Apparently, the Trump administration has a new policy about policy-focused grant applications to the National Institutes of Health, But it hasn’t yet told those who will be most affected by this policy—namely the applicants, other researchers, patients, healthcare professional, the public, policymakers besides the Trump administration and, well, basically everyone else with a human body or head. Trump political appointees have been “flagging and freezing policy-focused grant applications,” in the words of Max Kozlov reporting for Nature, including applications that have already been approved by scientific peer reviewers and NIH staff members.

That suggests that the the Trump administration may be halting the NIH’s longstanding practice of funding scientific studies that produce evidence to guide how health policies should be designed and implemented. Without such scientific evidence, you’ve gotta then wonder how the Trump administration may be making health-related policies going forward. In other words, how much of it will be actually based on scientific evidence versus pulled out of you know where?

In fact, “policy” may have even become a p-word—meaning a policed word at NIH. Last year, I listed in Forbes 197 words—ranging from “clean energy” to “pollution” to “trans” to “bias” to “race” to “women”—that when appearing somewhere in your grant application to a federal agency like the NIH or the National Science Foundation could get that application flagged and further scrutinized under the Trump administration. That reportedly even got grant applications that included words like transgenic mice, disease transmission an signal transduction flagged.

It looks like a similar thing is now happening with the word “policy.”Kozlov reported how “Dozens of applications have since been sent back to NIH programme officers in charge of the proposals, instructing them to remove the word ‘policy’ and its derivatives and determine whether the proposals can be salvaged.” It’s not clear whether those derivatives are actual synonyms of “policy” like rule, guideline, procedure, law, regulation, strategy and custom or things spelled somewhat similarly to “policy” like police, polio and polka. Therefore, you may want to be careful if you reference polka dots in any way in your grant application.

Kozlov mentioned something else at stake as well: whether the NIH will even continue to consider policymakers as a relevant stakeholder group for health. In this case, stakeholder doesn’t refer to someone who holds a piece of meat in his or her hand. Dictionary.com defines stakeholder as “a person or group that has an investment, share, or interest in something.” Kozlov cited internal NIH documents obtained by Nature as stating the following: “Policymakers are not considered a stakeholder group within the scope of NIH’s mission. NIH-funded research must empower decision-making by NIH mission-relevant stakeholder groups.” The documents then listed such “relevant” stakeholder groups as being patients, health-care workers, hospitals and scientists. I have reached out to contacts at the NIH to get further clarification on all these aforementioned actions and the reasons behind them.

To clarify, a policymaker is anyone who makes policies since that’s how words work. Policies are the rules, laws, and plans that determine how things work and run. Policymakers consist of elected leaders like the U.S President, governors, mayors, and Congress members, appointed officials like Presidential cabinet members and heads of government agencies, civil servants like various government employees and advisors, judges, business leaders like company executives and board members and leaders of different organizations such as schools, hospitals and community groups.

It seems a bit odd to exclude such people as relevant stakeholders when evaluating what to do health and healthcare-wise. That would be kind of like excluding coaches and owners when reviewing how the football team did. Or not including executives and board members when evaluating what a business should be doing.

It is, in fact, hard to find any issue in health that is not significantly affected by policymakers and policymaking in some way. For example, many have blamed the lack of action among policymakers for the persistent problems of pollution, food additives and gun violence. Similarly, there’s only so much that patients and healthcare professionals can do about obesity, heart disease, diabetes, cancers and other chronic conditions when conditions all around continue to push up the risk.

Policymakers are big parts of the systems that help cause, prevent, treat and care for different health conditions. They control the flow of funding and other resources. And the COVID-19 pandemic showed what can happen when the federal government does not act quickly and effectively enough to control the spread of a virus. If you want to fix any system, you’ve got to consider all parts of that system.

Now, if you are lobbying against the NIH funding policy-focused studies likening them to political lobbying, keep in mind that well-constructed scientific studies are very different from lobbying. Political lobbying is when you directly try to influence a decision maker, whether it’s a particular federal employee or U.S. Congress member, to vote or act in a particular manner. That’s very different from conducting a transparent scientific study that provides evidence that everyone can see and evaluate to support policymaking.

Again, the concern is that without proper scientific evidence, political leaders could end up making health-related policies that simply suit their agendas and needs rather than benefit others. Peter J. Hotez, MD, PhD, dean of the National School of Tropical Medicine and co-author of the book Science Under Siege: How to Fight the Five Most Powerful Forces that Threaten Our World with Michael Mann, MS, MPhil, PhD, has been warning about how authoritarian leaders can suppress scientists and others who may provide facts and evidence that counter what the leaders say. I’ve also covered in Forbes other moves made since January 2025 to give the U.S. President and his appointees much more control over federal funding and the work produced by it. This has included a new White House Office of the Management and Budget rule and proposed changes in the grant application reveiw process that could further push the scientific community and public out of the loop.

If flagging and freezing policy-related grant applications has indeed become an NIH policy, the question is why hasn’t it been clearly communicated already to everyone. And why haven’t scientists, patients and the rest of the public been given the opportunity to scientifically evaluate such a policy. After all, wouldn’t you want any policy to be a “Policy of Truth?”