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PATH/Matthew Dakin
November 10, 2026

GHTC signs letter warning congressional leadership against implementation of OMB grantmaking rule

GHTC joined 70 organizations in signing on to a letter to bipartisan congressional leaders, warning that a proposed Office of Management and Budget (OMB) rule making changes to the federal grantmaking process could undermine long-term research investments and weaken the conditions that enable scientific progress.

Read time: 3 minutes / PDF link
The Honorable Mike JohnsonSpeaker of the HouseU.S. House of RepresentativesWashington, DC 20515The Honorable Hakeem JeffriesHouse Minority Leader.U.S. House of RepresentativesWashington, DC 20515The Honorable John ThuneSenate Majority LeaderU.S. SenateWashington, DC 20510The Honorable Chuck SchumerSenate Minority LeaderU.S. SenateWashington, DC 20510November 10, 2026Dear House Speaker, House Minority Leader, Senate Majority Leader, and Senate MinorityLeader:The undersigned 71 organizations, representing public health, patients, clinicians and biomedicalresearchers, thank you for passing a Continuing Resolution that prevents the White House Officeof Management and Budget from implementing the proposed Regulation for Federal FinancialAssistance, and keeps federal biomedical research programs operating until December 11. Thisproposed regulation would undermine Congress’s constitutional role in directing the use oftaxpayer dollars by making unprecedented and comprehensive changes to the rules for federalgrants across federal agencies, including those within the Department of Health and HumanServices, like the National Institutes of Health and its National Institute of Allergy and InfectiousDiseases (NIAID). In the strongest possible terms, we urge you to act by December 11 to enact along-term policy that: 1) blocks the proposed regulation; and 2) protects against any executiveorder, regulations, or guidance that would put political appointees in charge of NIH grantmakingor making binding oversight decisions.Article 1 of the Constitution gives Congress the ultimate authority on how federal appropriationsare spent and administrations are expected to carry out these decisions. This proposed rule givescurrent and future administrations leeway to ignore those decisions. Thanks to Congressionalaction, patients with serious and life-threatening diseases and local communities have benefittedfrom peer-reviewed, evidence-based NIAID-funded research that has led to breakthroughs inpublic health practice, infectious diseases and allergy prevention, diagnosis, and treatment, asintended by Congress. If the proposed rule is implemented, progress to develop newbreakthroughs will be hindered.NIAID plays an essential role in addressing the impacts of allergy and asthma on human wellbeingand infectious disease threats such as antimicrobial-resistant infections, vector-bornediseases, HIV, viral hepatitis, sepsis, foodborne illness, tuberculosis, influenza, emergingpathogens and other infections that can seriously complicate cancer chemotherapy, organtransplantation and other medical procedures. NIAID supports research that helps explain howhuman behavior, social conditions and structural factors influence infectious disease prevention,treatment uptake, adherence and health outcomes. Additionally, NIAID funding is critical totraining the public health and scientific workforce. Students in NIAID-funded training programsand laboratories go on to work in public health agencies, clinical settings, academic research, andindustry.This proposed regulation would dramatically alter the way NIAID funding is allocated —placing grant decisions in the hands of political appointees instead of scientific experts andprioritizing political alignment over scientific merit and patient need. This will cause significantupheaval in medical research as biomedical discoveries take an average of 10 to 15 years frominitial laboratory discovery to availability for patient use and political priorities typically changewith every new president, if not more frequently.Further, political appointees often do not have the expertise necessary to determine which grantproposals are the most scientifically rigorous and most likely to deliver meaningful results forpatients. The proposed changes, along with the ability for grants to be canceled at any time, forany reason, will make it extremely difficult, if not impossible, to launch and sustain the type ofresearch needed to deliver new vaccines, diagnostic tests and treatments given the significantinfrastructure, staffing, expertise and time these studies require. The proposed rule would alsolikely have far ranging impacts beyond the intended goals of the current Administration. Theunprecedented authority that would be granted to OMB and federal agencies by this proposedrule would also be conveyed to future Administrations, which could use this authority for otherpolicy goals and preferences.Prohibiting the use of grant funds to publish findings in scientific journals and significantlylimiting the use of grant funds for scientific conferences will severely limit the ability ofresearchers to collaborate with other researchers, clinicians and patients and share their findingswith the public. This will dramatically curtail scientific progress and greatly slow the pace atwhich research findings become lifesaving new interventions for patients.Taken together, these changes will drive current and future researchers away from research oraway from the U.S., leaving our nation without the scientific workforce and infrastructure weneed to drive the innovation needed to improve the lives of Americans.Thank you for your attention to this issue and we strongly urge you to work with relevantcommittees and your colleagues to avoid this future by passing legislation that prohibitsimplementation of this proposed rule permanently, or at least for an extended period of time.Sincerely,#MEActionAIDS Action BaltimoreAlliance for Positive ChangeAmerican Academy of Allergy, Asthma & ImmunologyAmerican Academy of Family PhysiciansAmerican Academy of NursingAmerican Association of Colleges of PharmacyAmerican Association of ImmunologistsAmerican Association of Veterinary Medical CollegesAmerican Cancer Society Cancer Action NetworkAmerican College of Chest PhysiciansAmerican College of Preventive MedicineAmerican Institute of Biological SciencesAmerican Psychological Association ServicesAmerican Society for VirologyAmerican Society of Health-System Pharmacists (ASHP)American Society of HematologyAmerican Society of Tropical Medicine and HygieneAmerican Thoracic SocietyAPLA HealthASMAssociation for Professionals in Infection Control and Epidemiology (APIC)Association of Nurses in AIDS CareAsthma and Allergy Foundation of AmericaAutoimmune AssociationAVACBateman Horne Center of ExcellenceBiophysical SocietyCornell Reproductive Sciences CenterCornell UniversityCrohn's & Colitis FoundationCystic Fibrosis FoundationEntomological Society of AmericaFast-Track HealthFederation of Associations in Behavioral & Brain SciencesFive Horizons Health ServicesFoundation for Sarcoidosis ResearchGerontological Society of AmericaGlobal Health Technologies CoalitionHealthHIVHIV Medicine AssociationHROImmune Deficiency FoundationImmunize.orgInfectious Diseases Society of AmericaLupus Foundation of AmericaMosquito and Vector Control Association of CaliforniaNASTADNational Affordable Housing Management Association (NAHMA)National Association for Biomedical Research (NABR)National Coalition for LGBTQ HealthNational Eczema AssociationNational Environmental Health AssociationNational Foundation for Infectious DiseasesNational Working Positive CoalitionNMACNortheast Regional Center for Excellence in Vector Borne DiseasesOpen Medicine FoundationPeggy Lillis Foundation for C. diff Education & AdvocacyPenn State Health/Penn State College of MedicinePrevent BlindnessRockies and High Plains Vector Borne Diseases Training and Evaluation CenterSAGESan Francisco AIDS FoundationSave HIV funding campaignSociety for Healthcare Epidemiology of AmericaSociety for Scholarly PublishingSolve M.E.TB AllianceThe AIDS InstituteTreatment Action Group (TAG)

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PATH/Matthew Dakin
November 10, 2026

GHTC signs letter warning congressional leadership against implementation of OMB grantmaking rule

GHTC joined 70 organizations in signing on to a letter to bipartisan congressional leaders, warning that a proposed Office of Management and Budget (OMB) rule making changes to the federal grantmaking process could undermine long-term research investments and weaken the conditions that enable scientific progress.

Read time: 3 minutes / PDF link
The Honorable Mike JohnsonSpeaker of the HouseU.S. House of RepresentativesWashington, DC 20515The Honorable Hakeem JeffriesHouse Minority Leader.U.S. House of RepresentativesWashington, DC 20515The Honorable John ThuneSenate Majority LeaderU.S. SenateWashington, DC 20510The Honorable Chuck SchumerSenate Minority LeaderU.S. SenateWashington, DC 20510November 10, 2026Dear House Speaker, House Minority Leader, Senate Majority Leader, and Senate MinorityLeader:The undersigned 71 organizations, representing public health, patients, clinicians and biomedicalresearchers, thank you for passing a Continuing Resolution that prevents the White House Officeof Management and Budget from implementing the proposed Regulation for Federal FinancialAssistance, and keeps federal biomedical research programs operating until December 11. Thisproposed regulation would undermine Congress’s constitutional role in directing the use oftaxpayer dollars by making unprecedented and comprehensive changes to the rules for federalgrants across federal agencies, including those within the Department of Health and HumanServices, like the National Institutes of Health and its National Institute of Allergy and InfectiousDiseases (NIAID). In the strongest possible terms, we urge you to act by December 11 to enact along-term policy that: 1) blocks the proposed regulation; and 2) protects against any executiveorder, regulations, or guidance that would put political appointees in charge of NIH grantmakingor making binding oversight decisions.Article 1 of the Constitution gives Congress the ultimate authority on how federal appropriationsare spent and administrations are expected to carry out these decisions. This proposed rule givescurrent and future administrations leeway to ignore those decisions. Thanks to Congressionalaction, patients with serious and life-threatening diseases and local communities have benefittedfrom peer-reviewed, evidence-based NIAID-funded research that has led to breakthroughs inpublic health practice, infectious diseases and allergy prevention, diagnosis, and treatment, asintended by Congress. If the proposed rule is implemented, progress to develop newbreakthroughs will be hindered.NIAID plays an essential role in addressing the impacts of allergy and asthma on human wellbeingand infectious disease threats such as antimicrobial-resistant infections, vector-bornediseases, HIV, viral hepatitis, sepsis, foodborne illness, tuberculosis, influenza, emergingpathogens and other infections that can seriously complicate cancer chemotherapy, organtransplantation and other medical procedures. NIAID supports research that helps explain howhuman behavior, social conditions and structural factors influence infectious disease prevention,treatment uptake, adherence and health outcomes. Additionally, NIAID funding is critical totraining the public health and scientific workforce. Students in NIAID-funded training programsand laboratories go on to work in public health agencies, clinical settings, academic research, andindustry.This proposed regulation would dramatically alter the way NIAID funding is allocated —placing grant decisions in the hands of political appointees instead of scientific experts andprioritizing political alignment over scientific merit and patient need. This will cause significantupheaval in medical research as biomedical discoveries take an average of 10 to 15 years frominitial laboratory discovery to availability for patient use and political priorities typically changewith every new president, if not more frequently.Further, political appointees often do not have the expertise necessary to determine which grantproposals are the most scientifically rigorous and most likely to deliver meaningful results forpatients. The proposed changes, along with the ability for grants to be canceled at any time, forany reason, will make it extremely difficult, if not impossible, to launch and sustain the type ofresearch needed to deliver new vaccines, diagnostic tests and treatments given the significantinfrastructure, staffing, expertise and time these studies require. The proposed rule would alsolikely have far ranging impacts beyond the intended goals of the current Administration. Theunprecedented authority that would be granted to OMB and federal agencies by this proposedrule would also be conveyed to future Administrations, which could use this authority for otherpolicy goals and preferences.Prohibiting the use of grant funds to publish findings in scientific journals and significantlylimiting the use of grant funds for scientific conferences will severely limit the ability ofresearchers to collaborate with other researchers, clinicians and patients and share their findingswith the public. This will dramatically curtail scientific progress and greatly slow the pace atwhich research findings become lifesaving new interventions for patients.Taken together, these changes will drive current and future researchers away from research oraway from the U.S., leaving our nation without the scientific workforce and infrastructure weneed to drive the innovation needed to improve the lives of Americans.Thank you for your attention to this issue and we strongly urge you to work with relevantcommittees and your colleagues to avoid this future by passing legislation that prohibitsimplementation of this proposed rule permanently, or at least for an extended period of time.Sincerely,#MEActionAIDS Action BaltimoreAlliance for Positive ChangeAmerican Academy of Allergy, Asthma & ImmunologyAmerican Academy of Family PhysiciansAmerican Academy of NursingAmerican Association of Colleges of PharmacyAmerican Association of ImmunologistsAmerican Association of Veterinary Medical CollegesAmerican Cancer Society Cancer Action NetworkAmerican College of Chest PhysiciansAmerican College of Preventive MedicineAmerican Institute of Biological SciencesAmerican Psychological Association ServicesAmerican Society for VirologyAmerican Society of Health-System Pharmacists (ASHP)American Society of HematologyAmerican Society of Tropical Medicine and HygieneAmerican Thoracic SocietyAPLA HealthASMAssociation for Professionals in Infection Control and Epidemiology (APIC)Association of Nurses in AIDS CareAsthma and Allergy Foundation of AmericaAutoimmune AssociationAVACBateman Horne Center of ExcellenceBiophysical SocietyCornell Reproductive Sciences CenterCornell UniversityCrohn's & Colitis FoundationCystic Fibrosis FoundationEntomological Society of AmericaFast-Track HealthFederation of Associations in Behavioral & Brain SciencesFive Horizons Health ServicesFoundation for Sarcoidosis ResearchGerontological Society of AmericaGlobal Health Technologies CoalitionHealthHIVHIV Medicine AssociationHROImmune Deficiency FoundationImmunize.orgInfectious Diseases Society of AmericaLupus Foundation of AmericaMosquito and Vector Control Association of CaliforniaNASTADNational Affordable Housing Management Association (NAHMA)National Association for Biomedical Research (NABR)National Coalition for LGBTQ HealthNational Eczema AssociationNational Environmental Health AssociationNational Foundation for Infectious DiseasesNational Working Positive CoalitionNMACNortheast Regional Center for Excellence in Vector Borne DiseasesOpen Medicine FoundationPeggy Lillis Foundation for C. diff Education & AdvocacyPenn State Health/Penn State College of MedicinePrevent BlindnessRockies and High Plains Vector Borne Diseases Training and Evaluation CenterSAGESan Francisco AIDS FoundationSave HIV funding campaignSociety for Healthcare Epidemiology of AmericaSociety for Scholarly PublishingSolve M.E.TB AllianceThe AIDS InstituteTreatment Action Group (TAG)
PATH/Christopher Nelson
October 15, 2026

GHTC signs onto letter urging appropriators to maintain funding for NIH and ORWH

GHTC joined more than 30 other organizations in signing on to a letter addressed to Senate appropriators, urging them to maintain robust funding for the US National Institutes of Health (NIH) and specifically the Office of Research on Women's Health (ORWH).

Read time: 3 minutes / PDF link
123October 15, 2026The Honorable Shelley Moore CapitoChairSenate Appropriations Subcommittee on Labor,Health and Human Services, Education, andRelated AgenciesWashington, DC 20510The Honorable Tammy BaldwinRanking MemberSenate Appropriations Subcommittee on Labor,Health and Human Services, Education, andRelated AgenciesWashington, DC 20510Dear Chair Capito and Ranking Member Baldwin:On behalf of the Friends of the Office of Research on Women’s Health (ORWH), we write tothank you for your efforts to keep the federal government funded and to ensure that criticalgovernment functions and programs can continue without interruption. As the Senate Labor,Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriationssubcommittee considers its fiscal year (FY) 2027 funding requests, we urge you to remain firm inyour commitment to the health of all Americans by providing no less than $51.303 billion forthe National Institutes of Health (NIH) and $115.74 million for the ORWH in the SenateLabor-HHS funding bill.The Friends of ORWH is a coalition of more than 50 organizations representing researchers,clinicians, patients, and policy advocates that are committed to elevating the mission of ORWHto address biological sex differences in health and prioritize closing research gaps to advancewomen’s health. Earlier this year, the Friends of ORWH sent a letter to congressionalappropriators detailing the promise and benefits of the NIH and ORWH. We furtherdemonstrated the value of sustained women’s health research investment in testimony to boththe House and Senate Labor-HHS Appropriations Subcommittees .While we were encouraged by the proposed $111.48 million for the ORWH in the HouseLabor-HHS bill passed in June, we continue to urge Congress to provide no less than $115.74million for the ORWH. Not only is this request consistent with recommendations from thebroader scientific community (representing an 8.7 percent increase over FY2026 enactedfunding), but investment at this level is necessary to continue advancing research to close thewomen’s health gap. At a time when NIH funding has not kept pace with inflation, this level offunding would support meaningful growth in research funding even after accounting forincreases in the cost of conducting biomedical research, as reflected by the Biomedical Researchand Development Price Index (BRDPI).We recognize the challenges of the current fiscal environment and the many competingpriorities before Congress, but sustained investment in women’s health research is essential toaddressing some of the nation’s most pressing health challenges. Chronic conditions such asAlzheimer’s disease, heart disease, and autoimmune diseases burden a large portion of the U.S.population, and these conditions disproportionately or disparately affect women.1,2,3 Yetresearch is only recently beginning to reveal evidence of how sex and gender influence diseaserisk, progression, diagnosis, and treatment across condition areas. ORWH is uniquely positionedto help build the evidence base. By coordinating and advancing women’s health research acrossNIH Institutes and Centers, and through programs that support training and mentorship forinvestigators and programs in sex-differences research, the ORWH ensures that women’s healthis considered throughout the biomedical research enterprise.The consequences of insufficient investment in biomedical research on women’s health extendbeyond scientific progress. When women’s unique biology and health needs are not adequatelyreflected in research, it can contribute to missed or delayed diagnoses, less effectivetreatments, and preventable deaths. These gaps also carry significant economic costs,increasing avoidable health care spending, reducing productivity, and placing added financialstrain on individuals, families, and communities.While the Friends appreciate Congress passing the continuing resolution (CR) to keep thegovernment open through December 11 and avoiding a government shutdown, CRs create anenvironment of scientific uncertainty. They can disrupt ongoing studies, delay researchmilestones, and create difficult financial pressures for research teams, including potential staffreductions or the termination of studies, in medical research laboratories and institutions acrossthe country. These disruptions are particularly concerning for women’s health research, whichoften depends on longitudinal studies that collect and analyze data over many years tounderstand how women’s health and disease risk change across the lifespan. The Friends ofORWH strongly encourages Congress to work in a bipartisan manner to pass a full-yearspending bill as soon as possible. Maintaining stable, predictable federal funding is essential topreserving these investments and ensuring that years of research, data collection, and scientificprogress are not lost.3 Kronzer, V. L., Bridges, S. L., Jr, & Davis, J. M., 3rd (2020). Why women have more autoimmune diseases than men:An evolutionary perspective. Evolutionary applications, 14(3), 629–633. https://doi.org/10.1111/eva.131672 Centers for Disease Control and Prevention. (n.d.). About women and heart disease. Centers for Disease Controland Prevention. https://www.cdc.gov/heart-disease/about/women-and-heart-disease.html1 O'Neal M. A. (2024). Women and the risk of Alzheimer's disease. Frontiers in global women's health, 4, 1324522.https://doi.org/10.3389/fgwh.2023.1324522The Friends of ORWH looks forward to working with you to ensure sufficient and necessarysupport for federal medical research agencies in FY2027. We would welcome the opportunity tomeet with your offices to discuss our request in more detail. Please reach out to LindseyMiltenberger, MA, Chief Advocacy Officer at the Society for Women’s Health Research, atlindsey@swhr.org for any questions or if you need additional information.Sincerely,51&AcademyHealthAlliance for Aging ResearchAmerican College of Nurse-MidwivesAmerican College of Obstetricians & GynecologistsAmerican Medical Women's AssociationAmerican Physiological SocietyAvestria Ventures ManagementBlack Women's Health ImperativeCenter for Endometriosis CareCleveland Clinic Women’s Comprehensive Health and Research CenterEndocrine SocietyEvia Wellness, LLCFertility Alliance ProvidersFoundation for Sarcoidosis ResearchGlobal Health Technologies CoalitionHealthy Americas FoundationHealthyWomenImpact AdvocacyMaternal Mental Health Leadership Alliance (MMHLA)Miles for MigraineMinneapolis Heart Institute FoundationNational Alliance for Hispanic HealthNational Association of Nurse Practitioners in Women's HealthOvarian Cancer Research AlliancePreeclampsia FoundationRESOLVE: The National Infertility and Family Building AssociationSociety for Women's Health ResearchWomen First Research CoalitionWomen’s Alzheimer’s Movement at Cleveland ClinicWomen's Health AdvocatesWomenHeartWorld Health Education Foundation
PATH/Christopher Nelson
October 9, 2026

GHTC responds to RFI on proposed changes to reporting outcomes from NIH Peer Review

GHTC submitted a response to a request for information (RFI) on proposed changes to reporting outcomes from US National Institutes of Health (NIH) Peer Review, urging the agency to maintain a rigorous, transparent, and effective peer review process through any reforms to the process.

Read time: 3 minutes
GHTC submitted the below response to a request for information (RFI) on proposed changes to reporting outcomes from US National Institutes of Health (NIH) Peer Review, urging the agency to maintain a rigorous, transparent, and effective peer review process through any reforms to the process.The Global Health Technologies Coalition (GHTC), a coalition of more than 50 nonprofit organizations, academic institutions, and aligned businesses working to accelerate the development and delivery of new drugs, vaccines, diagnostics, and other health technologies, is committed to ensuring the NIH sustains a strong, predictable environment for scientific discovery to advance global health research and development (R&D). GHTC supports NIH’s goal of ensuring funding decisions reflect the full substance of scientific peer review. If NIH moves toward broader categories for reporting review outcomes, it should ensure that qualitative feedback is sufficiently clear and actionable to help researchers understand the scientific strengths and weaknesses identified through peer review and, where appropriate, improve future applications.  Peer review enables global health R&D NIH’s investments in early-stage biomedical research are critical for the global health R&D ecosystem. NIH support has helped advance more than 45 new global health technologies since 1999, including Lenacapavir for long-acting HIV prevention, monoclonal antibodies to treat Ebola, and new drugs to combat drug-resistant tuberculosis. The science leading to each of these transformative innovations moved through the NIH peer review process. For global health R&D, where promising discoveries often move through long and interconnected development pathways, GHTC’s primary interest is ensuring that NIH maintains a rigorous, predictable, and scientifically independent research environment that enables strong ideas to advance and researchers to continue improving the science. Transparency for researchers As NIH simultaneously implements a more flexible approach to funding decisions under the Unified Funding Strategy, transparency regarding how scientific merit is considered alongside programmatic priorities, portfolio needs, workforce considerations, and available resources will be important. Clear and consistently applied processes can help preserve confidence in the independence of scientific review while giving NIH appropriate flexibility to steward its research portfolio.  Researchers should be able to understand the substantive scientific feedback on their applications and use that feedback to inform future research and applications. Historically, scores, percentiles, and paylines have provided researchers with useful reference points in the review and funding process. If NIH moves away from this traditional system, the qualitative feedback provided through peer review becomes even more important. Written critiques and panel discussion summaries should provide researchers with sufficient information to understand the scientific strengths and weaknesses identified during review and assess whether and how to revise and resubmit an application.  Maintain scientific independence  Researchers and institutions have experienced significant changes to NIH funding policies, priorities, and grantmaking practices over the past year. Additional reforms should be implemented in a measured and thoughtful manner and clearly communicated to stakeholders to minimize unnecessary disruption to the research ecosystem. As the peer review and funding processes evolve, NIH should continue to provide clear safeguards and transparency regarding the respective roles of scientific peer review and programmatic considerations in final funding decisions. Preserving confidence in the independence and integrity of peer review is essential to maintaining researcher participation and ensuring that NIH investments continue to support high-quality science. A rigorous, transparent, and effective peer review process will help ensure that NIH resources continue to support scientific discovery and that today’s research can become tomorrow’s health technologies. 
PATH/Georgina Goodwin
October 1, 2026

GHTC and Impact Global Health's research cited in article on US benefits of global health research investments

An article in The Conversation focused on the economic returns of investments in global health innovation cites evidence from GHTC and Impact Global Health's report on how US federal funding for global health research and development is delivering impact both abroad and at home. 

Read time: 4 minutes / External link
PATH/Christopher Nelson
September 18, 2026

GHTC responds to RFI on reorganization of NIAID

GHTC submitted a response to a public hearing on a proposed reorganization of the National Institute of Allergy and Infectious Diseases (NIAID), warning of potential implications and urging the need for transparency throughout any future restructuring efforts.

Read time:
GHTC submitted the below response to a public hearing on a proposed reorganization of the National Institute of Allergy and Infectious Diseases (NIAID), warning of potential implications and urging the need for transparency throughout any future restructuring efforts.The National Institute of Allergy and Infectious Diseases (NIAID) is one of the world’s leading funders of global health research and development (R&D) and plays a unique role within the National Institutes of Health (NIH). The Institute’s mandate requires it to anticipate and respond to emerging and persistent infectious disease threats, advance understanding of disease mechanisms, and support the development of critical countermeasures. As the Global Health Technologies Coalition (GHTC), a coalition of more than 50 nonprofit organizations, academic institutions, and aligned businesses working to accelerate the development and delivery of new drugs, vaccines, diagnostics, and other health technologies, we are committed to ensuring that NIAID’s structure and mandate sustain this work.The Division of Clinical Research (DCR) is a key component of the research ecosystem, providing the infrastructure, oversight, expertise, and standards needed to translate scientific discoveries into safe and effective interventions for patients. DCR’s centralized structure within NIAID has supported patient safety, scientific integrity, clinical trial operations, and the advancement of medical innovation. These functions are essential for moving promising discoveries from the laboratory into products that can improve and save lives.This is particularly important for global health R&D. Clinical research increasingly spans borders, disease areas, and institutions, with universities, academic medical centers, nonprofit product development partnerships, and other partners contributing essential expertise and infrastructure. International clinical research is necessary to ensure that new tools are effective across diverse populations and can ultimately be developed into affordable, fit-for-purpose products for communities facing the greatest disease burdens. DCR provides multi-disciplinary services across NIAID to help facilitate high-quality clinical trials across the globe. Maintaining strong coordination between domestic and international research efforts is therefore essential to US leadership in biomedical innovation and global health.The proposed reorganization of NIAID, including the dissolution of DCR and redistribution of its core functions, risks undermining this coordination by creating new silos, fragmenting clinical research expertise and oversight, and weakening integration across domestic and international research activities. It could also introduce unnecessary disruption at a time when the United States must strengthen, not weaken, the infrastructure needed to respond rapidly to infectious disease threats and translate scientific advances into effective countermeasures.Additionally, it is critical to ensure that with any restructuring, NIAID maintains transparency, consistency, and strong oversight of clinical operations. Disruptions to established systems and expertise should not contribute to funding and administrative delays, increase burdens on clinical research partners, or jeopardize the timely, safe, and effective conduct of clinical trials. Ultimately, we ask NIAID to ensure these changes do not slow the development of new interventions against some of the world’s most pressing health challenges.NIAID’s ability to connect basic science, clinical research, and product development is a critical component of US biomedical leadership. Preserving the infrastructure and coordination that make this possible—including a strong, centralized clinical research function within NIAID—is essential to protecting research participants, maintaining scientific rigor, advancing global health R&D, and ensuring that US investments in discovery translate into health technologies that reach the people who need them most.