Stalled funding, canceled grants: How the NIH crisis is affecting Duke

Duke has lost hundreds of millions in federal research funding this year as the courts and President Donald Trump clash over the future of the National Institutes of Health. 

Duke receives around $1.2 billion in research grants a year, and much of it comes from the NIH. In fiscal year 2024 NIH support totaled $580 million. 

“Most of the time, that's a point of pride, a marker of success, but it's also a point of challenge when that fundamental model is changing. This is what we’re dealing with now,” said Mary Klotman, executive vice president for health affairs and dean of the School of Medicine, said in the June 26 State of the School of Medicine Address.

The NIH is the School of Medicine’s primary source of revenue.

By the end of the third fiscal quarter, which ended in March, the School reported $400 million and 832 NIH awards year-to-date, representing a 20% and 18% decrease, respectively, compared to the same period in 2024. The drop is particularly notable given that the Trump administration’s actions only impacted that single quarter, from January to March.

The School has also averaged around $18 million less in total federal award dollars each month of 2025 compared to the same month in 2024 — most recently in May, it reported roughly $43 million in funding, about $20 million less than it received in May 2025. 

Duke attributed these financial losses to an increased number of grant terminations, delays in the awarding of grant funding and reductions in existing grant budgets. 

“Some of those delays are due to changes in priorities of the current administration, but some are also due to staffing reductions in the federal government, as well as … additional transactional interactions we have to have with our sponsors,” said Geeta Swamy, executive vice dean for clinical sciences & research administration, in a June 10 webinar.

As of June 26, 28 NIH grants awarded to Duke had been canceled, leaving about $96.4 million in undisbursed funds, according to Grant Watch, a public database that tracks grant cancellations reported by the Department of Health and Human Services and independent researchers. 

But recently, the NIH directed its members to not cancel additional research. Still, the funding opportunities are far from their former levels. The agency's budget has been cut by $2.7 billion thus far and the “big, beautiful bill” proposes a 40% cut to its budget for the next fiscal year.

Which grants have been targeted?

The Trump administration first announced it would target federal funding related to environmental justice and diversity, equity and inclusion in a Jan. 20 executive order. Since then, the administration has pursued eliminating funding for a wide array of topics, such as vaccines and HIV research. 

Among the 28 canceled NIH grants at Duke, the targeted research largely falls in such “equity-related” areas — and areas that the Trump administration may mistakenly categorize as such.

Ten canceled grants had explicit mentions of DEI initiatives, and two were focused on vaccine developments with no additional DEI mentions. 

The largest grant cancellation was for ACTIV-6, which was initially budgeted for over $170 million. This project, a collaboration with Vanderbilt University Medical Center, aimed to create a master clinical trial platform to evaluate repurposed drugs’ effectiveness in treating COVID-19. The grant, however, was reportedly reinstated in April via the State of Colorado v. U.S. Department of Health and Human Services, alongside three other NIH awards to Duke. 

Duke Health did not respond to The Chronicle request for confirmation on the status of the grants or say whether any additional grants were expected to be reinstated after a judge’s recent ruling that some of the NIH grant terminations were illegal. 

However, 15 of the canceled grants either had supplements promoting diversity or may have been incorrectly flagged for containing DEI initiatives because they contained words federal agencies have attempted to avoid amid Trump's initiative to remove “woke” ideology. 

Grant Watch contains a field for “tagged_words” — which matches words from a list that The New York Times reported could trigger an automatic review of grants — to words used in a grant’s title or abstract. Noam Ross, a computational researcher part of Grant Watch, told The Chronicle that Grant Watch doesn’t know exactly how grants are flagged for termination, but “suspect that these words are part of a search process for selecting them based on [The New York Times article] and other reporting.”

The 15 canceled NIH grants contained flagged words like “expression,” “disability,” “trans” and “systemic.” However, these words were not used in contexts to promote DEI initiatives, although some may have had diversity supplements including the two described below.

The grant that had the word “disability” in its abstract focused on identifying biomechanical and biological factors that lead to early onset osteoarthritis following a partial meniscectomy — a surgical procedure commonly done to remove damaged meniscal tissue following a tear. The grant had over $750,000 remaining in funding at the time of termination.

Furthermore, a grant that had both “trans” and “systemic” in its abstract was working toward editing neural circuits by engineering channel proteins to control the point of contact between two neurons. It had around $1.4 million remaining in funding at the time of termination.

In most other cases where “trans” was flagged, the term generally referred to other words with the trans- prefix, such as disease transmission, transgenic genetic material, translational studies or signal transduction.

Most notably, the NIH ended Duke’s Center for HIV/AIDS Vaccine Development, which was a $129 million program and a leader in its field. The program was in its sixth year of funding out of seven and was largely expected to be renewed for an additional cycle. Associated funding has not been listed as terminated in federal databases and thus was not included in the Grant Watch data analysis.

Duke’s response to NIH cuts

Swamy described the School of Medicine as having a lot of its “eggs in one basket,” referring to its dependence on federal money as the primary source of funding. In response to the decline in such support, the School aims to cut discretionary spending by $125 million, about 20% of their former budget, with each department of the school receiving a specific reduction target. It has also halved the target class size of its Ph.D. program, now enrolling only 76 students.

The financial strain has already led to staffing cuts. Meghan, a former research associate in a Duke medical research lab who requested to only be identified by her first name, was informed that her position was being eliminated at an annual performance review. She said lab managers had been pressured to reduce spending following the NIH funding losses, resulting in the layoffs of her and several colleagues.

Meghan says the move came without prior warning, leaving her with little ability to find a new position at Duke — a difficulty compounded by a hiring freeze that Duke instituted just days later. 

“That made it even more difficult, nearly impossible, for those of us who were laid off in one lab to find work in another lab,” Meghan said. 

Alongside the cost-cutting initiatives, the School is changing the way it funds its research.

The School is expanding its bridge funding program, which will allow philanthropic donations to assist labs that have had their federal funding decreased or cut entirely and is diversifying its research portfolio by partnering with industry sponsors and focusing more heavily on clinical research. 

The industry partnerships were announced by Susanna Naggie, vice dean for clinical research, in an April 24 webinar. They will come alongside a "package" including a commitment to a 90-day study start up, access to Duke's clinical research patient population and an initiative to leverage the use of artificial intelligence in health care and clinical research.

However, partnering with industry can raise concerns about limiting public access to research, as corporate involvement may introduce restrictions related to intellectual property and profit motives. 

Duke Health did not respond to The Chronicle’s request for updates on these initiatives.

---

---