For public health researchers, getting a federal grant is a big deal. 

More than 30 years later, Karen Emmons hasn’t forgotten her first one. She was an assistant professor in Brown University’s Department of Psychiatry when the letter came in the mail on green carbon-copy paper that was so smudged she could barely read it. Now a professor of social and behavioral sciences at the Harvard T.H. Chan School of Public Health, she still has that faded piece of green paper.

“You go into science because you want to make a difference, and when you get a grant, it means you can do something to try to help people,” Emmons said. “It just has so much meaning.” 

Those meaningful moments are now under threat. The Trump administration has frozen more than $2.2 billion in research grants to Harvard, halting studies with implications for neurogenerative disease, tuberculosis, and other conditions. The government’s move came after Harvard rejected White House demands for viewpoint “audits” of students and faculty, hiring changes, and other measures. Last week, the University filed suit against the administration.

The halt to funding disrupts a process that researchers say is appropriately competitive considering the stakes of their primary goal: advances in science and human health.

Jorge Chavarro, a professor of nutrition and epidemiology at the Chan School, understands the challenges from both sides. He applies for grants for his research on nutrition and human reproduction, and he’s served for about a decade on a scientific review group, also called a study section, evaluating other investigators’ proposals. 

“The NIH really does everything it can to ensure there is an absolutely fair review process for every single application,” he said. 

“You can’t just say, ‘I have this idea, please give me grant money.’”

For Emmons, who studies strategies to reduce cancer risk in under-resourced communities, the work begins long before the application is written. It includes building relationships with community partners, staying up to date on what’s been published in her field, and networking with other researchers to gain a sense of what’s coming next.

“You don’t want to do things that somebody’s already doing,” she said. “You want to take things in a new direction.”

Then you have to test the idea. The NIH requires evidence that the research is not just innovative but grounded in evidence.

“You can’t just say, ‘I have this idea, please give me grant money,’” Emmons said. 

It could take another six months to write the application, which begins with a one-page statement, known in NIH lingo as specific aims, explaining how the study fills existing gaps, the impact it could have, and the methods investigators will use. After the aims page comes the full application, which can stretch to more than 100 pages once you add in the 12 pages of detailed science and all the required administrative documentation, Chavarro said. It includes dense summaries of previous work, results from preliminary research, detailed descriptions of methodology, and a biosketch, a kind of academic CV. For Emmons, who works with human participants, there are also lengthy requirements for ensuring the ethical treatment of her subjects. And of course, there’s the budget. 

The cost of doing innovative research has grown faster than the average size of a typical grant, Chavarro said, effectively requiring scientists to be more innovative with the same amount of money. So every line in the budget must be justified. “Why is it important to buy a new piece of equipment that you don’t have?” he said. “Why do you need money for tubes or pipettes, liquid nitrogen?” 

Once submitted, applications are assigned to Scientific Review Groups made up of volunteer scientists who can judge the research on its merits. Study sections score proposals against one another for their innovation, significance, and approach. Then, advisory councils for each institute perform a second-level review to determine whether the studies fit with the missions of their organizations. The two reviews are aligned, and only the top projects receive funding. 

Success varies by institute, but at the National Cancer Institute, where Emmons submits most of her applications, there was a 14.6 percent success rate for the most common type of grant, the R01, in 2023, the most recent data available. That means for all the months or years of preparation, the pilot studies, the partnership-building, the haggling over budget lines, only one in six proposals will be funded. Researchers whose proposals aren’t funded have a chance to incorporate feedback and resubmit.

Both Chavarro and Emmons accept that the process can be frustratingly slow. The meticulousness of the approach, they say, is part of what makes it exceptional. Emmons pointed to the decadeslong public-private partnership between universities and the government as a shared commitment to science as a public good. 

“Early on, the government realized it benefits society and it benefits the government: It keeps people healthier, it gives people access to lifesaving treatments, and it reduces the cost of taking care of people when they’re ill,” she said. “It’s just what the government should be doing: It should be helping people.”