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President Biden on Monday designed to increase the emphasis on women's health research across the federal government.

"In the early 1970s, researchers in the United States studied estrogen's effect in preventing heart attacks," First Lady Jill Biden said during the signing ceremony in the East Room of the White House; the event was part of the White House's Women's History Month observance. "It was observed that women who had gone through menopause -- and therefore who had lower levels of estrogen -- were likely to have heart attacks. So asking whether estrogen prevents heart attacks."

The First Lady went on to explain, however, that of 8,341 patients selected for that study, "all of them were men. This is how things were done, even though women are half the population. Women's health research has been underfunded and understudied. Too many of our medications, treatments, and medical school textbooks are based on men and their bodies. But that ends today."

President Biden agreed. "With the executive order I'm about to sign, I'm directing the most comprehensive set of executive actions ever taken to improve women's health," he said.

"And I'm going to ensure that women's health is integrated and prioritized across the entire federal government -- not just the NIH [but also] the National Science Foundation (NSF), the Defense Department, and the Environmental Protection Agency. I mean across the board. This is really serious."

"I will spearhead new research and innovation for breakthroughs in a wide range of women's health needs," he continued. "Because it really matters."

The executive order the president signed:

• Directs federal agencies to develop and strengthen research and data standards on women's health across all relevant research and funding opportunities.
• Directs federal agencies to prioritize funding for and encourage innovation in women's health, including through the Advanced Research Projects Agency on Health (ARPA-H) and multi-agency initiatives such as the Small Business Innovation Research Program and the Small Business Technology Transfer Program. "These entities are dedicated to high-impact research and innovation, including through the support of early-stage small businesses and entrepreneurs engaged in research and innovation," the administration . "The Executive Order further directs HHS and NSF to study ways to leverage artificial intelligence to advance women's health research."
• Directs the Office of Management and Budget and the Gender Policy Council to assess gaps in federal funding for women's health research and identify changes -- statutory, regulatory, or budgetary -- that will support the broad scope of women's health research across the federal government. Agencies will also be required to report annually on their investments in women's health research, as well as progress towards their efforts to improve women's health.

The executive order also emphasizes research related to conditions that often affect women in midlife and after menopause, such as rheumatoid arthritis, heart attack, and osteoporosis, the fact sheet noted. For instance, the order requires HHS to expand data collection efforts related to women's midlife health; launch a comprehensive research agenda that will guide future investments in menopause-related research; and develop new resources to help women better understand their options for menopause-related symptom prevention and treatment. The order also directs the Defense Department and Department of Veterans Affairs to study and improve the treatment of menopause for servicewomen and women veterans.

In addition to the executive order, the NIH is launching an agency-wide effort to close gaps in women's health research. This effort will initially be supported by $200 million from NIH beginning in fiscal 2025. Among other things, it allows NIH to launch ambitious, multi-faceted research projects such as research on the impact of perimenopause and menopause on heart health, brain health, and bone health. In addition, the president's fiscal 2025 budget request would double current funding for the NIH Office of Research on Women's Health to support new and existing initiatives that emphasize women's health research.

In his State of the Union address on March 7, Biden urged Congress to pass his plan for $12 billion needed to fund the entire NIH effort, which he said would "transform women's health research and benefit millions of lives all across America." On the background call Sunday, administration officials sounded confident the money would be forthcoming.

"We very much are looking forward to working with Congress" to get that funding, a senior administration official said on the call. "There have been long-standing champions of women's health research on both sides of the aisle. So I think that this is an area where there will be a huge opportunity to work together ... We firmly believe that we will be able to secure that funding to do some of the exciting things that he outlined."

Also on the background call, Carolyn Mazure, PhD, chair of the recently launched White House Initiative on Women's Health Research, noted that "just last month, the First Lady traveled to Cambridge, Massachusetts to announce ARPA-H's Sprint for Women's Health [project], with a commitment of $100 million dedicated to transformative research and development in women's health. This new sprint will accelerate the next generation of discoveries, from early-stage proofs of concept to products that are ready to be commercialized. And that is just the beginning."

For its part, the NSF is calling for new research and education proposals to advance discoveries and innovations related to women's health. The foundation, which is government-supported, seeks applications that would improve women's health through a wide range of disciplines, from computational research to engineering biomechanics. Proposals will be considered on an ongoing basis.

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