The U.S. clearly has health challenges. These have been well documented by the Commonwealth Fund1 and others2, through international comparisons of health system performance. Those assessments show that the U.S. fares poorly on indicators related to access, quality, and outcomes as the NIH faces proposed budget reductions. For example, data from the Organization for Economic Cooperation and Development (OECD) shows that avoidable mortality rates in the U.S. were 368.6 per 100,000 population compared to 161.5 in France, 194.6 in Germany, 167.8 in the Netherlands, and 361.8 in Estonia.3

The Trump administration, under the Department of Health and Human Services (DHHS) Secretary Robert F. Kennedy, has correctly highlighted the fact that chronic diseases are an important contributor to American health challenges. They have also noted that diet, nutrition, and substance misuse are important factors working through obesity and exposures to toxins that are associated with diabetes, heart disease, overdoses, and other disabling conditions. Evidence also suggests that dementia, cancer, influenza, pneumonia, and suicide remain sources of mortality and reduced well-being.4

Many of the proposed policies of the Trump administration and Secretary Kennedy may serve to reshape the U.S. role as the world leader in advancing biomedical science and the development of new treatments through investments at the National Institutes of Health (NIH) and other federal science agencies. The administration has also put at risk the traditional role of DHHS in promoting public health domestically as well as identifying and helping to treat diseases in low-income nations. For example, over 95% of new drugs were derived from research supported by the NIH.5

The administration’s first budget and the NIH facing this proposed budget reduction offers insights into the policy aspirations of the new administration with respect to health, public health, and biomedical science policy.6

The discretionary budget of DHHS serves to support the research activities and the direct investment in treatment capacity and services. The discretionary DHHS budget calls for departmental spending of $95.4 billion in 2026 compared to $128.7 billion in 2024 and $127.6 billion in 2025.7

Read the full article about the NIH's proposed budget reduction by Richard G. Frank at Brookings.