Washington — The United States has long held a position of global leadership in biomedical and health research. Yet, according to a recent special report by the National Academy of Medicine (NAM), the country’s research enterprise is not performing at its full potential. Key challenges—including fragmented funding, an underprepared workforce, and insufficient national coordination—are limiting the impact of U.S. biomedical research. These structural issues, combined with persistent health inequities and increasingly complex health challenges, threaten both the nation’s scientific dominance and the well-being of its population.
The NAM report lays out a comprehensive roadmap for revitalizing the country’s biomedical research and development (R&D) ecosystem. The plan identifies five strategic priorities to ensure that U.S. biomedical research continues to contribute to health, economic growth, and global innovation.
The Impact and Importance of U.S. Biomedical Research
The U.S. biomedical research enterprise spans a broad spectrum, including discovery and translational research conducted by federal agencies, academic institutions, pharmaceutical companies, and public health organizations. This system not only fuels national scientific progress but also has significant global influence, evidenced by the numerous Nobel Prize-winning scientists trained in the United States and the groundbreaking discoveries they have made.
“The U.S. biomedical research enterprise is a national treasure. It has already improved human health dramatically, but its potential is far greater,” said E. Albert Reece, former executive vice president for medical affairs at the University of Maryland, Baltimore, and chair of the NAM author group. “We must fine-tune this system to maximize health outcomes, drive economic growth, and ensure benefits for every American. Our recommendations offer a strategic roadmap to optimize the country’s biomedical research for the future. We owe it to ourselves—and to generations to come—to deploy our resources effectively and equitably.”
Establishing a National Strategic Vision
Currently, the U.S. biomedical research landscape is highly decentralized, with multiple stakeholders pursuing different agendas. This fragmentation often leads to duplication of effort and inefficient prioritization. To address this, the NAM report recommends creating a long-term advisory body, established jointly by the president and Congress. This body would include representatives from all sectors of the research ecosystem—scientists across disciplines, federal agency officials, and patient advocates—and would work to develop a cohesive national strategic vision.
The advisory body’s role would extend beyond strategic planning. It would identify priority areas for biomedical R&D, map workforce and technological needs, and coordinate funding and resources. In addition, the body could benchmark against global best practices to reduce barriers, maximize outcomes, and ensure accountability. Regular public engagement would help guide priorities, set measurable goals, and provide transparency in reporting progress to the president, Congress, and the public.
By uniting diverse stakeholders under a clear national strategy, the U.S. can better direct its biomedical research to improve population health outcomes and extend the benefits of research to all communities.
Streamlining Funding and Bridging Gaps
While the United States invests more in R&D than any other country, peer nations are increasingly dedicating a higher share of their GDP to biomedical research. The report suggests that funding should be more strategically allocated to address pressing health challenges affecting Americans.
The NAM proposes establishing a federally coordinated national biomedical research funding collaborative. This collaborative would integrate investments from government agencies, private industry, and philanthropic organizations. It would also adopt successful models from international partners to ensure efficiency and measurable impact. A particular focus would be on addressing the so-called “funding valley of death,” which currently impedes the translation of promising discoveries into new therapeutics, drugs, and diagnostic tools.
By strategically directing resources, the U.S. can accelerate the development of innovative treatments while ensuring research investments are aligned with public health needs.
Prioritizing Health Equity
Health disparities in the U.S. remain a critical concern. Racial and ethnic minorities consistently experience poorer outcomes across most health measures, and women, as well as individuals identifying as women, often face unequal access to care. The NAM report emphasizes federal prioritization of research aimed at achieving health equity.
The proposed approach focuses on the social determinants of health, workforce diversification, and inclusive research practices. Funding agencies could support studies that identify and remove barriers preventing vulnerable populations from accessing high-quality, culturally appropriate care. Key areas of focus include bridging the digital divide, addressing transportation limitations, mitigating geographic gaps in healthcare provision, and improving public trust in medical science.
Prioritizing health equity not only strengthens social justice but also enhances the overall effectiveness of the biomedical research enterprise, ensuring that the benefits of scientific progress reach every community.
Enhancing Federal Coordination and Convergence Science
The NAM report calls for improved coordination across federal agencies and collaboration with external stakeholders. Such coordination would enable the implementation of convergence science—an approach that combines expertise from multiple scientific disciplines to solve complex, interconnected health problems.
The report highlights the success of public-private partnerships during the COVID-19 pandemic as a model for future collaboration. By institutionalizing these practices, rather than limiting them to crises, the U.S. can promote more effective and efficient research strategies, accelerate discoveries, and better translate findings into real-world solutions.
Federal coordination could also facilitate information sharing, improve strategic alignment, and support the deployment of resources to areas with the greatest potential for impact. This approach promises to advance innovation while reducing redundancy and maximizing the return on research investment.
Supporting a 21st-Century Biomedical Workforce
International scholars, scientists, and students have historically been integral to the U.S. biomedical research enterprise. In 2019 alone, over 4,000 temporary visa holders earned bachelor’s degrees in biological sciences, more than 2,500 completed master’s degrees, and nearly 2,000 earned doctorates in related fields. Maintaining the U.S. as a welcoming destination for talent is essential for sustaining its global leadership.
The NAM report calls for targeted measures to ensure a competitive, well-supported workforce. These include fair compensation, career development opportunities, and retention strategies that attract top talent. Addressing workforce needs is critical to sustaining scientific innovation and translating research into improved public health outcomes.
“Until the biomedical research enterprise meets the needs of all Americans and ensures accessible, high-quality research and products, its mission remains incomplete,” said Victor J. Dzau, president of the National Academy of Medicine. “Now is the time for bold action: structurally improving the research ecosystem, enhancing efficiency, embracing convergence science, breaking down silos, and closing the health equity gap.”
About the National Academy of Medicine
The special report was authored by experts convened by the NAM, which was established in 1970 as the Institute of Medicine. The organization comprises leaders from medicine, public health, and the natural, social, and behavioral sciences, among other disciplines. Alongside the National Academy of Sciences and the National Academy of Engineering, NAM advises the U.S. and international communities on health, medicine, and policy. Through its domestic and global initiatives, NAM aims to address pressing challenges, inspire actionable solutions, and promote positive change across sectors.
By implementing the recommendations outlined in this publication, the U.S. can strengthen its biomedical research infrastructure, maintain global leadership, and improve health outcomes for all Americans—today and for generations to come.
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