Trump's Acting NIH Director appoints himself as acting head of the office that controls external grant funding. So, that's fun.

The Office of Extramural Funding distributes a cool $34.9 billion.

Hi all. I worked clinically until early Thursday morning, and I spent most of the afternoon revising a research manuscript that I care deeply about for [big medical journal] that is due today. So, I need to keep this one brief. Still, I wanted to share a story that encapsulates some of the mayhem over at the NIH, and which was brought to my attention by an Inside Medicine reader with extensive HHS experience.

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Acting NIH Director appoints himself head of extramural research.

Dr. Matthew Memoli, the Acting Director of the NIH, went ahead and just appointed himself as the lead for the Office of Extramural Research last week. The OER funded around $34.9 billion worth of grants to researchers outside of the NIH in 2023. That money was distributed across nearly 59,000 projects, with an average of $592,000 per award. Rising from relatively obscurity from within the agency, Dr. Memoli was appointed to temporarily run the NIH during President Trump’s first week in office.

This latest move is somewhat puzzling. First, as per the memo above, the announcement came days before the expected confirmation of a Senate-confirmed permanent director. So, it’s possible that Memoli is trying to decide what future job he wants, given that his previous position at the NIH was nowhere close to top-brass leadership and that his days as Acting Director are likely winding down. On the other hand, as you can see in the memo, he also delegated most of the authority of the position to three underlings. I’ll speak to some people at the NIH and try to get some answers.

The previous acting director of OER, Dr. Liza Bundesen is said to have resigned from the position after taking over sometime in February. Prior to that, the position had belonged Dr. Michael Lauer since 2018, who retired from the NIH after around 18 years there. A holdover in the job from both the previous Trump and Biden administrations, Lauer’s exit was described as “abrupt.”

Why Dr. Bundesen has also now left, on the eve of the arrival of a new permanent NIH Director is unclear to me. However, the last couple of weeks have been marked by targeted external grant terminations aimed at LGBTQ-related research and vaccine hesitancy research, both signs that the real power at the NIH belongs to the DOGE cronies who wrote the notifications, as reported here in Inside Medicine. It didn’t escape my notice that both Lauer and Bundesen did not merely leave their positions—but the NIH entirely.

It’s feasible that nobody with any actual NIH experience wants the Deputy Director for Extramural Research job right now, and it’s easy to see why, given the betrayal of its mission. Long-time NIH employees like Dr. Lauer and Dr. Bundesen probably didn’t sign up to be the figureheads for a bunch of DOGE-driven grant terminations. Meanwhile, it was reported yesterday that UMass Chan Medical School in Worcester rescinded graduate school offers to biomedical science graduate students out of fear that the longstanding NIH funding that supports the salaries of those students may not be reliable.

Taken together, it looks to me like nobody with any credibility wants to take over the wheel of the sinking ship that is NIH-funded extramural research at the moment. Still, at some point, the NIH will have to start funding new research—because, yes, Congress still exists and it decides how much research the federal government funds, not a bunch of Trump administration officials firing off memos. So, one could surmise that Memoli is taking this job because nobody else wants it now and it sets him up to slide into a high-ranking possibly permanent position once his tenure as Acting Director of the entire NIH ends. That said, the soon-to-be incoming director, Dr. Jay Bhattacharya, is under no obligation to keep Memoli in that role, just because he appointed himself to it last week.

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