BALTIMORE — Some scrambled to wind down projects that suddenly lost funding, some brushed up their resumes after being told this week they were being let go.

The Trump administration’s slashing of $800 million in USAID grants to Johns Hopkins University created immediate but also longer-range angst: How does the university that is more reliant on federal research funding than any other in the U.S. go on at a time when President Trump and his advisor Elon Musk’s Department of Government Efficiency are threatening even more spending cutbacks?

“DC is rethinking the federal government’s relationship to all of us,” said Michael Rosenbaum, a Baltimore-based tech entrepreneur and Hopkins trustee. “This compact between universities at large and the federal government that is being questioned now… We need to engage in the question. Do we still believe in this compact?”

Rosenbaum said he believes until the recent headline-generating upheavals over federal funding many people were unaware of the “order of magnitude of positive impact” that investments in Hopkins research produces.

“The country is safer, the country is healthier, the country has greater economic growth than it would have had without it,” he said.

While more cuts are anticipated at Hopkins, the first wave has hit those who work in global health. Hopkins cut more than 2,000 positions, 247 of which are based in the U.S. and the rest overseas. Some Americans may think, erroneously, that this won’t have an impact on their own well-being, those in the field say.

“The research that we were doing overseas directly affects Americans,” said Kelly Curran, who was laid off this week as the project director of Hopkins Medicine’s SMART4TB, an ambitious USAID-funded program to transform the diagnosis, treatment and prevention of tuberculosis.

“Tuberculosis anywhere is tuberculosis everywhere. It’s airborne,” Curran said.

She points to a recent and continuing TB outbreak in the Kansas City area, part of a rise in what has become the deadliest infectious disease in the world.

Investing in research to prevent the disease is “not just life-saving but also cost-saving for Americans,” Curran said, citing studies that show how controlling TB overseas more than pays back the initial outlay.

Curran only joined SMART4TB in January, having spent 27 years fighting infectious disease at another Hopkins affiliate that was also devastated by the USAID cuts, Jhpiego, which focuses on women’s health. Curran had been Jhpiego’s senior director for HIV and infectious diseases, overseeing a $391 million project to control and treat HIV and other viruses. It was funded by both USAID and PEPFAR, the President’s Emergency Relief Plan for AIDS Relief, which was started by President George W. Bush and widely considered among the most successful and cost-effective public health and foreign policy initiatives.

“I was hoping to have a similar impact on tuberculosis,” Curran said.

With Trump signaling from the start of his term that foreign aid was in his crosshairs, she and others who work in global health have been dealing with uncertainty for weeks now. Curran has been addressing how to continue caring for those currently enrolled in clinical trials — such as one in African and Asian countries studying if a shorter treatment regimen is as safe and effective as longer regimens in children under 10.

And, she and her colleagues are seeking alternative funding streams, although few believe other sources can take the place of the federal government’s grants.

“The $800 million in USAID award terminations represented an amount of funding that the university could not make up from other sources,” a Hopkins spokesman said in a statement to The Baltimore Sun.

“More than any other American university,” Hopkins is “deeply tethered” to federal grants, which amounts to nearly half of its incoming funds, JHU president Ron Daniels said in a recent statement posted on his office’s website.

Hopkins, including its Applied Physics Lab, topped the list the National Science Foundation’s annual survey of federally financed higher education research and development expenditures with more than $3.3 billion for fiscal 2023.

JHU also is the top recipient of funds from the National Institutes of Health. Hopkins received more than $1 billion from the NIH in fiscal 2024, according to a court filing by Laurent Heller, the university’s executive vice president for finance and administration.

Hopkins was founded almost 150 years ago as the country’s first research university, and its amount of federal support is something of a point of pride. Daniels’ statement notes how federal grants are awarded on a “competitive, meritocratic basis.”

“The question was always were you good enough, was your science good enough,” said Dr. Theodore “Jack” Iwashyna, a Hopkins medical professor, pulmonologist and NIH grant recipient.

Iwashyna said research has to pass “the most rigorous tests” to receive NIH funds, a system that he credits with producing “an incredible pace” of improvements in medical care.

“It seems like they’re trying to gut that,” he said.

Hopkins has joined litigation against the Trump administration’s efforts to cut NIH funding. Those cuts have been temporarily blocked by a federal judge.

Those who have lost USAID funding and their jobs say their work in such areas as family planning, maternal and child health, nutrition, clean water and disease control came at a relatively small price tag. USAID’s budget was less than one percent of federal spending.

“We were doing amazing work for very little money,” said a Jhpiego senior team leader who asked that her name not be used because she had not yet seen the terms of her separation agreement. “We were trying to offer people who are living on next to nothing a way out of lifelong poverty.”

Some have suggested that Hopkins could use its $13 billion endowment to make up for what it loses in federal grants, but according to its most recent financial statement, $10 billion of that comes with donor restrictions.

“The vast majority of the endowment is legally restricted, meaning that the funds are earmarked for specific uses stipulated by donors — most of which are to support core mission-critical activities, including faculty salaries, student financial aid, equipment, facilities, student affairs, and libraries — and cannot be used for other purposes,” according to a Hopkins spokesman.

A $1 billion donation from Hopkins alum and benefactor Michael Bloomberg last year, for example, greatly boosted the JHU endowment, but is designated for making medical school tuition free to almost every student — or at least those from families making less than $300,000 a year, which is 95% of all Americans, according to Hopkins.

How much deeper federal funding will be cut remains to be seen. But for Curran, the upheaval has only deepened her resolve to continue her work.

“I will never stop working to make the world a healthier place,” she said. “I feel more committed than ever.”

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