Professor Steven Kahn

A sharp slowdown in US biomedical research is beginning to take hold, with fewer grants awarded and key funding calls disappearing, as researchers warn a series of changes introduced under the Trump administration are beginning to reshape the system from within.

In a strongly worded editorial in Diabetes Care [link here], editor-in-chief Professor Steven Kahn and colleagues said targeted funding calls have collapsed by nearly 90%, while grant awards have fallen by about two-thirds, with funding to investigators cut by more than half.

Behind those figures, they argue, is a deeper shift in how research is being governed.

Advisory councils that traditionally provide independent scientific oversight are operating below capacity or facing delays, while decisions about what research gets funded are increasingly being drawn into central administrative control. Since mid-2025, the authors said, the appointment process for these councils has taken a “worrisome turn”, moving away from longstanding nonpartisan vetting toward more direct oversight by the Department of Health and Human Services (HHS).

At the same time, changes to how grants are funded are narrowing the number of studies that can go ahead.

Under new rules introduced in late 2025, multi-year grants must now be funded in full upfront, rather than allocated year by year – a shift the authors said could reduce the number of funded projects by about 40% and leave fewer resources available for new research.

“Multi-year funding clearly is a tool being used by the administration that will markedly and quickly deplete congressional appropriations, put at risk available funds for innovative science in future years, and limit vital research funding for current investigators,” they wrote.

Fewer calls, less direction

One of the clearest signals of change has been the collapse in targeted funding calls. Over the first 13 months of the current administration, the National Institutes of Health (NIH) issued just 84 Notices of Funding Opportunities, compared with 787 the year before.

These calls are used to steer research into priority areas – from early-stage discovery through to large, multi-centre clinical trials – helping build momentum in fields where new evidence is needed most.

But the editorial said that mechanism is now weakening. Approval for funding calls, once handled at the institute level by expert advisory councils, has shifted to the NIH director’s office and HHS, contributing to “severe delays or even disapprovals”.

“By moving away from specific funding opportunities… agencies lose the ability to cultivate expertise in emerging or rare fields or to address research gaps,” the authors wrote.

A system contracting

The impact is now showing up in grant activity.

Analysis of NIH funding over the first five months of the 2026 fiscal year suggests a sharp contraction, with the number of grants awarded falling from nearly 3,000 to fewer than 1,000. Over the same period, funding to researchers dropped from just over $1.3bn to around $600m.

The scale and speed of the decline point to more than routine fluctuation, the authors said, instead reflecting structural changes that are beginning to constrain both ongoing research and new studies.

What could be lost

For diabetes researchers, the concern is not just about individual grants, but about the types of studies that can be sustained.

“The actions of the Trump administration are reducing opportunities for NIH to implement and fund multicenter consortia, specialized research centers, and large networks and to conduct long-term, sustained programs to address complex issues, including those in diabetes,” the authors wrote.

Large, coordinated programs – including landmark trials such as the Diabetes Control and Complications Trial and the Diabetes Prevention Program – have depended on long-term funding, targeted calls and coordinated oversight. Their findings have shaped clinical care, from how tightly blood glucose is controlled in type 1 diabetes to how type 2 diabetes can be prevented.

Without those structures, the authors warn, the system becomes less able to support complex, collaborative research or respond to emerging clinical challenges.

“We must all act now”

While the editorial focuses on diabetes, the authors say the implications extend across all areas of biomedical research.

They warn that a combination of funding constraints, administrative changes and weakened oversight risks reversing decades of progress in health care innovation – and undermining the US’s position as a global leader in science.

“It is no longer enough to stand idly by or work behind the scenes with lawmakers,” they wrote, urging clinicians, researchers and organisations to speak out publicly. “Now is the time to recognise and fight to reverse the spiralling fall” in the nation’s research capacity.

“A few brushes of a pen… are rapidly destroying what generations have built,” they added. “We can no longer afford complacency and fear. We must all act now.”