Funding for Women’s Health Initiative Imperiled, but Appears Secure for Now

Over the course of the past week, the Department of Health and Human Services (HHS) canceled funding, and then reversed course, for the long-running Women’s Health Initiative (WHI) study.

Started in 1991, the WHI enrolled 161,808 women across 40 US clinical centers and continues to collect data on more than 42,000 participants ages 78 to 108 years. Practice-changing data from the study have affected menopausal hormone therapy prescriptions and increased the understanding of cardiovascular health, cancer, and healthy aging in women, among a variety of other topics like the effects of supplements, blood pressure thresholds, the impact of race and income on revascularization outcomes, and links between infertility and heart failure with preserved ejection fraction.

“It would’ve been really a devastating loss to women’s health and really to the health of all older adults if the study had been stopped or markedly reduced in funding,” JoAnn Manson, MD, DrPH (Brigham and Women’s Hospital, Boston, MA), who led a prominent WHI analysis on hormone replacement therapy (HRT), told TCTMD. “I’m very excited about the continuation of the largest and really most groundbreaking study in women’s health.”

On Monday, the initiative announced HHS funding cuts to its regional centers and clinical coordinating centers effective in September and January, respectively. The cuts shocked many researchers and led to a wave of criticism. Yesterday, according to several media reports, an HHS spokesperson said the agency is no longer planning on following through with these plans.

“These studies represent critical contributions to our better understanding of women’s health,” HHS spokesperson Andrew Nixon told Politico. “While NIH initially exceeded its internal targets for contract reductions, we are now working to fully restore funding to these essential research efforts.”

On social media, HHS Secretary Robert F. Kennedy affirmed the WHI would not be terminated, adding that the study’s mission is “critical for women’s health.”

To TCTMD, Martha Gulati, MD (Cedars-Sinai Medical Center, Los Angeles, CA), immediate past president of the American Society for Preventive Cardiology, pointed to WHI’s many contributions to cardiology above and beyond HRT, noting that it was the first study in which she was involved after finishing training. To stop would be “heartbreaking,” she said. “We will never have [another] study funded like this.”

“It should be the pride of the United States—how much we’ve learned and how much we’ve transformed women’s health and how many lives we’ve saved,” Gulati continued. “We should be looking at that and being so proud of the American contribution to understanding women’s health, healthy aging, and ways to treat women.”

Ron Blankstein, MD (Brigham and Women’s Hospital), feels similarly. “The WHI has provided instrumental data related to cardiovascular disease prevention in women and highlighted—more than any other study ever conducted—the importance of sex-specific research,” he told TCTMD in an email. “This study has informed many practice guidelines and has also helped shape the design of multiple prevention trials.”

Funding cuts would have led to effectively canceling the largest research program on postmenopausal women’s health, said Blankstein.

“Given the significant burden of cardiovascular disease, dementia, and cancer among older women, continued research on this cohort of women could lead to many more important discoveries,” he said. “Eliminating this program could jeopardize decades of important progress.”