This is an opinion column.

It just got real in Alabama.

The National Institutes of Health on Friday night announced huge cuts to biomedical research grants, a move that would deeply impact the University of Alabama at Birmingham, a huge Alabama employer, not to mention Birmingham and its suburbs and health care across the state. Not to mention human lives.

The University of Alabama at Birmingham has received more than a billion dollars in NIH funding in recent years and relied heavily on those and other federal grants for its rise to prominence.

In bragging about setting a $774.5 million federal funding record in 2022 – more than $400 million of it from NIH – UAB issued a press release boasting that it remained in the top 1 percent of all NIH-funded institutions, public or private.

“Furthermore,” it said, “all six of UAB’s health-related schools are in the top 15 public universities in NIH funding in FY 2022.”

These cuts, if they stand, will be devastating.

The cuts target “indirect” grant costs, which provide funds above the amount of the grant for things like administration, equipment, or other items needed to make the project work. NIH announced Friday night it would limit that indirect amount to 15% of the grant. It is unclear exactly what UAB’s indirect rate has been – I’ve been told everything from 30% to 56% and honestly do not know – but it appears to be much higher than average.

A UAB spokesman did not immediately respond to questions, but several professors and doctors privately were close to panic Friday night and this morning, wondering if they should pack their bags.

Steve Ammons, president of the Birmingham Business Alliance, said he was unsure of the specifics, “but certainly any reduction in funding would be a hit to UAB since they were in the top 30 for 2024 for NIH funding. Certainly something we need to watch and make sure we advocate for the state’s largest employer.”

Birmingham Mayor Randall Woodfin also said he was trying to assess the impact. He said the cuts would first hurt UAB’s ability to save lives, now and in the future, and potentially stifle technological growth that not only makes us healthier, but sustains the economy.

“People need to be reminded that UAB is not just the largest employer in the city, it’s the largest employer in the state,” he said. “So as it relates to our state’s GDP, as it relates to our economic growth, as it relates to our future around genomics, personalized medicine, and where health care is going, NIH research dollars play a massive, significant role. And without a doubt, without knowing numbers yet, I can tell you this early, just receiving the information, those in the UAB family have a right to be concerned.”

It is hard to talk about “ifs” in the world we live in, the moment we now find ourselves. Daily edicts are made and undone, and daily panic becomes anesthetizing over time. Because the sky can only fall so many times.

But if these cuts stick, millions upon millions will be lost in an institution that employs 28,000 people and enrolls 23,000 students, that provides jobs and health care and fuel to the regional economy that otherwise relies disproportionately on the service industry – restaurants and breweries and bars.

And it’s not just UAB. According to United for Health, NIH grants in Alabama in 2023 alone supported 4,769 jobs for an economic impact of $909 million and went to institutions from Mobile to Huntsville and in between. They impact almost 13,000 jobs at more than 1,200 businesses. Including HudsonAlpha.

Woodfin said it’s not about who you voted for or what you look like.

“And you’re either pro-Alabamian and American health or you’re not,” he said. “There’s no in-between here. And when you cut funding, you hurt not just employers, but you hurt the people who voted for you as it relates to the ability for life-saving medicine, period.”

NIH grant administration has been targeted as part of the witch hunt to root out demands for diversity in employment, and similar issues in research.

But it comes home to roost. At the beating heart of the largest metro area in a deep red state that already lags the nation in health care.

Republican Sen. Katie Britt is said to be the smart one, the up-and-comer on the Ways and Means Committee.

This is her moment to prove it.

John Archibald is a two-time Pulitzer winner for AL.com.