The National Institutes of Health (NIH) is the largest funder of biomedical research in the world, with D43 grants that support international science training programs receiving $47 million in 2022. Little is known about gender disparities in funding. This study aims (1) to identify the gender composition of principal investigators (PIs) and multiple PIs (MPIs) receiving NIH D43 grants by fiscal year (2000-2022), (2) to understand if gender composition varies by country-income class (CIC) and (3) to assess whether the introduction of the MPI structure in 2006 improved leadership representation for women scientists.

Methods

D43 grant data (2000-2022) were extracted from NIH eReporter, and we assigned PI gender by name and photo and CIC by World Bank Classification. For all D43s and a subset of D43s with ≥ 1 female MPI, we analyzed the proportion of the total award amount by gender and CIC by fiscal year.

Results

Between 2000-2022, male contact PIs received a higher proportion of awards and dollar amounts per fiscal year (mean 75.2%, $28.92mil) than female contact PIs (mean 24.8%, $9.86mil). Most (89.25%) awards were granted to PIs from higher income countries (HICs). As of 2022, 43.44% of the total award amount was allocated to D43s with one or more female MPIs.

Conclusion

A gender and CIC disparity was observed during 2000-2022 in the allocation of NIH D43 awards and dollar amounts. After introduction of the MPI structure, representation of female scientists as MPIs increased; however, structural barriers to contact PI leadership persist.

Key Words: NIH grants, D43, principal investigator, multiple principal investigators, income country class, gender disparity

Despite constituting 70% of the global health (GH) workforce, women have only 25% leadership representation indicating a lack of gender diversity in leadership. The COVID-19 pandemic has slowed progress in gender diversity in leadership as women had to shoulder a disproportionate share of job losses and caregiving roles. This study aimed to investigate challenges and facilitators for professional development among women in GH who live, work, or study in Massachusetts, and explore their interests in becoming mentors and joining a women-focused GH professional network.

Methods:

The cross-sectional online survey of women in GH in Massachusetts was conducted in Fall 2023. Participants were invited via email sent by professional associations, academic institutions, or their workplaces. Descriptive and stratified analyses were carried out.

Results:

Out of the 105 respondents, key challenges were work-life integration (19.4%), limited mentorship and sponsorship (13.9%), unequal pay (11.5%), and limited career advancement opportunities (9.7%), with 88.3% reporting personal experiences of these barriers. Career-enhancing factors included diverse and inclusive workplaces, equal-pay initiatives, and supportive professional networks, yet 33% had never benefited from these. Over 63% expressed interest in joining a women-focused GH professional network, citing networking, access to mentorship, sponsorship, and leadership development programs, policy change potential, alignment with the network's mission, and recognition as motivators. About 75% of them, with >10 years of experience expressed willingness to mentor others.

Conclusion:

Targeted interventions such as a women-focused GH professional network can address those barriers and promote gender equity in GH leadership.