[00:00:00] non: You are listening to the A TS Breathe Easy podcast brought to you by the American Thoracic Society.
[00:00:19] Erika: Hello, and welcome to the American Thoracic Society Breathe Easy podcast. I'm your host, Dr. Erica Moison, a pulmonary and critical care medicine physician with Legacy Health in Portland, Oregon, and host of the Air Health Our Health podcast. I am here today with Dr. Mary Rice. To talk about how the, changes at the NIH have been impacting our research community.
Dr. Mary Rice is a pulmonary and critical care medicine physician and the director of the Center for Climate Health and the global environment at the Harvard t Chan School of Public Health. She's the chair of the Environmental, occupational and Population Health Assembly of the American Thoracic Society, and a recipient of the Joe Ray Wright Award for outstanding Science.
She leads the [00:01:00] Environmental Health Research Program of the American Lung Association Lung Health Cohort, and is an NIH funded researcher. So welcome to the Breathe Easy podcast.
[00:01:10] Mary: Thank you for having me, Erica.
[00:01:12] Erika: And you know, we recently released a different Breathe Easy episode that was recorded at the American Thoracic Society meeting in the spring about the turmoil at the National Institute of Health and its impact, as well as how our community at a TS might respond.
And you yourself have been entrusted with funding from the NIH to study how to help patients with respiratory disease stay healthy. So tell us why is the NIH so important to people who care for those affected by lung disease and for patients who suffer from critical illness?
[00:01:41] Mary: Well, Erica, the NIH helps people affected by lung disease or critical illness in so many ways.
this funding advances understanding of disease origins because the NIH funds the basic. Translational and clinical research that uncovers causes of lung disease and critical illness. Everything from [00:02:00] genetic predispositions to environmental exposures. NIH funding drives the development of better treatments for our patients and evidence, evidence-based.
Standards of care. No, NIH. Funding of clinical trials and clinical studies has led to breakthroughs in therapies for our patients with asthma and C-O-P-D-A-R-D-S pulmonary fibrosis. It's also informed care guidelines that improve the survival of our patients and their quality of life. NIH funding also enables prevention through environmental research.
For example, grants make it possible to identify harmful exposures like air pollution, workplace hazards, and to evaluate interventions that protect the health, the respiratory health of our patients. And importantly, NIH funding also. Has historically trained, trained the, the next generation of scientists, NIH funding supports physician scientists, tracks and supports the [00:03:00] multidisciplinary teams that train them.
And, and that bridges research to patient care, for the future.
[00:03:07] Erika: Can you give an example of a study or studies on which you were working that were affected by NIH Cuts?
[00:03:14] Mary: Certainly I'm, as you mentioned, I'm faculty at the Harvard Chan School of Public Health and all direct federal grants to Harvard University, including, my grants were terminated in May of 2025.
I can tell you about two studies in particular, for which I'm one of the principal investigators that were impacted. One of them is a, an air purifier trial for people with. Eosinophilic, COPD to see if a year of air purification hence effects on lung function, respiratory symptoms, and also biomarkers of exposure and inflammation.
another study is, a center grant, that was testing, interventions for heat stress and we were gonna evaluate of window air conditioners for, [00:04:00] for older adults with, chronic medical conditions, including COPD. if they might benefit from, air conditioning intervention, in the summertime to reduce heat related symptoms and medical visits and indoor environmental hazards.
So especially relevant on a day like today, we happen to be having a heat emergency in the city of Boston.
[00:04:22] Erika: We're having one out here on the west coast in Portland, Oregon as well, and we last spoke on a podcast. In the podcast we recorded live for air health, our health and chest last fall. And even in that session, you could just see the hunger.
Of those caring for pulmonary patients to understand better the impact of climate change, wildfires, and more on the health of their patients and how to guide them. So studies such as yours on air cleaners for people with COPD and air conditioning seem so vital to help us understand what to do and you know, whether we should ask our patients to do these somewhat expensive interventions.
And so it's just so [00:05:00] devastating to me as a lung doctor that I may not get that vitally important information. And so you do clinical research, which means research that involves real people, real patients. So how has this affected the patients in your research?
[00:05:14] Mary: Well, let me tell you first about my air purifier study.
this study has been going on for many years actually. I received the notification that the grant was terminated right in the final year of the grant. and the study has been going on since, 2021. and over the past four years, we enrolled 178 people. With moderate to severe eosinophilic COPD, we randomized them to real or sham air purifiers, which we put in their homes.
And for each of these people, we collected blood, we collected nasal fluid samples. We, scraped their noses and collected nasal cell samples in addition to measuring lung function, nitric oxide questionnaires over 15 months. For [00:06:00] each of these people. And, went to their homes where we collected air samples.
And, and these are folks, who are suffering from, a severe chronic lung disease. And you know, for them it was a big deal to come in for clinic visits to accommodate our team into their home. And I think. Importantly as principal investigator I, I promised these trial participants that their time and energy and their tissue, tissue samples, those no stabs.
Yeah, the blood, you know, samples, all of that was being collected to help answer an important question that wouldn't necessarily benefit them, but it could benefit other people living with COPD and. In, in the face of this grant termination, I really didn't wanna break that promise or let those contributions go to waste.
And I think that's a really important piece of why these terminations are so worrisome. in addition [00:07:00] to the knowledge, the scientific knowledge that's lost, as you point out so much, we need to know about what we can do for air pollution and climate related hazards. that's just one piece of it. And also the scientific careers.
That are being interrupted, but it's also that we're breaking promises to patient volunteers, you know, many of them are not healthy and living with chronic diseases. And, and by doing so, we, we risk breaking that trust, between the scientific community and, and the patients that we're trying to help.
[00:07:33] Erika: Absolutely. How much money had already been spent on starting the study or had been spent on the study when you were first asked to stop?
[00:07:41] Mary: for that particular one, the trial, it was, we had a total budget in that final year of 507 in direct costs upwards of 700,000 total. At that point, we'd already spent more than a million dollars on that study in [00:08:00] total.
had already been spent, since 2021. And, uh. And now being in a position where there's still study participants who remain in the trial are to be, need to be followed. And we have specimens sitting in the freezer, that remain to be analyzed. and if we can't fi figure out a way to complete it all, those samples and that time will be wasted.
[00:08:27] Erika: How much taxpayer money for science do you think has been wasted in general, in the studies at least with which you are familiar?
[00:08:34] Mary: well, I can give you some statistics, some aggregate statistics. and there was a science analysis of a list of 477 NIH grants. That may have resulted in more than $1.4 billion in some costs in terms of money that had already been spent, you know, such as the more than 3 million that I'd already spent on that particular study [00:09:00] that may never yield results.
there was more recent, report in June by Reuters from. In which NIH staff estimated that termination of upwards of 2000 research grants, roughly $9.5 billion in grants and 2.6 in contracts putting 'em together, likely resulted in a combined potential loss of more than $12 billion of taxpayer payer money.
Um. These numbers are not my own, but I think they give you a sense of the, the size, the aggregate value of research that's at stake
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[00:10:16] Erika: Yeah, I mean, it's so interesting when you're looking at. These studies that, you know, reading just from, you know, other people had, you know, heard in research where, you know, they've, something had been going on for like five or six years and they were just kind of in the final stages of it and then it's canceled.
And so all those years, just like in your study, are just wasted. And so, you know, the salaries for the people doing the science, the samples, the equipment that was purchased, it's just a scale of waste that is, you know, hard to take.
[00:10:42] Mary: Yeah. And actually Erica, if I may, I can share. With you. there was a, an article in state news about one of the participants of my air purifier trial, who agreed to talk to the press.
And, [00:11:00] you know, for him, this is really personal, he, he relies on supplemental oxygen to manage his COPD. He's personally experienced how wildfire smoke in the northeast and heavy summer humidity really hits him like a ton of bricks and. Makes it harder for him to breathe. And, and he's really counting on this research, because in his mind this could help shape treatments, environmental protections, preventive strategies for other people like him.
And, you know, these, these cuts don't just mean slowing science, slowing down academic careers. They're, delaying solutions for real patients with lung disease who are, are struggling to breathe every day. Absolutely.
[00:11:45] Erika: How do you see the uncertainty at the NIH affecting Americans' health and healthcare, and what are your concerns about the future?
[00:11:52] Mary: Well, I have many concerns about, the, what this means for our future. delays in medical breakthroughs, as I [00:12:00] mentioned, uncertainty, stalls research, whether or not the grant is directly, terminated or not. the uncertainty slows things down and that interrupts patient studies that could have led to new treatments and preventive strategies.
slower public health progress. You know, I've talked about trials and clinical interventions, but we're interrupting all forms of health research, including essential population health research that could improve the health of communities. This kind of research may be delayed or may never come, and there's the erosion of trust.
Patients communities might lose faith in research if our commitments from the health research community can be honored. And long term that loss of talent. Young scientists who, who might leave research entirely and, and that might shrink the pipeline, you know, of future innovators for respiratory sleep and critical care research.
[00:12:58] Erika: Where are you finding [00:13:00] hope and what creative solutions may exist?
[00:13:03] Mary: Erica, I, I am finding a lot of hope and I, I am still doing those studies actually. So the ones that I Good on, yeah. Described none of them have stopped. and, what gives me hope for one thing, there's, there has been a lot of philanthropic support.
For research, I've seen it grow, to help meet this funding crisis, and I've seen individuals and corporations stepping up to help sustain high impact projects. I've been really heartened to see colleagues and staff from my own institution and a TS colleagues remain deeply committed to their research mission.
And despite, you know, persevering, despite losing funding and facing all this uncertainty, it gives me hope that I've met a lot of. Junior investigators in recent months who were still very eager to build careers in environmental, community and global health research. And they're bringing fresh ideas and fresh energy that [00:14:00] we need.
yeah, I do think we need to think creatively, about solutions and, how to support this work. And, you know, I think that. With federal funding being less certain, we have to diversify. Our funding portfolios include a mixture of sources now, and this could include forming new partnerships with, as I mentioned, the private sector, to try to tackle some of these most pressing, health challenges.
And I think we need to, work with our partners overseas, international collaborations to, you know, even expand the research that we do globally, even though we're facing. Funding cuts at home. And I really hope that the a TS can work together, or a TS members can work together to find sustainable solutions, so that we have a robust research pipeline going forward.
[00:14:56] Erika: Absolutely. The nice thing I think about being [00:15:00] engaged in environment and climate research is it really affects all of us. So there's a lot of stakeholders, so mm-hmm. Hopefully if we can't house all the research in the US federal government, we will find other places to house it and have science continue marching forward.
Sure. Hope so. What can people who are concerned about how the changes at the NIH are affecting us, health and science do.
[00:15:22] Mary: Well, we gotta speak up. We gotta speak up about the value of research. this is a critical time, for a TS members to explain what their work is about, why it matters, how it helps real people.
we have to engage with the press. I know it, it isn't, you know, always what we as doctors and scientists feel comfortable doing, but it's so important to share patient stories and research stories about the impact that it's had to make it clear what the stakes are and to the public. I think we can encourage our own [00:16:00] institutions to celebrate science.
Help your hospital, help your university leadership. Highlight the research successes and showcase what the tangible human benefits are of your work. You can also contact your elected officials. Call, write, meet with your representatives. Advocate for sustained federal funding for research. And also this is an a TS podcast.
We are a global community and we can work together to amplify our voices of the scientific, the voices of the scientific and the medical community, to talk about why medical research is so important for respiratory, sleep and critical care.
[00:16:41] Erika: I hope, you know, everyone listening to the Breathe Easy podcast is, an expert in respiratory health in some way.
Mm-hmm. Although, I think members of the a TS constantly view themselves as not experts. I've never met a group of the most expert people I've ever met, all claiming they're not an expert in something. The minute you ask [00:17:00] someone at a TS, well, hey, what do you think of this? I'm like, well, I'm not an expert.
And I think we all need to be empowered to realize we actually are experts in the importance of science and everyday life. And I think if anything, looking at what's happening at the IH just shows us how much faith has been lost in science. Mm-hmm. And how little people understand how much it really does benefit them day to day.
You know, the return on investment of even a few dollars at the NIH just magnifies to communities. And I think we as a community need to restore that trust as much as we can by starting to engage wherever we are in all of our communities and try to break through the noise. But it's really hard. Do you have advice?
Say that better than you, Erica? I, I
[00:17:42] Mary: fully agree.
[00:17:43] Erika: Do you have advice on things that you found to be particularly successful in communicating to either individuals or to legislators that, on, on how to kind of break through some of the, the turmoil?
[00:17:57] Mary: Well, I guess I can, I can most [00:18:00] comfortably talk about my own research and, um.
And I have found that the more tangible benefits are easier to talk about, even though it's all so important, right? We need to understand what the origins of diseases are so that we can develop treatments to help, cure them. but sometimes that basic research can seem abstract. Um. So I have fo I have focused on the more concrete examples, like the air purifier trial.
If we find that this works for people, then that might be something that could be a durable medical equipment that, providers covered that people could get into their homes to help them breathe easier. I have found that the, the short concrete, this is, we're studying this to see how it could help people.
Um. Are the, the easiest examples to share. but I, I think it's [00:19:00] also really important to then not make it seem like the basic science isn't important too, or that the observational population health research isn't important too, because ultimately the goal of this work is to help improve respiratory health across the lifespan.
Absolutely.
[00:19:19] Erika: Well, I wanna thank you very much for your time on this podcast today, and especially for your lifetime of research and care for your patients. Is there anything else you wanna add,
[00:19:30] Mary: Erica? I just wanna thank you and the a TS for hosting this podcast and for everything the a TS is doing, to support our work to support, junior investigators who are just starting their careers, in science and, um.
We're celebrating what we're doing, that we're supporting one another, and that we're advocating, to be able to continue our mission, to protect respiratory health, health, and help the the world breathe easier. Amen.[00:20:00]
[00:20:03] non: Thank you for joining us today. To learn more, visit our website@thoracic.org. Find more a TS Breathe Easy podcast. Song Transistor, YouTube, apple podcasts and Spotify. Don't forget to like, comment, and subscribe, so you never miss a show.