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A recent report published in JAMA Internal Medicine reveals the severe consequences of the Trump administration’s earlier federal funding cuts to biomedical research. These widespread reductions led to the abrupt cancellation of 383 active clinical trials, leaving over 74,000 participants without access to vital experimental treatments, ongoing monitoring, or crucial follow-up care.
Ethical Violations and Research Setbacks Unveiled
Conducted by Harvard researchers, the study addresses a critical knowledge gap regarding the specific impact of the administration’s funding decisions on clinical research. It not only underscores the significant waste and inefficiency inherent in these cuts but also exposes profound ethical breaches, as emphasized by the editors of JAMA Internal Medicine in an accompanying note.
In March, the National Institutes of Health (NIH), operating under the Trump administration’s directives, announced a staggering $1.8 billion in grant funding cancellations, specifically targeting projects deemed misaligned with its priorities. Health care policy expert Anupam Jena and his team at Harvard meticulously analyzed an NIH database alongside a federal accountability tracking tool. Their investigation identified grants supporting clinical trials that were active as of February 28 but subsequently terminated by August 15.
Massive Impact on Active Trials and Patient Care
During this critical period, 11,008 trials were actively funded and in various developmental stages. Of these, 383 were ultimately terminated. The cancellations impacted trials across different phases:
- Early Phases: 14% were in early stages before participant recruitment.
- Recruiting: 34.5% were actively in the process of recruiting participants.
- By Invitation: 3.4% were enrolling participants by invitation.
- Completed: 36% had already completed.
- In Progress: Crucially, 11% (43 trials) were actively in progress, with participants already receiving interventions. These 43 trials alone collectively involved a staggering 74,311 participants.
Which Disease Areas Were Most Affected?
The canceled trials spanned a wide range of medical fields. Among the 383 terminated studies:
- 118 (31%) focused on various cancers.
- 97 (25%) targeted infectious diseases.
- 48 (12.5%) were related to reproductive health.
- 47 (12%) addressed mental health conditions.
While cancer trials constituted 30% of the canceled studies, these 118 trials represented only 2.7% of the 4,424 total cancer trials funded during the study period. In stark contrast, canceled infectious disease trials accounted for over 14% of all 675 funded infectious disease trials. Other categories disproportionately affected included respiratory diseases and cardiovascular diseases, highlighting a significant impact on these critical health areas.
Researchers also categorized the purpose of the terminated trials: 140 were designed for disease treatment, while 123 aimed at prevention. The authors acknowledged limitations, such as the inability to ascertain specific cancellation reasons or compare these cuts with historical trends. They noted that comprehensive data on past clinical trial terminations is scarce, largely because the “termination of federal grant funding was rare prior to 2025.”
A “Betrayal” of Foundational Ethical Principles
In a scathing editorial, Teva Brender and Cary Gross vehemently condemned the cancellations. They argued that halting trials already underway represents a profound “squander[ing of] participants’ and investigators’ valuable time, effort, and resources,” given the significant “substantive sunk costs” already invested. Beyond the economic inefficiency, they stressed that such actions “stifle scientific discovery and innovation.”
More gravely, Brender and Gross asserted that the “premature and scientifically unjustifiable trial terminations” constitute a “violation of foundational ethical principles of human participant research.” They labeled it a “betrayal of the fundamental principles of informed consent for research.” Furthermore, they warned that “participants who have been exposed to an intervention in the context of a trial may be harmed by its premature withdrawal or inadequate follow-up and monitoring for adverse effects.”
Over 74,000 trial participants placed their “health and hope” in these research endeavors. Even if funding were to be eventually restored for some of these trials, it could, “at best, mitigate the harms,” leaving a lasting negative impact on trust, scientific progress, and patient well-being.