WASHINGTON — A recently released congressionally commissioned report from the National Academies of Sciences, Engineering, and Medicine urges the National Institutes of Health to adopt a cohesive, agencywide strategy that places greater emphasis on pediatric health research and funding. The report warns that rates of chronic illness and mental, emotional, and behavioral health challenges among American children are increasing, while U.S. child health outcomes lag behind those of other developed countries. It calls for systemic reforms that would enable NIH to more effectively support children’s health from early life through adulthood.

As the world’s largest public sponsor of biomedical research, NIH has played a central role in positioning the United States at the forefront of scientific innovation and medical advancement, including significant contributions to pediatric research. However, the recent decline in children’s health outcomes suggests that existing efforts may not be sufficient to address the complex and interconnected challenges facing young populations today.

Frederick P. Rivara, vice chair for academic affairs and professor of pediatrics at the University of Washington School of Medicine and Seattle Children’s, and co-chair of the report committee, emphasized the importance of investing in children’s long-term wellbeing. He noted that while pediatric research has achieved remarkable progress over the past decades, structural and organizational changes within NIH could further accelerate these gains.

Phyllis A. Dennery, chair of pediatrics at Brown University’s Warren Alpert Medical School and pediatrician-in-chief at Rhode Island Hospital, also a co-chair of the committee, highlighted NIH’s unique capacity to lead national efforts in advancing child health research. She stressed that continued scientific discovery could help secure a healthier future for the next generation.

The report identifies several barriers to conducting pediatric research. While emphasizing that children should be safeguarded through participation in research rather than excluded from it, the committee acknowledges that ethical, legal, and regulatory constraints often complicate studies involving minors. It recommends strengthening the role of the NIH Pediatric Research Consortium, known as N-PeRC, by granting it greater institutional authority, stable funding, and expanded resources. The consortium should also work more closely with other NIH initiatives to develop clear guidelines, foster public trust, and ensure responsible inclusion of children in research.

Financial constraints within the grant application and review process are another major challenge. The report suggests that NIH should provide researchers with more flexibility regarding budgets, project timelines, and supplemental funding, particularly for studies involving pediatric populations.

Additional recommendations include maintaining current levels of pediatric research at the NIH Clinical Center and refining the Research, Condition, and Disease Categorization system to provide a more accurate assessment of how funds are allocated.

Looking ahead, the committee outlines a vision in which the United States emerges as a global leader in child health. To achieve this, it proposes four overarching goals: embedding pediatric research more deeply across all NIH programs, expanding initiatives to address critical gaps in child health research, improving the translation of scientific findings into real-world medical practice, and strengthening public confidence through transparent communication.

The report also observes that while many NIH institutes support pediatric research, few have clearly defined metrics to track progress. It calls on all relevant institute directors to explicitly incorporate pediatric health into their strategic plans and establish measurable indicators of success. To support this effort, NIH is encouraged to adopt a unified definition of pediatric research across the agency.

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

The National Academies of Sciences, Engineering, and Medicine are independent, nonprofit organizations that provide objective analysis and policy guidance on complex scientific and societal issues. Founded under a congressional charter signed in 1863 by President Abraham Lincoln, they continue to advise the nation on matters related to science, engineering, and medicine.