WASHINGTON — A new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine calls for the National Institutes of Health to implement a unified, agencywide approach that prioritizes pediatric health research and funding. The report says incidences of chronic disease and poor mental, emotional, and behavioral health are on the rise, and American children are experiencing worse health outcomes than their peers in other developed nations — and calls for changes that will enable the agency to improve health outcomes through childhood and beyond.

As the world’s largest public funder of biomedical research, NIH has made the United States a global leader in scientific discovery and medical breakthroughs, and it has supported numerous advances in pediatric research. However, the recent worsening of pediatric health outcomes in the U.S. indicate that more should be done to address this multifaceted issue.

“We want to give today’s children the chance to grow into tomorrow’s leaders free of chronic disease and illness,” said Frederick P. Rivara, vice chair for academic affairs and professor of pediatrics at the University of Washington School of Medicine and Seattle Children’s and co-chair of the committee that wrote the report. “Pediatric research has made incredible strides over the last decades, but making structural and programmatic changes at NIH can advance this progress even further.”

“NIH is uniquely positioned to lead the efforts in advancing children’s health research,” said Phyllis A. Dennery, Sylvia Kay Hassenfeld Professor and chair of pediatrics at Warren Alpert Medical School of Brown University, pediatrician-in-chief at Rhode Island Hospital, medical director at Hasbro Children’s Hospital, and co-chair of the committee that wrote the report. “The important discoveries and insights can lead us to realizing a brighter future for America’s children.”

Challenges to Conducting Pediatric Research
The report emphasizes that children should be protected through research, rather than from research, but the committee recognized that in addition to scientific and methodological challenges, unique regulatory and legal requirements and ethical considerations impact research involving children. The report says the NIH Pediatric Research Consortium (N-PeRC) is a leader in facilitating and coordinating pediatric research within NIH and recommends N-PeRC receive enhanced institutional prominence and dedicated funding and resources. N-PeRC also should coordinate with initiatives across NIH to develop guidance and strategies for pediatric research, promote transparency and trust with the public, and ensure the deliberate and ethical inclusion of children in research.

Financial challenges posed by the grant application and review processes are another obstacle to advancing pediatric research. To address this, NIH should allow for more flexibility with budgets, timelines, and supplemental funding opportunities for researchers engaged in pediatric research, the report says.

Other recommendations include maintaining current levels of pediatric research at the NIH Clinical Center and improving the Research, Condition, and Disease Categorization system to better assess funding levels.

Vision for the Future
The committee envisions the United States as a global leader in promoting child health and developed a set of four goals to ensure all children can thrive through adolescence into adulthood. The four goals are:

• Integrating pediatric research throughout NIH programs and initiatives

• Expanding NIH initiatives and programs to address unmet research needs in child health

• Strengthening the impact of pediatric health research by optimizing translation of research into practice

• Building trust through effective communication of pediatric health research findings

Pediatric Prioritization and Inclusion
The report finds that though all NIH institutes and centers support pediatric research, few strategic plans specify how progress or success toward their goals will be measured or monitored. The report urges the directors of all institutes and centers that fund pediatric research explicitly incorporate pediatric health into their strategic plans, and include metrics to measure success in meeting those goals. To better facilitate this integration of pediatric research priorities across the agency, NIH should also adopt a consistent, agencywide definition of pediatric research.

The study — undertaken by the Committee on Strategies to Enhance Pediatric Health Research Funded by NIH — was sponsored by the National Institutes of Health.

The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, engineering, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.

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