The Council on Governmental Relations (COGR) virtual meeting on February 24, 2021, convened a panel of experts from academia, healthcare, and regulatory agencies to address the persistent lack of diversity in clinical trials. Presentations highlighted the ongoing underrepresentation of minority populations, older adults, and women in clinical research, as documented by FDA's Drug Trials Snapshots and related data. Panelists examined barriers to participation, including mistrust of the medical system, lack of awareness, inadequate recruitment efforts, strict eligibility criteria, language obstacles, and broader social determinants of health. Particular attention was paid to the exacerbation of disparities during the COVID-19 pandemic and the need for inclusive trial recruitment strategies.
The panel emphasized that rectifying these deficiencies requires more than procedural changes; it demands building sustained trust with marginalized communities, improving communication, and addressing systemic inequities that influence health outcomes and research participation. Institutions such as Mass General Brigham are creating structural models—like Centers of Excellence for Diversity, Equity, and Inclusion (DEI)—to enact systemic change through coordinated, cross-functional initiatives. The meeting also outlined actions for researchers and organizations, from forming task forces to revising recruitment and engagement practices, with the goal of making DEI a foundational aspect of all research. The discussion concluded that achieving meaningful diversity in clinical trials is essential for health equity, the generalizability of scientific findings, and the ethical conduct of research, and it requires ongoing, institution-wide commitment and collaboration.
