Early in his career, Lawrence Lustig, MD—now the chair of otolaryngology–head and neck surgery at Columbia University in New York— was studying basic cell physiology with a colleague at the University of California, San Francisco, and found a mouse model for congenital deafness that responded to gene therapy.
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September 2025Using crucial funding from the National Institutes of Health (NIH), they were able to move on to other types, including diseases associated with the rare gene otoferlin. Since then, a therapy targeting otoferlin has been developed for people using a similar technique that was developed in Dr. Lustig’s lab and is having life-changing effects today.
Dr. Lustig said he had just administered the treatment in a child in the previous week.
“That kid’s likely going to go from needing a cochlear implant now to having natural hearing,” he said. “That whole process was enabled by the research funding coming from the NIH. If that never happened, we wouldn’t be here today.”
With the Trump administration interrupting research at academic medical centers, court fights over the proposal of a 15% cap on the indirect rate, diversity research de-funded, and a proposal that would cut the NIH budget by 40%, traditionally robust federal support for medical research in the U.S. has eroded, and the research community shows little confidence that this will change in the short term.
This fog of uncertainty has led ENT researchers and research centers—along with academic research overall—to rethink how their research gets funded, what they research and how, and even whether the country still believes that science is worthwhile.
“I’m passionate about hearing, I’m passionate about solving why people get hearing loss and developing treatments for hearing loss—this is like an attack on that very premise,” Dr Lustig said.
No one is sure how much funding will ultimately be reduced. The proposal to cut the indirect rate to 15% down from 50% or more at many centers would mean much less money for the general research infrastructure that is not associated with any specific study or trial, but that is crucial to many of them. But that proposal is being litigated, and the result is unknown.
The budget proposal for the coming fiscal year called for a 40% cut in NIH funding, which would be a cut of about $20 billion. But Congress has pushed back, and it is unknown whether that amount will ultimately be passed legislatively or, if it is, how the reduction would materialize—for instance, how much would affect research projects, which projects would be funded and which would not, and how much this would affect the infrastructure of research, such as labs. The federal government has also proposed that the National Institute on Deafness and Other Communication Disorders (NIDCD) be absorbed into other agencies, another change that could affect how research is evaluated and funded.
Dr. Lustig said the university, which had its federal research funding totally halted on the grounds that Columbia had not done enough to address anti-Semitism on campus, had successfully argued, on humanitarian grounds, for the continuation of trials involving life-saving drugs. And, in late summer, Columbia reached a settlement with the government to restore that funding. But the dread of what might be on the horizon remains, researchers and administrators say.
“I think everything’s up in the air—we just don’t know,” Dr. Lustig said.
It’s very hard to tell somebody, “We have to let you go because you happen not to be funded.” And we’re not there yet by any means, but that’s the risk. As this becomes more real, we’re going to really hyperfocus on our people who have the most funding. And we will inherently lose the diversity of our researchers. —José Zevallos, MD, MPH
Sad, but true.
As a former clinical assistant professor, I had an agreement to have protected time to perform research in 2008. Due to illness and a change in staffing, I lost that protected time. My clinical services were needed, and my research time was taken away. I resolved to make my teaching and clinical services my priorities. When the affected individual returned to work later in 2009, my reward was that I was given more teaching responsibilities and no time or funding for research. As I scrambled for grants and contacted industries to help support funding after the economic downturn of 2008 and 2009, I came to realize that the likelihood for funding was gone. Without prior research or publications, no funding was available to support time off from clinical work for independent research. This did not stop me from continuing my clinical work and research, once I left the world of academia. I became self-funded by dedicating a percentage of my salary to research purposes.
I believe that self-funding is the way to go. If Universities will not use their endowments to invest in research at their institutions where their review boards approve the research, then why should the janitorial staff that cleans the research buildings pay for the research with their tax dollars. If Departments of Otolaryngology-Head and Neck Surgery are dedicated to researchers, then use clinical dollars to support the research that needs to be done. Shift funds generated from ancillary personnel, such as NP’s and PA’s and Fellows, to a core research fund. Researchers need to be held accountable for the costs of their studies for there are no more blank checks.