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Strategies to Enhance Pediatric Health Research Funded by NIH

A young Asian mother is holding her baby daughter on her lap. She is sitting on an examination table in a clinic. The woman has bought the child to a routine medical appointment. The pediatrician is a black woman. The doctor is using a stethoscope to check the baby's heart and lungs.

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The National Institutes of Health (NIH) has requested the National Academies of Sciences, Engineering, and Medicine establish an ad hoc committee to examine pediatric research supported by NIH. The committee will consider the perspectives of multiple NIH Institutes and Centers in its deliberations. After reviewing the current NIH pediatric research portfolio and structure, the committee will make recommendations focused on improving NIH’s overall support of child health research. The committee may also consider ways in which the NIH Clinical Center could be used to advance innovative pediatric research.

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Introduction

Recent advances in pediatric health, such as declines in child mortality, would never have happened without significant and consistent federal investment—supported by Congress and led by the National Institutes of Health (NIH). Despite these advances, there is broad consensus among experts that child health is in crisis. Children in the United States are experiencing rising rates of chronic diseases and poor mental, emotional, and behavioral health. They are 80 percent more likely to die than their peers in European nations. Children who experience poor health or adversity in childhood are also more likely to become adults with costly chronic health conditions. Social and economic factors such as poverty, food insecurity, and poor access to health care result in health inequities that imperil the health and future of many American children. To address this multifaceted child health crisis, continued and new robust efforts led by NIH are needed urgently.

Key takeaways

NIH’s Investment in Pediatric Health Research

From FY2015 to FY2024, NIH pediatric research expenditures increased by 70% while NIH-wide expenditures increased by 62%. After adjusting for inflation, the committee found that research expenditures flatlined between FY2020 and FY2024. During this period, pediatric research expenditures consistently accounted for about 13% of the total NIH non-administrative budget.

NIH Pediatric Research Consortium

Because every NIH Institute and Center (IC) supports some level of pediatric research, the NIH Pediatric Research Consortium (NPeRC) was created to facilitate communication, align priorities, and coordinate pediatric research activities across the agency. However, it currently operates without dedicated funding or resources. Providing appropriate funding for NPeRC and elevating it to the NIH Office of the Director is essential for its future success.

Protecting Children Through Research Rather Than from Research

Despite NIH policies requiring children be included in human subjects research unless there are scientific or ethical reasons to exclude them, children are still being left out of research. Shifting the default toward inclusion of children in research while ensuring ethical safeguards are applied appropriately will help to advance the health and well-being of all children.

Key Recommendations

Key Recommendations

Children in the United States are experiencing rising rates of chronic diseases and poor mental, emotional, and behavioral health. They are 80 percent more likely to die than their peers in European nations.

Strategies to Enhance NIH-Funded Pediatric Research: Optimizing Child Health 2026
Consensus Study Report

Conclusion

There is an opportunity for NIH to lead the United States out of the current crisis in child health to a brighter future. NIH can reaffirm the unique value of pediatric research to the health and well-being of children. Because children are the future, NIH can demonstrate the significant return on investment that the nation gains by prioritizing pediatric research that is comprehensive, equitable, and groundbreaking.

Doctor Listening to a Young Girls Heart

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