The results of the 2024 election could affect the health of Americans, especially women, for decades to come.
This article was produced in collaboration with The Fuller Project, a journalism nonprofit that reports on global issues affecting women.
The 2024 election is critical for medical advances, especially research that involves and affects women.
The Biden administration recognized decades of failure to include half the population in medical research when it established a White House Initiative on Women’s Health Research and dedicated tens of millions of dollars to study diseases affecting primarily women and to include more women in studies of diseases that affect everyone.
The National Institutes of Health, the world’s leading funder of biomedical research, is now better focused on ensuring females are included in all stages of medical study, and it’s working to include more women in the research it supports. That trajectory would likely continue and even expand if Vice President Kamala Harris is elected president.
It would likely stop dead if former President Donald Trump returned to the White House.
“It’s either going to enter its heyday or it’s going to be gutted like every other federal agency. We all know what’s going to happen,” said Emily Jacobs, a neuroscientist at the University of California Santa Barbara who is studying the effects of hormones on the brains of both men and women. “What happens in November determines whether this line of research continues or whether we are up against the strongest headwinds ever. This research depends on the support of the federal government.”
Federal efforts to improve women’s health with targeted research and treatment were just getting started in 2024, three decades after Congress directed the government to make clinical tests more equitable. Until now, women have been sorely missing from the trials, even those aimed at diseases that affect them more than men. As a result, medical science hasn’t figured out why women are more likely than men to die of heart attacks or to suffer life-threatening side-effects from drugs. And there is, as first lady Jill Biden said in January, a “stunning lack of information” about menopause.
“This November, voters will face a choice between two starkly different policy approaches, one that is likely to have a direct impact on the health of American women,” the Commonwealth Fund, a nonprofit research group focused on health care, said in a recent report.
Neither candidate has said much, if anything, about plans for research involving women, and neither campaign responded to requests for comment. But many scientists say they are excited about the prospect of a Harris presidency. Her mother, after all, was a medical researcher. Shyamala Gopalan earned her Ph.D in nutrition and endocrinology from the University of California at Berkeley and studied how breast cancer develops at Lawrence Berkeley National Laboratory in Berkeley, Calif. Harris often cites Gopalan, who died of colon cancer in 2009, as an inspiration.
“We need a leader who understands the nuance of these topics. Otherwise it’s a scary thing for scientists to put our findings out there,” said Laura Pritschet, a Ph.D. student in Jacobs’ lab. “We feel a little bit more confident if one of those people is commander in chief.”
Harris was front and center at the signing in March of President Joe Biden’s latest executive order strengthening efforts to better include women in medical research, to focus more research on women’s needs and to close gaps in federal funding for women’s health.
Biden’s administration has acted repeatedly in the past year, establishing the Initiative on Women’s Health Research to reinvigorate 30-year-old legislation that tried, but failed to get the female sex fully included in medical research. Biden’s budget request for fiscal year 2025 would double the funding for the Office of Research on Women’s Health at the NIH. Like much of the federal budget, this proposal is in limbo because Congress has yet to pass final spending bills. A new health agency established under Biden, the Advanced Research Projects Agency for Health, or ARPA-H, has pledged $100 million in funding for “transformative research and development” in women’s health.
While Trump’s plans for medical research policy are unclear, he left an extensive record from his four years in office. He tried repeatedly to chop the budget for the NIH during those four years, only to be defied by Congress.
Trump proposed cutting the NIH budget throughout his time in office. In 2020, as Covid-19 was starting to spread, he proposed reducing NIH and its medical research budget by 12.6 percent. Congress gave the agency a 22 percent increase. NIH currently has a $48 billion budget. In 2019, Trump tried to slash NIH’s budget by 27 percent and in 2017, his first year in office, he tried to cut $1.2 billion to offset increases in defense spending. Congress, which has the last word on federal spending, overruled him each time.
Congress may be able to defy a president’s funding requests, but the executive branch has considerable control over how money is allocated for specific programs and who heads up the agencies and departments that spend it. Trump has already demonstrated he’s willing to push policies so far that lawsuits follow, noted Zachary Baron, a director of the Health Policy and the Law Initiative at Georgetown University’s O’Neill Institute for National and Global Health Law. “Certainly what we saw during the previous Trump administration was a lot of chaos, a lot of disruption,” Baron said. “It takes away a lot of resources from trying to improve health outcomes in this country.”
While Trump has distanced himself from Project 2025, the conservative Heritage Foundation’s blueprint for the next Republican president, the plan has a detailed section devoted to NIH’s renewed focus on women, calling it “junk gender science.”
Instead, it says, NIH should divert money from mainstream medical research to the study of what it calls “cross-sex interventions” such as the use of puberty blockers. “HHS should create and promote a research agenda that supports pro-life policies and explores the harms, both mental and physical, that abortion has wrought on women and girls,” it adds.
Extensive research shows that legal abortion, provided via medication or by trained professionals, is safer than pregnancy and that denying women abortions can be harmful. Before the Supreme Court legalized abortion nationwide in 1973, many desperate women died or suffered dangerous complications from unsafe back-alley procedures. Since the court overturned that constitutional right in 2022, at least two women died when they were unable to access the care they needed, ProPublica has reported.
Project 2025 also attacks other aspects of NIH reforms that attempt to fairly distribute funding and include women in the agency’s work. “Under Francis Collins, NIH became so focused on the #MeToo movement that it refused to sponsor scientific conferences unless there were a certain number of women panelists, which violates federal civil rights law against sex discrimination,” the document reads. Collins, the longest-serving NIH director, served under three presidents of both parties, including Trump.
The repercussions will be global. U.S. medical research underlies much, if not most, global drug development, and the U.S. Food and Drug Administration’s approvals drive medical practice worldwide. Private industry may ignore politics to some degree, but new drugs need federal government approval and the NIH and other federal research agencies, including parts of the Department of Defense, fund much early stage medical research.
One recent study showed the NIH helped pay for the development of virtually every drug approved by the FDA between 2010 and 2019.
Voters typically don’t factor in medical research policy at the ballot box, although abortion rights are expected to motivate many voters this year as they have in the past two. But the results of the 2024 election will affect the health of Americans, especially women, possibly for decades to come.
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