Over the opposition of Health and Human Services Secretary Alex Azar, who was in the room, the president chose the course advocated by his political advisers and Vice President Pence: to end the work of government researchers and impose restrictions on funding for universities and other outside labs. Taking a tough stance on fetal tissue research appealed to Trump, who saw it as a way to burnish his antiabortion credentials for his reelection campaign.

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These internal dynamics in the late-May meeting, described by two senior administration officials and outside advisers familiar with the decision who spoke on the condition of anonymity, demonstrate the primacy of the 2020 election in shaping policy decisions at the administration’s highest levels.

During the conversation, White House officials acknowledged that the change might sacrifice important research and lead to litigation, but decided to go ahead anyway, said one administration official. Trump wants to make abortion an issue in 2020 to drive support among evangelical voters and saw the decision as one way to highlight differences with Democrats, aides said.

In the end, those political calculations outweighed the well-publicized “audit” that the Department of Health and Human Services launched last fall of all the biomedical research relying on fetal tissue carried out by government and academic laboratories funded by the National Institutes of Health. The review included workshops with scientists and listening sessions with social conservatives.

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The months-long audit was intended, in part, to explore whether there are adequate substitutes for human fetal tissue, which has become a lightning rod for antiabortion activists. Scientists were adamant that fetal tissue is an essential research tool — at least for now — because the cells are less specialized than adult tissue cells.

“What we wanted to happen was [for the White House] to keep off it and keep things the same,” said one NIH scientist, reflecting the institutes’ consensus.

An HHS spokeswoman declined to discuss Azar’s view. “From the beginning, the president and the secretary have been clear that this is a pro-life administration,” she said. “The secretary fully supports the [president’s] decision.”

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At the Oval Office meeting, Joe Grogan, director of the White House Domestic Policy Council, presented Trump with a menu of options. They included continuing the funding, boosting support for research to develop alternatives to fetal tissue, and immediately ending all NIH contracts and grants for government and outside research that uses fetal tissue, according to a senior administration official and two others familiar with the options.

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Azar argued for a less restrictive course, proposing a compromise that would extend both the review period and the search for alternative research methods, according to the sources.

The president rejected that idea and chose a course toward the ideologically conservative end of the spectrum, though not the most extreme. In a six-paragraph statement, HHS officials announced Wednesday that NIH would provide no more money for fetal tissue research by its own employees.

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The statement also said that federally funded projects at other institutions would face a new hurdle: They would now undergo a separate screening by an ethics advisory panel of up to 20 people, one-third to half of whom would be biomedical scientists.

In addition, HHS announced that it was terminating a long-running $2 million annual contract with a lab at the University of California at San Francisco that is the nation’s sole site for using “humanized mice” — implanted with fetal tissue — to test new HIV therapies that have appeared promising in test tube trials.

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Asked whether that lab has shut down and whether the university plans to try to replace NIH money, which was its only support, a UCSF spokesman said: “We just can’t say what’s next. Even we don’t know.”

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While antiabortion activists decry the use of what they call “baby body parts” in research, a broad cross-section of biomedical researchers say that the research model using mice implanted with fetal tissue has been pivotal to understanding diseases from AIDS to cancers to Zika, as well as developing new therapies to treat them and other illnesses.

One of the immediately affected projects is at the Rocky Mountain Laboratories in Montana, part of NIH’s National Institute of Allergy and Infectious Diseases. The researcher there, Kim Hasenkrug, has enough implanted mice to “do one more study,” according to Warner Greene, a former director of the Gladstone Institute of Virology and Immunology who has been preparing to collaborate with Hasenkrug on an emerging theory that could lead to an HIV cure.

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Hasenkrug, whom Greene said has been forbidden by federal officials from speaking publicly, “is in business for one more experiment that would probably run a couple of more months . . . It will be an incomplete study,” Greene said.

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Last fall, NIH informed the Montana lab that it could no longer procure fetal tissue for its work, though NIH officials later allowed Hasenkrug to buy more material under the policy that ended Wednesday.



Mike McCune, a longtime HIV researcher affiliated with the Gates Foundation, said, “The concrete effects [of the White House’s decision] are they are taking a scientific process and throwing it out the window.”