Science
Contributor: Slashing NIH research guarantees a less healthy, less wealthy America
In recent months, funding for biomedical research from the National Institutes of Health has been canceled, delayed and plunged into uncertainty. According to an April STAT News analysis, NIH funding has decreased by at least $2.3 billion since the beginning of the year. KFF Health News reports the full or partial termination of approximately 780 NIH grants between Feb. 28 and March 28 alone. Additional NIH funding cuts loom on the horizon, including proposed cuts to indirect costs.
Amid this volatility, one thing remains clear: NIH grant funding is a valuable, proven investment, economically and in terms of improving human health.
A recent United for Medical Research report shows that in fiscal year 2024, research funded by the NIH generated $94.58 billion in economic activity nationwide, a 156% return on investment. Further, the report shows that NIH funding supported 407,782 jobs nationwide. According to the NIH’s own figures, patents derived from work it has funded produce 20% more economic value than other U.S. patents.
These economic returns — including a return on investment that would thrill any startup or stock investor — cannot begin to capture the impact on individuals, families and communities in terms of increased longevity and higher quality of life.
While it is hard to precisely quantify human health improvements resulting from NIH-funded research, there are proxy measures. As one example, a study published in JAMA Health Forum found that NIH funding supported the development of 386 of 387 drugs approved by the Food and Drug Administration from 2010-19. Many of the approved drugs address the most pressing human health concerns of our time, including cancer, diabetes, cardiovascular disease, infectious diseases and neurological disorders such as Parkinson’s disease.
Many other NIH-funded advancements represent what is now considered common knowledge, such as the relationship between cholesterol and cardiovascular health, or standard practice, such as screening newborns for serious diseases that may be treatable with early medical intervention. But each of these fundamental aspects of contemporary medicine had to first be discovered, tested and proved. They represent what NIH funding can do — and the type of paradigm-shifting advancements in medicine that are now very much at risk.
Consider the biotechnology industry as one such paradigm shift. In the 1970s, Stanley Cohen and Herbert Boyer were the first scientists to clone DNA and to transplant genes from one living organism to another. This work launched the biotechnology industry.
Two decades later, the NIH and the Department of Energy began a 13-year effort to sequence the human genome, including through university-based research grants. In 2003, the consortium of researchers produced a sequence accounting for 92% of the human genome. In 2022, a group of researchers primarily funded by the NIH’s National Human Genome Research Institute produced a complete human genome sequence. This work paved the way for insights into inherited diseases, pharmacogenomics (how genetics affect the body’s response to medications) and precision medicine.
NIH funding has also led to major breakthroughs in cancer treatments. In 1948, Sidney Farber demonstrated the first use of a chemotherapy drug, aminopterin, to induce remission in children with acute leukemia. Before Farber’s research, which was funded in part by the NIH, children with acute leukemia were unlikely to survive even five years.
Over the years that followed, other modes of cancer treatment such as immunotherapy emerged, first as novel areas of inquiry, followed by drug development and clinical trials. NIH funding supported, among others, the development of CAR T cell therapy, which genetically modifies a patients’ own T-cells to fight cancer. CAR T cell therapy has improved outcomes for many patients with persistent blood cancers, and clinical trials are ongoing to discover other cancers that might be treatable with CAR T cell therapies.
For decades, scientists knew that breast cancer could run in families and hypothesized a genetic role. In the 1990s, teams of scientists — supported at least in part by NIH funding — tracked down the BRCA1 and BRCA2 genes responsible for inherited predispositions to breast and other cancers. Today, many people undergo testing for BRCA gene mutations to make informed decisions about prevention, screening and treatment.
These kinds of advancements, along with improvements in detection and screening, have meaningfully reduced cancer mortality rates. After hitting a smoking-related peak in 1991, U.S. mortality rates from all cancers dropped by 34% as of 2022, according to the American Cancer Society. For children with acute leukemias, who had effectively no long-term chance of survival just 75 years ago, the numbers are even more dramatic. The five-year survival rate is now approximately 90% for children with acute lymphocytic leukemia and between 65% and 70% for those with acute myelogenous leukemia.
These examples represent a fraction of the tremendous progress that has occurred through decades of compounding knowledge and research. Reductions in NIH funding now threaten similar breakthroughs that are the prerequisites to better care, better technology and better outcomes in the most common health concerns and diseases of our time.
It is not research alone that is threatened by NIH funding cuts. Researchers, too, face new uncertainties. We have heard firsthand the anxiety around building a research career in the current environment. Many young physician-scientists wonder whether it will be financially viable to build their own lab in the U.S., or to find jobs at research institutions that must tighten their belts. Many medical residents, fellows and junior faculty are considering leaving the U.S. to train and build careers elsewhere. Losing early-career researchers to other fields or countries would be a blow to talent for biomedical research institutions nationwide and weaken the country’s ability to compete globally in the biomedical sector.
The effects of decreased NIH funding might not be immediately visible to most Americans, but as grant cancellations and delays mount, there will be a price. NIH funding produces incredible results. Cuts will set scientific research back and result in losses in quality of life and longevity for generations of Americans in years to come.
Euan Ashley is the chair of the Stanford University department of medicine and a professor of medicine and of genetics. He is the author of “The Genome Odyssey: Medical Mysteries and the Incredible Quest to Solve Them.” Rachel Keranen is a writer in the Stanford department of medicine.
Science
Cancer survival rates soar nationwide, but L.A. doctors warn cultural and educational barriers leave some behind
The American Cancer Society’s 2026 Cancer Statistics report, released Tuesday, marks a major milestone for U.S. cancer survival rates. For the first time, the annual report shows that 70% of Americans diagnosed with cancer can expect to live at least five years, compared with just 49% in the mid-1970s.
The new findings, based on data from national cancer records and death statistics from 2015 to 2021, also show promising progress in survival rates for people with the deadliest, most advanced and hardest-to-treat cancers when compared with rates from the mid-1990s. The five-year survival rate for myeloma, for example, nearly doubled (from 32% to 62%). The survival rate for liver cancer tripled (from 7% to 22%), for late-stage lung cancer nearly doubled (from 20% to 37%), and for both melanoma and rectal cancer more than doubled (from 16% to 35% and from 8% to 18%, respectively).
For all cancers, the five-year survival rate more than doubled since the mid-1990s, rising from 17% to 35%.
This also signals a 34% drop in cancer mortality since 1991, translating to an estimated 4.8 million fewer cancer deaths between 1991 and 2023. These significant public health advances result from years of public investment in research, early detection and prevention, and improved cancer treatment, according to the report.
“This stunning victory is largely the result of decades of cancer research that provided clinicians with the tools to treat the disease more effectively, turning many cancers from a death sentence into a chronic disease,” said Rebecca Siegel, senior scientific director at the American Cancer Society and lead author of the report.
As more people survive cancer, there is also a growing focus on the quality of life after treatment. Patients, families and caregivers face physical, financial and emotional challenges. Dr. William Dahut, the American Cancer Society’s chief scientific officer, said that ongoing innovation must go hand in hand with better support services and policies, so all survivors — not just the privileged — can have “not only more days, but better days.”
Indeed, the report also shows that not everyone has benefited equally from the advances of the last few decades. American Indian and Alaska Native people now have the highest cancer death rates in the country, with deaths from kidney, liver, stomach and cervical cancers about double that of white Americans.
Additionally, Black women are more likely to die from breast and uterine cancers than non-Black women — and Black men have the highest cancer rates of any American demographic. The report connects these disparities in survival to long-standing issues such as income inequity and the effects of past discrimination, such as redlining, affecting where people live — forcing historically marginalized populations to be disproportionately exposed to environmental carcinogens.
Dr. René Javier Sotelo, a urologic oncologist at Keck Medicine of USC, notes that the fight against cancer in Southern California, amid long-standing disparities facing vulnerable communities, is very much about overcoming educational, cultural and socioeconomic barriers.
While access to care and insurance options in Los Angeles are relatively robust, many disparities persist because community members often lack crucial information about risk factors, screening and early warning signs. “We need to insist on the importance of education and screening,” Sotelo said. He emphasized that making resources, helplines and culturally tailored materials readily available to everyone is crucial.
He cites penile cancer as a stark example: rates are higher among Latino men in L.A., not necessarily due to lack of access, but because of gaps in awareness and education around HPV vaccination and hygiene.
Despite these persisting inequities, the dramatic nationwide improvement in cancer survival is unquestionably good news, bringing renewed hope to many individuals and families. However, the report also gives a clear warning: Proposed federal cuts to cancer research and health insurance could stop or even undo these important gains.
“We can’t stop now,” warned Shane Jacobson, the American Cancer Society’s chief executive.
“We need to understand that we are not yet there,” Sotelo concurred. ”Cancer is still an issue.”
Science
Clashing with the state, L.A. City moves to adopt lenient wildfire ‘Zone Zero’ regulations
As the state continues multiyear marathon discussions on rules for what residents in wildfire hazard zones must do to make the first five feet from their houses — an area dubbed “Zone Zero” — ember-resistant, the Los Angeles City Council voted Tuesday to start creating its own version of the regulations that is more lenient than most proposals currently favored in Sacramento.
Critics of Zone Zero, who are worried about the financial burden and labor required to comply as well as the detrimental impacts to urban ecosystems, have been particularly vocal in Los Angeles. However, wildfire safety advocates worry the measures endorsed by L.A.’s City Council will do little to prevent homes from burning.
“My motion is to get advice from local experts, from the Fire Department, to actually put something in place that makes sense, that’s rooted in science,” said City Councilmember John Lee, who put forth the motion. “Sacramento, unfortunately, doesn’t consult with the largest city in the state — the largest area that deals with wildfires — and so, this is our way of sending a message.”
Tony Andersen — executive officer of the state’s Board of Forestry and Fire Protection, which is in charge of creating the regulations — has repeatedly stressed the board’s commitment to incorporating L.A.’s feedback. Over the last year, the board hosted a contentious public meeting in Pasadena, walking tours with L.A. residents and numerous virtual workshops and hearings.
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Some L.A. residents are championing a proposed fire-safety rule, referred to as “Zone Zero,” requiring the clearance of flammable material within the first five feet of homes. Others are skeptical of its value.
With the state long past its original Jan. 1, 2023, deadline to complete the regulations, several cities around the state have taken the matter into their own hands and adopted regulations ahead of the state, including Berkeley and San Diego.
“With the lack of guidance from the State Board of Forestry and Fire Protection, the City is left in a precarious position as it strives to protect residents, property, and the landscape that creates the City of Los Angeles,” the L.A. City Council motion states.
However, unlike San Diego and Berkeley, whose regulations more or less match the strictest options the state Board of Forestry is considering, Los Angeles is pushing for a more lenient approach.
The statewide regulations, once adopted, are expected to override any local versions that are significantly more lenient.
The Zone Zero regulations apply only to rural areas where the California Department of Forestry and Fire Protection responds to fires and urban areas that Cal Fire has determined have “very high” fire hazard. In L.A., that includes significant portions of Silver Lake, Echo Park, Brentwood and Pacific Palisades.
Fire experts and L.A. residents are generally fine with many of the measures within the state’s Zone Zero draft regulations, such as the requirement that there be no wooden or combustible fences or outbuildings within the first five feet of a home. Then there are some measures already required under previous wildfire regulations — such as removing dead vegetation like twigs and leaves, from the ground, roof and gutters — that are not under debate.
However, other new measures introduced by the state have generated controversy, especially in Los Angeles. The disputes have mainly centered around what to do about trees and other living vegetation, like shrubs and grass.
The state is considering two options for trees: One would require residents to trim branches within five feet of a house’s walls and roof; the other does not. Both require keeping trees well-maintained and at least 10 feet from chimneys.
On vegetation, the state is considering options for Zone Zero ranging from banning virtually all vegetation beyond small potted plants to just maintaining the regulations already on the books, which allow nearly all healthy vegetation.
Lee’s motion instructs the Los Angeles Fire Department to create regulations in line with the most lenient options that allow healthy vegetation and do not require the removal of tree limbs within five feet of a house. It is unclear whether LAFD will complete the process before the Board of Forestry considers finalized statewide regulations, which it expects to do midyear.
The motion follows a pointed report from LAFD and the city’s Community Forest Advisory Committee that argued the Board of Forestry’s draft regulations stepped beyond the intentions of the 2020 law creating Zone Zero, would undermine the city’s biodiversity goals and could result in the loss of up to 18% of the urban tree canopy in some neighborhoods.
The board has not decided which approach it will adopt statewide, but fire safety advocates worry that the lenient options championed by L.A. do little to protect vulnerable homes from wildfire.
Recent studies into fire mechanics have generally found that the intense heat from wildfire can quickly dry out these plants, making them susceptible to ignition from embers, flames and radiant heat. And anything next to a house that can burn risks taking the house with it.
Another recent study that looked at five major wildfires in California from the last decade, not including the 2025 Eaton and Palisades fires, found that 20% of homes with significant vegetation in Zone Zero survived, compared to 37% of homes that had cleared the vegetation.
Science
At 89, he’s heard six decades of L.A.’s secrets and is ready to talk about what he’s learned
Dr. Arnold Gilberg’s sunny consultation room sits just off Wilshire Boulevard. Natural light spills onto a wooden floor, his houndstooth-upholstered armchair, the low-slung couch draped with a colorful Guatemalan blanket.
The Beverly Hills psychiatrist has been seeing patients for more than 60 years, both in rooms like this and at Cedars-Sinai Medical Center, where he has been an attending physician since the 1960s.
He treats wildly famous celebrities and people with no fame at all. He sees patients without much money and some who could probably buy his whole office building and not miss the cash.
Gilberg, 89, has treated enough people in Hollywood, and advised so many directors and actors on character psychology, that his likeness shows up in films the way people float through one another’s dreams.
The Nancy Meyers film “It’s Complicated” briefly features a psychiatrist character with an Airedale terrier — a doppelganger of Belle, Gilberg’s dog who sat in on sessions until her death in 2018, looking back and forth between doctor and patient like a Wimbledon spectator.
“If you were making a movie, he would be central casting for a Philip Roth‑esque kind of psychiatrist,” said John Burnham, a longtime Hollywood talent agent who was Gilberg’s patient for decades starting in his 20s. “He’s always curious and interested. He gave good advice.”
Since Gilberg opened his practice in 1965, psychiatry and psychotherapy have gone from highly stigmatized secrets to something people acknowledge in award show acceptance speeches. His longtime prescriptions of fresh food, sunshine, regular exercise and meditation are now widely accepted building blocks of health, and are no longer the sole province of ditzy L.A. hippies.
Beverly Hills psychiatrist Dr. Arnold Gilberg, 89, is the last living person to have trained under Franz Alexander, a disciple of Sigmund Freud.
(Robert Gauthier / Los Angeles Times)
He’s watched people, himself included, grow wiser and more accepting of the many ways there are to live. He’s also watched people grow lonelier and more rigid in their political beliefs.
On a recent afternoon, Gilbert sat for a conversation with The Times at the glass-topped desk in his consultation room, framed by a wall full of degrees. At his elbow was a stack of copies of his first book, “The Myth of Aging: A Prescription for Emotional and Physical Well-Being,” which comes out Tuesday.
In just more than 200 pages, the book contains everything Gilberg wishes he could tell the many people who will never make it into his office. After a lifetime of listening, the doctor is ready to talk.
Gilberg moved to Los Angeles in 1961 for an internship at what is now Los Angeles General Medical Center. He did his residency at Mount Sinai Hospital (later Cedars-Sinai) with the famed Hungarian American psychoanalyst Dr. Franz Alexander.
Among his fellow disciples of Sigmund Freud, Alexander was a bit of an outlier. He balked at Freud’s insistence that patients needed years of near-daily sessions on an analyst’s couch, arguing that an hour or two a week in a comfortable chair could do just as much good. He believed patients’ psychological problems stemmed more often from difficulties in their current personal relationships than from dark twists in their sexual development.
Not all of Alexander’s theories have aged well, Gilberg said — repressed emotions do not cause asthma, to name one since-debunked idea. But Gilberg is the last living person to have trained with Alexander directly and has retained some of his mentor’s willingness to go against the herd.
If you walk into Gilberg’s office demanding an antidepressant prescription, for example, he will suggest you go elsewhere. Psychiatric medication is appropriate for some mental conditions, he said, but he prefers that patients first try to fix any depressing situations in their lives.
He has counseled patients to care for their bodies long before “wellness” was a cultural buzzword. It’s not that he forces them to adopt regimens of exercise and healthy eating, exactly, but if they don’t, they’re going to hear about it.
“They know how I feel about all this stuff,” he said.
He tells many new patients to start with a 10-session limit. If they haven’t made any progress after 10 visits, he reasons, there’s a good chance he’s not the right doctor for them. If he is, he’ll see them as long as they need.
One patient first came to see him at 19 and returned regularly until her death a few years ago at the age of 79.
“He’s had patients that he’s taken care of over the span, and families that have come back to him over time,” said Dr. Itai Danovitch, who chairs the psychiatry department at Cedars-Sinai. “It’s one of the benefits of being an incredibly thoughtful clinician.”
Not long after opening his private practice in 1965, Gilberg was contacted by a prominent Beverly Hills couple seeking care for their son. The treatment went well, Gilberg said, and the satisfied family passed his name to several well-connected friends.
As a result, over the years his practice has included many names you’d recognize right away (no, he will not tell you who) alongside people who live quite regular lives.
They all have the same concerns, Gilberg says: Their relationships. Their children. Their purpose in life and their place in the world. Whatever you achieve in life, it appears, your worries remain largely the same.
When it’s appropriate, Gilberg is willing to share that his own life has had bumps and detours.
He was born in Chicago in 1936, the middle of three boys. His mother was a homemaker and his father worked in scrap metal. Money was always tight. Gilberg spent a lot of time with his paternal grandparents, who lived nearby with their adult daughter, Belle.
The house was a formative place for Gilberg. He was especially close to his grandfather — a rabbi in Poland who built a successful career in waste management after immigrating to the U.S. — and to his Aunt Belle.
Disabled after a childhood accident, Belle spent most of her time indoors, radiating a sadness that even at the age of 4 made Gilberg worry for her safety.
“It’s one of the things that brought me into medicine, and then ultimately psychiatry,” Gilberg said. “I felt very, very close to her.”
He and his first wife raised two children in Beverly Hills. Jay Gilberg is now a real estate developer and Dr. Susanne Gilberg-Lenz is an obstetrician-gynecologist (and the other half of the only father-daughter pair of physicians at Cedars-Sinai).
The marriage ended when he was in his 40s, and though the split was painful, he said, it helped him better understand the kind of losses his patients experienced.
He found love again in his 70s with Gloria Lushing-Gilberg. The couple share 16 grandchildren and seven great-grandchildren. They married four years ago, after nearly two decades together.
“As a psychoanalyst or psychiatrist ages, we have the ability, through our own life experiences, to be more understanding and more aware,” he said.
It’s part of what keeps him going. Though he has reduced his hours considerably, he isn’t ready to retire. He has stayed as active as he advises his patients to be, both personally (he was ordained as a rabbi several years ago) and professionally.
For all the strides society has made during the course of his career toward acceptance and inclusivity, he also sees that patients are lonelier than they used to be. They spend less time with friends and family, have a harder time finding partners.
We’re isolated and suffering for it, he said, as individuals and as a society. People still need care.
Unlike a lot of titles on the self-help shelves, Gilberg’s book promises no sly little hack to happiness, no “you’ve-been-thinking-about-this-all-wrong” twist.
After 60 years working with Hollywood stars and regular Angelenos, Gilberg is ready to share what he’s learned with the world.
(Robert Gauthier / Los Angeles Times)
His prescriptions run along deceptively simple lines: Care for your health. Say thank you. Choose to let go of harmless slights and petty conflicts. Find people you belong with, and stop holding yourself and others to impossibly high standards.
“People have the capacity to self-heal, and I have become a firm believer in that. Not everyone needs to be in therapy for 10 years to figure it out,” he said. “A lot of this is inside yourself. You have an opportunity to overcome the things and obstacles that are in you, and you can do it.”
So what is “it”? What does it mean to live a good life?
Gilberg considered the question, hands clasped beneath his chin, the traffic outside humming expectantly.
“It means that the person has been able to look at themselves,” he said, “and feel somewhat happy about their existence.”
The best any of us can hope for is to be … somewhat happy?
Correct, Gilberg said. “A somewhat happy existence, off and on, which is normal. And hopefully, if the person wants to pursue that, some kind of a personal relationship.”
As it turns out, there is no housing in happiness. You can visit, but nobody really lives there. The happiest people know that. They live in OK neighborhoods that are not perfect but could be worse. They try to be nice to the neighbors. The house is a mess a lot of the time. They still let people in.
Somewhat happy, sometimes, with someone else to talk to.
It is that simple. It is that hard.
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