Known as the UNITE initiative, the framework represents the first time all NIH institutes and centers are jointly focused on structural racism in biomedical science, both within the agency and throughout the biomedical workforce.

In the commentary the authors, led by Dr. Francis Collins, PhD, the director of the NIH, acknowledged that the issue was triggered by recent events in the U.S., including the Atlanta spa shootings in March 2021, the police killing of George Floyd in May 2020, and health disparities magnified by the COVID-19 pandemic.

Collins had already apologized in March 2021 for the agency's role in not fully addressing the issue and to "those individuals in the biomedical research enterprise who have endured disadvantages due to structural racism."

The authors noted that the NIH's reinvigorated commitment to ending structural racism is consistent with an executive order to advance racial equity and support for underserved communities through the federal government. The order was signed by President Joe Biden shortly after his inauguration on January 20.

The NIH's new framework includes "understanding barriers; developing robust health disparities/equity research; improving its internal culture; being transparent and accountable; and changing the extramural ecosystem so that diversity, equity, and inclusion are reflected in funded research and the biomedical workforce," according to the authors.

The goals of the UNITE initiative include the following:

• To establish an equitable and civil culture within the biomedical research enterprise and reduce barriers to racial equity in the biomedical research workforce
• To perform a broad, systematic self-evaluation to delineate elements that perpetuate structural racism and lead to a lack of diversity, equity, and inclusion within the NIH and the external scientific community
• To address long-standing health disparities and issues related to minority health inequities in the U.S. by ensuring NIH-wide transparency, accountability, and sustainability in marshaling resources for health disparity, minority health, and health equity research
• To change the NIH organizational culture and structure to promote diversity, equity, and inclusion throughout the NIH workforce
• To perform a broad systematic evaluation of NIH extramural policies and processes to identify and change practices and structures that perpetuate a lack of inclusivity and diversity within the extramural research ecosystem

On February 26, the NIH announced a new five-year, $60 million Common Fund program to support innovative investigator-initiated projects aimed at reducing health disparities and inequalities.

In addition, the National Institute on Minority Health and Health Disparities is soliciting investigator-initiated projects to understand and address the effects of structural racism and discrimination on minority health and health disparities with a commitment of up to $30 million.

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