Andy Meyers, CEO, HealthDay

Today we are joined by Dr. Alicia Zhou. Dr. Zhou holds a PhD in biological and biomedical sciences from Harvard University and completed her post-doctoral research in cancer biology at the University of California, San Francisco. Currently she serves as CEO of Cancer Research Institute. Thank you very much for joining us today.

Alicia Zhou, PhD, CEO, Cancer Research Institute

Thanks, Andy. It's nice to be here.

Andy Meyers, CEO, HealthDay

I wanted to start by dialing back a little bit to January when the National Institute of Health first started announcing their cuts to research funding.

At the time, everything was put on hold. As we've been talking to some of the people we know at the research hospitals across the country, we're kind of hearing some talk of movement, but you're right in the middle of everything. So, I really just wanted to kind of start off by... you know, getting your thoughts and getting some feedback from you, like, what are you hearing?

Are you hearing it's as draconian as it sounded like when it first started?

Alicia Zhou, PhD, CEO, Cancer Research Institute

Yeah, it's a great question. I think this is a moving target.

So, with the change of administration, there has been, and it's actually pretty normal when there's a change in federal administration that the NIH itself actually sort of pauses a lot of its activities. So, it initially happened in January. What's abnormal is that those pauses have been sort of indefinite.

There's been a really long freeze in terms of NIH activities. There's two sets of things that the NIH does for making it into grants. There's 2 types of meetings that it has to convene. These meetings are study sections and then scientific advisory council meetings.

Since the administration changed in January, both of these meetings have mostly been paused. And that means then, if you are a researcher who has submitted a grant to the NIH for a funding mechanism, it's not getting reviewed right now.

So, this has been pretty disruptive to the field. I have heard there's a bit of trickle on some of these meetings that are happening, but it's really not happening at sort of a large scale.

Andy Meyers, CEO, HealthDay

What's the impact for these delays? Like, let's forget about the cancelation, we'll address it a little bit, but like just the fact that some of this stuff is being paused, like what's the delays in funding going to mean?

Alicia Zhou, PhD, CEO, Cancer Research Institute

So, there's direct implications, which is that if these grants don't start flowing, the labs are going to have to start making headcount choices and they are going to have to tap back on personnel.

Andy Meyers, CEO, HealthDay

Is it like two weeks? Is it like four weeks? Is it eight weeks? Where are we in the process?

Alicia Zhou, PhD, CEO, Cancer Research Institute

What I've heard is that if these grants don't start being funded in the next three months, then this cutback on personnel is going to happen.

Andy Meyers, CEO, HealthDay

So now let's turn to the indirect cost issue because it's everyone's studying like this indirect cost thing. Are indirect costs really necessary? How come, you know, why is the government paying for all this stuff? Talk to us and tell us why it's important, what it is, and what's the difference between 15 and 30 percent.

Alicia Zhou, PhD, CEO, Cancer Research Institute

That's a great question. So, the indirect cost is also known as the facilities and administration costs, the F&A costs. It has always been the case that an indirect cost percentage has been added to every NIH grant that is given.

Typically, most organizations these days have indirect rates between 30 and up to 70 percent, especially some of the larger universities with really innovative large core facilities. They have a pretty high indirect rate. So why is that? What is the indirect rate paying for? There's a lot of things. Obviously, they pay for the basic facilities piece of this. They're paying for the labs themselves. They're playing for the infrastructure that sustains those labs. They're paying for sort of the shared resources that folks use.

Andy Meyers, CEO, HealthDay

You think maybe they tighten their belts a little bit? Like, what do you think about that 15% target that has been mandated and is now being challenged in the courts actually, right?

Alicia Zhou, PhD, CEO, Cancer Research Institute

I would say that if you ask anybody who works at an academic research institute today, 15% is a complete non-starter. I think 15% decimates biomedical research in the United States as we know it today. 15% will not be able to cover the basis of sort of the machine that we have built for biomedical research within the United States.

Andy Meyers, CEO, HealthDay

So, Jordan Green, a professor of oncology at John Hopkins said recently that roughly 30% of all cancer medicines that we currently have right now, these are the ones that are currently in practice. These are the one that are results of research that's come out of major medical research institutions. Do you think that's an accurate assessment of the kind of percentage that has come out of academic research. And then, you know, obviously, the big question is, like, what happens if this is cut?

Alicia Zhou, PhD, CEO, Cancer Research Institute

So, I think it's more than that. Actually, there's been analysis done, um, looking at the FDA approved drugs from 2010 to 2019. So, over the course of 10 years, there were 356 FDA approved drugs during that period of time. Of those 356, 354 of them had their origins with NIH funded research.

Andy Meyers. CEO, HealthDay

When you look at the thread of these cuts, what specific programs, what specific research are you most fearing will get cut.

You know, some people going through clinical trials are getting cut off. People who are expecting some new therapies that are about to come out. Talk to us about what that impact could be.

Alicia Zhou, PhD, CEO, Cancer Research Institute

Yeah, absolutely. And I think this is where really the rubber meets the road. And I know, having talked to the scientists who are doing the research, that in a world where they're worried about having NIH funding, they are choosing to only do the less risky projects. The projects that are getting cut are the higher risk, higher reward projects. Instead, researchers are now going to focus on the projects that they think will immediately result in a publication because those publications are important for them to show their productivity to their institutions.

The other thing that I'm very worried about is that this administration has been very clear about their views on vaccines and there has been a targeted cutback on research related to vaccines and specifically to mRNA vaccines. And for us in the cancer space, mRNA vaccines are actually... very promising for cancer vaccine research today. In fact, Moderna was developing a cancer vaccine before it pivoted to do COVID-19 vaccine work and infectious disease vaccine work during the pandemic. So, the underlying technology of mRNA vaccines actually plays a very important role in cancer vaccine development, which has been a very interesting and I would say innovative space for the last 10 years or so. So, I'm very worried that, for example, cancer vaccine research is going to get disproportionately impacted here.

For the full version of our interview on NIH Funding Cuts, please visit our Substack: https://healthday.substack.com/

NIH Funding Cuts Hit Cancer Research. What Does It Mean for Patients and Scientists?