Explainer: Why US health funding cuts are rattling Swiss science

The US National Institutes of Health is the largest funder of biomedical research in the world with an annual budget of $47 billion. (C) Arne9001 | Dreamstime.com

The Trump administration has upended funding by the National Institutes of Health (NIH) for biomedical research. This will have far-reaching implications for scientists and drugmakers, in many parts of the world, including in Switzerland.

Since taking office, US President Donald Trump has issued a litany of memos and executive orders that take aim at the way the NIH funds biomedical research. In the past month, the administration has banned communication by federal agencies, capped indirect funding by the NIH, and paused all federal grant payments.

In its latest move announced last Friday, the US government said it is terminatingExternal link NIH grants for scientists studying LGBTQ+ health, as part of its assault on diversity, equity and inclusion programmes.

Many of the moves are caught up in the courts, but scientists and drugmakers in Switzerland are already bracing for changes at the NIH and what they could mean for their own funding, and science more broadly.

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“The changes have created a lot of uncertainty for scientists everywhere,” said Adrian Wanner, a neurobiologist at the Paul Scherrer Institute in Switzerland and one of around 100 researchers involved in a major NIH-funded projectExternal link to build a detailed map of the brain of a mouse.

He was awarded $2.6 million (CHF2.3 million) in direct grants from the NIH, of which he has received about $1.7 million, to develop advanced microscopy techniques that can visualise and analyse brain structures at high resolution.

Wanner, who is expected to receive the final tranche of money in September, wonders whether there will even be a call for proposals for a second phase of the project. “No one really knows, even at the NIH, which direction the project will go,” he said.

Similar fears have been expressed by other researchers in Switzerland. How important is the NIH for biomedical research globally, and in Switzerland? An explainer.

How much of global biomedical research is funded by the NIH?

The NIH is the largest public funder of biomedical research in the world, with an annual budget of $47 billion, of which 80% is for grants for research. The rest goes to NIH-led research and administrative costs in the US.

This far surpasses funding for health research by the UK, Australia and the European Union combined. Europe’s largest research and innovation funding programme, Horizon EuropeExternal link, has a budget of €95.5 billion (CHF90.5 billion) for 2021-2027 for a range of topics that go beyond health. According to media reports, China’s National Natural Science Foundation spent around five billion yuan (CHF610 million) on health research in 2023.

The Swiss National Science Foundation is the most important public research funder in Switzerland, spending CHF432 million ($486 million) on biology and medicine in 2024.   

The largest philanthropies in health research include the Wellcome Trust in the UK and the Gates Foundation. In 2023, the latter spent around $1.8 billion on global health, but not all was for research. The Wellcome Trust invested £1.6 billion (CHF1.8 billion) in biomedical research in its 2023-24 grant cycle.

The NIH funding also outstrips what big pharma companies spend on research and development. For example, Swiss pharmaceutical company Roche spent around $14 billion on research and development in 2023, which made it the third-largest R&D spender among big pharmaExternal link.

How much of the US funding goes abroad and to Switzerland?

NIH research is already heavily America-first in the way it awards grants. Some 99% of NIH funding goes to US institutions. Over the last few years, only around $250 million a year of direct funding has gone to foreign institutions.

Swiss institutions received seven direct grants in 2024, worth around $9.1 million. Switzerland ranks among the highest NIH grant recipients when it comes to total dollar amount, although it received fewer grants than many other countries.

“It’s very difficult to get a grant from the NIH when you are outside the US,” said Wanner, who received one of the seven grants. “There’s less than a 1% chance that the NIH will award a grant to a foreign institution. You really have to show that you have something that can’t be found or done in the US.”

A deeper dive into the data shows that the NIH’s importance for global researchers goes beyond direct funding. Thousands of researchers around the world are involved as collaborators in NIH projects led by a US institution.

Swiss institutions collaborated in 489 NIH projects in 2024. One example of this is the PASAGEExternal link study, which is gathering people’s views on prenatal gene-editing therapies for rare diseases. US-based hospital Mayo Clinic is the direct grant recipient but it collaborates with several partners, including bioethics experts at the Swiss federal technology institute ETH Zurich.

This is one of nine NIH subaward collaborations ETH Zurich was involved in 2024, amounting to $285,000.

What does the NIH fund?

The NIH consists of 27 institutes and centres that fund everything from small studies on fluoride and basic science of ageing to major initiatives on addiction, cancer and maternal mortality. The NIH also offers fellowships and training grants, but these are rarely available to researchers outside the US.

Swiss institutions have received grants for a range of projects. The University of Bern was awarded close to $50 million in NIH direct grants since 2006 to investigate antiretroviral therapy and help establishExternal link the International epidemiology Databases to Evaluate AIDS in Southern Africa.

Last September, the NIH awarded the Swiss Institute of Bioinformatics in Geneva $10 million, of which $2.7 million has been dispersed, to develop a global Pathogen Data Network to improve pandemic response and outbreak surveillance.

“The ambition and risk-taking is different in the US. The NIH is willing to fund those moonshot projects,” said Wanner.

The NIH also spends around $18 billion a year on clinical research. As of March 3, there are over 7,900 clinical trials funded by the NIH, most of which were in early phases. As an example, this week Swiss firm RocheExternal link announced results from an NIH-sponsored clinical trial of its medicine Xolair against food allergies.

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NIH-funded research contributed to 386 of the 387External link drugs approved by the Food and Drug Administration between 2000 and 2019. Many top-selling drugs from Swiss pharma company Novartis, including Gleevec for various cancers and the gene therapy Zolgensma for spinal muscular atrophy, are thanks to NIH fundingExternal link dating back decades.

What impact could a cut in NIH funding have?

It’s still unclear how much NIH funding could be cut, and what priorities the NIH may have going forward.

The immediate concern for grant recipients is how they will continue to pay staff if funding stops. In Switzerland, it isn’t possible to hire and fire people on short notice. “If we lose funding, we will have to find other resources to pay the salaries of staff on the project,” Wanner said.

Researchers interviewed by SWI swissinfo.ch also said they were concerned that new criteria or requirements will be introduced on both who and what gets funded. “We don’t know if factors beyond the actual project’s achievements will be used to decide future funding,” said Aitana Neves, who leads the Pathogen Data Network at the Swiss Institute of Bioinformatics.

US officials have already started to flag projects with words such as gender, ethics and even Covid-19 in alignment with Trump’s orders.

If this is used to roll back funding, it could result in massive gaps in basic science for future drugs, vaccine development and women’s health. People interviewed also expressed fear that this could lead researchers to self-censor, seriously endangering academic and scientific freedom.

The importance of the US to science goes beyond funding itself. “Collaborations with US universities are very important to us because they are leading in many areas,” said Virginia Richter, the rector of the University of Bern. NIH funding contributes a small amount to its CHF942 million annual budgetExternal link. “It’s not about the quantity, but the quality of the research,” which would be impacted by any changes in the US.

Many research collaborations involve exchange and technology transfer to the US but also back to collaborators in foreign countries.

“I think what’s currently going on in the US could turn out to be extremely bad for science in general, because the US is a driving force in every aspect of science,” Wanner said. “It’s a role model.”

Edited by Virginie Mangin/ts