In March 2025, the US National Institutes of Health (NIH) began terminating thousands of research grants. Under the instructions of the administration of US President Donald Trump, projects were targeted for a variety of reasons. Some addressed diversity, equity and inclusion (DEI); others explored COVID-19. A few were axed because they involved international collaboration.
These directives were not scientifically grounded and remain legally questionable. In a ruling in June, a federal judge described the terminations as “arbitrary and capricious” and ordered a partial reinstatement of grants.
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NIH programme staff, including myself, have had to work with grantees to align their research with the administration’s ideological agenda, which often meant removing or changing the project’s goals and terminology. I remember spending an hour on a video call with one investigator, trying to make sense of what these changes meant for his research — and the next hour crying at my desk.
At the US National Institute on Drug Abuse (NIDA), where I was the chief of the behavioural and cognitive neuroscience branch, these changes have challenged the core of our research. How can substance-use disorders be studied effectively without accounting for the social contexts in which they develop and persist? I could not, in good conscience, comply with what was being asked of us — nor could I ask my staff to do so. Therefore, I made the difficult decision to resign from my position in June.
During my ten years working at the NIH, I’ve seen the agency’s approach to studying addiction evolve to incorporate the social determinants of health. Last September, I presented to the NIDA’s advisory council the promising steps that the institute had taken to better integrate factors such as structural racism and the role of neighbourhood resources while developing interventions for substance-use disorders.
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Previous frameworks, for instance, often pinned high rates of alcohol-use disorder in Indigenous US populations to innate factors, such as genetics. Such purely biogenetic explanations can increase public perceptions that individuals with these conditions are inherently dangerous or beyond help (A. Loughman and N. Haslam Cogn. Res. Princ. Implic. 3, 43; 2018), and fail to offer the nuanced understanding needed to develop effective, real-world interventions.
Recognizing the powerful influence of social and structural factors — such as systemic racism — in shaping health outcomes could lead to more-relevant clinical insights. Indeed, the NIDA’s 2022–26 strategic plan affirmed that: “Understanding the role of racism on substance use and its outcomes is essential to our mission.”
In line with this commitment, the NIDA Racial Equity Initiative (REI) launched five sets of funding opportunities in 2022 to support rigorous, community-partnered research. The resulting projects were unprecedented. One combined neuroscience methods — including brain imaging and behavioural assessments — with new cultural measurements to study how cultural ideas, conventions and social environments influence a person’s vulnerability to addiction.
Yet, by June, all these encouraging projects had been halted. The REI notices of funding opportunity had been withdrawn. A whole body of groundbreaking health-equity-related research is being disappeared.
