Investing in women’s health is investing in their lives
Gates’ archive
When I was a pediatrician in my native Karachi, Pakistan, I treated so many babies who were born prematurely due to pre-eclampsia. They fit in the palm of my hand, their little breasts working hard to breathe. We couldn’t always save them.
Pregnancy risks such as preeclampsia are a black box. We still do not know the cause of preeclampsia, or how to avoid premature birth more generally. This lack of knowledge contributes to maternal and newborn deaths around the world – every day more than 700 women and 6,500 newborns die from pregnancy and birth complications. The toll is highest in sub-Saharan Africa and South Asia, often due to strained health systems, unequal access to care, extreme poverty and poor infrastructure.
There is a shocking knowledge gap across almost all women’s health issues, including menopause – the fact that women feel unwell for as long as 10 years seems so normal that it’s barely even understood by doctors and researchers as a problem. This is not because the science is too difficult, but because of a prevailing sense of indifference. Discouraging women’s experiences of their own bodies has shaped what is studied and what is overlooked. When a problem is treated as unnoticeable rather than unacceptable, finding solutions will never be a priority.
Less than 1 percent of health research and innovation goes into women’s health conditions, if we exclude cancer. As a result of this and the fact that fewer women are included in clinical trials, there is a long list of fundamental questions about women’s health that researchers have yet to properly study. We know that heart disease, the leading cause of death in women worldwide, presents differently in women, but we don’t know why. We know how drugs enter the brain, for example, but not how they enter the female reproductive system. This is not the case for men – for example, we know a lot about the effects of Viagra.
Glimpses of hope
Things are starting to – slowly – change, and I’ve noticed glimmers of hope in recent years. At conferences and round table meetings I have attended on topics from global health to health innovation, there are serious conversations between serious people about the need to invest in women’s health. I see policymakers and investors not only recognizing the size of the problem, but also the potential windfall that can come from addressing it after decades of underinvestment.
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When a problem is treated as unnoticeable rather than unacceptable, finding solutions will never be a priority
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But acknowledging the problem doesn’t solve it. We need to start investing the resources and attention needed to address the breadth and complexity of the challenges facing women’s health as soon as possible.
What excites me is the incredible potential for advanced research, tools and products. An excellent example of a potential area of research is the vaginal microbiome, which describes the mix of good and sometimes bad bacteria that live in the vagina. The world began to study it seriously only a decade ago.
Now, my team at the Gates Foundation is supporting research to understand how the vaginal microbiome affects pregnancy outcomes such as preterm birth, along with women’s susceptibility to HIV and other sexually transmitted infections. We are still in the early stages of discovery, but we can already see the contours of exciting innovations that could help millions of women.
For example, interventions that would help good bacteria become and remain dominant in the vagina could prevent STDs. They can also treat bacterial vaginosis, a common infection that is mild on its own but can lead to serious pregnancy complications, including preterm birth, and increase the risk of conditions such as pelvic inflammatory disease and postpartum endometriosis, which can lead to chronic pain and even infertility.
Last year, the Gates Foundation committed $2.5 billion to women’s health innovation, but it’s still not enough. We need partners across the public and private sectors around the world to step up too. For the UK, this moment offers a chance to lead, build on its record of health innovation, help people at home and around the world lead healthier lives, and strengthen one of its most dynamic and economically important industries.
Investing in women’s health is investing in their lives and livelihoods. Women simply cannot do well if they cannot feel well. When women are healthy, they are more creative at work, more present in the family and more active in society. That’s basically true. This International Women’s Day, let’s also make it true in reality, by continuing to remind those in power that women’s health is important, and that now is the time to commit the resources.
Anita Zaidi is president of gender equality at the Gates Foundation
