At the Milken Institute’s Global Conference, we saw robust debate about the future of science in the United States. Members of the current administration focused outlined their goals to advance science which included “to achieve and maintain unquestioned and unchallenged global technological dominance.” However, leaders in academia, government, and philanthropy at the conference heavily contested the administration's policy alignment with its stated objectives. These leaders expressed concerns that recent federal cuts—both actual and proposed—to the biomedical ecosystem’s funding and workforce jeopardize the same scientific primacy that the administration claims to uphold.  

The American biomedical research system as we know it began in 1945 following a report—Science—The Endless Frontier—by the director of the US Office of Scientific Research & Development, Vannevar Bush. Bush argued that federal investment in science and engineering in times of peace would leverage the success of the government’s World War II-era programs and drive economic growth. The report set the stage for the US to recruit diverse researchers—many of whom had recently immigrated from countries destabilized by the war. New government agencies would soon leverage a competitive research funding infrastructure that incentivized creativity and merit.

The Milken Institute’s 2025 Global Conference ignited a conversation about American exceptionalism, scientific strategy, and philanthropy’s role amid shifting federal priorities.

Since 1945, the US biomedical ecosystem has blossomed into a network of organizations—universities, government agencies, and for-profit companies—each funded by a different profile of investors, including federal and state governments, philanthropic funders, and institutional and individual shareholders. Several Global Conference speakers cited this complementarity as integral to the model’s success, as evidenced by the fact that the National Institutes of Health (NIH)’s spending returns on average 2.46 times its investment.

The current administration’s proposed cuts to the biomedical ecosystem are a major reversal of decades of bipartisan, constructive efforts. Proposed changes include funding cuts to federal agencies, universities, and essential indirect costs stipulated in federal grants, as well as reduction in force at NIH, the Food and Drug Administration, and Centers for Disease Control and Prevention. Since January 2025, $2.7 billion worth of NIH grants has been terminated as part of a proposed 40 percent cut to the NIH’s share of the White House FY 2026 budget. 

Optimism for the next decade of advances in biomedical sciences is now overshadowed by concerns about a shift of dollars, time, talent, and attention away from science and biomedical research.

The policy changes to date have had immediate consequences:

• Patients participating in research into new medicines are losing access to defunded, understaffed, or interrupted research for diseases like ALS and cancer. 

• Three-quarters of the early career scientists and science-focused graduate students who responded to a March 2025 Nature poll are interested in leaving the US to pursue more stable research careers abroad. Federal grant terminations have put funding for graduate students at risk, which will shrink the US talent pool for years.  

• Research infrastructure and essential resources, such as federally maintained datasets, are indefinitely inaccessible, a barrier to transparency and continued scientific productivity.

Short-term consequences pale compared to potential long-term damage to the scientific enterprise, with catastrophic long-term implications for health care, workforce development, and research. 

Several speakers at Global Conference looked to philanthropic funding to leverage its strengths—convening power, flexibility, and appetite for risk—to mitigate the deficit of federal funding. Often complementary to federal funding, philanthropy already has a significant impact on biomedical research. However, the reduction in federal NIH funding in 2026 alone is estimated to be just under $18 billion—public and philanthropic leaders agreed that philanthropy cannot possibly compensate, dollar for dollar, for lost federal funding.

Speakers rallied around several strategic opportunities for philanthropy to address recent losses and shield science from systemic damage: 

1. Elevate the value of funding biomedical research: Many Global Conference panelists emphasized the need for philanthropically led communications campaigns to educate the public, leveraging trusted messengers with relevant expertise to stress the importance of maintaining a highly functional, well-funded biomedical ecosystem. 

2. Work with federal policymakers: Philanthropists and science funders should highlight priorities in science and health research and show examples of how federal investment in research pays dividends for years.  

3. Support talent retention: As incentives to work in other countries (for example, the EU or China) increase, philanthropy—already an apt funding source for early career scientists—can continue to bolster the academic career pipeline.

4. Continue to fund innovative science, independently and in partnerships: Philanthropy is well suited to support high-risk/high-reward research, and it should continue to do so, even in moments of uncertainty. Philanthropic funding can also build collaborations that support existing research and extend cash runway where research projects are especially threatened.

The collective voices from diverse perspectives that populated this year’s Global Conference largely aligned in their sentiment that federal support is the backbone of decades of biomedical research and advancement to ensure the American people become healthier and thrive. Discussions centered on federal investment in biomedical research as a domestic imperative while acknowledging the potential impact of strategic philanthropy to help course-correct before it is too late.