Prof Kogie Naidoo was leading a team of researchers trying to figure out whether people infected with tuberculosis (TB) but not yet showing symptoms might be unwitting “superspreaders” when she received notice from the US National Institutes of Health (NIH) withdrawing the project’s grant.
Now instead of wrestling with scientific problems she is trying to work out how many staff to retrench.
“People are despondent, people are depressed, the mood is very low,” said Naidoo, who is deputy director of the Centre for the Aids programme of Research in SA (Caprisa) at the University of KwaZulu-Natal. “The entire scientific environment is shaken up — it’s not as if they can go to another organisation,” she said.
Naidoo’s TB transmission study is one of hundreds of projects at SA universities and research institutions placed in jeopardy by US President Donald Trump’s actions. Not only has he purged a rapidly expanding list of NIH-funded projects deemed problematic, but he has also terminated research grants administered by the US Agency for International Development, and issued an executive order against SA freezing foreign assistance due to its stance on Palestine and its alleged discrimination against Afrikaners.
The NIH is the world’s biggest funder of biomedical research and has an annual budget of $47bn that has until now funded the work of tens of thousands of scientists in the US and in other countries. Grants are either awarded directly to SA scientists or indirectly via US researchers who subcontract with SA collaborators. It is the largest single funder of research conducted by scientists at SA universities, research councils and independent institutes, and over the past 30 years has supported the careers of hundreds of scientists, many of who are today leading figures in HIV and TB science.
In late March, Science magazine reported that acting head of the NIH Matthew Memoli had asked staff for lists of all SA-related grants, prompting fears they would all be axed.
“We are in peril, there is no question about it,” said University of Cape Town (UCT) professor emerita Valerie Mizrahi, a world-renowned TB researcher. “There are hundreds of people whose livelihoods are dependent wholly or in part on funding from the NIH. But what many people don’t understand is the tightly linked nature of research and postgraduate training: research is not a separate piece you can cleave off,” she said.
Not only does the looming funding gap jeopardise SA’s research enterprise, but it also threatens the global standing of research-intensive universities and hobbles their capacity to train the next generation of scientists, she said.
UCT is the single biggest recipient of NIH funding in SA: it had 155 NIH grants worth more than R300m a year that employed 400 staff and supported 60 post graduate students, according to data from the SA Medical Research Council (MRC). While it has received termination letters for only 21 grants, a question mark hangs over the rest.
Recipients of five-year NIH grants typically do not receive all their funding upfront, but in yearly tranches. Many researchers would have by now received their annual renewal notices, but this year there is stony silence, said MRC president Ntobeko Ntusi. Anxiety is running high that grants that are not officially terminated will simply not be renewed, he said.
NIH grants are not charity, said Ian Sanne, director of the Wits Clinical HIV Research Unit.
The work done in SA has made the US safer and more prosperous, since it has benefited the pharmaceutical industry.
— Ian Sanne, director of the Wits Clinical HIV Research Unit.
Not only do scientists have to compete against their peers to win prestigious NIH awards, but the knowledge they generate benefits patients about the globe, he said.
Over the past 30 years, six clinical trial units supported by the NIH in SA have produced ground-breaking studies ranging from preventing mother to child transmission of HIV by providing antiretroviral therapy during pregnancy, to demonstrating that the long-acting injectable lenacapravir could stop HIV transmission in its tracks.
“The work done in SA has made the US safer and more prosperous, since it has benefited the pharmaceutical industry,” he said. “The rapid response to Covid-19 — in terms of vaccine and treatment development — was only made possible because of the infrastructure developed by NIH-funded clinical trial units about the world,” he said.
SA has been at the cutting edge of global efforts to tackle HIV and TB, because in addition to having a large number of people living with these diseases, it has world-class research infrastructure and a strong regulatory system to oversee clinical trials, said Sanne.
The abrupt termination of studies in which trial participants were testing TB treatments or HIV prevention technology is not just unethical, but potentially deadly, he said. Researchers have consequently drawn on reserve funds to ensure trial participants are not abandoned, he said.
Caprisa director Salim Abdool Karim is not optimistic about the prospects for continued US funding for science, both domestically and for SA. Trump is going after established scientific institutions because he sees them as a threat, he said. “In many ways Trump’s administration has institutionalised disinformation. They do not want custodians of the truth. They do not want evidence-based scientists challenging them,” he said.
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