On Mar. 27, 2026, a STAT survey conducted of nearly 1,000 National Institutes of Health (NIH) -supported scientists, 25% of respondents said their research had been impacted a great deal or a fair amount by the move away from foreign subawards, and 20% said they had been affected a little. Administration officials said they acted to increase accountability and transparency, but the funding halt has disrupted clinical trials, forced scientists to alter or abandon projects, and led to a year-long pause on applications while the agency transitions to a new funding mechanism for work done in collaboration with researchers outside the U.S.

The idea of foreign subawards was to push forward projects that would be difficult to do in the U.S. alone. They enabled scientists here to work with entities abroad to do things like track viral outbreaks, recruit patients for trials of new drugs, and gain access to cutting edge laboratory instruments, techniques, or tissues, while taking on the bulk of the administrative burden, including reporting back to the NIH on any problems or progress.

Their use has been particularly widespread in global health, infectious disease research, and to support international clinical trial networks for rare cancers and genetic diseases. Last May, to “maintain national security” and better track how its $47 billion biomedical funding budget is spent, the agency abruptly put an end to renewing or issuing new foreign subawards.

One of the survey respondents was Christopher Sassetti, a tuberculosis researcher at UMass Chan Medical School, who said he has not been able to resume foreign partnerships since his NIH subawards were banned last year. In the U.S., tuberculosis is relatively rare, about 10,000 cases per year. But incidence of the disease — which is caused by airborne bacteria that replicate deep in the lungs — have been on the rise since 2021. Sassetti studies how different strains of the bacteria behave differently in human populations with diverse immune responses to infection to better understand how the bug evolves and spreads. The work has important implications for overcoming the rise of drug-resistant tuberculosis.

To pursue that work, Sassetti’s NIH grant paid for collecting blood samples from people in Lima, Peru — who carry a unique immune gene — and then infecting their cells with TB in the lab. Because of the subaward issue, his team has had to abandon that approach and work instead with genetically engineered cell lines. They don’t replicate the behavior of cells in the body as well since they are cancer cells that have been grown in labs for decades.

The project also included subawardees in South Africa who were doing a household contact study. When someone is diagnosed with tuberculosis, close contacts are monitored and blood samples taken, which allow researchers to see how the immune response looks early in disease and how that changes later on. Sassetti had to switch to doing an analysis of samples from infected macaques.

In both cases, Sassetti’s team was able to shift funding for the removed foreign subawards to domestic institutions to support the pivot. But, he said, it has meant losing the opportunity to work with large human populations of tuberculosis patients, which don’t exist in the U.S. The engineered cells and the non-human primate work “fulfills the aims of the grant, but I wouldn’t say are quite as scientifically compelling as a human cohort,” he said.