NIH Pauses New Funding for Grants That Include ‘Health Equity,’ ‘Structural Racism,’ Pending Review

The Trump administration is pausing new funding for National Institutes of Health grants that include terms like “health equity” and “structural racism,” pending review, according to new guidance sent to agency staff and obtained by NOTUS.

What’s more, the review must be conducted first with a “computational text analysis tool” that scans for terms “that may potentially be associated with misalignment with the administration’s priorities,” per the guidance.

No new funding will be issued to grants identified as misaligned “until the project has been assessed, and all areas of non-alignment have been addressed,” reads the memo, which was sent to staff last week.

It’s not clear what terms the tool will flag — or who specifically worked on its development. The computational tool is maintained by the National Institute of General Medical Sciences, an NIH institute, per the guidance.

Andrew Nixon, a spokesperson for the Department of Health and Human Services, said the tool “was developed to uphold gold-standard scientific rigor.”

“The review process is currently underway; however, all research activities will continue uninterrupted throughout this period,” Nixon added. He did not respond to questions about who developed the tool, what terms it will flag or whether it uses AI.

The new review guidance is the latest development in the Trump administration’s campaign to systematically identify and terminate funding for research it deems “poorly defined, non-scientific or subjective.”

NIH Director Jayanta Bhattacharya first ordered a review of all agency grants in August upon releasing an outline of the agency’s priorities. That document, titled “Advancing NIH’s Mission Through a Unified Strategy,” includes goals like “furthering our understanding of autism” and “shifting to solution-oriented approaches in health disparities research.” Bhattacharya wrote then that there was no list of “banned words.”

The new guidance appears to paint a different picture — particularly when it comes to the use of a technology designed to identify certain phrases.

The use of a computational tool instead of the expert knowledge base already within the NIH has raised concerns among staff, who tell NOTUS the process has already started and has proven to be time-consuming and tedious.

“I know someone who took hours to do this with a [primary investigator],” said an NIH employee who was granted anonymity in order to speak candidly. “Big ass hassle.”

Staff have been instructed to review all new and existing grants and cooperative agreements unless they are currently subject to litigation.

“If the text analysis tool identifies any potential aspects of the project that do not align with NIH priorities, the appropriate [institutes, centers and offices] staff must manually evaluate the award,” the guidance states.

The guidance specifically cites “health equity” and “structural racism” as terms that should be replaced with “well-defined, scientific concepts that have objective and measurable variables.”

If those changes are made, the guidance says, then the grant can “likely be renegotiated to focus on those instead.”

“For example, framing around ‘health equity’ might be refocused to emphasize studying and ameliorating a particular health disparity,” the guidance says.

But in cases where the “entire premise of the grant” relies on what the administration has deemed “subjective or poorly defined, non-scientific terms,” the guidance says it might not be possible to renegotiate the grant.

The guidance also includes stipulations on the language grants can use related to issues like gender, foreign affairs, race and ethnicity. It goes on to say that health disparities research is within the NIH’s priorities only if the area of research is “directly influenced by healthcare or biomedical science.” It gives poverty, employment and immigration as examples of areas that “would not be directly influenced by healthcare or biomedical science.”

Experts say research on the social determinants of health is crucial for understanding the full picture of what influences health outcomes in the U.S. But the Trump administration, in its quest to remove diversity, equity and inclusion initiatives from the federal government, has sought to roll back research it claims prioritizes minority groups over others.

“Please keep an eye out for grants that are overtly political in nature — for instance, take a clear political side rather than adopting a neutral, scientific approach to answering a question — and for grants that contain work that could be construed as lobbying,” the guidance says.

The guidance also says that NIH-funded research can focus on racial groups if it is “scientifically justified” — for example, if “the disease/condition could be more prevalent in a certain group,” or the effects of a potential therapy are not well-studied in that group.

Any awards found to be “fully out of alignment” with NIH priorities and unable to be negotiated must be terminated, the guidance says.

“Please remember that the [institutes and centers] will need to substantively renegotiate the project with the recipients,” the guidance says. “They are not just ‘changing words.’”