EXCITING TO INTRODUCE DR. VICTOR
BUT BEFORE WE DO THAT WE WOULD
LIKE HIM TO COME FORWARD TO
RECOGNIZE HIS EFFORTS. HE IS
PRESIDENT OF THE NATIONAL
ACADEMY OF MEDICINE. CHANCELLOR
OF DUKE UNIVERSITY. ONE OF THE
MOST INFLUENTIAL LEADERS OF
HEALTH AND RECOGNIZED GLOBALLY
AS A SCIENTIST, ADMINISTRATOR
AND LEADER. HIS RESEARCH LAID
THE FOUNDATION FOR LIFE SAVING
DRUGS KNOWN AS ACE INHIBITORS.
DR. DA SUE WAS A LEADER AND LED
THE ACTION COLLABORATIVE ON
COUNTERING THE U.S. OYED YOUED
EPIDEMIC AND THE ACTION
COLLABORATIVE ON CLINICIAN
WELL-BEING. AND RESILL YENS
AMONG OTHERS. AMONG HIS TENURE
IN THE ACADEMY TO IMPROVE HEALTH
EQUITY AND ADDRESS RACISM
THROUGH HIS -- THROUGH A VARIETY
OF PROGRAMMATIC ACTIVITIES
ESPECIALLY THE CULTURE OF HEALTH
PROGRAM DOCTOR DAZU OBTAINED HIS
DEGREE AT UNIVERSITY AND HIS
FELLOWSHIP WAS COMPLETED AT
HARVARD. UNIVERSITY HE DID TWO
FELLOWSHIPS IN BOSTON AND WORKED
IN THE CHILDREN'S HOSPITAL IN
BOSTON. WE ARE SO EXCITED TO
HAVE DR. VICTOR DAZU TODAY TO
DELIVER THE KEYNOTE ADDRESS
ENTITLED THE NATIONAL ACADEMIES
AND WOMEN'S HEALTH, PAST,
PRESENT AND OPPORTUNITIES FOR
PROGRESS. DR. DAZU?
>> JOI DON'T WANT TO BE THAT FA
FROM EVERYONE. HELLO, EVERYONE,
IT'S GREAT TO SEE SO MANY
FRIENDS AND PEOPLE WHO ARE SO
ENERGETIC AND COMMITTED TO
WOMEN'S HEALTH. IT'S A GREAT
HONOR FOR ME, THANK YOU, TO
SPEAK TO ALL OF YOU. I MEAN,
YOU ARE THE DRIVERS OF SUCH AN
IMPORTANT AREA OF WORK IN BOTH
CARE AND RESEARCH AND EDUCATION.
AND I TRULY APPRECIATE WHAT YOU
ARE DOING. WE HAVE MOMENTUM.
AS YOU KNOW, WOMEN'S HEALTH IS
NOW I THINK IT'S HERE. IT'S
MOVING FORWARD WITH GREAT
MOMENTUM AND I WANT TO TALK TO
YOU A LITTLE BIT ABOUT WHAT WE
HAVE BEEN DOING AT THE NATIONAL
ACADEMY, HOW WE CAN WORK
TOGETHER TO ADVANCE WOMEN'S
HEALTH. SO BY WAY OF
INTRODUCTION FOR THOSE WHO DON'T
KNOW US VERY WELL. I WILL TELL
YOU THAT A FOUNDING ORGANIZATION
IS IS NATIONAL ACADEMY OF
SCIENCES, 1863 CHARTERED BY
ABRAHAM LYNDON IN CONGRESS AS AN
INDEPENDENT PART OF THE
GOVERNMENT CLOSE WITH
GOVERNMENT,S OR THAT GIVES
ADVICE AND ENGINEERING AND
MEDICINE. SO WE'VE HAD HUNDREDS
OF HISTORY OF YEARS OF BEING AN
ADVISOR, FORWARD-THINKING OF
CONGRESS AND PRESIDENT LINCOLN
THINKING ABOUT THE CIVIL WAR AND
NEEDING SOMETHING INDEPENDENT.
VERY PROUD OF THAT. NOW IN 1970
WHEN IT BECAME CLEAR THAT HEALTH
AND MEDICINE IS A KEY AREA, WE
WERE THINKING AT THE TIME OF
CREATING A THIRD ACADEMY. BUT
IT WAS THEN THOUGHT THAT IT
SHOULD BE AN INSTITUTE WITH THE
NATIO
NATIONAL ACADEMY OF SCIENCES THE
IOM BUT IN 2015 THE YEAR THAT
ARRIVED WITH THE TRANSITION TO
NOW, THE THIRD ACADEMY SCIENCE,
ENGINEERING AND MEDICINE. NOW I
CAN TELL YOU ABOUT ALL OUR
MEMBERS BUT I THINK THE MORE
IMPORTANT THING I WANT TO TELL
YOU IS WHAT WE HAVE ON THE RIGHT
SIDE HERE. OUR JOB IS TO WORK
WITH ALL OF YOU TO CONVENE
PEOPLE LIKE YOURSELF ON CRITICAL
AND IMPORTANT ISSUES TO
CATALYZE, PROVIDE REPORT AND
REALLY SHAPE POLICY IN A BIG
WAY. NOW OVER THE YEARS YOU
LOOK AT WHAT WE'VE DONE, MANY OF
YOU KNOW THIS WELL, IN 1999, THE
TO AEROIS HUMAN. HOW MANY
PEOPLE KNOW ABOUT TO AEREAR IS
HUMAN. WE HAVE MEDICAL ERRORS
OCCURRING IN HOSPITALS AND AT
THE TIME WAS 98,000. NOW THE
NUMBER'S MUCH LARGER GIVEN THE
EXPANSION OF THE POPULATION,
AGING, ET CETERA
AND REALLY LAUNCHED THE WHOLE
GLOBAL EFFORT IN PATIENT SAFETY.
1986, WE PUBLISHED THIS REALLY
IMPORTANT REPORT TO SAY THAT
MAPPING AND SEQUENCING THE HUMAN
GENOME. AT THE TIME EVEN
GENETICISTS SAID, NO WE CAN'T DO
IT. THERE'S TOO MUCH
INFORMATION AND GUESS WHERE WE
ARE TODAY, WE CAN SEE THE
GENOME FOR A FEW HUNDRED DOLLARS
AND BECAUSE WE HAD A CRISIS IT
WAS STARTED AS WITH MOST PEOPLE
AS A SMALL PART OF THE
POPULATION SO THIS WAS
CONFRONTING AIDS AND LAUNCHED A
LOT OF EFFORT INCLUDING
AUTHORIZATION OF PEP FIVE AMONG
OTHERS AND BECAUSE IT WAS THE
FIRST TO POINT OUT THAT GENOME
EDITING HAS MANY ETHICAL AND
SOCIETAL IMPLICATIONS. ONE ON
POPULATION HEALTH AND BECAUSE
MORE RECENTLY ON PANDEMICS. I
SAY ALSO ALL THIS JUST TO GIVE
YOU AN IDEA OF WHY WE CARE ABOUT
THIS TOPIC SO MUCH BECAUSE OUR
JOB IS TO PROVIDED ADVICE TO TH
U.S. PUBLIC AND MORE GLOBALLY WE
LOOK AT WHAT ARE THE BIG ISSUES
WE NEED TO TACKLE WE CALL THEM
THE GRAND CHALLENGE AND THE TWO
WE HAVE LAUNCHED ARE CLIMATE
CHANGE AND LONGEVITY BUT WE ALSO
SAY, WE GOT TO JUMP IN WHEN
THINGS ARE IMPORTANT FOR US TO
WEIGH IN TO REDIRECT, SHALL WE
SAY, OR DIRECT THESE
CONVERSATIONS THAT INCLUDES
SYSTEMIC RACISM, FIREARM
VIOLENCE AND IMPORTANTLY WOMEN'S
HEALTH. PARTICULARLY POST DOBS
AND DECISION.
AND SO WE ARE TOTALLY COMMITTED
TO EQUITY.
DIVERSITY AND INCLUSION. SEW I
WANT TO TODAY TELL YOU ABOUT
WHAT WE'RE DOING IN WOMEN'S
HEALTH AND IT GOES BACK A LONG
WAY SINCE OUR FOUNDING OF IOM
BUT MAYBE THE SLIDE GIVES YOU
THE HISTORY, THE EVOLUTION OF
WOMEN'S HEALTH BECAUSE IT WAS
1972 AS YOU CAN REMEMBER THAT
THE SUPREME COURT DECISION ON
WOE VERSUS WADE APPROVED
CONTRACEPTIVES AND THE RIGHT TO
LEGALIZED ABORTION AND IN 1977
FDA SAYS WE SHOULDN'T HAVE WOMEN
OF CHILD BEARING AGE IN ANY DRUG
TRIALS AND IT WAS IN 1093 WHEN
THE REVITALIZATION ACT INCLUSION
OF WOMEN AND MINORITIES AND
RESCINDS THE GUIDELINE BANNING
WOMEN FROM RESEARCH. I THINK
WE'RE VERY EXCITED DURING THE
APPROVAL OF THE CARE ACT THAT
INCLUDES PREVENTATIVE SERVICES
PARTICULARLY, MAMMOGRAMS, BIRTH
CONTROL, BREAST-FEDING SUPPORT,
IN 2012 YOU HAVE TO REPORT SEX,
RACE, ETHNICITY IN YOUR REPORTS.
AND IN 2016, NIH FINALLY
IMPLEMENT POLICY OF SEX IS A
BIOLOGICAL VARIABLE AND BECAUSE
EXCITINGLY LAST YEAR AND THIS
YEAR WOMEN'S HEALTH RESEARCH
INITIATIVE ESTABLISHED BY THE
WHITE HOUSE.
IT'S A LONG JOURNEY, WE HAVE
FOUGHT WELL AND WE ARE STILL --
HAVE MANY, MANY LONG TRIPS TO
TAKE. BUT I AM VERY EXCITED
ABOUT WHERE WE ARE TODAY. NOW,
WHEN WE GOT INVOLVED IN IOM WE
FOUND IN 1970 YOU CAN SEE VERY
EARLY REWE COULDED THIS
IMPORTANT ISSUE. AND OF COURSE
MOST INITIAL WORK WAS LOOKING AT
REPRODUCTIVE HEALTH, THERE ARE
FIVE REPORTS HERE. THE
ASSESSMENT OF BIRTH SETTINGS,
LOOKING AT FINISHES WITH WOMEN
AND CHILDREN, CONTRACEPTIVE AND
OTHERS. BUT IN THE 1990S WE
BECAME VERY ACTIVE IN
RECOGNIZING THAT THERE REALLY IS
MUCH BROAD ISSUE IN WOMEN'S
HEALTH AND THIS IS JUST A
COLLECTION OF REPORTS THAT WE'VE
DONE IN REGARDS TO WOMEN'S
HEALTH. I THINK INCREASINGLY
IT'S THE UNDERSTANDING OF THE
IMPORTANCE OF WOMEN AND
INCLUSION IN CLINICAL RESEARCH
AND PERSPECTIVE OF THE NEEDS IN
WOMEN'S HEALTH. AS
REPRESENTATIVE SAYS, IF ANYONE
THINKS WOMEN ARE GOING TO KEEP
PAYING HALF THE COST OF CARE AND
(READING). AND SHE WAS REALLY A
PIE
PIONEER IN POINTING THAT OUT IN
1990. YOU SEE THE BOOKS 1994,
WOMEN AND HEALTH RESEARCH. THAT
WAS ONE OF THE FIRST STUDY TO
LOOK AT THE SCOPE OF RESEARCH IN
WOMEN'S HEALTH. BUT IMPORTANTLY
IN 2001, SEX AS A BIOLOGY. SEX
MATTERS. EXPLORING BIOLOGICAL
CONTRIBUTIONS. I THINK THE 2010
REPORT IN TERMS OF PROGRESS,
PITFALLS AND PROMISE IS A KEY
REPORT WHICH I WILL TALK ABOUT A
LITTLE BIT LATER AND OF COURSE,
PREVENTATIVE SERVICES THAT WERE
QUITE CENTRAL IN THE ADVISING
THE OBAMA ADMINISTRATION ON
INCLUDING WOMEN AND ACA, OVARIAN
CANCER IN CLINICAL TRIALS. SO
LOTS GOING ON IN TERMS OF THIS
WHOLE AREA THAT WE'VE BEEN
INVOLVED WITH. NOW MORE
RECENTLY WE'VE BEEN LOOKING AT
SEVERAL IMPORTANT AREAS ONE OF
COURSE IS THE INCLUSION OF
PREGNANT AND LACTATING WOMEN IN
CLINICAL RESEARCH. I WILL SAY A
FEW WORDS ABOUT THAT. ALSO
IMPORTANTLY, THE RECOGNITION
THAT CHRONIC CONDITIONED
EQUIPMENT LIKE IN MEN, NEEDS TO
BE REALLY LOOKED AT, HAVE MORE
DATA AND UNDERSTANDING OF THIS
ISSUE AND SO WE HAVE IN FACT A
REPORT ADVANCING RESEARCH IN
CHRONIC CONDITIONS IN WOMEN.
TOMORROW WE'RE GOING TO HAVE
INTERSECTION AND WORKSHOP OF
INTERSECTION OF REGEN RAHTIVE
MEDICINE IN WOMEN'S HEALTH BUT I
WOULD SAY IMPORTANTLY, THE LAST
ONE, ASKED BY CONGRESS TO SAY
WHAT'S THE FUTURE IN WOMEN'S
HEALTH, NIH AND THAT REPORT'S
COMING OUT IN NOVEMBER AND I
KNOW JANINE'S WIT -- WAITING.
WE THANK YOU FOR YOUR
LEADERSHIP. REALLY AMAZING. I
WORK WITH JANINE IN MANY
DIFFERENT FORUM. AND HER
LEADERSHIP IS GREATLY
APPRECIATED. BUT THIS REPORT,
WHICH WE WILL LAUNCH IN NOVEMBER
WILL MARK, I BELIEVE, WILL BE A
SEMINAL REPORT TO ASSESS WHAT DO
WE NEED TO DO? HOW MUCH DO WE
NEED TO INVEST IN AND WHAT
SHOULD NIH LOOK LIKE IN WOMEN'S
HEALTH RESEARCH? SO I WANT TO
BEGIN BY TALKING ABOUT RESEARCH.
AND THEN I WANT TO TALK ABOUT
THE BROAD ISSUE OF SOCIAL
FACTORS AND OTHERS. IN
RESEARCH, IF YOU LOOK AT HEALTH
DISPARITIES. SEX AND GENDER IT
REQUIRES EFFORT AT EVERY STAGE
OF HOW INNOVATION IN THE
ECOSYSTEM WE LOOK AT THE ENTIRE
ECOSYSTEM FROM DISCOVERY
RESEARCH ALL THE WAY TO
POPULATION SO IT'S IMPORTANT TO
INTEGRATE SEX AND GENDER AND TO
HELP REFRESH EDUCATION AND
TRAINING. AND ALSO IMPORTANT TO
PROMOTE CARE THAT RECOGNIZES
BIOLOGIC AND ENVIRONMENTAL
FACTORS THAT AFFECT WOMEN'S
HEALTH AND DISEASES. WE ARGUE
THAT RESEARCH MUST PROVIDE
EVIDENCE BASE TO UNDERSTAND THE
INFLUENCE OF SEX AND GENDER
ACROSS DEATH AND MORTALITY AND
MORBIDITY AND HAS TO
OPERATIONALIZE THIS RESEARCH TO
DO SO, WE REQUIRE CLINICAL TRIAL
DIVERSITY AND TARGETED ACTION.
SO LET ME TALK A LITTLE BIT
ABOUT THIS. WHAT ARE WE? WHERE
ARE WE? WELL, FIRST OF ALL AS I
MENTIONED, 2010, WE ACTUALLY
PUBLISHED A REPORT TO SAY
PROGRESS, PITFALLS AND PROMISE.
THIS WAS COMMISSIONED BY
CONGRESS AND IT SUGGESTS TO SAY
WHERE ARE WE? IN WOMEN'S HEALTH
RESEARCH IN BOTH POLICY,
REGULATION AND ORGANIZATION?
YOU CAN SEE THE SIX QUESTIONS WE
ASK. ARE WE STUDYING THE MOST
RELEVANT DETERMINANTS OF HEALTH,
WE FOCUS ON THE MOST APPROPRIATE
CONDITIONS AND END POINTS. ARE
WE STUDYING THE MOST RELEVANT
GROUPS OF WOMEN? ARE WE USING
THE MOST APPROPRIATE RESEARCH
METH
METHODS, ARE WE TRANSLATING
RESEARCH INTO PRACTICE AND ARE
WE COMMUNICATING THESE FINDINGS
EFFECTIVELY TO PATIENTS AND THE
PUBLIC? YOU CAN ANSWER THE
QUESTIONS AS WELL AS I DO. THE
ANSWER IS, YES AND NOT QUITE.
RIGHT? WE HAVE A ROCK WAY TO.
THESE QUESTIONS 14 YEARS AGO
WILL REMAIN RELEVANT TO WHAT WE
ARE TRYING TO DO. AND WE MUST
CONTINUE TO ADDRESS THESE
QUESTIONS. THAT IS PROMISE WITH
A LOT OF PITFALLS WE NEED TO
OVERCOME. I THINK WHAT WE
LEARNED IN WOMEN'S HEALTH
RESEARCH AND THIS SLIDES COMES
FROM REGENE IN 2022. BIOLOGICAL
PERSPECTIVE. THE INTERNAL
FACTORS, GENETIC, MOLECULAR, AND
PHYSIOLOGIC LEVELS BUT IT HAS TO
BE IN THE CONTEXT OF THE
ENVIRONMENT. EXTERNAL FACTORS
WHICH ARE GENDER, SOCIAL
DETERMINANTS OF HEALTH AS YOU
ALL KNOW, ENVIRONMENT AND PO
POLICY. AND THESE TWO MUST
INTERACT WITH EACH OTHER. NOT
JUST LOOKING AT THE BIOLOGY BUT
ALSO THE ENVIRONMENTAL FACTORS
AND VICE VERSA. AND
IMPORTANTLY, WHEN WE FIRST
STARTED WE TALKED ABOUT
REPRODUCTIVE HEALTH IT'S REALLY
ABOUT THE ENTIRE LIFE COURSE
FROM PRECONCEPTION IN UTERO, TO
ADOLESCENCE, ADULTHOOD ALL THE
WAY TO AGING. BUT YOU LOOK AT
THE SCOPE OF THIS RESEARCH YOU
CAN SEE THIS REALLY IS
ENCOMPASSING EVERYTHING THAT'S
REALLY IMPORTANT. THAT, IN
FACT, IS WHAT WE ARE ALL ABOUT
THAT'S IN FACT, WOMEN'S HEALTH
RESEARCH. NOW, SO I'M GOING TO
TALK ABOUT RESEARCH INTO
SPECIFIC CONDITIONS. I'M GOING
TO TALK ABOUT CLINICAL TRIALS,
FUNDING, PRIORITIZATION,
WORKFORCE AND LEADERSHIP. ALL
THESE AREAS WE NEED TO WORK
TOGETHER TO KEEP MOVING FORWARD.
SO FIRST OF ALL, YOU LOOK AT SEX
AND GENDER INFLUENCE. WELL,
THIS SLIDE SHOWS YOU ALREADY THE
DIFFERENT CONDITIONS, SUCH AS
AUTOIMMUNE DISEASE ON THE LEFT,
NEURODEGENERATIVE DISEASE ON THE
MIDDLE, AND PAINFUL AND
DEBILITATING DISORDERS ON THE
RIGHT AND PINK SHOWS YOU WOMEN
PREVALENCE. AND SOME OF THE
CONDITIONS HIGHLY PREVALENT IN
WOMEN THAN IN MEN. SO THAT SETS
A STAGE TO SAY REALLY THERE ARE
CLEARLY DIFFERENCES BUT WHEN YOU
LOOK AT WHAT ARE WE TRYING TO
STUDY I THINK THERE ARE THREE
CATEGORIES ONE IS CONDITIONS
WHICH ARE ONLY IN WOMEN SUCH AS
ENDOMETRIOSIS, MATERNAL HEALTH,
CONDITIONS HIGHLY PREVALENT IN
WOMEN. YOU SAW THAT IN
AUTOIMMUNE DISEASE, EVEN
ALZHEIMER'S AND I AM A
CARDIOVASCULAR KNOWING THAT
HEART DISEASE IS
UNDERRECOGNIZED. THE PATH OWE
PHYSIOLOGY IS DIFFERENT. MICRO
VASCULAR DISEASE. AND THE
EXPRESSION IS DIFFERENT AND
HENCE THE RECOGNITION, THE
CONDITIONS ARE DIFFERENT.
EXPRESSED BETWEEN MEN AND WOMEN.
SO WHEN WE LOOK AT STUDYING
DISEASES, THESE ARE THE THREE
THINGS WE NEED TO LOOK AT.
IMPACT SPECIFIC TO WOMEN AND
EXPRESSED IN WOMEN NOW IN
MATERNAL MORTALITY YOU KNOW
THESE ARE BIG ISSUES. WE DID A
STUDY IN 2020 CALLED BIRTH
SETTINGS IN AMERICA AND WE
POINTED OUT THERE'S NO RISK FREE
SETTING FOR A PERSON TO GIVE
BIRTH IN THE UNITED STATES. YOU
ALL KNOW THE DATA. WE RANK THE
WORST AMONG ALL DEVELOPED
COUNTRIES. AND SO, THE QUESTION
IS WHY. PATIENTS ARE SAYING
THERE ARE GAPS BETWEEN WHAT THEY
WANT AND THE CARE THAT THEY
RECEIVE. AND OF COURSE, WE NEED
TO UNDERSTAND THIS BASIC FOR
THIS THROUGH RESEARCH, BUT ALSO
INVEST IN WORKFORCE THAT CAN
ACTUALLY BE A LOT MORE FOCUSED
ON AND THEY BRING WOMEN'S
MATERNAL HEALTH ALTOGETHER. SO
IN 2021, WE HAD A WORKSHOP TO
SAY TO TAKE A LOOK AT ADVANCING
WOMEN'S HEALTH, MATERNAL HEALTH,
EQUITY, AND OF COURSE YOU ALL
KNOW THIS, YOU ARE THE LEADERS
IN THE FIELD TO RECOGNIZE
THERE'S SO MANY FACTORS
CONTRIBUTING TO FULL MATERNAL
HEALTH THAT INCLUDES ACCESS TO
CARE, PREVALENCE OF NCD,
MATERNAL STRESS AND TRAINING,
SOCIAL DETERMINANTS. BIAS AND
RACISM. AND YOU KNOW IT'S QUITE
AMAZING, WE LOOK AT THE
FREQUENCY OF THE INTERSECTION IN
OUR COUNTRY VERSUS OTHERS. SO
WE HAVE A LOT OF WORK TO DO, AND
I HAVE TO TELL YOU SOME DAYS I'M
A LITTLE FRUSTRATED TO SAY HOW
CAN WE NOT MAKE BETTER AND
FASTER PROGRESS? BUT I THINK
THERE'S LOTS OF THINGS THAT WE
DON'T FULLY UNDERSTAND. FOR
EXAMPLE, EVEN IF YOU TAKE
ACCOUNT FOR EDUCATION AT
SOCIOECONOMIC LEVELS THAT ARE
BEING EQUAL. WOMEN OF COLOR
STILL HAVING MUCH MORE MORTALITY
AND MORBIDITY. WHY IS THE CASE?
IS THIS GOT TO DO WITH RACISM?
WITH ACCESS TO CARE OR OTHER
FACTORS? I THINK THERE'S A LOT
OF WORK THAT NEEDS TO BE DONE IN
THIS CASE. CHRONIC CONDITIONS,
YOU KNOW, I THINK THIS IS REALLY
UNDERSTUDIED. PEOPLE LOOK AT
CHRONIC CONDITIONS AS A KIND OF
A BUCKET OF EVERYBODY IN THERE.
BUT AS I SAID, THERE'S A BIG
DIFFERENCE BETWEEN WOMEN'S
HEALTH AND MEN IN EXPRESSION OF
DISEASE AND MANY OTHERS SO IF
YOU LOOK AT THE GLOBAL DISEASE
BURDEN, 47% CONDITIONS AFFECT
WOMEN DISPROPORTIONATELY. AND
4% AFFECT WOMEN DIFFERENTLY AND
5% EXCLUSIVE TO WOMEN. SO WHEN
WE LOOK AT THIS STUDY, WE HAVE
MADE RECOMMENDATIONS THAT WE
NEED A LOT MORE -- REALLY GOOD
DATA TO IMPROVE DATA COLLECTION
CONDITIONS THAT LOOK AT WOMEN
AND PARTICULARLY ANY OF THE
PRECONDITIONS. TO IMPROVE
ESTIMATES OF IMPACT OF CHRONIC
CONDITIONS AFFECTING WOMEN, TO
UNDERSTAND HOW INFORMATION
AFFECT CHRONIC CONDITIONS,
PARTICULARLY WHEN YOU THINK
ABOUT MANY OF THE AGING
CONDITIONS, AUTOIMMUNE DISEASE
AND OTHERS. BUT I THINK
IMPORTANTLY UNDERSTANDING
HORMONAL FLUCTUATION BECAUSE
THEY REALLY INFLUENCE CHRONIC
CONDITIONS AND OF COURSE CHANGES
THE WAY IN WHICH WE APPROACH
SYMPTOMS OF MENOPAUSE AND OTHERS
AND IMPORTANTLY, UNDERSTANDING
SOCIAL DETERMINANTS OF HEALTH
THAT ARE AFFECTING WOMEN. NOW,
THIS LEADS TO OF COURSE THE
QUESTION OF DO WE HAVE ENOUGH
DATA? ARE WE COLLECTING ENOUGH
INFORMATION AND I THINK WE ALL
AGREE THAT IT'S UNCONSCIONABLE
THAT WOMEN ARE EXCLUDED FROM
CLINICAL TRIALS. SO FINALLY IN
1993 THROUGH THE REVITALIZATION
ACT MADE THE INCLUSION OF WOMEN
AND MINORITIES IN NIH-FUNDED
RESEARCH. WE MADE A LOT OF
PROGRESS. BUT NOT ENOUGH. AND
IN THE 2022 STUDY THAT WE
CONDUCTED WE SAY -- WE STILL
HAVE LOTS OF ISSUES DEALING WITH
THIS. WOMEN, YOU KNOW, IN
SUBGROUPS ARE FACED CHALLENGES,
PREGNANT, LACTATING WOMEN,
SEXUALLY GENDER MINOR
POPULATIONS AND SUBGROUPS. WE
WROTE THIS EDITORIAL TO SAY IT
IS IMPERATIVE FOR DIVERSITY
INCLUSION CLINICAL TRIALS IN
HEALTH RESEARCH. THE GOOD NEWS
IS THERE'S BEEN ACTION TAKEN BY
THE BIDEN ADMINISTRATION IN
DECEMBER 2022, BIDEN SIGNED
LEGISLATION. FOLLOWING THAT FDA
RELEASED A DRAFT GUIDANCE
REQUIRING RESEARCHERS TO IN
COMPANIES SEEK APPROVAL IN LATE
STAGE TRIAL, SUBMIT A PLAN TO
SAY, YES, THERE'S DIVERSITY
AMONG THE PARTICIPANTS. AND IN
2024, FDA RELEASED DRAFT
GUIDANCE REQUIRING DIVERSITY
ACTION TO PLANS TO IMPROVE
ENROLLMENT OF PARTICIPANTS FROM
UPSIDE REPRESENTED POPULATION
INCLUDING GENDER AND RACE AND
OTHERS.
SO I THINK THAT WE ARE GETTING
THERE, BUT NOT QUITE. ONE AREA
THAT CERTAINLY NEEDS TO BE
LOOKING AT IS PREGNANT LACTATING
PEOPLE IN RESEARCH. THEY HAVE
BEEN EXCLUDED FROM RESEARCH TO
DATE. SO WE TOOK THIS AREA ON
AND PUBLISHED THIS YEAR, REALLY
IMPORTANT POINT BECAUSE AS YOU
KNOW 70% OF WOMEN AND AS GREAT
AS 50% LACTATING PEOPLE TAKE
PRESCRIPTION DRUGS SO WE GOT TO
NOW WHETHER IT'S SAFE FOR THEM,
EFFECTIVE FOR THEM, OR NOT. AND
YET, PEOPLE HAVE CONFLATED
PREGNANT AND LACTATING
POPULATION AS PROBLEMATIC.
BECAUSE ASSOCIATING THE
LACTATING POPULATION WITH A
LIABILITY THAT YOU SEE IN
PREGNANT WOMEN AND THERE'S NO
EVIDENCE. SO I THINK WHAT WE
NEED TO DO IS BEGIN TO LOOK AT
THE RISK AND LIABILITY ON THIS
ISSUE. AND THE EXCLUSION OF
THEM SHIFTS A RISK LIABILITY
FROM WELL REGULATED CLINICAL
TRIALS INTO LARGER LESS
REGULATED PRACTICE. WHAT DO I
MEAN BY THAT? WELL, YOU DON'T
HAVE DATA AND YET YOU HAVE
PEOPLE PRESCRIBING. PRESCRIBING
WITHOUT INFORMATION OF EFFICACY,
SAFETY, TO PREGNANT WOMEN OR
LACTATING WOMEN SO I THINK WE
SAY BOTH POPULATIONS MUST BE
INCLUDED IN RESEARCH, TO BENEFIT
FROM PROTECTION OFFERED BY THE
MEDICAL REGULATORY SYSTEM. SO
WHAT ARE OUR RECOMMENDATIONS?
DIRECTLY MITIGATE LIABILITY.
LET'S JUST FACE OKAY, THERE ARE
RISK BUT JUST LIKE ANY OTHER
RISK, AND OTHER POPULATION AND
CLINICAL TRIALS, INFORMED
CONSENT. RELEASE GUIDANCE ON
RESEARCH EXPECTATION. IMPROVE
TRAINING FOR RESEARCH STAFF, AND
CONVERSATE HARM OF THOSE WHO ARE
HARMED BY RESEARCH. THOSE IN
FACT EXIST FOR EVERYBODY ELSE
OUGHT TO DO THE SAME OF PREGNANT
AND LACTATING WOMEN. THE SECOND
OF COURSE IS TO MINIMIZE
POTENTIAL HARM. CREATE GUIDANCE
ABOUT WHEN AND HOW TO CONDUCT
RESEARCH. AND INFORM OUR RODS
ABOUT HOW TO OVERSEE THIS
RESEARCH. THIS IS STILL A NEW
FIELD. WE GOT TO GET THEM
EDUCATED AND INVOLVE YOU, THE
LEADERS TO BE ABLE TO INFORM
THEM ABOUT THIS AND WE SAY TO
CONGRESS YOU HAVE TO TAKE SOME
ACTION. MORE RESEARCH FROM A
FUNDING MECHANISM INCENTIVES AND
REQUIREMENTS. WHAT AM I SAYING
ABOUT THAT? BECAUSE COMPANIES
ARE HESITANT BECAUSE OF
LIABILITY. BUT IF YOU ALSO LOOK
AT MANY OTHER AREAS, SUCH AS
VACCINE AND OTHER TO CREATE
OPPORTUNITY FOR THEM TO SAY,
OKAY, THERE ARE INCENTIVES FOR
US TO STUDY THIS POPULATION SUCH
AS DRUGS WHICH CAN BE A PATENT
EXCLUSIVITY, ET CETERA, AND CAN
BE STUDIED IN PREGNANT AND
LACTATING AND LET'S OPEN UP A
NEW CHAPTER TO MAKE SURE WE
DON'T EXCLUDE PREGNANT AND
LACTATING WOMEN AND THEY'RE NOT
THE SAME AND RECOGNIZE LIABILITY
ARE NOT THE SAME THAT WE TAKE
ALL OF THOSE ACTIONS. NOW LET
ME TALK ABOUT FUNDING. I MEAN,
I KNOW YOU KNOW THIS. RIGHT?
YOU HAVE BEEN TALKING ABOUT THIS
FOREVER. THAT WE LOOK AT STARK
GAPS BETWEEN, YOU KNOW, MEN AND
WOMEN, THOSE PARTICULAR
DISEASES, LOOK AT ALZHEIMER'S.
12% OF RESEARCH GO TO PROJECTS
THAT FOCUS ON WOMEN YET WOMEN
ARE TWO-THIRDS OF THE
POPULATION. AND CARDIOVASCULAR
DISEASE, 44% OF WOMEN HAVE SOME
KIND OF CARDIOVASCULAR DECIDE,
BUT ONE-THIRD TRIALS IN FEMALE
AND 4% OF NIH, IN THIS CASE,
CARDIOVASCULAR DISEASE BUDGET
FOCUS ON WOMEN. YOU KNOW THIS
WELL AND ONGOING CHANGE IN
FUNDING, I MEAN, THERE'S JUST
NOT ENOUGH FUNDING TO UNDERSTAND
WOMEN'S HEALTH. IF YOU LOOK AT
2021 FUNDING, I WILL GIVE YOU AN
EXAMPLE, ENDOMETRIOSIS, ONE IN
TEN AND PROSTATE CANCER, ONE IN
EIGHT IN MEN. LOOK AT THE
DIFFERENCE, TEN TIMES
DIFFERENCE, 280 MILLION DOLLARS
IN FUNDING. YOU ALL KNOW THIS
AND I'M NOT TELLING YOU ANYTHING
THAT'S NEW. IF YOU LOOK AT
CHRONOLOGIC CONDITIONS THEY FALL
UNDER NICHD SO YOU SAY, OKAY,
AND ONLY 9% OF NICDH BUDGET IS
FOR WOMEN'S HEALTH SO WE
RECOGNIZE THE PROBLEM, RIGHT?
AND WHEN YOU PUT A GRAND IN AND
THANK JI KNOWN FOR THIS, YOU CAN
SAY, WHICH DRIVE DO I PUT IT IN
AND DO I HAVE PEOPLE THAT
UNDERSTAND THE VIEW OF MY
APPLICATIONS?
SO THERE'S A LOT OF ISSUES THAT
NEED TO BE ADRESSED AND AS I
SAID, WE ARE ACTUALLY -- HAVE
COMPLETED OUR STUDY, IT'S
UNDERGOING FURTHER REVIEW AND
WILL BE LAUNCHING THE RESPONSE
LATER IN NOVEMBER. THIS IS IT.
SO WE'RE GOING TO ASK CONGRESS
TO SAY, LET'S DO A STUDY. LOOK
AT THE CAPSULE OF UNDERSTANDING
OF WOMEN'S RESEARCH ACROSS NI,H.
IT IS THE LARGEST FUNDING AGENCY
OF BIOMEDICAL SCIENCE IN THE
WORLD.
ARE THEY PUTTING ENOUGH EFFORT
INTO IT I KNOW MANY OF YOU ARE.
BUT WHAT ABOUT LEADERSHIP? WHAT
ABOUT THE WHOLE ORGANIZATION?
SO WE'RE GOING ANALYZE THE
FUNDING AND RESEARCH THAT AFFECT
WOMEN. WHAT IS COMMON AMONG
WOMEN AND HOW IT IS TO FIND
THEM. WE'VE ALSO BEEN ASKED TO
ADDRESS SEX HEALTH DIFFERENCES
AND OF COURSE WE NEED TO
DETERMINE THE FUNDING NEEDED TO
BRIDGE THE GAPS WITH HEALTH
RESEARCH AT NIH SO WHAT WE'VE
DONE IS, CONSULTED MANY OF YOU,
HELD WORKSHOPS AND I KNOW THAT
JENEEN HAS SPOKEN TO US, AND YOU
WILL HEAR FROM OTHERS LATER ON
AND I AM SURE YOU SERVE ON THE
COMMITTEE. I THINK WE'RE NOW
READY. AND I THINK CAN I TELL
YOU THE FINDING BUT I THINK THE
FINDING WAS CERTAINLY WILL TAKE
US SIGNIFICANTLY INTO THE NEXT
ERA. WHICH I THINK IS
WELL-DESERVED. IT'S GOING TO BE
VERY EXCITING. NOT EVERYONE'S
GOING TO AGREE WITH IT BUT IT'S
GOING IN THE RIGHT DIRECTION.
ALSO, WORKFORCE AND LEADERSHIP.
WE HAVE A COMMITTEE CAUSED THE
COMMITTEE ON WOMEN IN SCIENCE,
ENGINEERING AND MEDICINE. AND
WE HAVE BROUGHT TOGETHER FOR
MANY YEARS ON HOW TO DEVELOP
LEADERSHIP IN THESE THREE
DOMAINS AND LOOKING AT
CONDITIONS OF OPPORTUNITIES TO
UNABLE WOMEN TO LEAD. AND
LOOKING AT THOSE FORM -- MODEL
FORMS OF DISCRIMINATION, HOW WE
SHAPED THE EXPERIENCE OF
INDIVIDUALS AND WOMEN IN
SCIENCE, ENGINEERING AND
MEDICINE, SYSTEMIC INEQUITIES
WE'VE BEEN WORKING TO OVERCOME
THEM AND WE HAVE LOTS OF WORK IN
THIS AREA. NOW, I THINK I'M --
I HAVE A SLIDE THERE, MAYBE IT
COMES UP LATER BUT WHAT NIH IS
DOING. I THINK IT WILL COME UP
LATER. WHAT JENEEN'S DOING WITH
THE OPPORTUNITY MAP WHICH I WILL
TALK ABOUT, BECAUSE WE SET THE
STAGE FOR WHERE WE NEED TO GO
AND ABOUT THE LEADERSHIP ISSUE?
BUT LET ME TURN TOWARDS WOMEN'S
HEALTH AND THE IMPORTANCE OF
EQUITY ISSUES. FIRST OF ALL I
THINK WE ALL NEED TO RECOGNIZE
THAT HUMAN HEALTH IS SOCIALLY
PATTERNED. IT'S NOT JUST A
BIOLOGY. IT'S REALLY
ENVIRONMENT WHICH YOU LIVE IN
AND THE CAUSE OF FACTORS WHICH
ARE AFFECTING YOU AND
INFLUENCING THEREFORE THE
BIOLOGY RESPONSE. AND I WILL
JUST TELL YOU THAT WOMEN'S
HEALTH, WOMEN FACE SIGNIFICANT
CHALLENGES. MY WIFE IS VERY
MUCH INVOLVED, SHE WAS THE
PRESIDENT OF SECOND STEP IN
BOSTON WHICH REALLY LOOK AT
WOMEN AND VICTIMS OF DOMESTIC
VIOLENCE.
AND HOW DO YOU PROVIDE THEM WITH
SUPPORT, PROTECTION, AND
OPPORTUNITY TO HAVE REMEDIATION
TO DEVELOP CAREERS AND PATHWAYS.
VERY PROUD OF THAT. SO FROM HER
INVOLVEMENT, CERTAINLY I
RECOGNIZE THE ISSUES OF
VIOLENCE, SEXUAL VIOLENCE AND
THE CAUSE OF ONE OF THE GREATEST
REASON FOR HOMICIDE IS INTIMATE
PARTNER VIOLENCE. SECOND CAUSE
IS THAT THERE'S STIGMA
SURROUNDING MENSTRUATION AND
THEREFORE, YOU KNOW, THESE ARE
CHALLENGES PARTICULARLY FOR
PEOPLE AS THEY FACE
MENSTRUATION. THERE'S CERTAINLY
SOCIETAL STRUCTURES THAT I THINK
CONTINUES TO CAUSE OPPRESSION
AND LACK OF PRIVILEGES FOR
WOMEN, IMPACT OF SEXISM, I THINK
THAT AS I SAID BEFORE, WOMEN'S
HEALTH AND NOT JUST REPRODUCTIVE
HEALTH. ECONOMIC AND EDUCATION
DISPARITIES. YOU KNOW, MANY OF
THE CARE PROVIDERS, PARTICULARLY
FOR FAMILIES YOU KNOW, WITH
ELDERLY ARE WOMEN. AND SO WOMEN
HAVE MANY, MANY CHALLENGING
BURDENS ON THEIR LIFE. FOR MANY
OF THESE FACTORS THEY ARE
INTERSECTIONAL AND COMPOUNDED BY
SYSTEMIC ISSUES, RACIAL, ETHNIC
MINORITY POPULATIONS, SEX AND
GENDER MINORITY GROUPS. LET'S
TAKE THIS ONE, FOR EXAMPLE, WE
ARE A NONPOLITICAL ORGANIZATION.
AND I ALWAYS SAY THAT WE ARE NOT
ABOUT TO WEIGH IN POLITICS
BECAUSE OUR JOB IS TO BE
INDEPENDENT AS IS OUR CHARTER.
BUT WHEN IT COMES TO HEALTH,
PEOPLE'S HEALTH, WE HAVE TO
SPEAK UP, SO IN DOBBS VERSUS
JACKSON WAS DECIDED, WE
IMMEDIATELY JUMPED IN TO SAY
THIS IS REALLY BAD FOR HEALTH OF
WOMEN, ACCESS, QUALITY OF CARE,
AND OF COURSE MANY OTHER
CONCERNS. AND WHERE WE ARE
SEEING SHORT AND LONG-TERM
IMPACTS OF HEALTH AND WELL-BEING
OF BIRTHING PEOPLE AND FAMILIES
THEY INCLUDE HEALTH CARE ACCESS,
SAFETY, ETHICAL/LEGAL CONCERNS,
MANY OF YOU ARE PROVIDERS, YOU
WORK IN HOSPITALS U YOU KNOW THE
STORY, YOU CAN HEAR SO MANY OF
THEM.
BECAUSE RECENTLY YOU HEARD OF
THE WOMEN WHO SEEK, WHO SOUGHT
ABORTION CARE, DELAYED CARE
BECAUSE OF COMPLICATIONS.
DEATH. THESE TERRIBLE
SITUATIONS. MY COLLEAGUES ALSO
TELL ME WHEN THEY'RE FACED WITH
SOMEONE IN THE EMERGENCY WHO HAS
COMPLICATIONS OF CARE YOU HAVE
TO CALL THE LAWYERS IN THE
HOSPITAL. AND FREQUENTLY HEAR,
WELL SHE'S NOT SICK ENOUGH, WHEN
SHE'S SICK ENOUGH YOU CAN NOW DO
THE INTERVENTION. AND NO,
THAT'S NOT WHAT WE ARE HERE FOR.
WE ARE HERE TO INTERVENE AND TO
IMPROVE HEALTH. SO WE HEAR
ABOUT BECAUSE MANY CHINESE AND
MANY STATES ARE NOT GETTING THE
EDUCATION NEEDED AND BECAUSE
MANY ARE LEAVES THE UNITED
STATES CAUSING SHORTAGES SO THIS
IS LEAVING US WITH MANY ISSUES.
FOR THAT REASON, I LAUNCHED A
MAJOR INITIATIVE AT ACADEMY AND
THIS GROUP LED BY CLARE MADE THE
STATEMENT, THERE'S A NEED MORE
COMPREHENSIVE RESEARCH, AND
POLICY AGENDA (READING). NOW WE
CAN GO A LONG TIME ON THIS IN MY
OPINION. TERRIBLE DECISION, BUT
MY JOB WAS TO THINK ABOUT WHAT'S
HAPPENING TO HEALTH OF THE
POPULATION OF WOMEN. SO, WE
HAVE ACTUALLY WORKED THIS TASK
FORCE IS NOW BECOMING A STANDING
COMMITTEE ACROSS TALL -- ALL THE
ACADEMIES. WE PUBLISHED PAPERS
TO HIGHLIGHT THE IMPACT OF
HEALTH WORKFORCE AND SOCIETAL
IMPLICATIONS IN THE LANCET AND
OTHERS.
WE IN FACT HAVE A STANDING
COMMITTEE I MENTIONED TO YOU
THAT'S LOOKING AT THE
IMPLICATIONS OF ACCESS TO
REPRODUCTIVE HEALTH, ECONOMIC
OUTCOMES, SERVE AS NATIONAL
POLICY HUB FOR DISCUSSION IN
THIS AREA. RAISE AWARENESS TO
THE PUBLIC AND TO EVERYBODY ELSE
AND ADDRESS MISINFORMATION. SO
WE'VE REALLY HELD A SERIES OF
WEBINAR YOU CAN SEE MORE RECENT
ONES INCLUDE PROMISING STRATEGY
TO ADDRESS HEALTH DISPARITIES
ACROSS REPRODUCTIVE LIFE CYCLE.
SHAPING ACCESS OF REPRODUCTIVE
HEALTH. MATERNAL HEALTH
DISPARITIES AND PRESSING ISSUES
AROUND CONTRACEPTION. ACCESS,
FROM THE VIEW OF ROE VERSUS
WADE. BACK IN OCTOBER, WE HELD
A WORKSHOP TO SAY THAT MANY OF
YOU WHO ARE IN THIS RESEARCH
AREA SAY WE NEED DATA. THERE'S
JUST NOT ENOUGH DATA FOR US TO
BE COORDINATED TO BE ABLE TO
LOOK FORWARD TO SAY WHAT DO WE
NEED TO DO? THIS IN FACT
BROUGHT TOGETHER AS YOU CAN SEE
ALL THE KEY PLAYERS LOOK AT THE
LANDSCAPE OF DATA AND BECAUSE OF
DATA GENERATION INTEGRITY, DATA
COLLECTION, OVERCOMING THE
STIGMA ISSUES AND LOOKING AT
IMPROVEMENT AND THAT IS GOING TO
BE REALLY IMPORTANT, ENABLING US
TO SAY, TO HAVE MOMENTUM AND
INTERVENE. AND WE WILL HAVE A
SERIES OF ANOTHER WORKSHOPS THIS
ONE IN NOVEMBER TO LOOK AT
ISSUES OF IMPLICATIONS ON
OCCURRING AND PRACTICAL
IMPLICATIONS. THAT'S JUST A
VEHICLE OF FACTORS AND BECAUSE
MANY OTHER ISSUES OF RESEARCH.
TWO WEEKS AGO, WE HELD A MEETING
AT THE ACADEMY CALLED MEDICINE,
LOWER COURT AND SOCIAL CONTRACT.
WE BROUGHT TOGETHER THE LEGAL
PROFESSION INCLUDING PREVIOUS
JUDGES AND OTHERS. AND THE
MEDICAL TO TALK ABOUT THE RECENT
TRENDS IN LEGISLATIVE AND
JUDICIAL DECISIONS THAT SEEM TO
INTERFERE WITH OUR SOCIAL
CONTRACT TO PROVIDE THE BEST
CARE FOR WOMEN SO WE'RE DOING A
LOT OF WORK IN THIS AREA. SO
WHERE DO WE GO FROM HERE? WELL,
FIRST OF ALL, WE NEED TO
UNDERSTAND THAT GENDER AND SEX
EQUITY SHOULD BE IN THE CENTER
OF EVERYTHING WE DO. IN MEDICAL
RESEARCH, EDUCATION, CLINICAL
PRACTICE, WE LOOK AT YOUR CARE
SYSTEM WHERE YOU PRACTICE AND
ALL HEALTH CARE SYSTEMS, WHERE
ARE THEY CENTER SOMETHING SEX
AND GENDER EQUITY IN THEIR WORK?
SECONDLY WE NEED TO MAKE SURE
THE PUBLIC AND POPULATION HEALTH
HAVE CERTAINLY THE HEALTH OF
WOMEN CENTERED IN WHAT THEY DO
AND BECAUSE SO IMPORTANT THING
ABOUT POLICY, PRACTICE
GUIDELINES, AND BECAUSE POLICY,
THE THINGS THAT WE ARE ALL
FIGHTING FOR FOR THE RIGHT
REASON. NOW HERE'S THE SLIDE
I'VE BEEN LOOKING FOR WHICH IS
WHERE I THINK THE NEXT STEP IS
WITH JENEEN'S LEADERSHIP ALONG
WITH THE NIH MANY OF YOU MAY
HAVE ATTENDED THIS MEETING ON IN
FACT THE WOMEN'S HEALTH
INNOVATION OPPORTUNITY IN 2023
WHICH THEY PUT FORWARD AN
OPPORTUNITY MAP. THIS IS REALLY
IMPORTANT BECAUSE IT HELPS YOU
OUTLINE WHAT ARE THOSE ISSUES
AND OPPORTUNITIES, PRIORITIES
THAT ADVANCE WOMEN'S HEALTH
INNOVATION. THEY CALL TO
ACTION, EQUITABLE INCLUSION
PARTICIPATION FUNDING WOMEN'S
HEALTH ACROSS THE ENTIRE RND
ECOSYSTEM FROM DISCOVERY ALL THE
WAY TO POPULATION. ALONG WITH
CLINICAL TRIALS. INVEST IN
WOMEN'S HEALTH INNOVATION TO
PROGRESS THE NEEDS OF DIVERSE
GROUPS OF WOMEN AND CREATE
PARTNERSHIP. PUBLIC
PARTNERSHIP. YOU CAN SEE
THERE'S SIX AREAS OF ACTION. DA
TODAY TALKED ABOUT. DESIGN I
TALKED ABOUT REPERTOIRE AND
SCIENCE POLICY, INNOVATION.
SOCIAL DETERMINANTS, TRAINING
AND ACCESS AND BECAUSE
SCIENTIFIC AREAS OF NEEDS. IT
CAN BE DECIDE, AND OTHERS. SO
BACK IN A YEAR AGO, WE AT THE
ACADEMY OF MEDICINE, TOOK THIS
AS A MAJOR TOPIC FOR OUR ANNUAL
MEETING.
AND WE LOOK AT THE WHOLE ISSUE
FROM CELLS TO SOCIETY. BUT THE
KEYNOTE FROM PAULA JOHNSON MANY
OF YOU KNOW, AND BECAUSE WE
DISCUSSED THIS WHOLE LANDSCAPE.
BUT I WILL TELL YOU WHAT REALLY,
SUMMARIZE FROM OUR FINDING. ONE
THING THAT STUCK FROM ME WHEN WE
TALK ABOUT RESEARCH INNOVATION,
I ASKED ROB THE FDA, THE
COMMISSIONER WHAT IS THE
PIPELINE FOR WOMEN'S HEALTH? HE
SAYS, WELL, YOU KNOW, WE SEE
QUITE A LOT BUT WE DON'T SEE
THOSE WHICH YOU ACTUALLY LOOK AT
EQUITY AND ACCESS BECAUSE RIGHT
NOW LOTS OF INNOVATION IS DRIVEN
BY THE OPPORTUNITY TO CREATE
PRODUCTS THAT HAS A MARKET. TO
ME, THAT MEANS ARGUE STRONGLY
THAT WE NEED TO THINK ABOUT
EQUITY IN OUR RESEARCH. AND
BECAUSE HOW DO YOU INCENTIVIZE
THE PRIVATE SECTOR ALONG WITH
YOU TO CREATE A LOT MORE
PRODUCTS THAT CAN HELP WOMEN
WITH THEIR HEALTH AS ACCESSIBLE,
AFFORDABLE AND EQUITABLE. OUR
CONCLUSION WHICH I WROTE THIS --
WITH DESALVO AND MYSELF WILL
LOOK AT WHAT IS IMPORTANT IN THE
CONTINUUM OF HEALTH RESEARCH AND
THE DISPARITY THAT CONTINUES TO
STILL EXIST AND THROUGHOUT THE
KNOWLEDGE OUTCOMES AND
EXPERIENCE. PARTICULARLY FOR
BLACK, INDIGENOUS AND OTHER
WOMEN OF COLOR. WE TALKED ABOUT
RESEARCH, CARE, EDUCATION POLICY
AMONGST PATIENT AND
PARTICIPATION PROCESS BECAUSE WE
REALLY NEED THE FRONTLINE AND
THE LIVED EXPERIENCE TO INFORM
WHAT WE NEED TO DO IN GOING
FORWARD. AND THEN WE NEED TO
THINK ABOUT THE WHOLE CONTINUUM.
NOT SILOED BETWEEN CELLS TO
INFECT ALL THE REST OF SOCIETY
AND IT TAKES ALL OF US TO
UNDERSTAND THE NEED TO LOOK AT
WHAT YOU DO AND HOW YOU IMPACT
US. SO HERE'S SOME OF WHAT I
WAS THINKING, RIGHT? IF YOU
IMAGINE THAT YOU HAVE A
SCIENTIST WHO IS DOING SOME
WORK, THE CELLS THEY USE TO LOOK
AT THE BIOLOGY, HAVE THEY
ACTUALLY LOOKED AT THOSE CELLS
AND UNDERSTAND MAYBE THERE'S
DIFFERENCES BETWEEN THOSE THAT
COME FROM MEN AND WOMEN? AND IN
THE GENOME, THE REFERENCE
GENOME, WHO IS THE REFERENCE AND
SO THERE ARE LOTS OF ISSUES THAT
CAN BE POINTED OUT IN BASIC
RESEARCH AND, IN FACT, WE HAD A
LEADING SCIENTIST TALK ABOUT X
AND Y CHROMOSOME AND I THINK ALL
OF THAT HAS TO BE PART OF OUR
BASIC RESEARCH BUT THEN WE NEED
TO TAKE THIS DISCOVERY TO TRANS
LATE TO HAVE CLINICAL TRIALS TO
BE ABLE TO APPLY TO POPULATION.
THAT IS WHAT WE ARE ALL ABOUT.
SO I AM VERY EXCITED TO SAY WE
HAVE MOMENTUM. RIGHT? FIRST OF
ALL, LOOK AT WHAT PRESIDENT
BIDEN AND DR. JOE BIDEN DID AN
EXECUTIVE, IN THIS CASE
MEMORANDUM, AN EXECUTIVE ORDER
IN 2024 TO INITIATE THIS MAJOR
DIRECTION WITH HEALTH RESEARCH.
YOU'RE GOING TO HEAR FROM KAREN
LATER ON ABOUT WHERE ARE WE
GOING WITH THIS. I WOULD SAY
THE MOMENTUM'S THERE. FIRST OF
ALL, IRRESPECTIVE OF WHAT
ADMINISTRATION, I THINK WE GOT
MOMENTUM. SECONDLY, OUR REPORT
FROM CONGRESS NOT FROM THE
PRESIDENTIAL OFFICE IS GOING TO
ADVISE WHAT NEEDS TO BE DONE AT
NIH AND I CAN CERTAIN YOU TELL
YOU WE'RE GOING TO ASK FOR A LOT
MORE MONEY WITH HEALTH RESEARCH
AND I THINK IT'S CONSISTENT WITH
WHAT'S BEING LAUNCHED BY THE
WHITE HOUSE AND THERE ARE OTHER
ACTIVITIES WHICH WITH MANY OF
YOU AND ALMOST CERTAINLY JENEEN
IS, IN LOOKING AT THE FORUM, AND
GLOBAL LINES AND MANY OTHERS SO
I THINK, I'M VERY EXCITE THAT
HAD IN FACT, THINGS ARE
HAPPENING. IS IT ENOUGH? WELL,
OF COURSE NOT. BUT WE'RE GOING
TO WORK TOGETHER AND MAKE SURE
IT'S DONE RIGHT.
SO THANK YOU VERY MUCH.
>> WE HAVE FIVE MINUTES FOR ANY
QUESTIONS OR ANSWERS? ANYBODY
ANY QUESTIONS FROM ANYONE? YES.
>> REPLACE THE WORD SUGGEST WITH
REQUIRE. SHOULD I RESTATE IS
THAT? WITH DR. ROB CALIPH, A
GOOD COLLEAGUE AND AN
OPEN-MINDED PERSON, AS CHAIR OF
OUR FDA IS THERE ANY --
>> HE USED TO WORK FOR ME.
>> ANY OPPORTUNITY TO REPLACE
THE WORD "SUGGEST" TO "REQUIRE"
AT THE FDA?
>> KNOW WELL, YOU CAN PICK UP
THE PHONE AND TALK TO HIM AS I
WILL. BY THE WAY, ALSO, HE WILL
TELL YOU THAT WE ARE MAKING AN
EFFORT WITH GENERAL EDITORS,
RIGHT? AND THERE'LL BE A
MEETING COMING UP SOON.
TO SAY ONE, DISAGGREGATION OF
DATA. SECOND, A REQUIREMENT,
RIGHT, I MEAN, WHERE WE GO IS
GOING TO BE QUITE INTERESTING.
MY FEELING IS, IF MAJOR
LEADERSHIP IN THE ECOSYSTEM FROM
FUNDING AGENCIES TO SCIENTIFIC
JOURNALS AND OF COURSE ACADEMIC
ORGANIZATIONS INDUSTRY, ALL
PUTTING THAT CENTER I THINK WE
CAN GET THERE. SO THANK YOU.
>> WONDERFUL, DR. DAZU, MEDICAL
CLINICAL OF GEORGIA, I HAVE A
QUESTION ABOUT A SLIDE THAT CAME
UP EARLIER IN YOUR TALK AND IT'S
MORE OF A SUGGESTION THAN A
QUESTION. IT WAS ABOUT THE
CATEGORIES OF FOCUS, CONDITIONS
THAT ARE PREVALENT AND DIFFERENT
IN WOMEN. EXACT CONDITIONS
WHERE WOMEN ARE PROTECTED?
WOULDN'T THAT BE ANOTHER AREA OF
FOCUS THAT EVERYONE SHOULD FOCUS
ON, FOR EXAMPLE KIDNEY DISEASE,
IF A WOMAN IS PROTECTED FROM
KIDNEY DISEASE PREMENOPAUSE THAT
IS A GREAT OPPORTUNITY FOR
RESEARCH TO FIND NEW MECHANISMS
THAT COULD BE POTENTIALLY USED
IN THE OTHER SEX.
>> VERY HELPFUL. THANK YOU.
YES. WE SHOULD ADD THAT AND I
HAVE A FEELING THAT THE DOCTOR
IS GOING TO MENTION THE SAME
THING, YOU CAN SUGGEST THAT TO
HER AS WELL.
>> TERRIFIC THANK YOU.
>> HI, JANET RICHARD.
>> I SEE THERE'S A GREAT
CONTINGENCY FROM THE HOSPITAL.
>> I'M CURIOUS ABOUT WHAT FEELS
LIKE A SILENCE POSTOPS, ABOUT
THE FACT THAT FAIRLY HALF OF
U.S. PREGNANCIES ARE UNPLANNED.
AND THAT MANY WOMEN ARE REALLY
UNHAPPY WITH THEIR CONTRACEPTIVE
CHOICES. IF THEY EVEN KNOW
ABOUT THEM AT ALL. SO I'M
CURIOUS ABOUT HOW THE NATIONAL
ACADEMIES HAVE APPROACHED THAT
QUESTION WHERE IT BUBBLES UP TO
THE SURFACE?
>> NO, I THINK THAT THESE ISSUES
HAS TO COME FROM ALL OF YOU. IN
MANY WAYS WE ARE TRYING TO BE
THE VOICE, THE CONVENING OF
THIS, RIGHT? SO ABSOLUTELY, I
MEAN, WE ARE NATIONAL ACADEMY.
BUT WE ARE NOT THE ONLY
ORGANIZATION. I THINK IT TAKES
PEOPLE LIKE YOURSELF TO ACTUALLY
BRING THIS ISSUE TO TO FORE,
THAT'S IMPORTANT. ABSOLUTELY,
THANK YOU.
>> OKAY. SO I WOULD LIKE TO
THANK DR. DAZU.
>> THANK YOU.
>> LET ME JUST SAY, IT'S SUCH AN
HONOR TO SPEAK TO ALL OF YOU.
YOU GUYS ARE REALLY, SORRY, YOU
PEOPLE (LAUGHS). ARE REALLY
MOVERS AND SHAKERS I KNOW YOU
SPEND YOUR CAREER IN THIS AREA
AND LOOK AT THE PROGRESS YOU'RE
MAKING. I'M ACTUALLY QUITE
OPTIMISTIC AS YOU LOOK AT WHAT
IS COMING DOWN THE PIKE ON
THINGS THAT WE ARE WORKING ON,
YOU ARE WORKING ON, OTHERS. I
THINK THAT REALLY THERE'S A
SENSE OF TREMENDOUS MOMENTUM
GOING FORWARD. AND I WILL BE
WITH YOU ALL THE WAY. THANK
YOU