Our Nation’s Scientific and Medical Institutions Have Long Failed Women

The United States has enabled an inexcusable knowledge gap and dearth of innovation, which causes measurable harm.

By Jennifer Weiss-Wolf and Katy Brodsky Falco

Last week’s announcement of a $215 million contribution by Melinda French Gates in support of women’s health couldn’t have come at a more urgent moment, especially considering that June 10 was Equal Research Day, marking the anniversary of the day in 1993 when women were finally required to be included in clinical research. The Contrarian recently flagged that the Trump administration has slashed the number of grants funded by the National Institutes of Health (NIH) focused on women’s health — hardly a surprise given that words such as “women” and “gender” are now banned from funding proposals.

This is not just about attacks on DEI, though, nor is it solely a Trump-fueled crisis. No matter which party has been in charge, our nation’s scientific and medical institutions have long failed women. The United States has enabled an inexcusable knowledge gap and dearth of innovation, which causes measurable harm — starting with the reality that American women die from avoidable causes more than in any developed country.

Photo by Gizem Nikomedi on Unsplash

Maternal mortality rates in the United States are among the highest worldwide and exponentially worse for Black women. The majority of states have imposed some form of abortion ban and more than one in four prohibit the procedure altogether. Skyrocketing burnout rates among practicing OB-GYNs is contributing to a rise in healthcare deserts, especially in rural communities; over 2.3 million women of reproductive age in this country now live in an area with zero access to care.

But the gap goes far deeper than reproductive health. Our nation lags in overall commitment to preventing, treating, and curing diseases that affect women uniquely, disproportionately or differently than men, whether those be chronic conditions, genetic disorders, or infectious diseases.

Take cardiovascular disease, the No. 1 killer of women in the United States. A bit more than a third of patients enrolled in clinical trials are female. Just 4.5 percent of the National Institutes of Health’s coronary artery disease research budget focuses on women-only research; findings based on male subjects are extrapolated to women even though women bear a disproportionate burden of death and disability from heart disease. On average, women are diagnosed years later than men.

Nearly four in five autoimmune patients are women. The reason for such a high prevalence among women? Unknown. Answering this question would inform development of new treatments and therapeutics that could save millions of lives. Yet the commitment to research is negligible.

Typical drug dosages assigned to women are based on a man’s average weight and metabolism and derived from data from male-only drug trials, though women are at twice the risk for adverse drug reactions than men.

This is a shameful legacy of Democratic and Republican administrations alike. Did you know women were mostly excluded from federally funded clinical trials until, wait for it, 1993? (As the comedian Samantha Bee puts it in her one-woman show, How to Survive Menopause, that’s just one Justin Bieber lifetime ago.) In the decades since, no more than 8.8 percent of NIH grant spending has gone to women’s health research. Even as the agency’s overall funding increased, the allocation to women’s health decreased proportionately.

Commitments by the private sector are equally appalling. According to Deloitte, women’s health represents just 2 percent of the more than $41 billion in healthcare venture funding. About 2 percent of all charitable giving goes to nonprofit organizations focused on improving outcomes for women and girls.

It is time for a change. No doubt the federal landscape will continue to pose challenges under the Trump administration, but we must never take our eyes off the NIH prize, given that the agency is the largest funder of biomedical research in the world.

That said, we could be closer to closing the research gap than we realize — and doing so in a way that bypasses the standard pitfalls of venture and nonprofit models, which inevitably include conflicts of interest and notoriously slow timelines.

One of the authors of this column, Katy Brodsky Falco, is the founder and executive director of the Foundation for Women’s Health, which has developed a novel approach to leverage small philanthropic contributions for targeted grants with simpler processes, which are awarded to world-class scientists working only in the most underfunded areas of women’s health. No doubt, multi-million contributions from billionaires are a boon. But a six-figure tranche of funds can also be transformative if deployed to fund innovative research deemed too risky for commercial capital and then leveraged to efficiently develop better therapeutics and diagnostics for women. Ditto for using findings to improve training and professional licensing for doctors, who too often aren’t adequately educated to diagnose, let alone treat, women. This is exactly what the Foundation for Women’s Health is doing.

When it comes to women’s health and lives, now is definitely the time to think big — and that necessarily entails doing more with smaller dollars. Yes, we must press for equitable federal funding, which means voting for candidates who prioritize equity in public health and treating that commitment as non-negotiable. And yes, we must also lean on philanthropic leaders like Melinda French Gates to lead by example.

Ultimately, it means invoking every avenue of support to ease women’s burden of disease. It is well past time to end the era of sidelining and undermining women’s health, which we all should agree is a national disgrace.

Jennifer Weiss-Wolf is executive director of the Birnbaum Women’s Leadership Center at NYU School of Law. She also leads strategy and partnerships at Ms. Magazine. Katy Brodsky Falco is the founder and executive director of the Foundation for Women’s Health.

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