President Donald Trump’s first budget proposal for his second term, released Friday, calls for cutting the National Institutes of Health budget by nearly $18 billion next year, citing the agency’s role in the COVID-19 pandemic and recent transgender medical research as the primary justification for the massive cuts.

The premier public health research agency has “broken the trust of the American people with wasteful spending, misleading information, risky research, and the promotion of dangerous ideologies that undermine public health,” according to the budget proposal.

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The White House budget is merely a recommendation to Congress for spending and tax levels, and does not have the force of law. Congress is unlikely to pass major cuts to the NIH. Nevertheless, the document spells out the Trump administration’s priorities.

The proposed NIH cuts would make next year’s operating budget $27 billion, down from the nearly $48 billion it spreads across its 27 separate institutes and centers. Most of that money goes to grant projects at universities and nonprofit organizations across the country.

The White House provided a lengthy description of the justifications for the steep cuts in its 46-page proposal sent to Senate Appropriations Committee Chairwoman Susan Collins (R-ME) on Friday morning.

The budget document alludes to the congressional testimony from several key Biden administration NIH leaders that the agency could not disprove allegations that NIH research directed toward bat coronavirus research at the Wuhan Institute of Virology in China may have helped trigger the COVID-19 pandemic.

The NIH has also had a history of funding possibly dangerous research on viruses with pandemic potential, which, according to the proposal document, “further undermines public confidence in NIH.”

“The NIH’s inability to prove that its grants to the Wuhan Institute of Virology were not complicit in such a possible leak, or get data and hold recipients of Federal funding accountable is evidence that NIH has grown too big and unfocused,” the budget proposal reads.

The White House also cited the NIH’s funding for “radical gender ideology to the detriment of America’s youth” as a reason for slashing the agency’s budget. Specifically, the proposal cites the suicides of two teenage participants in a longitudinal study of youth on hormone replacement therapy.

On Thursday, the NIH published a striking rebuke of medical treatments, including hormones and surgical procedures, for minors struggling with gender dysphoria, signaling a sea change from the prior administration’s emphasis on the so-called “gender-affirming care” model.

The proposed budget would also eliminate funding for the National Institute on Minority and Health Disparities, the National Center for Complementary and Integrative Health, and the National Institute of Nursing Research, saving a combined total of over $900 million.

The president’s proposal would also eliminate the Fogarty International Center, a critical player in global HIV and AIDS prevention that has received bipartisan support for decades.

The White House budget proposal would also cut funding to the Centers for Disease Control and Prevention by $3.6 billion, eliminating “duplicative, DEI, or simply unnecessary programs.”

The CDC would retain an operational budget of $4 billion under the president’s plan.

The budget would also eliminate global health and family planning funding from the State Department and U.S. Agency for International Development budgets on the grounds that funds have been previously allocated to promote abortions worldwide.

“The Budget protects life and prevents a pro-abortion agenda from being promoted abroad with taxpayer dollars,” the proposal reads.

In addition to the myriad of cuts across public health programs, the budget proposal includes a $500 million bump for the Department of Health and Human Services to execute the Make America Healthy Again initiative.

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The funds are intended to “allow the Secretary to tackle nutrition, physical activity, over-reliance on medication and treatments, the effects of new technology habits, environmental impacts, and food and drug quality and safety across HHS.”

The Senate health committee will hold a hearing with HHS Secretary Robert F. Kennedy Jr. on May 14 to discuss the department’s budget.