There is no question that diversity matters—it does. In the context of clinical trials, a lack of diverse representation can lead to medicines and vaccines that are less effective in treating disease and health conditions in groups underrepresented in such trials, giving rise to health equity concerns. The issue of health equity has become even more pressing in light of the recent COVID-19 pandemic.

In an effort to address health equity concerns and mitigate health disparities, a U.S. House of Representatives bill—The NIH Clinical Trial Diversity Act of 2022 (H.R. 7845)—has sought to seize upon the National Institute of Health's (NIH) vital role in increasing diversity in clinical trials by tying receipt of federal funding from the NIH to an application process requiring a clinical trial sponsor's demonstrated commitment to diversity in clinical trials. The regulatory framework of H.R. 7845 is anchored in the following pillars of accountability: (1) transparency, (2) goal-setting and action planning, (3) education and awareness, and (4) identification and elimination of barriers to diverse participation in clinical trials.