Funding for Defense Department medical research into traumatic brain injuries has dropped by more than three-quarters in the last three fiscal years, even as the problem continues to plague U.S. servicemembers. At issue is the Pentagon-funded program to research detection and treatment of TBIs and to understand psychological health issues, including those that can come with TBIs, such as post-traumatic stress disorder. Spending on this initiative has dropped from $175 million in fiscal 2024 to $40.5 million in fiscal 2026, and the House’s Defense spending bill for fiscal 2027 would not increase the funding. The House Appropriations Committee approved that bill on June 24. The drop in funding for research into brain health has received little public attention. But it is one of several Pentagon-funded research areas of vital importance to military personnel that have seen funding cutbacks in the last several years, according to the funding laws, lawmakers and advocates in the medical research community. TBIs have been called the signature wound of this generation’s wars. Scores more cases have come in since February due to Iran’s ongoing attacks on U.S. bases in the Middle East, on top of injuries that regularly arise from the blasts troops face during training with weapons such as shoulder-fired missiles. “The cut in program funding for traumatic brain injuries essentially shuts down the pipeline of research needed to understand the underlying cause of these injuries,” said Shannon Connell, the chief executive officer of the Invisible Wounds Foundation, which secures private funding for TBI research, in an email. “Until effective diagnostics and treatments can be developed, our warfighters, veterans, and their families will continue to struggle and suffer.” ‘Lifesaving’ research Each year for more than three decades, Congress has added appropriations for the Pentagon's Congressionally Directed Medical Research Programs, which has led to advances against diseases and disorders, with an emphasis on those that affect servicemembers. In the program’s history, some $20 billion has been allocated for thousands of peer-reviewed research grants, yielding dozens of drugs, devices and diagnostics. “The program supports crucial lifesaving breakthrough research into a wide array of afflictions,” said Rep. Rosa DeLauro of Connecticut, the top Democrat on the House Appropriations Committee, at the panel’s markup of the Defense money measure. “Duchenne muscular dystrophy, bone marrow failure, breast cancer, ovarian cancer, prostate cancer, Alzheimer's, Parkinson's, traumatic brain injuries, psychological health, military burns, tick-borne diseases, spinal cord injuries, toxic exposure — the list goes on,” DeLauro said. CDMRP typically enjoys bipartisan support. But its overall funding level has been an unusually contentious topic in recent years. Total annual spending on the program, while still above $1 billion, has shrunk. And research into afflictions such as brain injuries that disproportionately affect U.S. military personnel have seen some of the largest cutbacks. The funding fight is already underway this year and will peak in the months ahead as the fiscal 2027 Defense spending bills advance. CDMRP topline Under pressure from fiscal hawks in Congress, funding for CDMRP dropped by more than half from fiscal 2024 to 2025. While it then went up slightly in fiscal 2026, it has not yet returned to the level of two years prior. More specifically, in the fiscal 2024 Defense spending law the overall CDMRP program got $1.51 billion. But in the fiscal 2025 continuing resolution, the total dropped 57 percent, to $650 million. In the current fiscal year, the program’s money rose to $1.27 billion, but that was still 16 percent below the fiscal 2024 level. The House’s draft fiscal 2027 Defense spending bill would set the CDMRP’s overall funding level at $916.5 million. But the Senate — which has yet to mark up its bill — typically adds about $370 million above the House level each year. So lobbyists expect the program’s total fiscal 2027 funding to stay flat compared with fiscal 2026. But the fiscal 2027 Defense spending bill — at least as the House has written it, before any Senate additions — would cut research funding aimed at fighting numerous diseases and disorders, according to Rep. Mike Levin, D-Calif., an outspoken advocate for the programs “Funding for autism, melanoma, and vision research is reduced,” Levin said at the House Appropriations Committee markup of the Defense bill. “Epilepsy, hearing restoration, and military burn research is eliminated entirely.” Mark Vieth, the coordinator of the Defense Health Research Consortium — a coalition of several dozen groups representing the health care community, patients and veterans — said the Pentagon's medical research programs are still catching up after the fiscal 2025 spending cutback and with overall funding still below the fiscal 2024 level. The House’s proposed funding for the CDMRP program “is still well short of levels proposed by the committee in previous years and insufficient for regaining the ground lost to our global competitors resulting from the 57 percent cut in FY25,” Vieth said by email. Vieth said the House bill is a start toward adequately funding the program but added, “We hope that the Senate will provide significantly higher levels of funding in their version of the bill.” Zeroing out research Regardless of what happens with overall funding totals, how individual programs will fare within that total is a separate question. When funding for the CDMRP program dropped 57 percent in the fiscal 2025 CR, funding for several diseases and disorders fell fully 100 percent — and some of these afflictions are particularly problematic for servicemembers. TBI research was one. It received $175 million in fiscal 2024, but it was zeroed out in fiscal 2025. So its fiscal 2026 funding of $40.5 million is less than a quarter of the fiscal 2024 level. All told, the fiscal 2025 cutback completely eliminated new spending that fiscal year on 23 of the program’s 35 diseases or disorders — including work on prosthetics, multiple sclerosis, lupus, kidney cancer, spinal cord injuries, glioblastoma, autism, arthritis and substance abuse. TBI's toll The Defense Department estimates that more than a half-million servicemembers have suffered TBIs in this century, including from combat, training and off-duty accidents. In recent decades, roadside bombs in Iraq and Afghanistan caused many of the injuries. Going forward, drones may be the source of even more such casualties. Most of the U.S. military brain injuries in the last quarter-century were considered “mild” concussions. Even so, by the official Pentagon count, non-mild brain injuries among current and former servicemembers still number in the tens of thousands. Moreover, the Pentagon figures count only reported cases, and the Invisible Wounds Foundation estimates the real total could be two-to-four times higher. And the number of cases are growing. Since the Iran war began in February, the majority of the more than 500 U.S. troops injured in the Middle East sustained brain injuries, most of them categorized as not serious, U.S. Central Command has said. The enemy is not the only one triggering TBIs. Increasingly, attention has focused on how the so-called blast overpressure from U.S. forces’ own weapons — fired either in combat or in training — can cause brain injuries. Congress has responded by requiring in the fiscal 2025 NDAA that safety limits be set and troops’ exposure to blasts be tracked. The Pentagon’s Warfighter Brain Health Initiative has begun to gather more data and explore solutions. Needed: accurate diagnoses The U.S. government has spent more than $2.1 billion since 2015 on TBI research, more than half at the Department of Health and Human Services, including the National Institutes of Health, and the rest at the Pentagon, according to RAND Corporation. But NIH funding has also been scaled back during the second Trump administration. Experts said such funding cuts are hampering development toward a key need: better diagnostic tools. There is currently no reliable way to diagnose TBIs, which is the first step to treating them, experts said. CT scans and MRI scans can rule out some of the most serious brain injuries but cannot detect all TBIs, according to the Food and Drug Administration. “More sensitive and objective ways to diagnose and detect mild TBI are needed,” the FDA’s website says. Connell of the Invisible Wounds Foundation said much more work needs to be done. “We do not have an accurate scanning device (MRI machine) that can detect a TBI from repetitive blast exposure at the necessary microscopic levels, which we urgently need, or any FDA-approved treatments for them,” Connell said. “In fairness, the science is evolving rapidly and because of that, we understand more than we did 10 years ago. We’re now closer to developing a diagnostic but funding cuts limit us from getting there.” The lasting effects of these so-called invisible wounds can be grave. Earlier this year, a Veterans Affairs Department study of suicides found that, in 2023, veterans who had been in the department’s care and who had been diagnosed with a TBI were nearly twice as likely to have died by suicide.
