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News — As the Senate Health, Education, Labor, and Pensions (HELP) Committee met for a confirmation hearing of the next National Institutes of Health (NIH) Director on Wednesday, March 5, a coalition of leading medical and research organizations urging policymakers to reconsider proposed NIH funding restrictions.

The letter, led by Alexander Khalessi, MD, MBA, chair of the Department of Neurological Surgery at University of California San Diego School of Medicine and neurosurgeon at UC San Diego Health, was convened by his office to unite major stakeholders in the medical research community against the proposed policy.

Indirect costs cover essential expenses that research institutions incur to sustain scientific work, including administration, facilities, equipment, and regulatory compliance. The proposed 15% cap on indirect cost rate would force institutions to absorb much of these expenses, straining budgets and threatening the long-term sustainability of critical research efforts.

Khalessi, who also serves as chair of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) Washington Committee, warns that this policy poses an urgent threat to the nation’s biomedical research system. He cautions that reducing indirect cost rates would weaken research infrastructure, deter recruitment and retention of top scientific talent, and slow or halt critical medical advancements.

Key concerns outlined in the letter include:

• Threat to research infrastructure: The proposed cap would severely restrict the ability of institutions to maintain research facilities, support staff, and essential services.
• Impact on scientific talent: Reduced funding for research operations could drive top scientists and researchers away from U.S. institutions, weakening the nation’s leadership in medical innovation.
• Slowdown in medical breakthroughs: Indirect cost cuts jeopardize essential research in critical areas such as cancer treatment, Alzheimer’s disease, and neurological disorders.
• Global competitiveness risks: As other nations, including China, ramp up investments in biomedical research, this policy could weaken U.S. standing in the global research community.
• Potential violation of federal procedures: Concerns have been raised that the policy change was announced without adequate stakeholder input, bypassing established administrative processes.

Alongside Khalessi and the Presidents of AANS and CNS, the letter has been signed by over 40 leading organizations representing the medical and research communities, including:

• American Academy of Allergy, Asthma & Immunology
• American Academy of Dermatology
• Association American Academy of Emergency Medicine
• American Academy of Hospice and Palliative Medicine
• American Academy of Physical Medicine and Rehabilitation
• American Association of Neuromuscular & Electrodiagnostic Medicine
• American Association of Orthopaedic Surgeons
• American College of Allergy, Asthma and Immunology
• American College of Chest Physicians
• American College of Emergency Physicians
• American College of Gastroenterology
• American College of Obstetricians and Gynecologists
• American College of Osteopathic Family Physicians
• American College of Osteopathic Internists
• American College of Rheumatology
• American Gastroenterological Association
• American Medical Association
• American Psychiatric Association
• American Society for Gastrointestinal Endoscopy
• American Society for Surgery of the Hand Professional Organization
• American Society of Anesthesiologists
• American Society of Dermatopathology
• American Society of Nuclear Cardiology
• American Society of Pediatric Nephrology
• American Society of Pediatric Neurosurgeons
• American Society of Plastic Surgeons
• American Society of Transplant Surgeons
• American Urogynecologic Society Association for Clinical Oncology
• Association of Academic Physiatrists
• Association of Department of Family Medicine
• Association of Women in Rheumatology
• Heart Failure Society of America
• Infectious Diseases Society of America
• North American Neuromodulation Society
• North American Primary Care Research Group
• North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
• North American Spine Society Society for Cardiovascular Angiography and Interventions
• Society of Gynecologic Oncology
• Society of Neurological Surgeons
• Society of Teachers of Family Medicine
• Society of Thoracic Surgeons

Khalessi is available to provide insight into how these changes would affect both researchers and patients, as well as discuss the broader implications for the U.S. biomedical research enterprise.

Biography :

, is a board-certified neurosurgeon who specializes in complex cranial surgery, endovascular neurosurgery, stroke care, and neurological oncology. He is chair of the Department of Neurological Surgery at UC San Diego Health and professor of neurological surgery, radiology and neurosciences and the Don and Karen Cohn Chancellor's Endowed Chair in Neurosurgery at UC San Diego School of Medicine.

Khalessi provides both open surgical and minimally invasive, catheter-based approaches to complex neurosurgical conditions, including brain tumors, aneurysms, arteriovenous malformations (AVM), carotid disease and ischemic stroke.

Khalessi is a founding member of the Medical Device Innovation Consortium (MDIC) that advises the FDA on early clinical feasibility for emerging neurovascular devices. He serves on the NIH Interventional Advisory Panel for StrokeNet, which provides scientific oversight for federally funded research in neurovascular disease.