The ability for universities to perform medical research relies largely on funding from the National Institutes of Health (NIH). The Trump administration’s recent policy changes limiting that agency’s funding would hinder research across Dartmouth’s various research institutions, and others around the country, into treatments for a range of diseases from childhood cancer to Alzheimer’s disease.
Medical leaders at Dartmouth Health, Dartmouth College and Dartmouth Cancer Center held a press conference on Feb. 14 to address the administration’s policy changes, saying cuts to NIH funding, currently blocked by a federal judge, would limit reimbursement for “indirect costs” to 15%, which is far below the current rate of 64%.
Steven Bernstein, chief research officer at Dartmouth Hitchcock Medical Center, says a rate cap of 15% “would be potentially devasting to the research enterprise here.”
Grant funding for indirect costs to carry out research are based on a formula, which are not built into the direct costs when institutions apply for a grant, Bernstein explains. “These are costs that don’t go into the direct budget,” he says, adding that indirect costs include such expenses as utilities, maintenance, facilities, and salaries for those who process grants.
Steven Bernstein, chief research officer at Dartmouth Hitchcock Medical Center (Courtesy photo)
Steven Leach, director of the Dartmouth Cancer Center, one the country’s 57 National Cancer Institutes, says the national cancer centers rely on federal grants to do research. Over the last five decades they have contributed to a 30% reduction in cancer mortality, he adds.
Overall, Leach says the proposed reduction in grant dollars effectively calculates to a 25% reduction in investment into the nation’s bio medical research sector. “This is truly life-saving work [and] at Dartmouth these cuts would impact exciting initiatives that are going to lay the groundwork for future breakthroughs in cancer research,” Leach says, explaining that rate cuts could affect research on breast cancer surgery seeking to minimize the amount of normal breast tissues removed during surgery while maximizing chances for successful tumor removal. “All of this is at risk with the proposed reductions in bio medical research.”
Dean Madden, vice provost for research at Dartmouth College and professor of biochemistry and cell biology, says Dartmouth receives nearly $100 million a year in NIH research funding and that if the indirect funding rate is capped there will be “less science, fewer breakthrough therapies and less innovation.” The research happening across various Dartmouth institutions is particularly important in addressing the needs of rural areas, he adds, which include access to healthcare and other social determinants of health.
“We have a deep commitment in our research programs to addressing issues that are particularly severe in rural populations,” he says. “This will also have a huge impact for our local region as we are the only medical school in New Hampshire, and Dartmouth Hitchcock is the only level-one trauma center within a two hour radius from Boston, Massachusetts to Burlington, Vermont.”
Madden, who also serves as the director of Dartmouth’s Institute for Biomolecular Targeting and DartCF, the Dartmouth Cystic Fibrosis Research Center, says the reimbursement for the indirect cost of research is money Dartmouth has already spent. “In asking for reimbursement we provide the government with a substantial discount on the costs we actually incur,” he says. “This is a model of efficiency. We can’t do this alone, and we can’t do it on a shoestring. If the federal government cuts its investment we will have to scale back on research. I don’t know what discoveries won’t be made as a result but it could include a cure for childhood cancer or a treatment for Alzheimer’s or dozens of other diseases.”
Prioritizing certain projects over others would be difficult, Madden says, given the interconnections between programs. “This is a holistic ecosystem and if you disrupt one part of it you can’t just operate in one corner,” he says.
Dartmouth is exploring alternative funding sources and partnerships but Maddens says this could be expensive. “I have to say, university research is really efficient, and it would be hard to go to a contract research organization or other industry and do it more cheaply there,” he says.
Bernstein says any short-term solutions would be “stop gaps” and that the potential for “damage to the American biomedical enterprise is real.”
Over the coming weeks Dartmouth research leaders say they are continuing to budget grants at full indirect rates and researchers are continuing with projects as they have been budgeted.
“Right now, we’re not looking at what kinds of projects we prioritize,” Bernstein says. “That would be a troubling thing because the nature of open science and open inquiry is scholars and scientists and investigators following their passion and tackling the questions they think are important as they effect human health. It’s hard to pick winners and losers in that way.”