A recent surge in terminations of research grants by the National Institutes of Health (NIH) is severely disrupting the landscape of critical clinical research, affecting an estimated 1 in 30 trials and involving over 74,000 participants.
These unprecedented funding cuts, which began when President Trump took office in early 2025, raise serious concerns regarding data integrity, financial waste, and the ethical responsibilities owed to trial participants.
Clinical trials represent the primary and most essential mechanism for assessing medical interventions, but their operation is known to be intensely resource-intensive.
Because these trials require sustained financial support to ensure smooth operations and the safety of participants, unexpected funding disruptions are feared to compromise ethical obligations and lead to avoidable waste.
A cross-sectional study utilized the NIH ExPORTER database to track all NIH-funded interventional clinical trials with active grants as of February 28, 2025, the date the first termination was reported.
During the study period, from February 28, 2025, to August 15, 2025, 11,008 clinical trials received NIH funding. Of these, 383 trials (3.5%) subsequently had their supporting grants terminated.
The impact was substantial, with an alarming 74,311 individuals enrolled in trials classified as “active and not recruiting” at the moment their funding was cut. These individuals may have been in the middle of receiving interventions, highlighting the potential for severe disruption.
Trials affected by funding cuts had a higher median anticipated enrollment of 105 participants, compared to 72 for those that retained funding, indicating that larger, more ambitious studies were disproportionately affected.
Furthermore, the trials that lost funding were not evenly distributed across research areas or geography. Trials focused on infectious diseases were most affected, with 14.4% experiencing grant termination.
Studies on prevention and behavioral interventions were also disproportionately affected, while neurological and reproductive health trials saw the lowest rates of termination (2.2%).
Geographically, trials conducted outside the U.S. were significantly more vulnerable to termination, with 5.8% of these trials losing funding, compared to 3.4% for U.S.-based trials.
In the U.S., trials in the Northeast were also disproportionately affected.
By trial phase, terminations were highest in phase 1 (3.7%) and lowest in phases 2-3 (0%).
When government funding was terminated, 36.1% of the 383 affected trials were already completed, but 34.5% were actively recruiting new participants.
The study acknowledged limitations, including reliance on investigator-reported data and the lack of comprehensive historical data on grant terminations before 2025.
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