A Trump administration plan to change how the National Institutes of Health pays for medical research at universities and other institutions has sent shock waves through labs around the country.
Dr. Donald Milton's lab at the University of Maryland, which studies how respiratory viruses spread, faces a threat to its funding and staffing if the new policy goes through.
The centerpiece of his lab is a contraption inside a booth with plastic windows: A giant silver cone that resembles the horn of an old-fashioned gramophone is hooked up to a tangle of wires, tubes and cables.
This is the Gesundheit II, a research tool that collects and measures particles in people's exhalations (or sneezes).
"We have people come in who have flu or other respiratory infections. The person sits with their face in the cone and the air around them is drawn into the cone," says Milton, a professor of environmental health at the university's School of Public Health in College Park, Md.
The device is one way that Milton and his colleagues study how respiratory viruses like the flu and COVID-19 spread from one person to another.
"That's a big important question because how you stop transmission depends on how that's happening," he says.
But Milton says his work is threatened by the Trump administration proposal to cap indirect costs associated with medical research like his at 15%. His university has been getting about 56%.
"It would be really bad for our work," Milton says. "It would slow us down. It may prevent us from continuing the work in the longer run."
The NIH, which is also reeling from the layoffs of about 1,000 workers in the agency's Bethesda, Md., campus, is the world's largest public funder of biomedical research. The agency spends most of its $48 billion annual budget on research outside the agency, including about $9 billion in indirect costs.
"Since World War II the United States built up the world's most effective and successful research enterprise anywhere in human history," Milton says. "And we did that because the federal government supported the infrastructure that makes research possible. And that's what the indirect costs do. Without that, the whole thing crumbles."
The Trump administration says many institutions could cut bloat or use their endowments to cover those costs. That would allow the NIH to use the $4 billion in savings to pay for even more research outside the elite academic enclaves, the administration says.
Some outside experts agree.
"Rates should be reasonable for universities to cover their overhead and allow more of NIH's budget to be directed towards actual scientific research," says Avik Roy, president of the Foundation for Research on Equal Opportunity, a conservative think tank.
"The majority of people who apply for NIH funding are directed. So by directing more of the funding to scientists we can actually fund more meritorious research," he says.
A federal judge in Boston temporarily blocked the plans to cap NIH funding of indirect costs on Feb. 10, after two lawsuits charged the change would violate federal law. U.S. District Court Judge Angel Kelley is expected to rule any day about whether the cap can go into effect. Lawyers representing the Trump administration, 22 state attorneys general and a coalition of universities, medical school, research hospitals and others presented their arguments for and against the blanket cap during a two-hour hearing on Friday.
If the plan is not stopped, Milton estimates he would lose about $1.1 million of his $3.3 million in NIH funding, forcing him to lay off up to half of his 21-member team.
"That's what has people on edge," Milton says. "It's so hard to know what's going to happen."
The Gesundheit II is just one piece of equipment in just one of the labs that the NIH funds, where Milton and his colleagues conduct their research.
"We are having to replace pieces of our Gesundheit II because it's now going on 20 years old and, you know, stuff wears out," Milton says.
In fact, Milton says about one-third of what he gets from the NIH goes for indirect costs.
"The lights, the maintenance on the machinery, the heat, the air conditioning, the clerks who send out payment bills," he says.
The funding change is just one reason staff at the NIH are on edge. They're also nervous about the confirmation of Robert F. Kennedy Jr., a frequent critic of the agency, to run the Health and Human Services Department, which oversees the NIH. Dr. Jay Bhattacharya, another NIH critic, is President Trump's pick to be the next NIH director.
The NIH is also trying to get the the White House to lift a freeze that's been imposed on the agency on posting any notices in the Federal Register. That freeze is blocking the NIH from convening any new meetings, which is necessary for the agency to move forward with any new grant proposals, halting billions in research funding.
Meantime, research still goes on at Milton's lab. A feverish student arrives to have his blood drawn, nose swabbed, saliva collected and take a turn in the Gesundheit II.
"Are you still doing all right?" one of Milton's assistant asks the student once he's in position. "Could I have you recite the alphabet slowly for me into the cone?"
The goal of this experiment is to help figure out how to protect people against potential threats that could cause the next pandemic, like bird flu.
"Is it airborne? Do masks work? Are there other things that we should be doing, like making sure we have good ventilation and filtration?" Milton says.
These are all questions for which scientists and the medical community would urgently like answers.
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