Editor’s Note: Jennifer Holter-Chakrabarty, MD, is a former chair of the ASH Committee on Government Affairs and a current ASH Councillor who has continued her advocacy efforts in support of hematology. She is a hematologist in Oklahoma.
My interest in advocacy started as a blonde pigtailed child following my parents around the neighborhood to campaign for state representatives who supported child health care and mental health initiatives. When I became a physician, I was lucky enough to serve on ASH’s Committee on Government Affairs, where I learned the ins and outs of effective advocacy. In my early years of advocacy work for ASH, the nonpartisan support of research and science was virtually inviolate on Capitol Hill. Individuals may have differed on the precise number needed to fund initiatives that would benefit patients, but almost every staff member, regardless of political affiliation, understood the national need to have a vigorous research arm, along with a strong health care delivery system. As costs increased, there were more disagreements on how to balance the budget, but the fundamental value of supporting research and health care was never questioned.
The dynamic has become more challenging of late. In recent sessions of Congress, we routinely faced fiscal years that lacked full, dedicated funding. Short-gap funding — covering a few months at a time — has become the mainstay. This method of funding research has made it increasingly difficult to hire and maintain research staff and launch and sustain research trials and studies. I am sure it has delayed cures.
But all that pales in comparison to what is happening today. The cuts to (and ideological restrictions on) research funding, the mass layoffs at key federal agencies — including the Department of Health and Human Services and the Centers for Disease Control and Prevention — announced this year by the Trump administration, along with looming cuts to Medicaid, are draconian and threaten the entire livelihood of medicine.
With these cuts (both real and threatened), the likelihood of keeping early-stage investigators in the pipeline is low, and the likelihood of other nations scooping up well-educated research professionals is high. This brain drain will jeopardize the U.S.’s position as a leader in medical innovation and the development of new cures.
Areas of the U.S. that do not have significant endowments, such as the middle of the country, will likely see a loss of researchers, physicians, and medical students who will migrate to areas where research and translational science opportunities exist. We will lose the expertise and opportunities in states like my own.
The impacts of cuts to Medicaid and the federal health workforce cannot be overstated. These cuts will inevitably lead to an increase in the number of patients without adequate resources, placing an even greater burden on tertiary care centers that are already struggling to meet the demand. The result will be longer wait times, reduced access to care, and poorer health outcomes for vulnerable populations. The drastic federal cuts will ripple through entire communities, affecting not only health care providers but also the broader economy.
Participants in the 2024 ASH Advocacy Leadership Institute Hill Day included (left to right): Emily Limerick, MD; Jennifer Holter-Chakrabarty, MD; Quinto Gesiotto, MD; Muhamed Baljevic, MD; and Ugochi Ogu, MD.
Participants in the 2024 ASH Advocacy Leadership Institute Hill Day included (left to right): Emily Limerick, MD; Jennifer Holter-Chakrabarty, MD; Quinto Gesiotto, MD; Muhamed Baljevic, MD; and Ugochi Ogu, MD.
On another front, the rollback of diversity, equity, and inclusion initiatives in research can significantly hinder our understanding of different health outcomes among various populations. Without this research, we risk losing valuable insights into the physiological underpinnings of these disparities, which are essential for developing precision medicine and improving health equity.
This landscape makes the role of advocacy even more important. We must educate the public and clarify the significant impact of these cuts in each of our states. When I was rounding in my hospital recently, patients of varying political beliefs expressed concern about the impact of these cuts on their lives. Would new therapeutics be available to them when needed? Would their trial still be open? These were questions I could not answer.
As physicians, we are very accustomed to making difficult concepts simple and educating groups at different levels of understanding. We excel at telling the stories of our patients’ successes and failures, illustrating how the availability of treatments such as CAR-T therapy can transform disease management and change lives.
Also, as physicians, we have taken a vow to “do no harm.” Let’s use our storytelling skills to advance that vow and speak out in support of sustained scientific research and a commitment to key federal health care agencies. By doing so, we can ensure that our patients receive the best possible care and that our nation remains at the forefront of medical innovation.
To learn more about ASH’s advocacy and what you can do, visit the #Fight4Hematology Action Hub.
