Federal research funding is under pressure from two directions: domestic budget shifts and global competition. A JAMA Internal Medicine analysis found that NIH grant cuts this year disrupted 383 clinical trials, imperiling participant safety, data integrity and long‑term research agendas in cancer and infectious disease studies. Researchers warned that canceled grants disproportionately hit trials in the Northeast and those already recruiting participants. At the same time, research advocates flagged that China’s R&D spending may already outpace the U.S. as new federal research funding is being restored, intensifying concerns about America’s global research footprint. Higher education research offices and medical centers now face urgent questions about sustaining long‑running studies, recruiting and retaining graduate researchers, and the downstream impact on graduate training and commercialization pipelines.