Hey Peter, Here’s What To Do With Your Billions

Hey Peter, Here’s What To Do With Your Billions

By

Leonard Zwelling

https://www.nytimes.com/interactive/2025/12/02/upshot/trump-science-funding-cuts.html

The tenuous state of research in all areas of science and medicine is well described in this article from The New York Times web site on December 2 by Aatish Bhatia, Amy Fan, Jonah Smith, and Irena Hwang. If you can read it on-line, do so. There are easy-to-understand graphics displaying the trends in funding over the past ten or so years (rising) and then the fall off since Trump 2.0 began. This is true of NIH grants, NSF grants, and fellowships. Grants involving diversity have been axed completely. I’ve seen the letters PIs have received. They were unnecessarily demeaning and cruel. The Trump crew has no class.

I think this is yet another example that the heathens have taken over the palace and the barbarians have breached the gates. This appears to me to be the imposition of a policy fearful of the new and clinging to old ideas. The problems are two.

First, the United States has had the leadership role in translating research into medical advances for decades. This is how we lose our leadership position to China. In essence we stop investing and reap fewer dividends.

Second, our population will not have the access they have always had to the newest medical innovations and new medicines that prolong life and relieve suffering. If they do not get access from the U.S., they will get the new drugs from China at a hefty price with or without tariffs.

The question is why would the Trump Administration want to decrease research particularly in biomedicine? New drugs and new devices mean more jobs and more wealth generated in the United States as well as a healthier population. Who could oppose that?

Clearly Mr. Trump and those around him either think they know better than the current experts as to how to invest research dollars or they fear the power of the current research community rising against them. It is not power the Trump people understand and it is not a power that respects the Trump Administration after the drastic cuts by DOGE.

The good news for the scientists of MD Anderson is that President Pisters has raised $1.9B on his way to $2.5B. Here’s my question. How much of that will be used to backfill the losses experienced by MD Anderson scientists whose grants have been eliminated or whose grants were in the 5^th percentile when funding stopped at the fourth?

I understand that Dr. Pisters has hospitals to build in both Austin and Houston and staff them. I am not sure I see how he does the latter even with all the money in the world. Are there enough doctors and nurses willing to come to Houston and how many will be able to get to the United States with its new immigration policies? Will they be of sufficient quality to maintain MD Anderson’s as number one for cancer care?

What if, instead of building more structures, we invest in research that will eliminate the need for cancer hospitals entirely? Wouldn’t that be something!

Even just 10% of the $2.5B would probably sustain current researchers, defray the shortfalls that are the fallout from NIH cuts, and allow the recruitment of the best scientists in the country seeking a respite from writing ten grant applications just to have one succeed.

I think that the shift to working from home must have freed up some space in the current Anderson buildings. How much space do we need? I’ll bet the Boat Building (the good ship Mendelsohn) is half empty although repurposing it for research would be hard and expensive.

I know everyone in Houston and Austin has his heart set on a new and bigger MD Anderson hospital. (I wonder whose name will go on these new buildings.) But investing in bricks and mortar, while possibly filling the institutional till with patient care revenue will not speed the fulfillment of the MD Anderson mission—eradicating cancer. Research will.

Dr. Pisters, I think your plan includes dollars for research. How much? How soon? For how long? For what type of research?

I’d like to hear the specific plans. Wouldn’t you?

Here’s one idea that would win you kudos from every faculty member doing research.

One of the attractions of MD Anderson when I was being recruited in 1984 was the fact that I did not have use any grant money I was able to raise to pay my own salary. The institution valued me enough that it would cover my salary. That was true of me and all the rest of the MD Anderson faculty—those seeing patients, those doing bench lab, and those doing both.

It was John Mendelsohn, in a foolish maneuver he believed would increase the quality of research at Anderson, who first mandated salaries on grants. He felt that if you couldn’t raise your salary through NIH, ACS, or other funding, you were not of sufficient caliber to work at MD Anderson. So rather than make the assessment of the value of a faculty member’s research contribution himself or use an internal committee to do so (like the Promotions and Tenure Committee), he deferred to NIH Study Sections. Now the institution is stuck with this foolishness at a time when the expected pay line for NCI grants is the fourth percentile.

So, Dr. Pisters, how about rolling back the poor idea Mendelsohn had and support all faculty salaries with some of the billions you have already raised. The entire funding model for research is collapsing. Institutions are going to have to find ways to support investigators and their labs if academic medicine is to include laboratory research as part of its mission. If academic medicine is forced to go the way of private medical practice and literally be corporatized into a healthcare-industrial complex where the only coin of the realm is the RVU, why would a young physician-scientist bother going into academics at all? You may as well become an employee of a large healthcare delivery system or work for the pharmaceutical industry.

Academic medicine is under attack. Dr. Pisters has the wherewithal to stem the tide at Anderson. But if all the money he raised goes into buildings, it will undoubtedly be some researcher who is the one to turn out the lights in those buildings and on academic medicine as we know it.

How sad.