The Current State of DEI in Clinical Trials: Progress, Pressure, and the Path Forward

The industry has been discussing clinical trial diversity, equity, and inclusion (DEI) for decades. What is different now is the convergence of regulatory expectations, organizational accountability structures, and a political environment that is simultaneously creating pressure and hesitancy. Understanding where progress is real, where it is stalling, and what is actually working is more important than ever.

Here are 10 questions addressing the current state of DEI in clinical trials and what it will take to move forward.

1. Is corporate DEI actually retreating in life sciences, or does the public narrative overstate it?

Shareholder behavior tells a more stable story than headlines suggest. Across 31 cross-industry shareholder meetings in 2025, all 31 companies rejected anti-DEI proposals. Most life sciences companies are not dismantling DEI programs but reframing them within broader language around culture, belonging, and performance.

As Nancy Levine Stearns of Impactivize observed, "The headlines were a little bit misleading. In fact, most corporations maintain their commitments even if they're called other things."

The underlying commitments, according to research from Catalyst and the Meltzer Center, largely remain intact.

2. Why are pharmaceutical executives being cautious about public DEI statements?

The industry operates under intense regulatory oversight, relies heavily on federal approvals, and faces significant litigation exposure. Federal agencies including the Department of Justice (DOJ) and Equal Employment Opportunity Commission (EEOC) have signaled increased scrutiny of corporate DEI programs, and DOJ leadership has been explicit about its intent. In that environment, many executives have chosen quieter strategies, relying on boards and investors to sustain commitments internally

3. What is the business case for sustaining DEI in research-driven organizations?

The evidence is substantial. Companies in the top quartile for ethnic and cultural diversity are 33% more likely to outperform peers. Organizations with inclusive cultures are six times more likely to be innovative and agile and twice as likely to meet financial targets. For life sciences specifically, diverse scientific teams generate broader perspectives and more innovative solutions across complex therapeutic problems.

4. How does organizational DEI commitment connect to clinical trial diversity outcomes?

Clinical trial diversity is not separable from broader organizational inclusion. Research shows that the diversity of study teams is directly associated with the diversity of participants enrolled at trial sites, and that communities are more likely to engage with research teams that reflect their own backgrounds. Companies with diverse leadership and inclusive cultures consistently outperform peers in execution and innovation, creating the structural conditions that support equitable research. As the evidence base shows, corporate DEI programs establish the accountability structures that make meaningful trial diversity possible at the operational level.

5. What does meaningful accountability for clinical trial diversity look like inside a sponsor organization?

At Merck, accountability means tracking diversity action plans against specific goals, evaluating tactics periodically, and holding strategy meetings focused on performance. As Adrelia Allen, executive director of clinical trial patient diversity at Merck, described in a recent interview with Applied Clinical Trials:

"The accountability is also inclusive of those communities—how are we reaching out, hearing the voice of the community, and partnering alongside them? Not just showing up when there's a clinical trial, but are we present in those communities before there's a need to enroll participants?"

Representation is embedded in trial execution from pre-planning through last patient in, not treated as a program with a start and end date.

6. What is the Let's Talk Trials initiative and what problem was it designed to solve?

Let's Talk Trials is an initiative designed to close the gap between community interest in clinical trials and access to information about them. As Allen explained: "It still remains a mystery for many communities to have access to the information—and even to know where a clinical trial exists in their community." The campaign addresses myths, explains participant rights and informed consent, and directs people to ClinicalTrials.gov to find local studies.

7. Why is trust such a persistent barrier to diverse enrollment, and how is the industry addressing it?

Historical inequities in medical research continue to shape community attitudes toward clinical trials, particularly among Black and Hispanic populations. Rebuilding trust requires acknowledging that history, explaining the protections in place today, and maintaining sustained community presence rather than appearing only when a trial needs participants. Surveys consistently show that Black participants are interested in clinical trials; the barrier is often simply that they were never asked.

8. What has emerged as the most effective community engagement strategy for improving representation?

Sustained, boots-on-the-ground presence in communities consistently outperforms digital campaigns as a primary lever for diverse enrollment. In a panel discussion at the 2026 SCOPE Summit, Angel Akinbinu, director, trial equity & representation, Takeda described the shift:

"Community engagement has been a buzzword that whole time, but it's really leaning into it. What I mean by that is not just the digital campaigns—even though that's great and there's a place for it—but really, boots on the ground, actually showing up in communities."

Customization matters equally. As moderator Bianca Green, clinical program diversity head, UCB noted, "You have to be nimble, and you have to be able to customize the solutions that you come up with."

9. What structural changes to protocol design and site selection are making the most difference?

Intentional site selection in underrepresented communities, review of inclusion and exclusion criteria for unintended barriers, and protocol adjustments that account for social determinants of health are among the highest-impact operational changes.

Allen described Merck's approach as beginning before protocol design: understanding disease epidemiology, identifying barriers specific to affected demographic groups, and building representation strategies from the earliest planning stages.

In the SCOPE panel discussion, Natanya Candelario, senior director, inclusive research, Bristol Myers Squibb, highlighted the opportunity in trial-naive sites: "There's an opportunity in that light, not just for sponsors to consider providing guidance or investing in those trial-naive sites, but then also recognizing that the community needs to be part of this conversation."

10. What will most determine whether the industry makes meaningful progress on diversity over the next five years?

Sustained focus, cross-sector collaboration, and a refusal to treat representation as optional are the conditions most likely to drive progress. Allen framed the long-term goal clearly: "We're not going to be able to turn this ship overnight—it's the slow and steady strokes that we make, continuing to remain focused and intentional and building representation into how we execute our trials."

Progress on clinical trial diversity is real but fragile, and the current political environment is introducing new hesitancy at precisely the moment when momentum matters most. The sponsors making the most meaningful advances share a common approach: they treat representation as a scientific and operational standard built into every stage of trial design, not a program to be launched and concluded. Sustaining that approach, amid external pressure and internal competing priorities, is the defining challenge for the industry in the years ahead.

This FAQ article is based on three previous pieces of Applied Clinical Trials content:

The Business Case for DEI in Pharmaceutical Innovation: Why Organizational Commitment Matters for Inclusive Clinical Trials

Building Trust, Not Just Enrollment: Q&A with Adrelia Allen, Merck

SCOPE Summit 2026 Panel Discussion: Diversity in Clinical Trials—What’s Working, What’s Next