Opinion: U.S. biomedical research relies on philanthropy, large and small

The National Institutes of Health remains the largest funder of biomedical research in the country at roughly $48 billion.

But it is imperiled. The Trump administration has proposed reducing its budget by 40% to $27.9 billion for fiscal year 2026. Congressional committees have pushed back, proposing funding at current levels (albeit with different allocations and emphases).

The National Institutes of Health is the nation’s largest supporter of basic research, but it’s important to remember it is not the only one.

Private industry is a much bigger driver of biomedical research and development, but its focus, not surprisingly, is on the development of commercial products. A critical source of support for biomedical research that is often overlooked and underappreciated is private philanthropy.

The origins of modern scientific philanthropy began in the late-19th century with the fortunes of men like John D. Rockefeller and Andrew Carnegie, whose wealth from industries like oil, steel and railroads created private foundations to fund long-term, original medical and scientific research where government and commercial support was essentially non-existent.

One example: In 1902, the Rockefeller Foundation spent more than $1 million in medical research compared to $50,000 spent in 1904 for the federal Hygienic Laboratory, the forerunner to the National Institutes of Health.

There are nearly 700,000 private foundations and nonprofit organizations in the United States, according to a 2024 study published in Scientific Reports. Approximately 10% fund or perform scientific research, averaging $30 billion in grants and other funding per year, approaching National Institutes of Health funding levels.

This fact makes U.S. science distinct from other countries where scientific philanthropy is relatively rare. In this country, it’s common to read about an alumnus of a research university or the recipient of a life-changing medical treatment showing their appreciation in the form of a gift or donation, paying back to pay forward.

In the rest of the world, not so much.

Philanthropic funding of science is critical because foundations, private organizations and individuals tend to be more flexible, more accepting of risk and more open to innovation and experimentation. More than industry, private philanthropy embraces a longer payoff horizon.

Cancer research in particular has long benefited from local visionaries. Some of the oldest and largest cancer research centers in the nation — M.D. Anderson in Houston, Memorial-Sloan Kettering in New York City and Fred Hutchinson in Seattle — were fundamentally launched and sustained with individuals’ largesse, long before these institutions made names and reputations for academic excellence.

Monroe Dunaway Anderson was a Texas banker and cotton trader. Alfred P. Sloan Jr. was an industrialist. Charles F. Kettering was an inventor. Fred Hutchinson was a Major League Baseball player who died of cancer in 1964. The institute was named after him by one of its founders: his brother William B. Hutchinson, a cancer surgeon.

Over the course of my career as a physician-scientist and as head of major biomedical research enterprises, I have talked with many, many people about why they give. Most often they do so out of a sense of altruism and desire to help find new treatments, to prevent or cure disease and to improve or save lives — sometimes focused on diseases that have affected them or loved ones.

A few years ago, I walked into the room of a patient who was clearly dying of cardiovascular disease. A young specialist was describing to the family a last-ditch procedure. I listened. I said enough. The procedure was both too much and too little. It was time to focus on the patient’s comfort and ensure his final days were dignified and pain-free.

The family agreed. And shortly after the patient passed, without any notice, they gave a multimillion-dollar gift to create an expansive palliative care program.

Every gift, large or small, advances the cause of medicine and science. The next great leap in health research, the next translation from bold idea to life-saving cure, may emerge from a simple experiment paid for by someone’s $25 donation.

It’s a great American tradition.

Brenner is a physician-scientist and president and chief executive of Sanford Burnham Prebys Medical Discovery Institute in La Jolla.