NIH Budget Cuts Threaten Critical Spondyloarthritis Research

For many living with spondyloarthritis (SpA), research isn’t an abstract pursuit—it’s a foundation for hope. It leads to better diagnostic tools, safer treatments, and a future where this chronic, painful disease is more manageable. Yet these gains face uncertainty as proposed deep cuts to the National Institutes of Health (NIH) budget threaten decades of progress.^{1, 2}

Why SpA Research Matters

Spondyloarthritis is not a single disease but a family of inflammatory conditions that primarily affect the spine and sacroiliac joints, often beginning in early adulthood. It includes axial spondyloarthritis (axSpA), ankylosing spondylitis (AS), and related diseases that can involve the eyes (uveitis), skin (psoriasis), and gut (inflammatory bowel disease).

As a painful chronic disease, SpA affects quality of life, work, and mental health. Research is crucial for new treatments, earlier detection, and personalized care. Advances in biologics and imaging have already transformed diagnosis and management. Much of this progress has relied on stable NIH funding.³

NIH’s Role in Advancing SpA Research

The NIH is the largest public funder of medical research in the world. In the U.S., it supports over 300,000 researchers across more than 2,500 universities, hospitals, and other institutions.³ For SpA, much of the NIH research funding flows through the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).⁴

NIH grants are critical for nurturing early-career investigators, seeding pilot studies that later attract industry support, and sustaining long-term genetic and epidemiological work. For example, breakthroughs in TNF inhibitors, which revolutionized SpA treatment, relied on years of research funded by NIH.⁴

Organizations like the Spondylitis Association of America (SAA) also play a vital role, having invested over $10 million in SpA research to date.⁵ Often, SAA’s grants serve as the first step that helps researchers qualify for larger NIH funding. Without robust federal support, these complementary efforts lose much of their leverage.⁶

The Proposed NIH Cuts

In this context, the proposed federal budget for fiscal year 2026 has raised alarm. It calls for reducing NIH funding by nearly 40%, slashing it from approximately $48 billion to $27–28 billion.^1,2 This would be one of the largest single-year cuts in NIH history.

The proposal also includes major structural changes. It calls for consolidating NIH’s 27 institutes into fewer entities and eliminating funding for programs focused on the health of underserved populations and international research.² For NIAMS, which funds much of the U.S.-based SpA research, these changes could mean more competition for limited funds.

In early 2025, uncertainty over budget prospects triggered a freeze on many NIH grant decisions, creating a $4.7 billion gap in university and hospital research funding.⁶ Thousands of grant applications have been delayed or canceled, and nearly 5,000 NIH staff, including scientists and support personnel, have been laid off.⁷ These disruptions stall clinical trials and derail early-career investigators’ training.⁸

Impact on Spondyloarthritis Research

The consequences of these proposed cuts would be especially harsh for modestly-funded fields like SpA research. Unlike cancer or cardiovascular disease, SpA isn’t a well-funded area drawing billions in private-sector investment. Instead, it relies on public funding to advance understanding of genetic risk factors, explore environmental triggers like the microbiome, and conduct rigorous clinical trials.

If NIH funding is cut dramatically:

• Fewer grants will be available, meaning many promising projects may never launch.
• Ongoing studies could be interrupted, wasting years of effort and investment.
• Training pipelines for new rheumatologists and researchers specializing in SpA could dry up, worsening provider shortages.
• Innovation in imaging, diagnostics, and precision medicine approaches could stall.
• Eliminating specialized institutes could weaken international collaboration and reduce funding for health equity in SpA research.²

Broader Economic and Societal Implications

Critics of the proposed cuts also point to the broader economic impact. NIH funding is not just a cost—it’s an investment that generates returns. Estimates suggest every dollar of NIH funding creates approximately $2.56 in economic activity, supporting jobs in research, technology, manufacturing, and healthcare.⁹

And the threat to research progress doesn’t stop with NIH. The National Science Foundation (NSF) faces a proposed 56% cut.¹⁰ Meanwhile, federal agencies have already canceled many current research grants, leaving labs scrambling to maintain staff.

Trade policies are also worsening the situation. Import tariffs on essential lab supplies—like microscopes, glassware, and reagents—have made it much more expensive to conduct basic science in the U.S.¹¹

Beyond direct research cuts, other federal policy changes threaten the healthcare safety net. The recently passed One Big Beautiful Bill Act reduces Medicaid funding by $930 billion over 10 years and makes Affordable Care Act enrollment more difficult. These changes could leave nearly 12 million Americans uninsured by 2034. The American College of Rheumatology and the American Medical Association warn that these cuts will limit access to care for vulnerable patients.¹²

These compounding pressures are driving a brain drain. A March 2025 Nature survey found that 75% of U.S. scientists have considered leaving the country amid funding instability and restrictive immigration policies.¹³ Many are already relocating to Canada, Europe, and other research-friendly regions.^13,14

The Road Ahead

Federal funding instability is already having real consequences. As Dr. Maximilian Konig of Johns Hopkins explains, “The federal cuts have had a chilling effect on the medical community and research. … There is tremendous uncertainty about what next year will bring and how we will advance the development of next-generation therapies.”¹⁶

The good news: these proposed cuts are not yet law. Congress must negotiate and approve any final NIH budget before the new fiscal year begins on October 1, 2025. Early signals suggest bipartisan resistance to such dramatic reductions, with lawmakers on both sides recognizing the value of investment in medical research.⁷

To date, multiple lawsuits have been filed, including a multistate case led by 22 state attorneys general. They argue the abrupt cancellation of grants, especially those focused on LGBTQ health, diversity, and targeted populations, violates existing laws and regulations.¹

Courts have issued temporary restraining orders stopping some of these budget restrictions from taking effect. For example, a proposed rule capping at 15% the “overhead” funding that research institutions rely on for facilities, staff support, and equipment was blocked.² Some frozen grants have begun to resume. However, these legal wins don’t guarantee full funding restoration. Many scientists remain in limbo, awaiting clarity on future grant cycles.²

Researchers argue that now is the time to speak up, support sustained funding, and stay engaged to safeguard the progress already made. By contacting lawmakers, supporting advocacy, and spreading awareness, we can help ensure SpA research continues to move forward and deliver new breakthroughs in care.