How to Lose a War We Were Winning: The Trump Administration’s Assault on Cancer Research

For three decades, America has been quietly winning one of humanity’s grimmest battles. Since 1991, the US cancer death rate has fallen by roughly a third—translating into more than 4–4.5 million lives not cut short, thanks to better prevention, earlier detection, and treatments born in publicly funded labs. As of the latest tallies, the American Cancer Society reports a 34% decline in mortality through 2022, with momentum continuing into 2024—progress built on stable NIH and NCI support, clinical trials infrastructure, and hard-won scientific collaboration. 

Which brings us to 2025, where this administration has decided to “reform” that success with a chainsaw. The White House’s FY26 blueprint proposes nearly 40% cuts to NIH (down to $27.5B), with a plan to collapse 27 institutes into eight and outright eliminate the National Institute on Minority Health and Health Disparities, the Fogarty International Center (our global research lifeline), the National Center for Complementary and Integrative Health, and the National Institute of Nursing Research. Let’s be clear: slashing grants and ripping out whole institutes doesn’t streamline discovery—it strangles it. 

Congress, to its credit, is balking. Both chambers have moved to reject those NIH cuts and even nudge NCI modestly upward in their counterproposals. But while that fight plays out, agencies are whipsawed: hiring freezes, delayed paylines, and canceled projects reverberate through labs and clinics. Oncology leaders are already warning about slowed trials and lost talent—“brain drain” you don’t fix with a press release. 

And it’s not just health. The administration has opened a second front against the broader scientific enterprise—because why stop at undermining cancer research when you can kneecap the whole ecosystem that feeds it? The NSF (which bankrolls the basic biology, computing, and engineering that tomorrow’s cancer cures will need) is staring down massive reductions, and a federal judge just allowed the administration to revoke over $1 billion in active NSF grants, abruptly gutting ~1,600 projects. Pull enough Jenga blocks out of basic science and your “moonshots” crash back to Earth. 

Meanwhile, the “health policy” coming out of HHS looks like it was workshopped on Facebook circa 2015. There’s the White House-promoted “Make America Healthy Again” report, long on culture-war talking points and short on actionable regulation, and—buckle up—a no-bid contract to study a debunked “vaccine–autism” link. Pouring taxpayer money into questions science settled years ago isn’t skepticism; it’s sabotage by distraction. Every dollar spent relitigating myths is a dollar not funding the next immunotherapy, early-detection blood test, or trial that adds years to a patient’s life. 

If you’re asking “why do this?”—the answer sits in the fine print and the footnotes of movement documents like Project 2025, which openly toy with converting NIH’s competitive, peer-reviewed grant system into state block grants and imposing political leashes on science leadership. Dismantle the independent grant pipeline and you replace “best ideas win” with “best-connected ideas win.” That’s not reform; that’s patronage. 

Now, let’s connect the dots. Cancer progress is cumulative and fragile. You don’t get a 34% mortality drop by accident; you get it through decades of stable funding, global collaboration (Fogarty), attention to disparities (NIMHD), and a pipeline where basic discoveries (often at NSF-funded labs) flow into translational trials (NIH/NCI) and then into practice. Tear out any of those rungs and fewer drugs reach patients, trials enroll slower, and rural and minority communities see the gains stall first. This is how you strategically dismantle a public good while insisting you’re just “cutting waste.” 

The cost isn’t abstract. When paylines fall and institutes vanish, junior investigators leave the field, trials close, and patients wait—sometimes until it’s too late. That “wait” shows up years later as flatter survival curves and the obituary nobody will link back to a 2025 budget line. Cancer doesn’t care that a politician “disagrees” with peer review. Cancer cares whether that next-generation KRAS inhibitor, CAR-T tweak, or AI-guided screening model gets funded now. 

So what do we do? First, name the thing: these are not reforms, they are cuts—to science capacity, to equity, and to Americans’ odds of surviving cancer. Second, keep the pressure on Congress—because right now they’re the sandbag between the lab bench and the flood. Third, defend the guardrails: independent peer review, stable multi-year commitments, and yes, the unglamorous infrastructure of global collaboration and training. That is how you save lives at scale. 

We were winning this war. If we let political theater defund the labs, dismantle the institutes, and chase conspiracy theories with our research dollars, we’ll learn the oldest lesson in public health the hard way: progress isn’t permanent—unless you keep paying for it.

Julie Bolejack, MBA