Federal grant disruptions have removed funding from hundreds of active clinical studies, imperiling patient safety, data integrity and ongoing research timelines. A JAMA Internal Medicine analysis found 383 NIH-funded trials lost grant support through mid‑August, affecting tens of thousands of participants and dozens of cancer and infectious‑disease studies. The report lists trials in recruiting and active stages and warns of ethical and scientific fallout when funding stops midstream. Researchers and trial sponsors told JAMA that sudden cancellations force sites to halt enrollment, compromise participant follow‑up and risk wasting costly data collection. Investigators said trials most affected focused on infectious and respiratory diseases and that trials in the Northeast and international sites were overrepresented in the cuts. A separate analysis of federal research funding dynamics flags a bigger structural concern: while U.S. agencies inch back toward restoring funding after recent interruptions, international competitors — especially China — are accelerating R&D investment. That report projects Chinese public and private spending may already outpace U.S. commitments in key research areas, potentially widening talent and infrastructure gaps. For university research offices and sponsored programs teams, the immediate implications are operational: renegotiate contracts, protect participant safety, and communicate to faculty and funders. For policy teams, the developments underscore the urgency of stable appropriations and strategic planning to retain domestic research capacity.