Now, apparently political appointees of U.S. President Donald Trump have been “flagging and freezing policy-focused grant applications” to the U.S. National Institutes of Health. (Photo by Wesley Lapointe/For The Washington Post via Getty Images)
The Washington Post via Getty Images
Would you rather have health policy guided by or not guided by scientific evidence—you know real facts and stuff like that versus just someone’s opinion? If it is the former then you may as a policy want to pay close attention to what’s happening at the US National Institutes of Health to policy-focused grant applications. The NIH has long funded such studies for researchers to gather and assess such scientific evidence for policy-makers to then use. But that policy may already be in the process of changing.
Political Appointees Have Been Flagging And Freezing Policy-Focused NIH Grant Applications
Now, apparently political appointees of U.S. President Donald Trump have been “flagging and freezing policy-focused grant applications,” in the words of Max Kozlov reporting for Nature. That’s included applications that had already been approved by scientific peer reviewers and NIH staff members. Doing so after the fact would be kind of like flagging and freezing the 2024 Paris Olympics all-around gold medals that U.S. gymnast Simone Biles and Japanese gymnast Shinnosuke Oka have already won.
Has ‘Policy’ Become A Banned Word For NIH Grant Applications?
Not only that. It looks like the p-word might have become a dirty word at the NIH. Last year, I detailed in Forbes how mentioning any of 197 words like “women”, “female”, “bias” snd “race” somewhere in your grant proposal to a federal agency like the NIH or the National Science Foundation could get your proposal flagged and further scrutinized under the Trump administration. Of course, if artificial intelligence is being used to screen federal grant applications, one option might be to replace highly controversial words like “women” with something like “those people who would rather have the toilet seat down,” because AI may not have figured that out yet.
Regardless, it looks like a similar thing is now happening with the word “policy.”Kozlov reported how “Dozens of applications have since been sent back to NIH programme officers in charge of the proposals, instructing them to remove the word ‘policy’ and its derivatives and determine whether the proposals can be salvaged.” It’s not clear whether this just applies to p-word policy or if synonyms of “policy” such as rule, guideline, procedure, law, regulation, strategy and custom are no-no words as well.
Policymakers May Not Be Considered A Stakeholder Group Within NIH’s Mission
Kozlov mentioned something else at stake as well: whether the NIH even continues to consider policymakers as a relevant stakeholder group for health. In this case, stakeholder doesn’t refer to someone who holds a piece of meat in his or her hand. Dictionary.com defines stakeholder as “a person or group that has an investment, share, or interest in something.” Kozlov cited internal NIH documents obtained by Nature as stating the following: “Policymakers are not considered a stakeholder group within the scope of NIH’s mission. NIH-funded research must empower decision-making by NIH mission-relevant stakeholder groups.” The documents then listed such “relevant” stakeholder groups as being patients, health-care workers, hospitals and scientists. I have reached out to contacts at the NIH to get further clarification on all these aforementioned actions and the reasons behind them.
To clarify, a policymaker is anyone who makes policies since that’s how words work. Policies are the rules, laws, and plans that determine how things work and run. Policymakers consist of elected leaders like the U.S President, governors, mayors, and Congress members, appointed officials like Presidential cabinet members and heads of government agencies, civil servants like various government employees and advisors, judges, business leaders like company executives and board members and leaders of different organizations such as schools, hospitals and community groups.
It seems a bit odd to exclude such people as relevant stakeholders when determining what to do health-wise. After all, would you say that when it comes to a sports team the relevant stakeholders are the players but not the coaches and owners? Or with a business, would you tell the employees, “You decide what to do about fixing everything, just don’t involve the executives” with a straight face?
Policymakers Affect Most Of The Biggest Issues In Health
It is, in fact, hard to find any issue in health that is not significantly affected by policymakers and policymaking in some way. As has already been clearly demonstrated, dealing with climate change, pollution and gun violence, for example, requires action from policy makers. The risks of obesity, heart disease, diabetes, cancer and other chronic conditions depend heavily on factors beyond the control of patients, health-care workers, hospitals and scientists such as what’s in the environment, buildings, healthcare systems, food and objects used on a daily basis.
Keeping policymakers out of any scientific evaluation of a health issue would not be scientific indeed because it would overlook a potential major part of that issue. Governments, businesses and other organizations are responsible for the distribution of many things that affect health such as vaccines, medications, medical devices, food, resources and money. And the COVID-19 pandemic showed how lack of proper government action can lead to thousands and thousands of deaths as well as many other getting hospitalized and chronically disabled by long COVID. If you want to fix any system, you’ve got to consider all parts of that system.
Policy-Focused Scientific Studies Are Not The Same As Lobbying
Some have lobbied against policy-related studies claiming that it is like political lobbying. Well-constructed scientific studies should be very different from lobbying, though. Political lobbying is when you directly try to influence a decision maker, whether it’s a particular federal employee or U.S. Congress member, to vote or act in a particular manner. That’s very different from conducting a transparent scientific study that provides evidence that everyone can see and evaluate to support policymaking.
Without such scientific evidence, you’ve got to then wonder how health-related policy may end up being made. Will it instead be based purely on what certain political or business leaders want? Will this allow certain leaders to simply say, “So it’s been said, so it will be done or not done” rather than having to present independently-collected evidence?
Peter J. Hotez, MD, PhD, dean of the National School of Tropical Medicine and co-author of the book Science Under Siege: How to Fight the Five Most Powerful Forces that Threaten Our World with Michael Mann, MS, MPhil, PhD, has been warning about how authoritarian leaders can suppress scientists and others who may provide facts and evidence that counter what the leaders say. I’ve also covered in Forbes other moves made since January 2025 to give the U.S. President and his appointees much more control over federal funding and the work produced by it. This has included a new White House Office of the Management and Budget rule and significantly reducing the role of scientific peer review in the grant application selection process.
If flagging and freezing policy-related grant applications has indeed become an NIH policy, it should be clearly stated to everyone why. And scientists, patients and the rest of the public should have the opportunity to weigh in on such a policy and examine the evidence of how it may affect society. That would be the open and scientific thing to do. Otherwise, the risk is that many health-related policies will no longer be anywhere near the “Policy of Truth.”