Imperatives for United States Clinical Research Leadership and Coordination

The United States spends nearly 18 percent of its gross domestic product on health care, yet health outcomes continue to lag behind those of peer nations, even as US leadership in life sciences faces growing global competition. This report argues that the opportunity lies not in spending more but in coordinating better. Today, no single entity is responsible for optimizing the nation’s clinical research enterprise; funding, infrastructure, and priorities remain dispersed across federal agencies.