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Recent trends and structural patterns in NIH pediatric research funding, 2015-2024
Christopher B Forrest1, Lauren J Koenigsberg2, David C Schwebel3
1Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. forrestc@chop.edu.
Pediatric Research
|August 13, 2026
Summary
National Institutes of Health (NIH) pediatric research funding has remained stagnant, comprising about 13% of the budget despite children being 22% of the population. A lack of coordinated strategy hinders prioritization of pediatric and life-course research.
Area of Science:
- Pediatric Research Funding Analysis
- Health Services Research
- Biomedical Research Policy
Background:
- Pediatric research funding from the National Institutes of Health (NIH) has historically not aligned with children's proportion of the US population or disease burden.
- A significant gap exists between the health needs of children and the allocation of research funds.
- The current funding landscape necessitates an examination of NIH's commitment to pediatric health.
Purpose of the Study:
- To analyze trends in NIH pediatric research expenditures from FY2015 to FY2024.
- To investigate the distribution of pediatric research funding across different NIH components.
- To assess the accuracy of the NIH Research, Condition, and Disease Categorization (RCDC) system in identifying pediatric research.
Main Methods:
- A repeated cross-sectional analysis was performed using RCDC, NIH Office of Budget, and NIH RePORTER data (FY2015-2024).
- Expenditures were adjusted for inflation using the Biomedical Research and Development Price Index (BRDPI).
- A random audit of 200 RCDC-categorized pediatric projects evaluated classification accuracy.
Main Results:
- While nominal NIH research expenditures increased, inflation-adjusted growth was only 26%.
- Pediatric research consistently represented approximately 13% of nonadministrative NIH expenditures, falling short of the 22% of the US population under 18.
- A 6% misclassification rate was found in the RCDC system, particularly in maternal health studies lacking pediatric outcomes.
Conclusions:
- NIH pediatric research funding has remained proportionally stagnant, increasing passively with the overall budget rather than through targeted prioritization.
- A coordinated, trans-NIH strategy is needed to effectively prioritize and oversee pediatric and life-course research.
- Current funding mechanisms do not adequately reflect the health burden or population share of children, indicating a need for policy adjustments.
