Beyond the Bottom Line: Why Philanthropy Is Essential to the Future of Autoimmune Disease Research

Autoimmune disease is often called a "silent epidemic" — and for good reason. More than 100 conditions, from rheumatoid arthritis to lupus to multiple sclerosis, fall under this umbrella, yet because they're rarely discussed as a single category, the true scale of the crisis stays hidden.

"This is a high-stakes moment for public health," said Laurie Venning, Founder and Chairman of Praespero. "Cases are rising, diagnosis and treatment costs are climbing, and we cannot rely on any single source of funding, especially government, to keep pace. This is an all-hands-on-deck moment."

The numbers bear this out. According to the Autoimmune Association, 90% of U.S. healthcare spending ($4.5 trillion/year) goes toward chronic diseases, including autoimmunity and the projected cost of autoimmune diseases was $180 billion in 2025 for 29 diseases, doubling within 15 years without new treatments.  This figure that doesn't even capture the indirect toll of lost productivity, presenteeism, and reduced quality of life. It typically takes 4.5 years and nearly five physicians to reach a diagnosis — time during which disease often progresses and costs continue to mount.

At the very moment this need is accelerating, the traditional engine of biomedical research funding is stalling. According to a 2025 report from the Association of American Medical Colleges, roughly 2,300 National Institutes of Health grants totaling nearly $3.8 billion were terminated as of June 2025, including at least 160 clinical trials studying cancer, HIV/AIDS, and chronic diseases. Legislative action has since staved off the most catastrophic scenarios for NIH's baseline budget, but shifting multi-year payment rules, thinning success rates, and mounting administrative friction continue to destabilize academic and clinical research pipelines across North America.

"There is no replacing the NIH as the central funder of American biomedical research; private foundations, industry, and philanthropy will not fill this gap," wrote physician Harold Collard, MD, in a recent analysis of the funding landscape. "This decline in new NIH awards will undoubtedly result in lost discoveries and innovations, lost jobs, and an accelerated ceding of America's scientific leadership to other countries that are investing heavily in cutting-edge research."

"He's right that philanthropy cannot replace the NIH's scale. But that has never been philanthropy's job," notes Venning. "Where organizations like Praespero matter most is earlier in the pipeline - funding the exploratory, high-risk work that later makes a scientist's case to a major granting agency in the first place."

"He's right that philanthropy cannot replace the NIH's scale. But that has never been philanthropy's job. Where organizations like Praespero matter most is earlier in the pipeline... -Laurie Venning, Praespero Founder

Venning adds that philanthropic funding from non-profits like Praespero may seem like a drop in the bucket compared to government grants.  "But its value goes well beyond the dollar amount. For many scientists, our support gives them the latitude to explore and build proof of concept, so their science can even reach the point where a major funder will look at it."

Praespero calls this the multiplier effect: since 2018, the foundation has donated $7 million across 50 gifts to more than 30 labs, catalyzing an estimated $30 million in additional funding from other sources.

That flexibility matters because legacy funding structures tend to be risk-averse by design.

"The funding environment from governmental funding is very challenging right now," said Jeffrey Hubbell, Vice President, Life Sciences and Engineering at New York University. "They want something that can't possibly fail — but if you can't possibly fail, you can't possibly win big either. Philanthropic funding allows one to take an educated, calculated risk, in a team with collaborators, and do something important."

"They want something that can't possibly fail — but if you can't possibly fail, you can't possibly win big either." - Jeffrey Hubbell, Vice President, Life Sciences and Engineering at New York University.

Edwin Wan, PhD, Associate Professor at West Virginia University School of Medicine, sees the same dynamic play out in his own lab. "The advantage of private funding like Praespero is more academic freedom and fewer restrictions," he said. "If unexpected results open the door to another area, we're able to pursue that. With federal funding, we sometimes have limitations."

Praespero's model is built around that freedom: few-strings-attached grants for higher-risk, higher-reward research; an emphasis on fundamental science over incremental therapies; and, through Praespero Summits and its forthcoming Synergy Awards, structured opportunities for researchers to collaborate across institutions rather than compete in silos. In a field where information gatekeeping and duplicated effort slow everyone down, that connective tissue is its own form of infrastructure.

"What makes Praespero particularly unique is its emphasis on fundamental science and basic researchers," said Dean Tantin, PhD, Professor of Pathology at the University of Utah School of Medicine. "A lot of the money isn't spent to develop the next incremental therapy — it's spent to pursue fundamentally transformative ideas that, in the long run, have the potential for a much bigger benefit."

None of this suggests philanthropy can or should shoulder the funding gap alone. Government investment remains, by a wide margin, the backbone of American biomedical research, and no foundation can replicate its scale. But in a landscape where that backbone is under strain, the role philanthropy plays — funding the earliest ideas, tolerating risk, and connecting researchers who might otherwise work in isolation — becomes not just valuable, but necessary. It is the difference between a promising idea dying quietly in a lab and a promising idea surviving long enough to become a cure.

In a landscape where that backbone is under strain, the role philanthropy plays — funding the earliest ideas, tolerating risk, and connecting researchers who might otherwise work in isolation — becomes not just valuable, but necessary.

Autoimmune disease research is at an inflection point. The question isn't whether government or philanthropy alone can meet the moment. It's whether both, working differently but in concert, can move fast enough for the millions of patients waiting on an answer.