Priorities

NIH training programs should focus on training future physicians and scientists to lead American preeminence in biomedical research in the 21st century. Programs should allow trainees to design and conduct the highest quality scientific studies. Importantly, these programs should be based on merit, follow civil rights law, and not discriminate against anyone. NIH and the institutions we support must also uphold safe, equal, and healthy working and learning conditions conducive to high-quality research and free inquiry.

NIH will continue to support research that advances the health of all Americans, regardless of their age, race, ethnicity, sex, or other characteristics. To conduct meaningful biomedical research, scientists must consider both individual and external factors that influence health outcomes, guided by the details of the specific research question. In certain cases where scientifically justified, personal characteristics such as race and sex may be relevant, while some contextual factors, like environmental exposures and socioeconomic conditions (e.g., poverty), may also be scientifically significant. Any distinctions made in study design must be directly relevant to the health outcomes under investigation. NIH will support scientifically rigorous research that considers these factors when they are scientifically justified and aligned with the study’s objectives. 

In contrast to research that considers personal characteristics when scientifically justified (described in the paragraph above), research based on beliefs that promote differential treatment or unnecessary classification of people based on race or ethnicity, or on poorly defined concepts or on unfalsifiable theories, does not follow the principles of Gold-Standard science. Overly broad or subjective assumptions —such as attributing, without evidentiary basis, worse health outcomes in a particular population to poorly measured or unproven factors like systemic racism—should not be presented as established background facts or otherwise included in proposed research. Funding research containing such poorly defined concepts and unfalsifiable theories would divert resources away from projects that advance the health and longevity of all Americans, including minority populations. The NIH will always prioritize gold-standard science. 

Relatedly, research involving participant volunteers should be based on appropriate population descriptors and categories that use precise language to define participant attributes, comparator group attributes, and to whom the study findings apply. Research based on overly broad and scientifically imprecise goals is of low value and off-mission. 

In the past, the NIH invested substantially in health disparities research that has not resulted in tangible improvements in health outcomes for the populations it purports to benefit. Going forward, the NIH will prioritize research that goes beyond measuring health disparities outcomes to focus on solution-oriented approaches. This includes actively testing, advancing, scaling, and implementing innovative evidence-based interventions and treatments that address poor health outcomes. The NIH, of course, will continue to fund research into health issues that are more likely to affect particular populations, such as genetically inherited disorders.  

The NIH will continue to support research collaborations with institutions and scientists outside the U.S. Many critical breakthroughs that improve the health of Americans have resulted from global partnerships, so foreign scientific research collaborations often have clear scientific value. However, we must take action to ensure better oversight of our funding abroad. 

All NIH institutes, centers, and offices should consider whether there is a scientific justification for conducting a research program at a foreign site rather than a domestic one. The NIH should prefer the latter over the former when scientifically justified. We should also consider whether each project involving foreign collaboration will likely lead to better health for Americans, since American taxpayers fund NIH research. 

We must also assess risks to national security, biosecurity, and waste, abuse, or fraud at foreign sites where NIH has substandard or no oversight. To address this goal, we have established an award structure for foreign collaboration. Foreign institutions receiving funds for work on a funded project will are considered independent awards linked to the parent project. This system will allow the NIH to directly track funds awarded to all foreign components receiving NIH funding and hold all institutions receiving NIH funding to grant terms and conditions regardless of where they are in the world, and will follow all government-wide policies regarding dangerous gain-of-function research. 

Replicable, reproducible, and generalizable research must serve as the basis for truth in biomedical science. The “publish or perish” culture favors the promotion of only favorable results, and replication work is little valued or rewarded. NIH is prioritizing research that produces robust, reproducible results. We are exploring various mechanisms to support scientists focused on replication work, to publish negative findings, and to elevate replication research. 

NIH is establishing the Office of Research Innovation, Validation, and Application under the Division of Program Coordination, Planning, and Strategic Initiatives, to develop, validate, and scale the use of human-biology-based new approach methodologies (NAMs) to complement animal models and enhance investigations. This office will coordinate with NIH institutes, centers, and offices to explore and prioritize ways to reduce our reliance on animal testing and to advance technologies that improve translation to humans. Accordingly, all new funding opportunities that include support for animal models will also incorporate language on the consideration of NAMs. The office will serve as a hub for interagency collaboration and expand funding opportunities and infrastructure for non-animal approaches. 

NIH is establishing a robust and secure national infrastructure to integrate and link data from various real-world sources consistent with a deep respect for individual privacy rights. This new Real-World Data Platform will provide advanced computational analysis resources for investigators across numerous research areas, including neurodevelopmental disorders and chronic diseases. 

Artificial intelligence breakthroughs provide exciting new possibilities for science and medicine, but require careful, rigorous research to fulfill their promise. The NIH developed an AI Strategic Plan to enhance transparency in AI models, develop replication standards for AI use in research, and expedite the research, development, and translation of AI discoveries to benefit patients. The plan will consider strategic architecture, high-impact AI use cases, new opportunities to use AI for agency operations, and best practices for validating AI in healthcare delivery.

NIH will champion initiatives rigorously exploring the role of poor diets in causing common chronic conditions and the identification of healthy diets that can prevent and better manage these conditions. We will prioritize projects focusing on the role of maternal and infant dietary exposures on health outcomes across the lifespan. NIH will also work to initiate long-term studies to understand the impacts of certain foods and diets on obesity and insulin resistance in children.

NIH is supporting initiatives to understand the etiology and the treatment and care needs of the broad spectrum of people with autism. The new autism data science initiative will support investigators in identifying and addressing data gaps in scientific understanding of the etiology of autism and commonly co-occurring conditions. Activities supported will include creating new data resources and integrating existing data resources into state-of-the-art analyses on autism etiology. The program aims to develop knowledge to improve health outcomes for people on the autism spectrum.

Ending the HIV epidemic in the United States remains a key priority. For more than 40 years, NIH support has enabled significant advances in antiretroviral therapies, transforming the landscape of care and prevention approaches. Recent breakthroughs in simpler-to-take treatments and long-acting prophylactics, and many other recent breakthroughs, show the benefit of NIH investment. To take advantage of this opportunity, the NIH will support implementation science and other research directions to improve the uptake of and access to existing medical and behavioral interventions that can significantly limit and eventually eradicate HIV infection from the United States. Additional research on HIV/AIDS prevention, treatment, and cure will continue as needed to support the ambitious goal of ending the epidemic.

NIH will implement these priorities consistent with applicable laws, regulations, court orders, and any required procedures.

When funding research into care for children and teenagers diagnosed with gender dysphoria, NIH will prioritize the most promising avenues of research. The state of the scientific literature regarding optimal care and support approaches for children and teenagers diagnosed with gender dysphoria is described in the recent HHS review of treatment for pediatric gender dysphoria. In accordance with these data, there are clearly more promising avenues of research than conducting studies that involve the use of puberty suppression, hormone therapy, or surgical intervention for gender dysphoria, gender identity disorder, or gender incongruence in minors. By contrast, research that aims to identify the utility these interventions, therapies, and procedures have for minors diagnosed with gender dysphoria, gender identity disorder, or gender incongruence, and how to best address the needs of these individuals so that they may live long, healthy lives, is more promising.