Abstract for: Slashing NIH Funding: Trump’s Gamble on Science and Health

Proposed National Institutes of Health (NIH) funding cuts under the second Trump administration have raised concerns about their implications. As a key sponsor of foundational research and workforce training, NIH plays a vital role in biomedical innovation. Understanding the potential effects of these cuts is critical for policymakers. This study aims to examine how NIH budget cuts interact with broader economic and biomedical research systems, identifying potential tradeoffs. This study applies a qualitative systems modeling approach, using causal loop diagrams to examine interconnected effects that result in feedback structures. Key variables and causal relationships were extracted from studies and reports. Having fiscal deficit management theories at the core, the model incorporates evidence from innovation economics, organizational sciences, and science and technology policy through a structured literature synthesis. We identify four cycles that may amplify NIH budget cuts' effects and offset fiscal savings. First, reduced fundamental research—which accumulates to drive discoveries—could slow innovation. Second, fewer NIH-funded training opportunities may shrink the biomedical workforce. Third, greater reliance on private-sector R&D could raise healthcare costs. Finally, decreased public health investment may lead to missed disease prevention opportunities, further increasing expenditures. NIH budget reductions may have far-reaching implications for scientific progress, the biomedical innovation environment, and healthcare costs. Beyond immediate budgetary impacts, systemic interactions shaping long-term biomedical research and public health must be considered in funding policies.