Ingrid Katz

The support and investment of the United States has been responsible for some of the most groundbreaking and historic health milestones in the world. The National Institutes of Health (NIH) has led to highly effective treatments, such as of life-saving antiretroviral therapy and pre-exposure antiretroviral prophylaxis, turning a fatal infection into a chronic, manageable one in many places. Millions of lives have been saved by implementing those scientific advances through the US President's Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund to Fight AIDS, Tuberculosis and Malaria, including the elimination of mother-to-child HIV transmission in several countries. These incredible achievements have positioned the US as a global leader in aspirational and innovative approaches to human health, garnering respect and gratitude from the world.

Today, potentially historic gains against HIV are within our grasp, including the possibilities of an HIV cure, a preventive vaccine and long-acting antiretroviral regimens. Yet, the US President’s first budget proposal threatens to slash support for the necessary life-saving scientific research that would get us there. This is not the time to pull back, but to put our foot on the gas to advance research and scientific discovery, as well as the delivery platforms, systems, and partnerships to make the research meaningful to reach the people who need it.

To generate the tools we need to save lives and tackle the health issues we face today, the NIH needs to be secure in its funding to make new commitments for multi-year research grants. The proposed 18% cut to the NIH budget – which includes the elimination of the NIH’s Fogarty International Center – would prevent the awarding of new grants and cripple important research endeavours. The budget savings from elimination of the Fogarty Center will be minimal – representing only 0.1% of the NIH budget – but the costs will be staggering, depriving the world of new generations of researchers who would undertake studies of vital importance.

To better understand the full ripple effects from the US funding cuts, we talked to three IAS Members and leading scientific researchers. Here is what Ingrid Katz had to say…

Ingrid Katz is an assistant professor at Harvard Medical School and a physician-researcher based at Brigham and Women’s Hospital in Boston, Massachusetts. Ingrid’s research focuses on the social determinants of health behaviour among disenfranchised populations. She is currently studying factors impacting HIV treatment refusal in Soweto, South Africa.

You only have to look at HPTN 052 to see the impact of the massive NIH undertaking. When those results were released, we found out that, basically, anyone living with HIV who is on treatment and has their viral load suppressed can get to the point where they will not transmit the virus to their partner. This drove the World Health Organization to change its guidelines; it was really a game changer, and HPTN 052 was just one of the NIH studies that provided critical evidence for how we proceed in the work we do around HIV.

I think that when you have budget cuts like this, it discourages people from going into this field. You take any promising researcher out there, any recent graduate who might be interested in doing this work, and if they see that there is absolutely no opportunity, then they are not going to do it. They are going to go in a different direction, and so we will lose a generation of researchers. This is a challenging time to be a scientist or a researcher, and the environment is certainly not as hospitable as it used to be.

The NIH impacts all of us, not just those of us who are primarily focused on research, because to address such a huge issue as HIV, you need to come at it from different angles: policy, clinical work, research and programmatic. Everything is interrelated; so if one piece is completely removed, then the rest of the infrastructure can really fall apart. Whether you are a professional in Kansas or in Kisumu, we are all working in this together, and the NIH holds it all together.

Note: this interview has been edited for length.