GOOD AFTERNOON, AND WELCOME.
I'D LIKE TO CALL TO ORDER THE
62nd MEETING OF THE NIH ADVISORY
COMMITTEE ON RESEARCH ON WOMEN'S
HEALTH.
MY NAME IS VIVIAN OTA WANG THE
ORWH DIRECTOR AND EXECUTIVE
SECRETARY OF THIS COMMITTEE.
THE MEETING IS OPEN TO THE
PUBLIC BY LIVE BROADCAST ON THE
NIH VIDEOCAST NETWORK AND
RECORDED FOR OUR ARCHIVES AND
FOR FUTURE ON DEMAND VIEWING BY
THE PUBLIC.
IF YOU'RE A MEMBER OF THE PUBLIC
PER THE FEDERAL REGISTRY NOTICE
YOU MAY SUBMIT YOUR QUESTIONS IN
WRITING TO ME AT ACRWH@NIH.gov.
WE'LL BE ADDRESSING THESE
QUESTIONS AFTER THE MEETING.
THIS MEETING IS ENVIRONMENT.
THE ADVISORY COMMITTEE AND OUR
INVITED GUEST PRESENTERS ARE
PARTICIPATING THROUGH ZOOM.
NOW, FOR A MESSAGE FOR OUR
MEMBERS.
AS MEMBERS OF THIS FEDERAL
ADVISORY COMMITTEE, YOU ARE
SPECIAL GOVERNMENT EMPLOYEES
WHICH MEANS YOU'RE SUBJECT TO
THE SAME ETHICS RULES THAT APPLY
TO GOVERNMENT EMPLOYEES.
THESE RULES ARE DESCRIBED IN THE
PAMPHLET ENTITLED STANDARDS OF
ETHICAL CONDUCT OF EMPLOYEES FOR
THE EXECUTIVE BRANCH.
YOU ED A COPY WHEN YOU WERE
APPOINTED.
AT EVERY MEETING WE'D LIKE TO
REVIEW THE STEPS WE MAKE AND TO
IDENTIFY AND ADDRESS PUBLIC
RESPONSIBILITIES AN PRIVATE
INTEREST.
AS YOU KNOW, BEFORE EACH MEETING
YOU PROVIDE US WITH A GREAT DEAL
OF INFORMATION ABOUT YOUR
PROFESSIONAL, PERSONAL AND
FINANCIAL INTEREST.
WE USE THIS INFORMATION AS A
FOUNDATION FOR ASSESSING WHETHER
YOU HAVE ANY REAL, POTENTIAL OR
APPARENT CONFLICTS MUCH INTEREST
THAT WOULD COMPROMISE YOUR
ABILITY TO BE OBJECTIVE IN
RECEIVING ADVICE.
IF YOUR NEED FOR SERVICES
OUTWEIGHS YOUR POTENTIAL
CONFLICTS OF INTEREST IDENTIFIED
WE WOULD ISSUE A WAIVER OR
RECUSE YOU FROM A PARTICULAR
PORTION OF THE MEETING.
WE USUALLY WAVE THEM FOR GRENERL
MATTERS BECAUSE WE BELIEVE YOUR
ABILITY TO BE OBJECTIVE WILL NOT
RELY ON FINANCIAL INTEREST.
YOU NEED TO BE ATTENTIVE TO AN
ISSUE THAT COULD ARISE OR COULD
APPEAR TO AFFECT YOUR RESPECT TO
A CERTAIN PARTY OR MATTER.
YOU'LL BE ASKED TO RECUSE
YOURSELF FROM THAT PORTION OF
THE MEETING.
BEFORE THE INTRODUCTIONS, I'LL
BRIEFLY REVIEW BEST PACTS FOR
PARTICIPANTS.
FIRST MUTE YOUR MICROPHONE AND
STATE YOUR NAME BEFORE COMMENTS
OR RECOMMENDATIONS.
THREE, TRY TO USE A HEADSET WITH
A MICROPHONE WHEN SPEAKING
USUALLY RESULTING IN THE
CLEAREST SOUND AND LEAST AMOUNT
OF AUDIO FEED BACK.
FOURTH, IF YOU HAVE A QUESTION
OR WOULD LIKE TO MAKE A COMMENT,
PLEASE RAISE YOUR HAND.
OKAY.
NEXT I WOULD LIKE TO HAVE THE
MEMBERS INTRODUCE YOURSELVES BY
NAME AND WHAT INSTITUTION YOU
REPRESENT.
START WITH DR. ARNOLD.
>> I'M ART ARNOLD AT UCLA AND DO
ANIMAL RESEARCH STUDYING SEX
DIFFERENCES IN DISEASE.
>> THANK YOU
>> AND I'M ALSO THE ASSOCIATE
CHIEF CLINICAL OFFICER FOR THE
WOMEN'S HOSPITAL AND DIVISION
DIRECTOR FOR OUR GENERAL RISK
GROUP.
>> DR. NELLANDS.
>> I'M AT THE SCHOOL OF
EPIDEMIOLOGY AT COLUMBIA
UNIVERSITY.
>> DR. JONES.
>> I'M DR. JONES REPRESENTING
THE INVESTIGATION OF NORTH
CAROLINA AT CHAPEL HILL AND
SPECIALIZE IN SUBSTANCE USE
DISORDER AND TREATMENT WITH
WOMEN AND SEX DIFFERENCES IN
PRENATAL EXPOSURE TO CHILDREN
WITH SUBSTANCE USE PROBLEMS.
>> DR. TEMPLETON.
>> I'M AT THE PAST PRESIDENT OF
THE AMERICAN WOMEN'S
ASSOCIATION.
>> I'M THE CHIEF SINCE OFFICER
FOR THE SOCIETY FOR WOMEN'S
HEALTH RESEARCH.
>> I'M AN ASSOCIATE PROFESSOR AT
LOUISIANA STATE UNIVERSITY AND
MY LRCH FOCUS ON IN UTERO
EXPOSURES TO DIFFERENT
ENVIRONMENTAL POLLUTANTS AND HOW
THAT AFFECTS LUNG DISEASES LATER
IN LIFE ABLE FEMALE AND
OFFSPRING.
>> I'M DR. ANDERSON PROFESSOR
AND SENIOR VICE PRESIDENT AT
FRED HUTCH INSON CANCER CENTER.
MY RESEARCH IS IN CHRONIC
DISEASE PREVENTION AND I LEAD
THE COORDINATING CENTER FOR THE
WOMEN'S HEALTH INITIATIVE.
>> DR. SIMON.
>> GOOD AFTERNOON.
I'M AN OB-GYN AT NORTHWESTERN
UNIVERSITY AND DIRECT THE CENTER
FOR HEALTH EQUITY
TRANSFORMATION.
>> I'M STEVE HIGGINS BEHAVIOR
AND HEALTH AT THE UNIVERSITY OF
VERMONT AND DO A LOT OF RESEARCH
ON TOBACCO USE IN WOMEN AND
ESPECIALLY PREGNANT WOMEN.
>> THANK YOU.
I'D LIKE TO THANK MEMBERS FOR
THEIR SERVICE INCLUDING
DR. ANINYE AND DR. ANDERSON.
>> NOW I'D LIKE TO INTRODUCE THE
CHAIR AND DIRECTOR OF THE OFFICE
OF WOMEN'S HEALTH, DR. JANINE
CLAYTON.
>> THANK YOU, DR. OTA WANG.
GOOD AFTERNOON AND WELCOME TO
THE 62nd ANNUAL MEETING OF
ACRWH.
TODAY OUR AGENDA INCLUDES ONE
MAIN AGENDA ITEM.
AND THAT IS THE NATIONAL
ACADEMIES ON THE RESEARCH OF
WOMEN'S HEALTH FOLLOWED BY A
SESSION OF QUESTION AND ANSWERS
BETWEEN THE ACRWH MEMBERS AND
OUR SPEAKERS.
BY WAY OF BACKGROUND, I WANT TO
HIGHLIGHT THE FACT THAT CONGRESS
CALLED FOR AN ASSESSMENT OF NIH
RESEARCH ON WOMEN'S HEALTH AND
IN THE FISCAL YEAR '23
CONSOLIDATED APPROPRIATIONS ACT
INCLUDED $2 MILLION TO THE
OFFICE OF RESEARCH ON WOMEN'S
HEALTH OR ORWH TO IDENTIFY GAPS
IN WOMEN'S HEALTH RESEARCH AND
EXPLORE THE PROPORTION OF
RESEARCH ON CONDITIONS THAT ARE
MORE COMMON OR UNIQUE TOO WOMEN,
ESTABLISH IT HOW THE CONDITIONS
ARE DEFINED AND ENSURE IT
CAPTURES CONDITIONS ACROSS TRE
LIFE SPAN, EVALUATES SEX
DIFFERENCES AND DETERMINE THE
APPROPRIATE LEVEL OF FUNDING
NEEDED TO ADDRESS GAPS OF
WOMEN'S HEALTH RESEARCH AT NIH,
END QUOTE.
THE NATIONAL INSTITUTES OF
HEALTH IS GRATEFUL TO THE
NATIONAL ACADEMIES COMMITTEE FOR
THEIR ATTENTION TO IMPROVE THE
HEALTH OF WOMEN, AN IMPORTANT
TOPIC.
AND WE ACKNOWLEDGE AND THE
FOCUSSED REPORT FOCUSSED ON
IMPROVING WOMEN'S HEALTH.
THE REPORT DETAILS HEALTH
DISPARITIES AND CONDITIONS THAT
ARE FEMALE SPECIFIC,
DISPROPORTIONATELY AFFECT WOMEN
OR PROGRESS DIFFERENTLY IN WOMEN
OR PRESENT DIFFERENTLY AND
SEVERAL APPROACHES TO
STRENGTHENING WOMEN'S HEALTH
RESEARCH AND PROPOSED ACTIONS.
ON DECEMBER 5, 2024 THE NATIONAL
ACADEMIES BRIEFED THE PUBLIC ON
AT AN EVENT A NEW VISION FOR
WOMEN'S HEALTH RESEARCH AT A
TRANSFORMATIVE CHANGE AT THE
NATIONAL INSTITUTE OF HEALTH.
THE RECORDING IS AVAILABLE AT
THE NATIONAL ACADEMIES WEBSITE
AT THIS POINT I WANT TO
ACKNOWLEDGE STAFF WHO SUPPORTED
THE COMMITTEE FOR THE REPORT.
HERE I WOULD LIKE TO ACKNOWLEDGE
SHEILA BURKE AND DR. ALINA
SALGANICOFF ARE THE CO-CHAIRS.
MS. BURKE IS AT BAKER DONALDSON
AND A FORMER ADJUNCT LECTURER
AND EXECUTIVE DEAN OF THE JOHN
F. KENNEDY SCHOOL OF GOVERNMENT
AT HARVARD UNIVERSITY AND WORKED
IN CHILD AND MATERNAL HEALTH
POLICY AND WE'LL HEAR FROM
DR. SALGANICOFF HAS SERVING ON
NUMEROUS STATE AND NON-PROFIT
ADVISORY COMMITTEES RELATED TO
WOMEN'S HEALTH POLICY AND
CONTRIBUTING MEMBER TO THE WOMEN
WOMEN'S PREVENTIVE SERVICES
INITIATIVE OF THE AMERICAN
COLLEGE OF MEDICINE.
AND PLEASED TO HAVE TWO
COMMITTEES TO SHARE IN THE
CONVERSATION.
DR. SUSAN CHENG THE ERIKA J.
GLAZER CHAIR IN WOMEN'S
CARDIOVASCULAR HEALTH AT
CEDARS-SINAI AND HAS HELD ROLLED
AT THE AMERICAN COLLEGE OF
CARDIOLOGY AND DR. SCHILLER
ASSOCIATE PROFESSOR OF THE
PSYCHIATRY AT UNIVERSITY OF
NORTH CAROLINA CHAPEL HILL AND
HAS EXPERTISE ON THE IMPACT OF
OVARIAN HORMONES ON THE IMPACT
OF THE LIFE SPAN OF WOMEN.
I'D LIKE TO THANK THE CONSENSUS
COMMITTEE FOR THEIR THOUGHTFUL
DELIBERATIONS ON THE TOPIC AND
EFFORTS THAT LED TO THIS REPORT.
AS WE MOVE FORWARD I'M GOING TO
TURN THE ENVIRONMENT MICROPHONE
TO MY COLLEAGUES, DR. OTA WANG,
WILL YOU DO FURTHER INTRODUCTION
OF DR. GELLAR AND TEAM OR TURN
IT OVER.
>> WE CAN TURN IT OVER.
>> WE'RE ANXIOUS TO ANSWER ANY
QUESTIONS YOU MIGHT HAVE.
AS DESCRIBED THERE'S FOUR OF US
FROM THE COMMITTEE WITH YOU
TODAY AND AGAIN EACH OF US IS
MORE THAN HAPPY TO RESPONSE
RESPOND TO QUESTIONS YOU MIGHT
HAVE.
NOTED ON THE SLIDE BEFORE YOU
ARE THE FULL MEMBERS OF THE
COMMITTEE.
I WOULD NOTE IT COMPRISED
LEADERS FROM A VARIETY OF FIELD
OWN BONE HEALTH AND FEMALE
SPECIFIC CANCERS AND OTHER
SPECIALTIES AND NURSING,
POPULATION HEALTH AND BEHAVIORAL
HEALTH AND HEALTH DISPARITIES
AND DATA AND MEASUREMENT.
WE'LL BE MORE TO ANSWER
QUESTIONS YOU HAVE HAVING LOOKED
AT THE REPORT IN ALL THOSE
AREAS.
THE TASK I WOULD NOTE THAT WAS
PROVIDED TO THE COMMITTEE AS
DESCRIBED BY THE APPROPRIATIONS
PROCESS WAS REALLY QUITE WIDE
RANGING.
WE WERE ASKED TO ANALYZE A
PROPORTION OF RESEARCH THAT NIH
FUNDS ON CONDITIONS THAT ARE
FEMALE SPECIFIC.
MORE COMMON IN WOMEN AND IMPACT
WOMEN DIFFERENTLY.
WE WERE ASKED TO LOOK AT THE
LIFE SPAN AND LOOKING AT SEX
DIFFERENCES BETWEEN ETHNIC AND
RACIAL DISPARITIES AND DEFINE
WOMEN'S HEALTH FOR THE PURPOSE
OF THE REPORT.
IN ADDITION THE COMMITTEE WAS
ASKED TO PROVIDE RECOMMENDATIONS
ON THE FOLLOWING, NIH RESEARCH
PRIORITIES, NIH TRAINING AND
EDUCATION EFFORTS NEEDED TO
BUILD AND SUPPORT AND MAINTAIN A
ROBUST WOMEN'S HEALTH RESEARCH
WORKFORCE AS WELL AS TO
EFFECTIVELY SOLICIT, REVIEW AND
SORT WOMEN'S HEALTH RESEARCH.
THE NIH STRUCTURE IN SUPPORT OF
THOSE EFFORTS BOTH EXTRA AND
INTRAMURAL, THERE'S SYSTEMS,
REVIEW PROCESSES AND TO OPTIMIZE
WOMEN'S HEALTH RESEARCH AND
FINALLY TO RECOMMEND THE
ALLOCATION OF FUNDING NEEDED TO
ADDRESS GAPS IN WOMEN'S HEALTH
RESEARCH AT NIH.
FINALLY, WE WERE ASKED TO
IDENTIFY METRICS THAT WOULD
ENSURE THE RESEARCH IS TRACKED
AND MEETS THE CONDITIONING
HEALTH NEEDS OF WOMEN OVER TIME.
IT WAS CONSOLIDATED BY THE
APPROPRIATIONS ACT OF 2023 AND
TOOK A ROBUST PROCESS TO INFORM
OUR DELIBERATIONS.
WE IDENTIFIED AND REVIEWED THE
RELEVANT LITERATURE AND BUILT ON
PASSED AS WELL AS ONGOING WORK
RATHER THAN TRYING TO REINVENT
THE WHEEL.
OUR INFORMATION GATHERING ENDED
IN PLAY OF 2024, I WOULD NOTE.
HOWEVER, WE RECOGNIZED WORK ON
WOMEN'S HEALTH HAS CONTINUED AND
THAT THE NIH HAS UNDERTAKEN
REFORMS TO STRENGTHEN WOMEN'S
HEALTH RESEARCH SINCE THE TIME
THAT ARE NOT REFLECTED IN THE
REPORT BECAUSE OF THE TIME LINE
THAT WE LAD TO GATHER
INFORMATION.
WE SOUGHT OUT EXTENSIVE RESEARCH
AS WELL AS FEEDBACK FROM
CLINICIANS AND PUBLIC AND
THERE'S A NUMBER OF REFERENCES
AND DESCRIPTIONS OF THEIR PERSON
EXPERIENCES.
WHAT THEY HOPED WE WOULD ACHIEVE
IN DOING THIS REVIEW.
WE ALSO UNDERTOOK A NOVEL
ANALYSIS TO DETERMINE THE IMPACT
AND GRANT FUNDING SPENT BY NIH,
THE INSTITUTES AND THE CENTERS.
AND TO DETERMINE THE IMPACT OF
WOMEN'S HEALTH CONDITIONS IN THE
YEARS OF LIVES LOST DUE TO
MORTALITY AND YEARS LIVED WITH
DISABILITY.
WE UNDERWENT A REVIEW PROCESS
AND THE FINAL IS A NINE-CHAPTER
REPORT WITH 15 CONCLUSIONS AND 8
RECOMMENDATIONS WE'LL REVIEW
WITH YOU TODAY.
I'LL NOW PASS IT LONG TO MY
FELLOW COMMITTEE MEMBER
DR. SCHILLER.
>> WE ESTABLISHED DEFINITION TO
CONDUCT OUR WORK.
A FULL LIST IS AVAILABLE AT THE
REPORT.
WE BUILT ON AND ADAPTED EXISTING
DEFINITIONS WHERE POSSIBLE.
SO I JUST WANT TO GO OVER TWO TO
START WE FDEFINED WOMEN'S HEALT
AS THE PSYCHOLOGICAL AND
CULTURAL AND SPIRITUAL AND
HEALTH AND WELLNESS ACROSS THE
LIFE COURSE.
THIS INCLUDES THE EXPERIENCES
AND NEEDS OF ALL PEOPLE WHO
IDENTIFY AS A WOMAN, GIRL,
FEMALE, NON-BINARY, TRANS GENDER
MEN OR WOMEN GENDER FLUID OR TWO
SPIRIT OR ASSIGNED FEMALE AT
BIRTH.
WE DEFINES WOMEN'S HEALTH
RESEARCH AS THE SCIENTIFIC STUDY
OF THE RANGE OF AND VARIABILITY
IN WOMEN'S HEALTH AND THE
MECHANISMS IN DISEASE AND
NON-DISEASE STATE ACROSS THE
LIFE COURSE.
THIS CONSIDERS SEX AND GENDER,
DISEASE RISK, PATHOPHYSIOLOGY,
SYMPTOMS, DIAGNOSIS AND
TREATMENT AND ADDRESSES
INTERACTING CONCERNS RELATED TO
WOMEN'S BODIES AND ROLES AND
SOCIAL AND STRUCTURAL
DETERMINATES AND SYSTEMS.
THE U.S. IS A LEADER IN
INNOVATION AND HEALTH
DISCOVERIES BUT SCIENTIFIC
ENTERPRISES HAVE NOT YIELDED
IMPROVED WELL BEING FOR WOMEN
AND GIRLS, HALF THE POPULATION
BECAUSE IT'S USED MALE
PARTICIPANTS TO THE NORM LEADING
TO A GAP IN UNDERSTANDING FEMALE
SPECIFIC PHYSIOLOGIC AND
BIOLOGICAL DIFFERENCES FOR
EXAMPLE HORMONAL AND CHROMOSOMAL
DIFFERENCES.
IT'S RESULTED IN A LACK OF
COMPREHENSIVE DATA HOW FEMALE
PHYSIOLOGY UNIQUELY CONTRIBUTES
TO AND AFFECTED BY MENTAL AND
PHYSICAL HEALTH DISORDERS AND
THEIR TREATMENTS.
THERE'S ALSO BEEN A LACK OF
ATTENTION AND FUNDING FOR
RESEARCH AND TO CONDITIONS
SPECIFIC TO MORE COMMON AMONG OR
AFFECT WOMEN AND GIRLS
DIFFERENTLY.
THIS HAS PARTICULARLY BEEN THE
CASE FOR RACIALLY AND ETHNICALLY
MINORITIZED WOMEN, MANY OF WHOM
SUFFER OR DIE MORE OFTEN FROM
FEMALE SPECIFIC CONDITIONS SUCH
AS FIBROIDS, ENDOMETRIAL AND
UTERINE CONDITIONS AND HEART
DISEASE AND STROKE.
ADVANCES IN WOMEN'S HEALTH
RESEARCH CONTRIBUTE TO SPECIFIC
PROGRESS AND INNOVATION.
THERE'S BEEN ADVANCES IN WOMEN'S
HEALTH THAT IMPROVED MEN'S
HEALTH AND THERE'S BEEN GUIDANCE
ON MEN'S BONE HEALTH AND
RESEARCH ON BREAST CANCER HAS
IMPROVED CARE FOR MEN WITH
PROSTATE CANCER.
WOMEN ARE VITAL TO A HEALTHY
SOCIETY AND GROWING ECONOMY.
ON AVERAGE NINE YEARS ARE 25%
LONGER THAN MEN IMPACTING THEIR
QUALITY OF LIFE AND
PRODUCTIVITY.
ENABLING HEALTH RESEARCH WILL
HELP MEET WOMEN'S DIVERSE HEALTH
NEEDS LEADING TO BETTER OUTCOME
AND PARTICIPATION IN THE
ECONOMY, SOCIETY, COMMUNITIES
AND FAMILIES.
HOWEVER, THE HISTORICAL
EXCLUSION OF WOMEN FROM RESEARCH
HAS LED TO PERSISTENT GAPS IN
THE EVIDENCE BASED THAT STILL
IMPACTS RESEARCH TODAY.
WOMEN FACE INTERSECTING BARRIERS
TO CARE INCLUDING ECONOMIC,
GEOGRAPHY, INSTITUTIONAL, SOCIAL
AND CULTURAL BARRIERS
DISCRIMINATION AND BIAS, LACK OF
EDUCATION AND HEALTH LITERACY
AND STIGMA.
THIS HAS LED TO A LACK OF HEALTH
CARE KNOWLEDGE AND PREVENTIVE
APPROACHES AND DIAGNOSTIC TOOLS
AND TREATMENTS FOR MANY WOMEN'S
HEALTH CONDITIONS.
I'LL NOW PASS THIS TO MY FELLOW
COMMITTEE MEMBER DR. SUSAN
CHANG.
>> WHEN THE COMMITTEE WAS ASKED
WHEN ANALYZING THE PORTION OF
RESEARCH --
>> THE WHICH THE WAS TASKED WITH
ANALYZING THE RESEARCH.
WE WERE NOT ABLE TO USE OUR
PUBLICALLY AVAILABLE ANALYSIS
AND SPECIFIC NIH DEFINITION USED
BY THE RESEARCH CONDITION AND
DISEASE CATEGORIZATION METHOD
NOT PUBLICALLY AVAILABLE.
FOR THIS REASON WE CONDUCTED OUR
ANALYSIS OF NIH FUNDING FROM
FISCAL 2013 TO 2023 AND
DOWNLOADED INFORMATION FROM OVER
8,000 GRANTS.
THE COMMITTEE HAD ACCESS TO
PUBLIC AVAILABLE DATA AND DID
NOT HAVE ACCESS TO THE CONTENT
OF THE GRANT PROPOSALS.
WE USED A MULTI-METHOD AND STAGE
APPROACH EMPIRICAL METHODS AND
LARGE LANGUAGE MODEL TESTED.
THE METHODS DEVELOPMENT AND
VALIDATION PROCESS ARE APPENDED
IN THE REPORT.
THE SHARED FUNDING WAS 8.8% OF
ALL NIH FUNDING GRANTED OVER THE
TOTAL 11-YEAR PERIOD.
THE SHARE OF FINDING FOR WOMEN'S
HEALTH RESEARCH WAS 7.9% FOR
FISCAL YEAR 2023, THE MOST
RECENT ANALYZED.
THERE WERE SEVERAL LIMITATIONS
WE WERE LIMITED IN OUR ABILITY
TO DISTINGUISH BETWEEN MATERNAL
HEALTH GRAND RATHER THAN
EXCLUSIVELY OR PRIMARILY ON
INFANT HEALTH OUTCOMES.
SUCH LIMITATION PLAY HAVE LED TO
AN OVER ESTIMATE IN THE SHARE OF
FUNDING ATTRIBUTED TO WOMEN'S
HEALTH RESEARCH IN OUR ANALYSIS.
AS SHOWN IN THE FIGURE, NIH
GRANT FUNDING INCREASED
SUBSTANTIAL LY TO $46 BILLION.
THE PROPORTION OF FUNDING FOR
WOMEN'S LEATH RESEARCH HAS
REMAINED SMALL AND PROPORTION
ATELY DECREASED.
THE COMMITTEE ANALYZED GRANT
FUNDING FOR HEALTH RESEARCH BY
INSTITUTE, CENTER AND OFFICES
AND FOUND A GENERALLY SMALL
PROPORTION OF WOMEN'S HEALTH
RESEARCH EXTENDED ACROSS THE
FUNDING ORGANIZATIONS.
THE INSTITUTES CENTER OFFICE OR
ICO WITH THE LARGEST PROPORTION
OF FUNDING FOR WOMEN'S HEALTH
RESEARCH WAS NICHD WITH 37% OF
GRANTS FUNDED AND ALLOCATED FOR
WOMEN'S HEALTH RESEARCH.
HOWEVER, WHILE MANY GRANTS
INVOLVE THE STUDY OF WOMEN, A
LARGER PORTION INCLUDED SOME OR
A LARGE PART FOCUSSED ON CHILD
OR FETAL HEALTH OUTCOMES.
OTHER ICOs SPENT LESS THAN 20%
AND MANY CASE LESS THAN 10% ON
WOMEN'S HEALTH RESEARCH.
OVER ALL, OUR SHOWED IT SPENT
$33 BILLION ON WOMEN'S HEALTH
RESEARCH OVER THE COURSE OF THE
11-YEAR ANALYSIS PERIOD.
AND THERE WERE FEMALE SPECIFIC
CANCERS SUCH AS OVARIAN AND
CERVICAL IN ADDITION TO
PREGNANCY AND INFERTILITY AND
MENOPAUSE AND PERIMENOPAUSE.
CONDITIONS THAT AFFECT MEN WERE
HIV AIDS, DIABETES AND
DEPRESSIVE DISORDERS.
THERE WERE LOW LEVELS OF FUNDING
FOR FEMALE SPECIFIC CONDITIONS
SUCH AS ENDOMETRIOSIS, FIBROIDS,
ACLS, POSTPARTUM DEPRESSION AND
UTERINE CANCER AND OTHERS AND
THE COMMITTEE FOUND MANY
CONDITIONS HAD RECEIVED
RELATIVELY AFLAT AMOUNT OF
FUNDING.
>> IT'S NOT MEETING THE NEED FOR
ADVANCES IN RESEARCH THAT
DIRECTLY INFORM AND IMPROVE
WOMEN'S HEALTH AND ALSO WE
CONCLUDED THE NIH IS UNDER
SPENDING ON WOMEN'S HEALTH
LEADING TO KNOWLEDGE GAPS IN
WOMEN'S HEALTH AND CONCLUDED
INCREASED FUNDING ALONE IS NOT
GOING TO BE ENOUGH TO MAKE
SIGNIFICANT PROGRESS IN WOMEN'S
HEALTH AND THE CURRENT STRUCTURE
OF THE NIH LIMITS ITS ABILITY TO
ADDRESS WOMEN'S HEALTH RESEARCH
GAP.
MANY CONDITIONS RELATIVE TO
WOMEN'S LEATH DO NOT FALL WITHIN
THE PURVIEW OF THE EXISTING 27
INSTITUTES AND CENTERS RESULTING
IN A DEPROER -- DEPRIORITIZATION
OF THESE.
THE FIGURES ED A HIGH LEVEL
OVERVIEW OF ELEMENTS AUTOMATIC
WE HAVE RESEARCH IN BREAKS
THROUGH AND BUILD A WORKFORCE
ULTIMA
ULTIMATELY LEADING TO MEASURABLE
IMPROVEMENTS AND STARTS AT THE
TOP BY THE NIH DIRECTOR CHIEF
RESPONSIBILITY FOR THE OVERSIGHT
OF WOMEN'S HEALTH ACROSS THE
INSTITUTES AND CENTERS IN ORDER
TO HAVE A CENTRAL POINT OF
ACCOUNTABILITY THE COMMITTEE
ALSO RECOMMENDS THE INSTITUTES
AND CENTERS AND THE NIH AS A
WHOLE ALSO HAVE A RESPONSIBILITY
FOR TRACKING, TRANSPARENCY AND
ACCOUNTABILITY WHEN IT COMES TO
THEIR RESPECTIVE ROLES IN
SUPPORTING WOMEN'S HEALTH
RESEARCH.
THE COMMITTEE IDENTIFIED ACTION
STEPS THAT CONGRESS AND THE NIH
TAKE TO FILL WOMEN'S HEALTH
RESEARCH GAPS AT THE NIH WHICH
WE WILL NOW WALK YOU THROUGH.
AS PART OF OUR CHARGE, YOU HEARD
WE WERE ASKED TO LOOK AT THE NIH
STRUCTURE AND HOW IT COULD BE
IMPROVE TO ADVANCE WOMEN'S
HEALTH RESEARCH AND CONCLUDED
WITHOUT A CHANGE IN STRUCTURE,
PROGRESS WILL CONTINUE TO BE
SLOW AND STAGNANT FOR MANY
CONDITIONS THAT AFFECT THE
HEALTH AND QUALITY OF LIFE OF
MILLIONS OF WOMEN IN THE
COUNTRY.
WE CONSIDERED SEVERAL STRUCTURAL
OPTIONS.
EVERYTHING'S ON THE TABLE AND
AFTER WEIGHING THE PROS AND CONS
OF EACH WE CONCLUDED NO SINGLE
SOLUTION COULD ADDRESS THE
SUPPORT NEED TO BUILD A ROBUST
WOMEN'S HEALTH ENTERPRISE AT THE
NIH AND RECOMMEND CONGRESS
ELEVATE IT TO AN INSTITUTE TO
LEAD AND CONDUCT RESEARCH ON
CHROMOSOMAL DIFFERENCES,
REPRODUCTIVE DIFFERENCES AND
FEMALE SPECIFIC THAT DO NOT FALL
UNDER THE PURVIEW OF OTHER
I.C.s.
WE RECOGNIZE IT WOULD REQUIRE A
STATUTORY CHANGE OR NEW
INSTITUTE AND RECOMMEND A NEW
OFFICE OF THE DIRECTOR TO
SUPPORT THE BIOMEDICAL
DISCOVERIES IN WOMEN'S HEALTH
AND SEX DIFFERENCES RESEARCH
WITH A FOCUS ON
INTERDISCIPLINARY RESEARCH.
THE FUND SHOULD HAVE A DEDICATED
INDEPENDENT BUDGET COMPARABLE TO
THAT OF OTHER MAJOR NIH
INITIATIVES SUCH AS THE COMMON
FUND, CANCER MOONSHOT AND BRAIN
INITIATIVE.
FURTHER THE NIH DIRECTOR AND NIC
DIRECTORS SHOULD PRIORITIZE IT
TO A GREATER EXTENT.
IT SHOULD ASSUME OVERSIGHT AND
RESPONSIBILITY FOR THE WOMEN'S
HEALTH RESEARCH PORTFOLIO ACROSS
THE NIH WITH RESPECT TO FUNDING
ALLOCATIONS AND IMPLEMENTATION
OF PRIORITIES AND POLICIES
RELEVANT TO WOMEN'S HEALTH SUCH
AS SEX AS A BIOLOGICAL VARIABLE.
I.C. DIRECTORS SHOULD INCREASE
SUPPORT FOR WOMEN'S HEALTH
RESEARCH THAT FALLS UNDER THEIR
PER VIEW AND GIVEN THE LONG
STANDING DISPARITIES THAT
DISPROPORTIONATELY FACE WOMEN
PARTICULARLY WOMEN OF COLOR WE
RECOMMEND THE NATIONAL INSTITUTE
OF MINORITY HEALTH AND HEALTH
DISPARITIES EXPAND ITS ROLE TO
INCLUDE WOMEN AND GIRLS TO LOOK
AT DISPARITIES AND CONGRESS
SHOULD APPROPRIATE ADDITIONAL
FUNDING TO ADEQUATELY SUPPORT
THE EFFORTS AND THE CHANGE
DETAILED IN THE CHAPTER 9 OF THE
REPORT AND NOW PASS IT BACK TO
DR. SCHILLER.
>> WOMEN'S HEALTH RESEARCH IS
ESSENTIAL TO HAVE A ROBUST AND
PRODUCTIVE NIH INTERMURAL AND
EXTRAMURAL EXPERTISE IN CLINICAL
TRIALS AND IMPLEMENTATION
SCIENCE.
I WON'T REVIEW ALL THE
CONCLUSIONS BUT DUE TO CHRONIC
LACK OF FUNDING ON SEX
DIFFERENCES RESEARCH THERE'S NET
ENOUGH OPPORTUNITIES TO GROW AND
RETAIN THE WOMEN'S HEALTH
WORKFORCE.
AND THE WOMEN'S HEALTH RESEARCH
LED TO AN INSUFFICIENT NUMBER OF
RESEARCH INVESTIGATORS.
A ROBUST INTRA AND EXTRAMURAL
WORKFORCE IS NEEDED AND INSTILL
CONFIDENCE IN STABLE FUNDING
HOPEFULLY BUILDING AND RETAINING
NEW RESEARCHERS TO THE FIELD OF
WOMEN'S HEALTH.
MENTORSHIP AND CAREER
DEVELOPMENT ARE VITAL.
STUDIES ON WOMEN'S HEALTH
RESEARCH WORKFORCE PROGRAMS THAT
INCLUDE MENTORSHIP SHOW GREAT
EFFECTIVENESS SUCH AS THE
BUILDING INTERDISCIPLINARY
RESEARCH CAREERS IN WOMEN'S
HEALTH OR BIRCH PROGRAM AND
IMPACTING WHO IS AWARDED NIH
GRANTS.
THE COMMITTEE PROVIDES TWO
RECOMMENDATIONS IN THIS AREA.
FIRST, BASED ON THE THESE
CONCLUSIONS THE COMMITTEE
RECOMMENDS AUGMENTATION OF
EXISTING PROGRAMS AND
DEVELOPMENT OF NEW INITIATIVES
TO ATTRACT, SUPPORT AND RETAIN
WOMEN'S HEALTH RESEARCHERS AT
ALL CAREER STAGES.
SPECIFICALLY NIH SHOULD CREATE A
NEW SUB CATEGORY FOR WOMEN'S
HEALTH OR SEX DIFFERENCES
INVESTIGATORS.
AND FINANCIAL SUPPORT UP TO 10%
FOR MENTORS ON ALL MENTORED
GRANTS THAT SUPPORT CAREERS OF
EARLY AND MID CAREER
INVESTIGATORS IN WOMEN'S HEALTH
AND SEX DIFFERENCES RESEARCH AND
EXISTING AND EARLY MID YEAR
GRANT MECHANISMS THAT SUPPORT
GROWING AND DEVELOPING THE
WOMEN'S HEALTH RESEARCH
WORKFORCE.
SUPPORT EARLY CAREER MENTORED
INSTITUTIONAL K AWARDS FOR UP TO
FIVE YEARS TO INCREASE RETENTION
IN THE WOMEN'S HEALTH WORKFORCE.
CREATING NEW EARLY CAREER
MECHANISMS FOR WOMEN'S HEALTH
RESEARCH CAN BE MODELLED ON
EXISTING MECHANISMS SUCH AS THE
STEVEN I KATZ AWARD AND GRANTS
FOR EARLY MEDICAL AND TRANSITION
TO AGING RESEARCH OR GEM STAR
PROGRAM.
IT'S ALSO ESSENTIAL TO ENSURE
OPPORTUNITIES FOR MID CAREER
INVESTIGATORS TO FURTHER REFINE
THEIR SKILLS AND ALLOW THEM TO
SUPPORT EARLY CAREER
INVESTIGATORS.
FOR EXAMPLE, THE K24, R35, UP
ADMINISTRATIVE SUPPLEMENT AND
OTHER MECHANISMS COULD BE
EXPANDED OR NEW MECHANISMS
DEVELOPED.
SEVERAL WORKFORCE DEVELOPMENT
PROGRAMS THE COMMITTEE REVIEWED
HAVE BEEN EFFECTIVE AT LAUNCHING
AND SUPPORTING RESEARCHERS'
CAREERS BY ADDRESSING GAPS
LEVERAGING PROVEN PROGRAMS NIH
CAN HELP BUILD A ROBUST RESEARCH
WORKFORCE CAPABLE OF ADDRESSING
THE NEEDS OF WOMEN'S HEALTH AND
THE OF WORKFORCE DEVELOPMENT
PROGRAMS AND DEVELOPMENT OF NEW
GRANT INITIATIVES SPECIFICALLY
DESIGN TO PROMOTE
INTERDISCIPLINARY SCIENCE AND
CAREER DEVELOPMENT IN THE AREAS
RELATED TO WOMEN'S HEALTH.
BUILDING INTERDISCIPLINARY
RESEARCH CAREERS IN WOMEN'S
LEATH KNOWN AS THE BIRCWH
PROGRAM AND SCORE PROGRAM AND
THE WOMEN'S ROECHT HEALTH
RESEARCH AND RESEARCH SCIENTIST
DEVELOPMENT PROGRAM AND PROGRAM
GRANTS THAT FOCUS ON WOMEN'S
HEALTH RESEARCH.
FOR EXAMPLE, NIH SHOULD DOUBLE
THE NUMBER OF BIRCWH AND
INCREASE IT TO $1.5 MILLION
ANNUALLY AND PRIORITIZE AND
PROMOTE PARTICIPATION OF WOMEN
AND INVESTIGATORS FROM UNDER
REPRESENTED COMMUNITIES.
ANY EXPANSION SHOULD INCLUDE
ADDITIONAL FUNDING TO ENSURE
EXISTING RESEARCH BUDGETS ARE
NOT REDUCED.
THESE PROGRAMS SHOULD BE
DISTRIBUTED ACROSS THE COUNTRY
GEOGRAPHICALLY AND GRANTEE
INSTITUTIONS SHOULD COLLABORATE
WITH OTHER DISCIPLINES WITHTHEIR
ORGANIZATION TO OFFER MENTEES A
COMPREHENSIVE AND
MULTI-DISCIPLINARY RESEARCH
EXPERIENCE.
I'LL NEW PASS THIS BACK TO
COMMITTEE CO-CHAIR SHEILA BURKE.
>>
>> THE COMMITTEE CONSIDERED A
VARIETY OF OPTIONS TO IMPROVE
THE INVEST OF RESEARCH IN
WOMEN'S HEALTH AND TO IMPLEMENT
OUR RECOMMENDATIONS WE BELIEVE A
NEW FUNDING IS NEEDED AS
DESCRIBED BY DR. SALGANICOFF
WITH A RAMP UP ULTIMATELY
REACHING $3 BILLION IN YEARS
THREE TO FIVE WHICH IS THE SAME
INVESTMENT AS OTHER NIH SPECIAL
NIFTS AND OTHER STUDENT-ATHLETES
AT APPROXIMATELY $800 MILLION A
YEAR IN LINE WITH THE FUNDING
LEVELS OF MEDIUM SIZED
INSTITUTES AND AS JUST DESCRIBED
AN EXPANSION OF THE WORKFORCE
PROGRAM FOR THE RAMP UP REACHING
$74 REASON IN YEARS FOUR TO
FIVE.
OVER ALL THE COMMITTEE
RECOMMENDS $15.7 BILLION IN NEW
FUNDING OVER A FIVE-YEAR PERIOD.
OVER THE FIVE YEAR PERIOD, THIS
WOULD APPROXIMATELY DOUBLE THE
AVERAGE NIH YEARLY INVESTMENT IN
WOMEN'S HEALTH RESEARCH.
WE RECOGNIZED THERE WILL ALSO BE
ADDITIONAL FUNDS NEEDED FOR THE
OPERATIONAL REQUIREMENTS, FOR
EXAMPLE, THE OVERSIGHT OF THE
OFFICE OF THE DIRECTOR AND
INCREASED FUNDING FOR NATIONAL
INSTITUTE ON MINORITY HEALTH AND
HEALTH DISPARITIES.
AFTER FIVE YEARS WE BELIEVE THAT
PROGRESS WILL HAVE BEEN MADE BUT
WE ALSO BELIEVE WE OUGHT TO
ASSET AT THIS POINT WHETHER OR
NOT WE ACHIEVED WHAT WE'D HOPED
TO ACHIEVE AND WHAT THE
APPROPRIATE LEVELS OF FUNDING
WOULD BE GOING FOR WARD.
-- FORWARD.
SINCE RESEARCHERS HAVE ONLY
BEGUN TO UNDERSTAND THE
COMPLEXITIES OF SEX DIFFERENCES
IN HEALTH AND NEGLECTED MANY OF
THE FEMALE-SPECIFIC CONDITIONS,
FUNDING NEEDED TO BRING THE
KNOWLEDGE BASE UP TO PAR WITH
THAT OF CONDITIONS FOR WHICH
SCIENCE HAS IN FACT CONTRIBUTED
TO A DEEP UNDERSTANDING OF
PREVENTION, OF DIAGNOSIS AND
TREATMENT IS SIGNIFICANT AND THE
EFFORT WILL TAKE DECADES FOR
EVEN MORE APPROPRIATE FUNDING
BUT I WOULD UNDER SCORE AT THIS
POINT FUNDING IS REALLY ONLY
PART OF THE INVESTMENT AND ONLY
PART OF WHAT WE ENVISION IS ALL
THE RESTRUCTURING AND THE FOCUS
AND RESPONSIBILITY ESSENTIALLY
WE'RE LOOKING TO IMPROVE.
I'LL NOW PASS THIS BACK TO
DR. CHANG.
>> THANK YOU.
I WILL NOW DISCUSS OUR ACTION
AREA TO STRENGTHEN OVERSIGHT AND
PRIORITIZE FOR WOMEN'S HEALTH
ACROSS NIH.
THE RESEARCH CONDITION AND
DISEASE CATEGORIZATION SYSTEM
ALSO KNOWN AS RCDC WAS FOUND TO
BE INADEQUATE FOR GUIDING BUDGET
ALLOCATION AND INFORMING THE
PUBLIC AND CONGRESS FOR HOW MUCH
SPENT ON WOMEN'S HEALTH RESEARCH
AND WE HAVE RECOMMENDATIONS,
ELIMINATING DUPLICATIVE
CATEGORIES.
SECOND, THE PROCESS FOR
REVIEWING, REVIVING AND ADDING
NEW RCDD CATEGORIES FOR WOMEN'S
LEA
HEALTH RESEARCH SHOULD BE UPDATE
AND DATA ANALYSIS NEEDS TO BE
MORE TRANSPARENT AND
TRANSFERRABLE AND USE PARAMETERS
AND IDENTIFY AND CATEGORIZE THE
CONTENT OF THE GRANT.
RIGOROUS TESTING REVEALED THE
APPROACH OFFERS EQUAL OR
SUPERIOR ACCURACY WHEN COMPARED
TO EVALUATION WHEN A APPLIED TO
AFTER AMOUNT OF DATA AND THE
ANALYSIS MAY BE USED BY NIH TO
TEST APPROACHES FOR USE OF
SIMILAR OR BROADER FUNDING
ANALYSTSES.
-- ANALYSISES.
THE COMMITTEE CONCLUDED THE NIH
PRIORITIZATION PROCESS HAS NOT
ESTABLISHED A COHESIVE
CROSS-AGENCY SET OF PRIORITIES
FOR WOMEN'S HEALTH RESEARCH.
FOR EXAMPLE, WOMEN'S HEALTH
RESEARCH IS RARELY MENTIONED IN
I.C. STRATEGIC PLANS AND NIH
DOES NOT HAVE A COMPREHENSIVE
PRIORITIZATION PROCESS TO USE
DATA AND INPUT.
THEREFORE THE COMMITTEE
RECOMMENDS THE NIH DIRECTOR
SHOULD DEVELOP A BIANNUAL
PROCESS TO IDENTIFIED RESEARCH
PRIORITIES AND FUNDING FOR
WOMEN'S HEALTH RESEARCH AND
SHOULD BE REPORTED PUBLICALLY
AND SHOULD LEAD TO REQUEST FOR
APPLICATIONS, NOTICES OF SPECIAL
INTEREST AND PROGRAM
ANNOUNCEMENTS.
THE COMMITTEE WAS ASKED TO
PROVIDE RESEARCH PRIORITY GIVEN
THE BREADTH OF CONDITIONS THAT
IMPACT WOMEN, THE COMMITTEE DOES
NOT PROVIDE SPECIFIC CONDITIONS
TO BE STUDIED.
INSTEAD OF RECOMMENDATION NUMBER
8 WE DESCRIBED AREAS FOR
PRIORITIZATION NEEDED TO ADVANCE
WOMEN'S HEALTH RESEARCH ACROSS
THE SPECTRUM INCLUDING BASIC,
CLINICAL, PRECLINICAL AND
POPULATION AND IMPLEMENTATION
SCIENCE.
THIS IS DETAILED IN CHAPTER 9.
EXAMPLES INCLUDE HORMONAL
PROFILES TO UNDERSTAND THE
MECHANISMS OF SEX DIFFERENCES
AND PATHOBIOLOGY AND AFFECTING
DEPRESSIVE DISORDER,
ENDOMETRIOSIS AND OTHERS TO
REDUCE THE AMOUNT OF TIME WOMEN
ARE IN DEBILITATING CONDITIONS
AND THOSE THAT CAUSE EARLY
MORTALITY SUCH AS CARDIOVASCULAR
DISEASE AND FEMALE SPECIFIC
CANCERS.
CHAPTER 9 OF THE REPORT INCLUDES
SUGGESTED MEASURES FOR TRACKING
AND ACCOUNTABILITY TO ENSURE THE
ADVANCEMENT OF WOMEN'S HEALTH
RESEARCH IN THREE AREAS.
NUMBER ONE, FUNDING ALLOCATION
TRENDS, NUMBER TWO, WOMEN'S
HEALTH WORKFORCE TRENDS
INCLUDING NIH STAFF FOR STAFF
AND ENDOMETRIAL RESEARCHERS AND
THREE, RESEARCH PROCESS OUTPUT
AND IMPACT.
FOR EXAMPLE, TRACKING THE EXTENT
TO WHICH GRANTS FULFILL THE IL
FEMALE IN STUDIES AND SEX AND
GENDER DIFFERENCES IN STUDY
RESULTS AND REPORTING THE
FINDINGS.
I'LL NOW TURN THIS BACK TO
DR. SCHILLER.
>> THEY ARE DID NOT DISCUSS THE
COMMITTEE RECOMMENDATIONS FOR
PROGRAMS AND POLICIES SUCH AS
PEER REVIEW AND SEX AS A
BIOLOGICAL VARIABLE POLICY TO
SUPPORT WOMEN'S HEALTH RESEARCH.
THE PEER REVIEW PROCESS IS
COMPLEX WITH THE CENTER FOR
SCIENTIFIC REVIEWS HAVING THE
HUGE RESPONSIBILITY OF
OVERSEEING TENS OF THOUSANDS OF
GRANTS EACH YEAR THROUGH A
RIGOROUS AND THOROUGH PROCESS ON
VARIED TOPICS AND AREAS.
THE COMMITTEE CONCLUDED THAT IT
IS ESSENTIAL FOR CSR STAFF, IC
PROGRAM SERVICE MEMBERS AND
COUNCIL MEMBERS AND PEER
REVIEWERS TO INCLUDE THOSE WITH
WOMEN'S LEATH EXPERTISE.
BASED ON PUBLICALLY AVAILABLE
INFORMATION IT WAS DIFFICULT FOR
THE COMMITTEE TO DETERMINE THE
TYPES OF EXPERTISE HELD BY NIH
STAFF.
THE COMMITTEE FOUND THERE IS NO
SPECIFIC STUDY SECTION FOR
WOMEN'S HEALTH OR SEX
DIFFERENCES RESEARCH OTHER THAN
THAT FOCUSSED ON PREGNANCY AND
MATERNAL HEALTH.
THE NIH CENTER FOR SCIENTIFIC
REVIEW WHICH OVERSEES MUCH OF
THE PEER REVIEW PROCESS HAS
TAKEN STRIDES TO IMPROVE THE
EXPERTISE ON THE PANELS AND A
LARGE PROPORTION OF GRANTS ARE
BY PANELS AND NOT STUDY SECTIONS
ING STANDEE STUDY SECTION DO NOT
HAVE THE EXPERTISE TO REVIEW
WOMEN'S HEALTH RESEARCH GRANTS.
THE COMMITTEE THEREFORE
RECOMMENDS THAT NIH CONTINUE TO
STRENGTHEN ITS EFFORTS TO ENSURE
BALANCED REPRESENTATION AND
APPROPRIATE EXPERTISE WHEN
EVALUATING GRANT PROPOSALS ON
WOMEN'S HEALTH AND SEX
DIFFERENCES RESEARCH.
IT SHOULD ALSO EMPLOYEE DATA
SCIENCE METHODS AND USE
PROFESSIONAL NETWORKS TO
IDENTIFY EXPERTS AND RECRUIT
RECENTLY FUNDED INVESTIGATORS.
SECOND, EXPAND THE EARLY CAREER
REVIEWER PROGRAM, THIRD, WORK
WITH NIH-FUNDED INSTITUTIONS TO
IDENTIFY QU
IDENTIFY QUALIFIED INDIVIDUALS
WITH EXPERTISE IN WOMEN'S HEALTH
AND BUILD IN THE INTRA AND
EXTRAMURAL WORKFORCE AND MAKE
SURE THEY'RE REVIEWED BY
APPROPRIATE INDIVIDUALS.
AND NOW SEX AS A BIOLOGICAL
VARIABLE.
>> IT'S KNOWN AS SABV INTENDED
TO RECOGNIZE THE IMPORTANCE OF
SEX IN RESEARCH AND ADDRESS THE
TENDENCY TO EXCLUDE OR EXCLUDE
FEMALES IN PRE CLINICAL RESEARCH
AND DESPITE THE INITIATIVE TO
INCLUDE THIS UPTAKE IN
APPLICATION HAS BEEN SUB
OPTIMAL.
A IT'S IN THE INCLUDED IN A
MEANINGFUL WAY AND LANGUAGE AND
IMPLEMENTATION IS THE NO NOT
GEARED TOWARDS GENDER AND GENDER
IDENTITY AND STATUS.
THERE'S CURRENTLY NO MECHANISM
AT NIH FOR ASSESSING HOW SABV
GRANTS ARE EVALUATED AND LACK OF
ACCOUNTABILITY AND SUBSTANTIAL
INVESTMENTS IN KNOWLEDGE AND AT
PRESENT NO CONSEQUENCES FOR
GRANTEES IF THEY DO NOT
IMPLEMENT FOR SABV AND NO
INCENTIVES TO DO SO AND DO NOT
INCLUDE IT WOULD AT ADEQUATE
FUNDING AND IT'S USUALLY NOT
WITHIN THE CONSTRAINTSES OF THE
FUND STRUCTURE AND NEED TO LOOK
AT HOW COSTS CAN PRODUCED LESS
BALANCED AND LESS VIGOROUS
RESEARCH AND CAN OCCUR GREATER
COSTS OVER THE LONG TERM.
THOUGH NIH HAS DEVELOPED READING
AND TRAINING MATERIALS ON THE
APPLICATION RESEARCH THERE IS
PROOM ROOM FOR IMPROVEMENT AND
WHERE SABV MAY NOT BE INTUITIVE
AND INCLUDE POLICY AND REQUIRING
RESEARCHERS TO BE ACCOUNTABLE
FOR PROPOSING AND CONNECTING SEX
SPECIFIC ANALYSES.
THE COMMITTEE THEREFORE
RECOMMEND TO SUPPORT EFFECTIVE
RECOMMENDATION OF THE POLICY THE
NIH SHOULD EXPAND EDUCATION AND
TRAINING RESOURCES FOR
INVESTIGATORS ON HOW TO
IMPLEMENT SABV ACROSS ALL TYPES
OF SCIENCE AND SYSTEMICALLY
REVIEW IN THE GRANT PROCESS AS
PART OF THE PROCESS GRANTEES
SHOULD BE EVALUATED IN THE
ORIGINALLY PROPOSED PROCESS AND
EXPAND THE POLICY OF HUMAN
STUDIES TO INCLUDE GENDER,
GENDER IDENTITY AND ANALYSES AND
REPORTING.
THE COMMITTEE RECOMMENDS THE NIH
ENSURE THE GRANTS BE EXEMPT FROM
ACROSS THE BOARD BUDGET CUTS TO
PROTECT SAMPLE SIZES AND
ANALYSES TO STUDY SEX
DIFFERENCES.
ACCESS TO ADMINISTRATIVE CUTS
AND UNDER GO STREAMLINE PROCESS
FOR REQUESTING HIGHER BUDGETS.
ADDITIONALLY, INTRAMURAL
RESEARCHERS SHOULD HAVE A
PARALLEL STRUCTURE AND SUPPORT
FOR INCLUDING SABV IN THEIR
RESEARCH.
COMMITTEE CO-CHAIR DR. BURKE
WILL PROVIDE FINAL REMARKS.
>> MUCH RESEARCH IS NEEDED TO
ADVANCE WOMEN'S HEALTH CARE IN
THE UNITED STATES.
I'D LIKE TO UNDER SCORE A COUPLE
POINTS MADE IN THE REPORT.
ONE, INCREASED FINANCIAL
INVESTMENT IS ONLY A FIRST STEP.
AS EVIDENT IN OUR
RECOMMENDATIONS OTHER WORK TO BE
DONE TO ENSURE RESEARCH DOLLARS
AND STUDIES THAT INCLUDE BOTH
MEN AND WOMEN ARE MAXIMIZED BY
CONSISTENT IMPLEMENTATION OF SEX
AS A BIOLOGICAL VARIABLE POLICY,
IMPROVED REPRESENTATION OF
WOMEN'S HEALTH AND SEX REVIEW
AND AT THE STAFF LEVEL AT NIH
AND IMPROVING QUALITY OF LIFE
AND MORBIDITY AND MORTALITY FOR
WOMEN INCLUDES ACCOUNTABILITY AS
WE'VE OUTLINED.
ON THE FOUNDATIONAL ASPECTS OF
WOMEN'S HEALTH IS FAR BEYOND
WHERE WE BELIEVE IT SHOULD BE
AND THIS IS NOT A ONE AND DONE
TYPE OF INVESTMENT.
RATHER WILL NEED TO BE ADDRESSED
OVER A LONG PERIOD OF TIME.
AGAIN, HOWEVER, WITH WHAT WE
BELIEVE TO BE AN INFLUX OF
FUNDING AT OF ACCOUNTABILITY AND
PRIORITIZATION WE BELIEVE MANY
OF THE BREAKTHROUGHS WE'VE
DESCRIBED CAN IN FACT BE
ACHIEVED.
AND FINALLY, BY INVESTING MORE
FOCUSSED, COMPREHENSIVE RESEARCH
ON WOMEN'S HEALTH, WE DO BELIEVE
WE ARE IMPROVING NOT ONLY THE
LIVES OF MILLIONS OF WOMEN BUT
STRENGTHENING THE FOUNDATION OF
HEALTH CARE FOR EVERYONE.
THE BENEFITS OF THE ADVANCEMENTS
WILL EXTEND FAR BEYOND THE
RESEARCH INFLUENCING BETTER
POLICIES, MORE EFFECTIVE
TREATMENTS AND ULTIMATELY
CREATING, WE BELIEVE, A
HEALTHIER SOCIETY FOR FUTURE
GENERATIONS.
WE BELIEVE NOW IS THE TIME TO
ACT.
WE BELIEVE IT WILL TAKE A LONG
PERIOD OF TIME TO ACHIEVE THE
RESULTS WE HAVE IN MIND BUT WE
HAVE TO BEGIN SOMEWHERE AND
BELIEVE IT'S A FIRST STEP.
LET ME PAUSE THERE AND ASK IF
YOU HAVE QUESTIONS OF THE
COMMITTEE MEMBERS.
>> DR. OTA WANG ARE YOU SET TO
MODERATE Q&A?
LET ME KNOW IF THERE'S -- THERE
YOU GO.
DR. ARNOLD.
>> THANK YOU FOR THE IMPRESSIVE
PRESENTATION.
THE REPORT SOUNDS TERRIFIC AND
CONGRATULATIONS TO THE
COMMITTEE.
I WANTED TO ASK ABOUT TRAINING
IN WOMEN'S HEALTH RESEARCH.
WAS THERE ATTENTION GIVEN TO
AUGMENTED FUNDING OR NEW
PROGRAMS OF TRAINING BECAUSE NOT
ONLY DO WE HAVE TO TRAIN STUDY
SECTION MEMBERS ABOUT THE
IMPORTANCE OF THIS OR THE IMPACT
OF SEX DIFFERENCES RESEARCH BUT
ALSO WE HAVE A NEW GENERATION
COMING UP WHICH ARE STILL BEING
TRAINED BY PEOPLE WHO DON'T
BELIEVE THAT SEX DIFFERENCES ARE
VERY IMPORTANT.
SO WAS THERE A PLACE IN YOUR
REPORT FOR AUGMENTED TRAINING
PROGRAMS?
>> CRYSTAL OR SUSAN?
>> THAT'S A SUPER QUESTION, ART.
THE COST OF TRAINING AS YOU KNOW
IS SUBSTANTIAL.
WE WEREN'T ASKED TO LOOK AT THE
COST OF TRAINING THAT'S INTERNAL
TO NIH OR SPECIFIC TO NIH
PROGRAMS.
WE WERE ASKED SPECIFICALLY TO
LOOK AT THE GRANT FUNDING.
IT WASN'T PART OF OUR ANALYSIS
IN TERMS OF THE COST AND
RECOMMENDED FUNDING FOR THE
TRAINING PROGRAMS.
WE DO OUTLINE IN DETAIL THE
TYPES OF EXTENDED EFFORTS MORE
EXPANSIVE AND MORE DETAILED IN
COMPREHENSIVE EFFORTS YOU'RE
TOUCHING ON WITH RESPECT TO
TRAINING IN SABV.
WE ALSO TRIED TO PUT MORE
EMPHASIS IN PARTICULAR NOT ONLY
THEN THE GREAT WORK ALREADY
BEING DONE BY NIH AND INSTITUTES
AND CENTERS TO INCREASE
PRODUCTIVITY IN THE AREA AND ON
THE EMERGING FIELDS IN SCIENCE
WHERE CONSIDERATIONS ARE NOT
THAT INTUITIVE ONLY TO KEEP UP.
>> THAT WAS PART OF
RECOMMENDATION SEVEN.
>> CHAPTER 3 PROVIDES A FAIR
AMOUNT OF INFORMATION IN TERMS
OF TRAINING SABV.
YOU MAY WANT TO TAKE A LOOK AT.
>> GREAT, THANK YOU.
ARE THERE OTHER AC OR ORWH
MEMBERS MEMBERS THAT WOULD LIKE
TO ASK THE COMMITTEE CO-CHAIR.
DR. SIMON.
>> HI, EVERYBODY.
GOOD TO SEE SOME OF YOU THAT I
KNOW.
THANK YOU FOR THE REPORT.
I WANT TO MAKE A COMMENT.
I THINK THAT THIS REPORT IS
QUITE AMAZING AND WELL
ARTICULATED AND I WANTED TO JUST
APPLAUD THE COMMITTEE FOR THE
AMOUNT OF WORK THAT GOES INTO
THESE TYPES OF REPORTS.
SO THANK YOU VERY MUCH.
I ALSO WANT TO APPLAUD OR
ADVISORY COMMITTEE BECAUSE I
THINK THIS IS A PRODUCT THAT WE
SHOULD BE PROUD OF.
THANK YOU ALL, I APPRECIATE IT.
>> THANK YOU.
>> DR. ANDERSON.
>> I ALSO WANT TO THANK YOU.
I THINK THIS IS A TERRIFIC
REPORT AND HARD TO ARGUE WITH
ANY OF IT AND A QUESTION OF
CURIOSITY IS ABOUT THE BUDGET
INCREASE.
LOTS OF LONG STANDING NEEDS
HERE.
THERE'S A SENSE OF URGENCY AMONG
WOMEN AND WOMEN'S HEALTH
RESEARCHERS AND YET SPENDING
MONEY VERY QUICKLY OFTEN ISN'T
SPENT WELL SO I'M JUST WONDERING
WHAT YOUR PHILOSOPHY IS OR WHAT
PRINCIPLES YOU USED TO PROPOSE
THE LEVEL OF BUDGET INCREASE
OVER THIS FIVE-YEAR PERIOD?
>> I'LL MAKE AN INITIAL COMMENT
AND YOU'RE CORRECT, THIS NEEDS
TO BE DONE OVER TIME.
WE ENVISION A RAMP UP OTHER THAN
A HUGE AMOUNT OF MONEY AT THE
OUTSET AND WOULD TAKE TIME TO
BUILDING RESOURCE AND CAPACITY
WITHIN THE NIH THE HIRING OF
STAFF AND TRAINING OF STAFF.
SO OUR VISION IS NOT IN FACT IT
WOULD OCCUR ALL AT ONCE BUT OVER
A THREE TO FIVE-YEAR PERIOD AND
ENVISION AT THE END OF THE
PERIOD LOOKING TO SEE WHETHER WE
HAVE IN FACT ACHIEVED WHAT WE'D
HOPED, WHETHER THE MONEY IN FACT
HAS BEEN WELL USED AND TARGETED
AND WHETHER ADDITIONAL FUNDS OR
NECESSARY OR MOVING OF FUNDS
AROUND ARE NECESSARILY BUT YOUR
POINT'S A GOOD ONE.
>> AND TO ADD THAT WE RECOGNIZE
THAT BUDGETARY ISSUES ARE REALLY
THE MOST DIFFICULT INVESTIGATORS
CAN FACE AND SO THAT'S WHY WE
REALLY PRIORITIZED AS PART OF
THE MULTI-PRONGED TO INCREASE
FUNDING NOT ONLY FOR THE NEW
INSTITUTE BUT FOR A NEW FUND AS
WELL.
SO TO PROVIDE AN INCENTIVE AND
RECOGNIZING IN MANY CASES,
GRANTS ARE CUT AND MANY CASES
WOMEN'S HEALTH OR SEX
DIFFERENCES ENDS UP AS WE SAY ON
THE CUTTING ROOM FLOOR AND THAT
THEN IS A REALLY MAJOR
LIMITATION TO WOMEN'S HEALTH
RESEARCH.
>> WE HAVE DR. JONES.
>> I WANT TO AMPLIFY WHAT A
STELLAR PIECE OF WORK THIS IS
AND CAN'T IMAGINE ALL THE TIME
THAT WENT INTO IT AND THE CARE
AND HOW DO WE ALL HELP YOU
EDUCATE OTHERS AND HELP GET THIS
OUT AND AMPLIFY IT AND WHAT IS
YOUR COMMUNICATION PLAN AND HOW
CAN OUR MEMBERS HELP WITH THAT.
>> ALINA DID YOU WANT TO COMMENT
?
>> THANK YOU FOR YOUR OFFER AND
KIND WORDS.
ON BEHALF OF THE COMMITTEE IT
WAS TRULY A LABOR OF LOVE FOR US
TO DO THE WORK AND IT WAS A
PRIVILEGE AND HONOR TO BE ABLE
TO CONTRIBUTE.
I THINK THERE ARE MANY WAYS THIS
COMMITTEE AND MESSAGE CAN BE
AMPLIFIED, PROFESSIONAL
CONFERENCES, WHEN YOU DO
TRAINING, WHEN YOU DO RESEARCH
IN APPLICATIONS, THERE ARE MANY
MANY DIFFERENT WAYS THAT THIS
THE FINDINGS OF THIS REPORT
PIECES OF IT WHERE THE REPORT IN
WHOLE CAN BE AMPLIFIED AND
COMMENTARIES IN JOURNALS AND
OTHER SUPPORTIVE WORK AS WELL.
WE'RE PLANNING TO DO THAT AS
PART OF OUR WORK BUT CLEARLY THE
COMMITTEE AND NATIONAL ACADEMIES
OF SCIENCES CAN'T DO THAT
WITHOUT THE AMPLIFICATION OF THE
BROADER RESEARCH COMMUNITY.
>> THANK YOU, DR. TEMPLETON.
>> IT'S BEEN AN INTERESTING AND
IMPORTANT DISCUSSION.
MY QUESTION IS ON THE MENTION OF
WHAT CONDITIONS WOULD BE
ADDRESSED BY THE INSTITUTE.
YOU SAID CONDITIONS THAT ARE NOT
COVERED BY OTHER INSTITUTES AND
CENTERS.
MY QUESTION IS WHAT IS THE
VISION OF THE COMMITTEE ON HOW
THAT WOULD PLAY OUT.
WILL SOMEONE BE KEEPING TRACK OF
INSTITUTES AND CENTERS AND DOES
IT HAVE TO BE RESEARCH THAT
SOLELY CONFINED TO WOMEN I THINK
IS SOMETHING AND I APPRECIATE
THE INCLUSION OF OSTEOARTHRITIS
BUT IT'S MORE COMMON IN WOMEN
BUT WITH DIFFERENT RISK FACTORS,
PRESENTATION AND OUTCOMES AND
TREATMENT.
FOR EXAMPLE, IF NIAMS IS FUNDING
RESEARCH BOTH INCLUDING WOMEN
AND WOMEN AND SEX-BASED
DIFFERENCES WOULD THAT NOT BE
WITHIN THE INSTITUTE OR THINKING
ONLY OF CONDITIONS THAT OR
RESEARCH PROJECTS THAT ONLY
FOCUS ON WOMEN OR IF THEY
INCLUDE WOMEN, IS THAT THOUGHT
TO BE SUFFICIENT AND THUS NOT
GOING UNDER THE NEW INSTITUTE?
>> YOU RAISE A VERY IMPORTANT
QUESTION AND I KNOW ONE THAT
OTHERS WILL LOOK AT AS WELL.
ONE, RRM THE ROLE OF THE
DIRECTOR OF NIH WE BELIEVED TO
BE CRITICAL GOING FORWARD.
THAT ISN'T OVERSEEING WHAT IS
GOING ON IN THE OTHER INSTITUTES
AND CENTERS AND WORKING WITH
THEM TO DEVELOP THEIR OWN
STRATEGY AND OWN AGENDA FOR THE
COMING YEAR AND LOOKING AT WHAT
IN FACT IS OCCURRING.
THE NEW INSTITUTE, WE BELIEVE,
WILL HAVE THE OPPORTUNITY TO
FOCUS ON THE AREAS NOT CURRENTLY
COVERED BY THE OTHER INSTITUTES
BUT BY NO MEANS SUGGESTS THERE
SHOULDN'T BE COLLABORATION,
COOPERATION.
THE NEW FUND WE IDENTIFY WE VIEW
AS A TOOL THAT COULD POTENTIALLY
BE USED TO INCENTIVIZE OTHER
INSTITUTES AND CENTERS TO FOCUS
ON OTHER CONDITIONS THAT MAY
WELL TOUCH ON AREAS WITH OTHER
INSTITUTES.
SO IT ISN'T SIMPLY ALL WITHIN
ONE BUT RATHER THE DIRECTOR TO
TAKE A LOOK AT THE
RESPONSIBILITY OF EACH OF THE
INSTITUTES AND CENTERS TRACKING
WHAT'S OCCURRING AND WHAT'S
ENVISIONED IN TERMS OF THEIR
AGENDAS FOR THE COMING YEAR AND
FINDING OPPORTUNITIES FOR
COLLABORATION WHICH MAY BE
FUNDED BY THE NEW FUND OR MAY
WELL OCCUR WITHIN THE NEW
CENTER.
SO IT'S GOING TO OCCUR IN A
VARIETY OF WAYS, I THINK.
AGAIN, MY COLLEAGUES MAY WANT TO
COMMENT AS WELL.
>> I'LL ADD ONE THING.
WE WERE VERY DATA DRIVEN.
IF YOU LOOK AT THE FUNDING
ANNOUNCEMENTS CHAPTER THERE'S
TWO MAJOR CONCLUSIONS THAT CAN
BE DRAWN FROM ALL THE DATA
INCLUDING THE APPENDIX.
THE FIRST IS CURRENT FUNDING FOR
WOMEN'S HEALTH RESEARCH IS
PROPORTIONATELY LOW AND
DISAPPEARING FROM OF ACROSS
INSTITUTE.
IF WE COULD SOMEHOW MAGICALLY
AUGMENT THE PER -- PROPORTION OF
WOMEN'S HEALTH RESEARCH ACROSS
ALL INSTITUTES, 8%, 10% WOULD
THAT FIX EVERYTHING AND THE
CONCLUSION OF THE COMMITTEE WAS
IT WOULDN'T BE SUFFICIENT AND
THE SET OF RECOMMENDATIONS WERE
NOT AS SIMPLE AS THAT.
>> DR. NOEL.
>> I FOUND THE WORK INTERESTING.
TO PIGGYBACK ON DR. JONES A
QUESTIONS AND REGARDING SEX AS A
BIOLOGICAL VARIABLE, THE REPORT
HIGHLIGHTED MANY
RECOMMENDATIONS.
HOW CAN NIH OR EVEN THIS
COMMITTEE HELP TO HAVING BETTER
REPORT OF SEX AS A BIOLOGICAL
VARIABLE WHETHER I KNOW WE CAN'T
REALLY DO ANYTHING AT THE LEVEL
OF SAY STUDY DESIGN BUT IN TERMS
OF REPORTING THE DATA.
WHAT ARE THE SOLUTION IN THAT
AREA?
>> AT THE END OF THE DAY ONE
MAJOR ISSUE IS ACCOUNT.
AND EMPHASIS IS ON
ACCOUNTABILITY.
REPORTING REQUIRES BY THE NIH
WHICH AT PRESENT IS PROBABLY
ABOUT HALFWAY THERE WE BELIEVE.
AND THAT'S WHY WE PUT IN THE
RECOMMENDATIONS MORE COULD BE
DONE PARTICULARLY WITH RESPECT
TO ACCOUNTABILITY.
>> DR. ANINYE.
>> I ATTENDED SOME OF THE
MEETINGS AND IT'S A THOUGHTFUL
REPORT YOU PUT TOGETHER.
I KNOW YOU MENTIONED EARLY ON
THAT THERE WAS NOT ONE
PARTICULAR FIX.
SO YOU GAVE THIS COMBINATION OF
RECOMMENDATIONS BUT I KNOW WITH
SOME THERE'S PRETTY BIG GRANT
CHALLENGES IN SOME OF THOSE AS
FAR AS BECOMING AN IC OR THE
AMOUNT OF FUNDING.
MY QUESTION IS TO YOU IS WHILE
WANTING TO PROPOSE
RECOMMENDATIONS FOR FIXES BEING
WHAT WERE KEY CHALLENGES YOU
ADDRESSED EVEN IN YOUR
RECOMMENDATIONS YOU MAY BE ABLE
TO HIGHLIGHT TO GET AHEAD OF TO
ACTION SOME OF THESE
RECOMMENDATIONS?
>> YOU RAISE AN INTERESTING
QUESTION.
WE ALSO LOOKED AT THE QUESTION
OF WHAT COULD BE DONE MORE
QUICKLY OR READILY WITHOUT
HAVING A CONGRESSIONAL PROCESS,
STATUTORY CHANGES IN THE NUMBER
OF INSTITUTES.
WHAT IS IN THE PURVIEW OF THE
EXISTING STRUCTURE TO IMPROVE
THE SITUATION?
AND THERE IS NO QUESTION THAT
HEIGHTENED SENSE OF TRACKING,
THE OFFICE OF THE ESSENTIALLY
TAKING RESPONSIBILITY FOR
WORKING WITH EACH OF THE
INSTITUTES AND CENTERS TO MAKE
SURE THAT WOMEN'S HEALTH CARE
WAS PART OF THEIR AGENDA GOING
FORWARD SO THE ACCOUNTABILITY
ISSUE EQUALLY WOULD BE IMPORTANT
AND SOMETHING THAT COULD BE DONE
IN THE ABSENCE OF NEW FUNDING.
REALLY WHAT'S TRACKING NOW WE
THOUGHT WAS IMPORTANT BUT WE
DON'T IMAGINE ALL THIS OCCURRING
AT ONCE AND IN FACT IT MAY NOT.
YOU MAY FIND THE PEER REVIEW
PROCESS, FOR EXAMPLE, UNDER GOES
A REVIEW AND THERE'S ADDITIONAL
ATTENTION PLACED ON PEOPLE
REVIEWING THE GRANTS AND THE
GRANTS ESSENTIALLY RESPONDING TO
THE ISSUES OF WHETHER IT'S SABV
POLICY OR WHETHER OR NOT IT'S
THE INDIVIDUALS REVIEWING.
I THINK THERE'S A NUMBER OF
THOSE KINDS OF STEPS WE COULD
ENVISION CALLED OCCUR EVEN IN
THE ABSENCE OF MAJOR CHANGE.
AM I FORGETTING ANYTHING ELSE?
>> IN THIS CURRENT CLIMATE AS
THE AN EXCELLENT QUESTION TO
ASK.
THERE'S A LOT OF THOSE ISSUES.
WE RECOGNIZE THERE'S BEEN
EFFORTS UNDERWAY AT THE NIH OVER
THE LAST-FEW MONTHS TO TRY TO
STRENGTHEN AND IMPROVE THE NIH'S
EFFORTS AROUND SABV AND OTHER
ISSUES AND I THINK RECOGNITION I
THINK WHAT'S GOING TO TO BE A
HOLE OF NIH EFFORT AND EVERY
I.C. AND OFFICE HAS SOMETHING TO
CONTRIBUTE AND THINK THE REPORT
HAS GOOD OPTIONS.
WE REALLY TOOK A DEEP DIVE.
I THINK WE ALL LEARNED A LOT
THOUGH WE CAME IN WITH A LOT OF
KNOWLEDGE ON THE ISSUES AND
THERE'S A LOT OF TRAFFIC
NAVIGATE IN THE REPORT WE HOPE
WILL SERVE AS GUIDANCE AS THE
NIH MOVES FORWARD IN IMPROVING
ITS EFFORTS IN WOMEN'S HEALTH
RESEARCH.
>> AND WOULD LIKE TO HIGHLIGHT
THE TRAINING OPPORTUNITIES WE
RECOMMENDED ARE A GREET PLACE TO
START.
IT'S NOT AN ENORMOUS AMOUNT OF
MONEY BUT WOULD SPECIALLY
DEVELOP THE WORKFORCE TO DO THIS
WORK SHOULD ADDITIONAL FUNDING
BE AVAILABLE IN THE FUTURE.
>> IT WOULD BE SHORT-SIGHTED TO
SAY THE NIH COULD DO THIS WOULD
ADDITIONAL FUNDING.
WE CAME UP WITH THE ESTIMATES
BECAUSE WE RECOGNIZE THERE NEEDS
TO BE MORE OF AN INVESTMENT
THERE.
WE RECOGNIZE THERE ARE FINANCIAL
CHOICES AND LIMITATIONS BUT
THERE'S NOT A LOT OF MORE THAT
CAN BE SQUEEZED.
THERE NEEDS TO BE MORE FINANCIAL
SUPPORT FOR WOMEN'S HEALTH
RESEARCH.
>> I'D TURN IT OVER TO A
QUESTION IN THE CHAT BEFORE I
TURN TO DR. ARNOLD.
THIS IS DR. AGUIRRE.
THANK YOU SO MUCH FOR ALL YOUR
WORK, I PARTICULARLY LOVED THE
FIRST RECOMMENDATION OF CREATING
A WOMEN'S HEALTH RESEARCH I.C.
WHAT DOES THAT MEAN FOR THE
CURRENT ORWH OFFICE?
HOW WILL GRANTS SPECIFIC TO THIS
NEW I.C. DISTINGUISHED FROM
GRANTS FROM OTHER I.C.s?
>> THIS IS RELATED TO A QUESTION
EARLIER HOW A PURVIEW IS
DISTRIBUTED ACROSS THE EXISTING
I.C.s AND THEY ARE HAVE THEIR
OWN UNIQUE SET OF PRIORITIES AND
MANY OF THEM ALREADY INCLUDE
WOMEN'S HEALTH RESEARCH
PRIORITIES AND WE CAN SEE HOW
MUCH IS ALLOCATED TO GRANT
FUNDING REMAINS LOW.
WE ANTICIPATE OR WE'D HOPE IF
THE RECOMMENDATIONS WERE TO BE
FOLLOWED THROUGH THERE'D BE
RECOMMENDATIONS ACROSS ALL I.C.
AND THE NEW I.C. WOULD AS
PRIORITY THOSE DISEASES AND
CONDITIONS THAT DON'T NATURALLY
HAVE A HOME.
IN PARTICULAR AS MENTIONED IN
THE REPORT AS WELL AS IN THE
PRESENTATION, WE RECOGNIZE THE
NEED FOR INTERDISCIPLINARY
COLLABORATION WHICH IS NOT
ALWAYS POSSIBLE GIVEN THE
CURRENT STRUCTURE.
EVERY I.C. HAS SO MUCH ON ITS
PLATE AND TO DO IN TERMS OF
FOCUSSING ON ITS SET OF
PRIORITIES.
INTERDISCIPLINARY COLLABORATION
IS WE WOULD HOPE AS PART OF THE
RECOMMENDATIONS WOULD BE A FOCUS
AT THE HIGHEST LEVEL.
>> I WOULD JUST ADD THAT MANY OF
THE ROLES AND RESPONSIBILITIES
OF THE CURRENT OFFICE WOULD BE
ELEVATED TO THE NEW INSTITUTE
AND DIRECTOR'S OFFICE.
SO, THOSE WOULD NO GO AWAY AND
BELIEVE THERE NEEDS TO BE AN
INSTITUTE WITH A RESEARCH BUDGET
AND ALSO HOUSES THE EXPERTISE IN
WOMEN'S HEALTH RESEARCH.
THE CURRENT OFFICE OF WOMEN'S
HEALTH IS JUST NOT FUNDED AND
STAFFED TO THE NUMBERS OF
RESEARCHERS AND THE LEVELS OF
EXPERTISE THAT WE BELIEVE IS
NEEDED STRUCTURALLY THAT'S A
LIMITATION RIGHT NOW.
>> DR. MIELENZ.
>> I WANT TO APPLAUD THE
COMMITTEE FOR YOUR EXCELLENT
EFFORTS AND OUTPUTS OF OTHERS
HAVE SAID AND MY QUESTION
FOLLOWS ALONG NICELY FROM THE
CHAT I WONDERED IN YOUR
RECOMMENDATION ABOUT
TRANSITIONING THE OFFICE TO AN
I.C. AS ONE OF YOUR
RECOMMENDATIONS.
WAS THERE ANY DISCUSSION ON
EXAMPLES OF OFFICES THAT HAVE
TRANSITIONED TO I.C.s AND ANY
SUCCESSES OR BARRIERS AROUND
THAT TRANSITION?
I WONDERED IF THAT CAME UP IN
CONVERSATION.
>> WE LOOKED AT ADDITIONAL I.C.s
AND THERE WAS CONSIDERATION
GIVEN AS TO THE IMPORTANCE OF
BOTH TARGETING AND FUNDING AND
RESPONSIBILITY AND
ACCOUNTABILITY.
IN FACT MOVING TO AN I.C. THAT
HAS AUTHORITY, THAT HAS FUNDING
TO INCENTIVIZE OTHERS TO PARTNER
WITH THEM WAS A CRITICAL ELEMENT
TO HIGHLIGHT THE IMPORTANCE OF
THE WORK IN THE AREA.
ESSENTIALLY THE CREATION OF AN
INSTITUTE THE AUTHORITY OF AN
INSTITUTE , THE FUNDING OF AN
INSTITUTE AND FRANKLY THE
DIRECTOR HOLDING THE INSTITUTE
ACCOUNTABLE FOR THE WORK TO BE
DONE WE THOUGHT WAS AN IMPORTANT
PART OF WHAT NEEDED TO BE
CONSIDERED.
>> AND I WOULD SAY THE NATIONAL
INSTITUTE ON MINORITY HEALTH AND
HEALTH DISPARITIES WAS
ORIGINALLY AN OFFICE ELEVATED TO
AN INSTITUTE.
THERE IS PRECEDENT FOR THAT.
>> WITH GRE THAT, GREAT, THANK ,
AR -- DR. ARNOLD.
>> WE HEARD ABOUT THE COMPLEXITY
OF WHO WILL COVER THIS AND WHERE
WILL THE REPORT GO AND WHO WILL
TAKE THE NEXT STEP?
IT'S GOING TO TAKE YEARS, I
WOULD THINK, TO GET THE
CONGRESSIONAL SUPPORT AND ALL
THE THINGS TO GET A NEW
INSTITUTE.
THERE'S QUICKER WAYS TO GET
MONEY HOPEFULLY QUICKER WAYS TO
GET MORE MONEY TO THE OFFICE OF
RESEARCH ON WOMEN'S HEALTH BUT
WHAT'S GOING TO HAPPEN NOW?
>> WELL, THE REPORT IS
COMPLETED.
WE SUBMITTED THE REPORT.
COMMITTED IT BOTH TO THE OFFICE
OF WOMEN'S HEALTH RESEARCH AS
WELL AS THE COMMITTEES.
WE BRIEFED THE CONGRESSIONAL
COMMITTEES.
WE'VE BRIEFED THE WHITE HOUSE.
SO OUR NEXT STEPS ARE MAKING
SURE MAKE REPORT IS OUT TO THE
PUBLIC AND RESPONDS TO THE
ASSIGNMENT AND THERE'S
PUBLICATIONS, PARTICIPATING IN
CONVERSATIONS, ENCOURAGING OTHER
TO DO SO BUT THE NEXT STEP IS
REALLY A CONGRESSIONAL STEP IN
SOME RESPECTS AS IT HAS TO DO
WITH FUNDING OR THE CREATION OF
AN INSTITUTE CLEARLY WITHIN
CONGRESS'S PURVIEW.
AND WHETHER THERE'S INCREASE IN
TRAINING AND IDENTIFICATION OF
THE ISSUES, THE RESPONSIBILITY
OF THE DIRECTOR IN TERMS OF
OVERSIGHT, ALL OF WHICH WOULD
FALL BACK ON NIH HOW TO TAKE THE
REPORT AND MOVE IT FORWARD.
>> I WANT TO BRING ATTENTION TO
A COMMENT AMY PUT IN THE CLASS
THAT STATES NIMHD WAS ORIGINALLY
IN OFFICE THEN CENTER THEN
INSTITUTE.
THAT EXAMPLE AND OTHER RELEVANT
INFORMATION IS AVAILABLE IN
CHAPTER 3.
ARE THERE EARTH -- OTHER
QUESTIONS FROM THE ACRWH
MEMBERS?
ASHLEY, I MAY ALSO PUT YOU ON
THE SPOT IF THERE ARE ANY
QUESTIONS SUBMITTED DURING THE
TIME AT THE ACRWH MAILBOX.
>> DR. OTA WANG.
NO QUESTIONS WERE SUBMITTED TO
THE MAILBOX.
>> OKAY.
DR. ARNOLD IS THAT A LEGACY HAND
OR DO YOU HAVE ANOTHER QUESTION
FOR US?
>> SORRY.
I WAS JUST LEFT UP.
SORRY.
>> THANK YOU.
OKAY.
WELL, THANK YOU SO MUCH FOR THE
GREAT QUESTIONS AND RESPONSE
SESSION.
DR. CLAYTON, I WOULD LIKE TO
TURN IT OVER TO YOU.
>> THANK YOU, DR. OTA WANG AND
LET ME THANK THE COMMITTEE
LEADERSHIP DR. SALGANICOFF AND
DR. BURKE AND DR. AMY GILLER AND
OTHERS FOR THE WORK AND THE
ENTIRE COMMITTEE FOR THE
THOUGHTFUL WORK AND APPROACH OF
THIS IMPORTANT TOPIC.
WE WANT TO EXPRESS OUR
APPRECIATION FOR THE EFFORTS AND
YOUR THOUGHTFUL DELIBERATIONS AN
COMPREHENSIVE APPROACH.
I WANT TO APPRECIATE THE TALKS
THAT WERE PROVIDED TODAY AS PART
OF THE ADVISORY COMMITTEE AND
WANT TO ACKNOWLEDGE THE
IMPORTANT WORK OF THIS ADVISORY
COMMITTEE AND YOUR ROLE WHICH IS
CRITICAL TO WOMEN'S HEALTH
RESEARCH ADVANCEMENT AT NIH SO
THANK YOU FOR YOUR EFFORTS,
ACRWH AND I WANT TO ACKNOWLEDGE
THE ORWH STAFF AND SCIENTISTS
AND BEHIND THE SCENES OR
CONTRACT SUPPORT FOR MAKING THIS
MEETING POSSIBLE.
SO ON BEHALF OF ORWH, THANK YOU
ALL AND WE LOOK FORWARD TO
SEEING YOU AT THE 63rd MEETING
OF THE ADVISORY COMMITTEE ON THE
RESEARCH ON WOMEN'S HEALTH HELD
ON APRIL 8, 2025 WHICH WILL BE A
HYBRID MEETING.
AND WISHING YOU ALL A SAFE AND
HEALTHY HOLIDAY SEASON AND
TODAY'S MEETING IS NOW
ADJOURNED.
THANK YOU VERY MUCH, EVERYONE.
>> THANK YOU.