration the day after his second inauguration.

Instructions for a pause on external communications were delivered Jan. 21 to the National Institutes of Health and the Department of Health and Human Services, which includes the Centers for Disease Control and Prevention and the Food and Drug Administration, according to The Washington Post.

“As the new Administration considers its plan for managing the federal policy and public communications processes, it is important that the President’s appointees and designees have the opportunity to review and approve any regulations, guidance documents, and other public documents and communications (including social media),” Dorothy A. Fink, acting secretary of the federal Department of Health and Human Services since Jan. 20 wrote in a memo to heads of divisions and staff at her agency.

That led to a chaotic halt to the review of grant applications, the presentation of research findings and travel related to the projects. (Researchers already away from home were instructed to return there.) CNN reported Jan. 24 that NIH scientists were told the Trump directive also included a pause on all purchases.

The effects could be profound, experts said, leading to experiments being scrapped, delays in research grants getting started and in young scientists getting their careers established.

Caught off guard

Rattled researchers reached out to NC Health News via text, social media and phone last week to register their alarm and share information.

Many people were unwilling to speak for publication, fearful that their work could be in jeopardy if they spoke out publicly.

Other researchers broadcast their frustrations and concerns on social media.

Mark Peifer, a UNC Chapel Hill researcher and NIH grantee whose work focuses on cell biology, posted an email on Bluesky, a social media platform, that he sent to North Carolina’s U.S. Sens. Thom Tillis and Ted Budd. Peifer said that the U.S. “has led in biomedical research for many decades, yielding impressive improvements in treatment of cancer and heart disease, and stunning new opportunities to use gene therapy in diseases like Type 1 diabetes and sickle cell disease.”

“In the last 10 years, China has massively increased investment in science, and is threatening our lead,” Peifer added. “To remain competitive we need to continue our investment. The actions this week by the Trump Administration to shut down NIH study sections and pause funding sent shock waves through our community. We need to resume bipartisan support for NIH or lose a generation of scientists.”

Chrystal Starbird, a cancer structural biologist at UNC Chapel Hill, told NPR in a Jan. 23 report that a study section organized by the National Institutes of Health that she was scheduled to participate in this week was cancelled because of the Trump directive with little explanation.

Study sections are the peer-run groups that vet and rate grant applications from other scientists. In essence, scientists who are peers to the applicants pick apart those grant proposals, assign them numerical scores based on the merits and shortcomings of the research and then pass their evaluations back to the NIH, which has the final say.

Chemistry World reported Jan, 24 that Matthew Hirschey, a biochemist and cell biologist at Duke University, who has served as an ad hoc NIH grant reviewer for more than 10 years, only learned about the cancellation of study meetings after sending a grant proposal he was working on to a colleague.

‘That’s really jobs’

The Trump administration directive this week only underscored the uncertainty many in health and public health fields had expressed about how their work would be affected during the Trump Administration.

“North Carolina is one of the leading states in the country for research dollars, and so people just don’t know what that really means,” said Brian Toomey, retired head of Piedmont Health Services, a community health center based in Carrboro.

“That’s really jobs. It’s jobs in health care, and I think it’s important for people to know that it’s not just jobs for doctors, but it’s jobs for a lot of regular folks that will be at risk who do a lot of the regular work for this research,” Toomey added.

Toomey and Walden explained that this economic activity bolsters local economies as well as the educational entities that house the projects in no small part because research universities retain large chunks of the grant funds to cover overhead such as the costs of keeping lights on, maintaining physical plants where research occurs and all the auxiliary personnel needed to run a large institution.

At the University of North Carolina system, that totals about 55 percent of research dollars that goes to the university to cover those indirect costs.

In 2024 alone, the UNC system was on the receiving end of more than $617 million in NIH research dollars distributed beyond the Research Triangle area to UNC Charlotte, UNC Greensboro and UNC Wilmington. UNC Chapel Hill — now the ninth largest research university in the country — received the lion’s share of those NIH dollars, with more than $531 million.

In a Dec. 10 news release lauding that ranking, UNCCH Chancellor Lee Roberts said: “This achievement translates to greater impact for our state, from providing tailored health care treatments, to improving our understanding of the environment to building more resilient communities.The growth of our research enterprise and the expertise of our faculty means that Carolina will continue solving our most critical challenges.”

In a letter posted online from Jennifer Lodge, the Duke University vice president for research and innovation, she noted that the Durham campus received more than 3,300 awards, grants and contracts for fiscal year 2024 — nearly $1.33 billion in research funding, with more than $863 million coming from federal sponsors.

Universities play it close to the vest

The memo that went out to federal health agency heads last week wrapped up with an assurance that the president’s appointees “intend to review documents and communications expeditiously and return to a more regular process as soon as possible.”

Nonetheless, like many others, university administrators across the state are being circumspect about the new restrictions created by the Trump directive.

“University leadership including the Office of the Vice Chancellor for Research (OVCR) and the Office of Federal Affairs (OFA) will carefully review information as it becomes available from our federal partners to ensure that Carolina researchers are well prepared for any necessary adjustments,” UNC Chapel Hill media relations said in a statement provided to NC Health News.

Roberts, the UNCCH chancellor, told the university faculty council at its Friday meeting that the school’s vice president for research was in Washington at a meeting of research officers from universities across the country.

“There still remains a lot that is unknown,” Roberts said. ‘We have a lot of people paying attention to it, focused on it, advocating on our behalf.”

Public affairs officers at Duke University Health Sciences and the University of North Carolina medical system declined to comment to NC Health News. NC Health News also reached out to spokespeople from East Carolina University and Wake Forest University but received no response.

Some have said that this reticence to comment publicly is a reflection of the huge sums of money at stake for universities, which — like individual researchers — could fear reprisal. Former Duke University law professor Barak Richman penned a critique of university spending priorities in POLITICO last year, taking particular aim at universities that support health systems.

“Universities with health systems are better understood as health systems with universities,” he wrote. “As such, they are highly dependent on the graces and whims of policymakers, and their leaders are structurally restrained from asserting independence against, or challenging the wrongheaded politics of, elected leaders.”