We must close the ‘shocking’ knowledge gap in women’s health

When I was a pediatrician in my hometown of Karachi, Pakistan, I treated many babies born too early due to preeclampsia. They fit in the palm of my hand, their little chests working hard to breathe. We couldn’t always save them.

Pregnancy risks like preeclampsia are a black box. We still don’t know the root cause of preeclampsia, or how to avoid premature birth more generally. This lack of knowledge contributes to maternal and neonatal deaths worldwide: every day, more than 700 women and 6,500 newborns die from complications related to pregnancy or childbirth. The toll is heaviest 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 gap in knowledge about almost all women’s health issues, including menopause – the fact that women feel bad for 10 years seems so normal that it is barely intelligible to doctors and researchers as a problem. This is not because the science is too hard, but because of a prevailing feeling of indifference. Neglecting women’s experiences of their own bodies has shaped what is studied and what is overlooked. When a problem is treated as trivial instead of unacceptable, finding solutions will never be a priority.

Less than 1 percent of health care research and innovation is devoted to women’s health issues, excluding cancers. As a result, and because fewer women are participating in clinical trials, there is a long list of fundamental questions about women’s health that researchers have yet to adequately study. We know that heart disease, the leading cause of death among women worldwide, manifests itself differently in women, but we don’t know why. For example, we know how drugs get into the brain, but we don’t know how they get into the female reproductive system. This is not the case for men – for example, we know a lot about the effects of Viagra.

Glimmers of hope

Things are – slowly – starting to change, and I have noticed glimmers of hope in recent years. At conferences and panel discussions I’ve participated in on topics ranging from global health to healthcare innovation, serious conversations are being had among serious people about the need to invest in women’s health. I see that policymakers and investors recognize not only the scale of the problem, but also the potential benefits that could result from a solution after decades of underinvestment.

But recognizing the problem doesn’t solve it. We must begin investing the resources and attention needed to address the scale 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. A great example of a potential area of ​​research is the vaginal microbiome, which describes the mix of good and sometimes bad bacteria living in the vagina. The world began to study it seriously only ten years ago.

Today, my team at the Gates Foundation supports research aimed at understanding how the vaginal microbiome affects pregnancy outcomes, such as premature birth, as well as women’s susceptibility to HIV and other sexually transmitted infections. We are still in the early discovery phase, but we can already see the outlines of exciting innovations that could help millions of women.

For example, interventions that help good bacteria become and remain dominant in the vagina could prevent STIs. They could also treat bacterial vaginosis, a common infection that is mild in itself but can lead to serious pregnancy complications, including premature 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 also need public and private sector partners from around the world. For the UK, this moment offers a chance to lead, building on its track record of health innovation, helping people at home and around the world live healthier lives and strengthening one of its most dynamic and economically important industries.

Investing in women’s health is investing in their lives and livelihoods. Women simply can’t succeed if they can’t do well. When women are healthy, they are more creative at work, more present in the family and more active in society. This is true in principle. This International Women’s Day, let’s make this reality too, by continuing to remind those in power that women’s health matters and now is the time to dedicate resources to it.

Anita Zaidi is Chair of Gender Equality at the Gates Foundation