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Closing the Women’s Health Gap: A $1 TrillionOpportunity to ImproveLives and Economies

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Closing the Women’s Health Gap: A $1 TrillionOpportunity to ImproveLives and Economies

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Health Gap: A $1 Trillion

Opportunity to Improve

Lives and Economies

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Over the past two centuries, the rise in life expectancy-for both men and women-has been a tremendous success story. Global life expectancy increased from 30 years to 73 years between 1800 and 2018. But this is not the full picture. Women spend more of their lives in poor health and with degrees of disability (the "health span" rather than the "life span"). A woman will spend an average of nine years in poor health, which affects her ability to be present and/or productive at home, in the workforce, and in the community and reduces her earning potential (see sidebar "Terminology used in this report").

Critically, better health is correlated with economic prosperity. The women's health gap equates to 75 million years of life lost due to poor health or early death per year (Exhibit 1), the equivalent of seven days per woman per year. Addressing the gap could generate the equivalent impact of 137 million women accessing full-time positions by 2040. This has the potential to lift women out of poverty and allow more women to provide for themselves and their families. Addressing the drivers of this gap-namely, lower effectiveness of treatments for women, worse care delivery, and lack of data-would require substantial investment but also reflect new market opportunities.

While improving women's health has positive economic outcomes, it is foremost an issue of health equity and inclusivity. Addressing the women's health gap could improve the quality of life for women, as well as creating positive ripples in society, such as improving future generations' health and boosting healthy aging.

The challenges women face when seeking healthcare play out in multiple different ways and in different diseases and sectors of society. In terms of the potential economic impact of addressing these challenges, all age groups and geographies could benefit, with most of the potential coming from women of working age (Exhibit 2).

Embracing the full definition of women's health

Women are most likely to be affected by a sex-specific condition between the ages of 15 and 50. Other conditions occur throughout women's lives, but nearly half of the health burden affects women in their working years, which often has an impact on their ability to earn money and support themselves and their families (Exhibit 4).

Health equity encompasses access to the interventions and options that are right for each individual, regardless of their gender, sex, sexual identity, sexual orientation, age, race, ethnicity, religion, disability, education, income level, or any other distinguishing characteristic. For women, this can start with a better understanding of and access to interventions that lead to the best outcomes.

How to read this report

The analysis presented in this report includes an assessment of the health burden associated with the women's health gap as measured in potential years of healthy life. This health improvement potential was then translated to economic potential, measured as contribution to gross domestic product (GDP). Sections 2 through 4 of this report focus on health improvement potential (measured in DALYs), broken down by three root causes related to disparities in science, data, and care delivery. The economic value of this combined health improvement potential is presented in section 6, where economic impact is measured in terms of additional GDP.

While this report focuses on the potential economic benefits of closing the women's health gap, there is also a moral imperative to close the women's health gap and to improve the lives of millions of women worldwide.

Effectiveness of and access to medical therapies may vary

There are well-known cases where women and men experience important differences in the uptake or effectiveness of a medicine designed and approved for use in both sexes. This is true, for example, for some therapies used in asthma and cardiovascular disease. Analysts looked at 183 of the most widely used interventions across 64 health conditions representing roughly 90 percent of the health burden for women, reviewing more than 650 academic papers, to assess the extent of this phenomenon. Of the interventions studied 50 percent reported sex-disaggregated data. In cases where sex-disaggregated data was available, 64 percent of the interventions studied were found to put women at a disadvantage due to lower efficacy, more limited access, or both, while for men this was the case only for 10 percent of interventions (Exhibit 5).

Examples include:

Asthma is a common respiratory condition affecting men and women at similar prevalence rates. Acute asthma exacerbations present as symptoms such as shortness of breath, wheezing, cough, or chest tightness. A mainstay of treatment is inhaler therapy with bronchodilators and corticosteroids, but studies indicate that this treatment is around 20 percentage points less effective in reducing exacerbations in women than in men.

Cardiovascular and cerebrovascular disease-particularly ischemic heart disease and stroke-is the biggest single contributor to disease burden globally for both men and women, accounting for 16 percent of DALYs globally for men and 14 percent for women. One German study found that, despite identical technical success of a percutaneous cardiac intervention for men and women, the age-adjusted risk of death or of cardiac events was 20 percent higher in women than in men.

Research in women's health primarily focuses on diseases with high mortality, overlooking diseases leading to disability

One way to assess research priorities is through pipeline assets. There is up to a tenfold higher volume of new therapies in development for some of the most common women's cancers compared with debilitating gynecological conditions (Exhibit 6). One possible reason is the higher mortality rate of oncologic conditions. The solution is not to trim cancer funding, but to recognize the possibilities for advances in research related to other women's health conditions-in particular, menopause, premenstrual syndrome, endometriosis, and polycystic ovary syndrome.

In all, when tackling women's health, the solution is not to divide more slices of one pie: it's to make more pie.

How the lack of sex- and gender-specific data and research affects safety

The research conducted indicates that systematic lack of disease understanding created a women's health gap of 40 million to 45 million DALYs per year, or four days per woman per year. This is equivalent to around 60 percent of the total gap due to sex-related biology differences (see Exhibit 1 above). This estimate includes the known gap for conditions that affect both sexes and an estimate of the gap represented by the average lower effectiveness for women-specific conditions relative to men. It also includes the "unknown" gap: this is where no sex-disaggregated evidence is available for specific conditions that could, if evidence existed, potentially demonstrate levels of effectiveness difference comparable to conditions where sex-based analysis is available. The longevity of women cannot explain the disparity, and the effectiveness gap has a disproportionate impact on women and girls between ten and 40 years old and in certain regions (Latin America and Central Asia).

Shining a light on the interventions for which this information was not reported would benefit both men and women by enabling innovators to develop interventions that are better suited for specific subpopulations.

Gaps exist across the data value chain

Stage 1: Pre-data generation

The data gap starts at the very definition of women's health. There is a lack of consistent and aligned definitions and measurement scales for conditions and symptoms affecting women. For example, definitions of health-related burden associated with menopause or menstrual syndromes differ, and pain instruments and scales lack consistency.

Stage 2: Data generation

Stage 3: Data aggregation

Stage 4: Data analysis

Women can face barriers to timely and accurate diagnosis

Gaps in understanding the effectiveness of health interventions

Ensuring sex-differentiated results

Representative clinical studies capable of producing stratified results may involve larger and longer clinical trials, increasing costs and extending time to market. However, the results would likely lead to more effective interventions with higher uptake among patients. The risk/reward equation for investors becomes more balanced if payers (governments, insurers, and patients) and regulators insist on evidence for cohort-specific impact.

Today, some conditions, such as leukemia and meningitis, are believed to affect men and women equally. But the research to identify potential differences is lacking. Stakeholders may explore how a systematic and proactive approach to designing and reporting clinical outcomes could take sex and gender into account.

Inequalities exist throughout the full pathway of care

The care pathway runs from awareness of a health issue to access to services and preventive care, timely and accurate diagnosis and effective treatment and follow-up. At each segment of this pathway, inequalities exist, especially for women who are disadvantaged in ways beyond their gender (see sidebar "Intersectionality and health outcomes").

Awareness and prevention

The importance of increasing awareness goes beyond patients. Many doctors are unaware of how diseases can affect or manifest differently in women, so they are unable to provide proper care to many patients.

Accessibility and affordability of care

Timely diagnosis

Choice of treatment

Creating solutions to tackle care disparities

Overall, the gap in care delivery contributes 34 percent to the women's health gap (see Exhibit 1 above). Consider how sex- and gender-appropriate care delivery could reduce the women's health burden by 25 million DALYs per year globally, corresponding to 2.5 days per woman per year.

Improvements in the diagnostic tools available would represent a major step forward for patients. Yet even without innovative tools, it would be possible to improve care and bridge the gaps in diagnosis with more consistent and standardized screening and data collection. Earlier diagnosis and a more holistic, patient-centric treatment approach could help improve disease and symptom management, prevent uncontrolled progression and resulting complications, and reduce unnecessary treatments.

At a global level, AI, unbiased data sets, and interoperable electronic records are potential options for enhancing care delivery. Ultimately, a combination of innovation, investment, and ability to scale could unlock better care delivery solutions for women.

There has been a historical underinvestment in women's health research from the public, social, and private sectors. Funding sources typically overlook the fact that many conditions manifest differently in each sex, creating variances in outcome.

Closing the health gap will require increased investment not only for understanding sex-based differences but also for addressing unmet needs in women's health. Further, additional funding and new business models could support sex- and gender-appropriate care.

Research funding neglects women's health

Private equity/venture capital investors are increasing investments in women's health, with excitement about digital health solutions

Given the large unmet need and resulting opportunity, those who continue to forgo investing in women's health may find themselves left behind by the players that tap into this high-potential market.

The disparities in women's health affect not only women's quality of life but also their economic participation and ability to earn a living for themselves and their families. Health is intricately linked to economic productivity, prospects for prosperity, and contribution to economic output. Economic growth over the past 70 years has been closely tied to women's increased labor force participation. Therefore, it is not surprising that the gap in women's health results in lost economic potential.

Addressing the health gap women face could boost the global economy by adding at least $1 trillion to the global economy by 2040. This means a 1.7 percent increase in the average per capita GDP generated by women.

Women's economic participation has been and will be a major driver of economic growth

Addressing the gap could generate the equivalent impact of 137 million women accessing full-time positions by 2040. This would enable women to secure an income to support themselves and their families and has the potential to lift more women out of poverty.

Better health often enables individuals to work more effectively

Looking at the different channels affecting GDP, the largest impact, amounting to around $400 billion or avoiding 24 million years with disability, would be created through fewer health conditions (Exhibit 9). Expanded participation and increased productivity could each contribute more than 20 percent of total impact.

Treating ten health conditions would contribute more than half of the economic impact

The conditions having the greatest economic impact in different countries will differ from one geographic region to another based on each region's disease burden and healthcare status. The examination of economic impact, rather than DALY impact, gives more weight to conditions that affect people during years of working age, as that is when economic contribution is highest. Conditions such as ischemic heart disease may affect more people, but if the burden of morbidity and premature mortality happens after the usual age of retirement, the economic impact is more limited.

Generally, a reduction in health conditions is tied to a woman's economic potential, with allowances for regional socioeconomic and healthcare factors (Exhibit 11). The top two conditions by contribution to GDP impact of the women's health gap are always a combination of two of the top four global conditions: PMS, depression, migraine, or other gynecological conditions. Larger differences among regions are observed when looking at the top ten or more conditions.

Across the four channels, the highest GDP impact relative to women's GDP is observed in HICs and LICs (Exhibit 12). For LICs, most of the impact comes from fewer early deaths and fewer health conditions. Both upper-middle-income (UMIC) and lower-middle-income (LMIC) regions exhibit an overall lower projected GDP impact.

Investing in women's health shows positive return on investment (ROI): for every $1 invested, approximately $3 is projected in economic growth

The expected economic return varies by region. The ROI is greatest in higher-income settings, where it is around $3.50 returned for every $1 invested. More investment is probably needed in some LICs to establish the basic health infrastructure required to support low-cost delivery of high-quality health services, as well as to create better and more rewarding economic opportunities for women. Still, the analysis indicates that the overall benefit would exceed the costs even in these settings, at a rate of around $2 returned on $1 invested.

The analysis examines only the direct costs of addressing the gaps in care delivery identified. In the longer term, a range of greater positive returns is possible, given that improvement in the lives of women influences the health and resilience of their families and communities.

Where to start tackling the women's health gap to reap the greatest benefit for all

Globally, the top ten conditions by economic impact account for more than 50 percent of the total GDP impact. This highlights areas with high unmet needs and potential, aiding decision makers in prioritizing efforts to address health disparities. Specific conditions and their socioeconomic contexts vary among regions, influencing their contribution to the economy. This information could guide tailored strategies toward health equity.

The content and sequence of each action will need to be tailored to regional conditions. Building on the knowledge developed throughout this report, a fact-based strategic assessment can lead to better health equity for each country.

As noted in this report, women's health has been under-researched, and women face different challenges from men in affordability and access to treatment. This health gap creates unnecessary suffering and preventable economic losses.

It does not have to be this way. Through collaborative efforts on five fronts, a more equitable and healthy future is possible. There is an opportunity to close the women's health gap by (1) investing in women-centric R&D, (2) strengthening the collection and analysis of sex- and gender-disaggregated data, (3) enhancing access to gender-specific care, (4) encouraging investments in women's health innovation, and (5) examining business policies to support women.

Invest in women-centric research to fill the knowledge and data gaps in women-specific conditions, as well as in diseases affecting women differently and/or disproportionately

The women's health gap could be narrowed by increasing funding to achieve equality with investments in funding for men's health and using protocols that set standards of equity and diversity. Scientists, life science companies (pharma, biotech, medtech), healthcare providers, and others in the healthcare ecosystem may consider how the traditional understanding of disease is focused primarily on the male body. A more in-depth understanding of these differences would enable more effective care interventions and improved health outcomes. One example of venture-capital-backed funding addressing this disparity is Repro Grants, which allots up to $100,000 for research projects aimed at deepening understanding of female reproductive biology.

For conditions that affect women differently or disproportionately, more effective interventions start with clinical trials designed with inclusivity at their core, informed by preclinical research using female animal models. Specifically, there should be stronger diversity, equity, and inclusion guidelines for clinical trial design. Guidance could incorporate male versus female disease prevalence mix and use sex-specific thresholds for biomarkers to yield an adequate patient representation in clinical trials.

Systematically collect and analyze sex-, ethnicity-, and gender-specific data to have more accurate representation of women's health burden and the impact of different interventions

The prevalence of conditions such as endometriosis and menopause is underestimated, leading investors and life science companies to underestimate the market potential of these conditions and underinvest. By accurately assessing and reporting on the prevalence of such conditions, national health institutes and other authorities may direct additional funding to the research and treatment of these underserved conditions.

Biotech, medtech, and FemTech enterprises also have exciting opportunities related to AI and ML, which ensures that these models do not exacerbate existing biases or violate patient privacy rules. Developing robust, secure, and holistic data sets could enable companies to differentiate in an overcrowded marketplace.

Enhance access to gender-specific care, from prevention to diagnosis and treatment

Women deserve the same high-quality level of care from their healthcare providers as men, which doesn't mean the same care per se. There is a pressing need to redesign medical curricula as well as residency and fellowships to reflect sex and gender differences. In addition to medical schools, continuing medical education organizations and credentialing entities could assess whether healthcare providers are receiving the latest information and training on the women's health gap and sex- and gender-based differences. Current and future healthcare professionals of all specialties must be equipped with accurate and updated knowledge of biological differences, including sex-specific manifestations of symptoms. Future certification or tests could include questions meant to address whether providers have internalized this knowledge.

Governments, educational bodies, philanthropic institutions, and many other stakeholders can use this moment to raise awareness of the sex-specific manifestations of disease-for example, ensuring that newly diagnosed endometriosis patients have access to up-to-date resources, including which trials they could potentially participate in. Healthcare entities, philanthropic organizations, or community health workers could start or reinvigorate in-person support groups for conditions such as endometriosis or menopause or for mental health support. Collectively, better education and resources, plus new diagnostics, are among the ways to potentially elevate the quality of healthcare women receive.

In addition, two things to enable closing the gap include:

Create incentives for new financing models to close the women's health gap

Historically, given lower levers of investments overall for women's health under the traditional financing model schemes, new financing models have a critical role to play. These models can accelerate innovation. One example is the advance market commitment (AMC) geared to COVID-19 vaccine development and deployment.

Research and reliable data on the women's health landscape can help spur investment. For investors, the gender-based healthcare landscape presents a mosaic of unexplored opportunities. By pivoting toward this opportunity, investors can channel funds into high-impact areas, bridge the data gap, and enable more investment and innovation.

Governments could explore policies that encourage sex- and gender-responsive health research and services-for example, by earmarking funds, providing tax incentives, lowering application fees, and expediting the drug approval process. Philanthropic organizations, donors, and international bodies could offer grants and prizes at a national or local level to spur innovation while supporting capacity building in regions where gender-based health disparities are highest. Examples might be launching a grant or award program geared toward reducing rates of respiratory illnesses in areas where there is a high percentage of women smokers, or toward a technology-based solution for women in vulnerable populations to access transportation to healthcare services.

With collaboration, stakeholders have the potential to encourage investments and inspire the development of innovative financing models in women's health.

Establish business policies that support women's health

Data-driven, scalable actions to improve women's health may vary widely, but the critical component is to determine how each stakeholder can contribute to narrowing the gap.

If health equity efforts sit within a tree of principles, they can be watered by research, flourish in the sun of business investments, and grow far-reaching branches that stretch into the economy.

Achieving health equity is a collaborative and ongoing endeavor that relies on the active participation of governments, healthcare institutions, nongovernmental organizations, individuals, and all stakeholders vested in this cause. Tackling the women's health gap depends on addressing the interconnected factors outlined in this report: the deficit of women-specific knowledge in science, the glaring data gaps, the disparities in healthcare delivery, and the insufficient investment in women's health.

Recognizing the vast potential to improve the lives and livelihoods of half the global population while boosting the economy serves as the catalyst for closing the women's health gap. Every facet of this gap, from limited education to suboptimal treatments, offers an opportunity for transformation with the active involvement of governments, life science innovators, educational institutions, philanthropists, activists, and more.

In this endeavor lies an opportunity of $1 trillion in economic potential driven by improved women's health and economic participation. The question is not whether this wealth of opportunities exists but rather who will take the initiative to seize it and drive change.

Women's health is not a stand-alone issue; it is a cornerstone of societal well-being and progress. Better health and well-being for women creates a ripple effect that extends to families, communities, and nations. This holistic approach, supported by collective action and sustained investment, will not only narrow the health gap but also contribute to the betterment of a shared global future.

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Closing the women's health gap: A $1 trillion opportunity to improve lives and economies

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Investments addressing the women's health gap could add years to life and life to years-and potentially boost the global economy by $1 trillion annually by 2040.

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The International Agency for Research on Cancer (IARC)

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The Global Cancer Observatory (GCO) is an interactive web-based platform presenting global cancer statistics to inform cancer control and research.

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The Future of Jobs Report 2023 explores how jobs and skills will evolve over the next five years. This fourth edition of the series continues the analysis of employer expectations to provide new insights on how socio-economic and technology trends will shape the workplace of the future.

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A Fundação do Câncer apresenta a sua publicação info.oncollect, um boletim periódico sobre o câncer no Brasil. Através de dados, análises e discussões mostraremos um retrato epidemiológico da doença em nosso país.

Esta publicação vem se juntar a outros esforços da Fundação do Câncer para alertar a sociedade e orientar profissionais sobre a importância da prevenção e do combate ao câncer em nosso país.

A cada edição, enfocaremos um novo tema para que todos tenham acesso a informações relevantes, com potencial para subsidiar políticas para o enfrentamento do problema.
" Volume Nº 4 - O impacto do HPV em diferentes tipos de câncer no Brasil " Volume N° 3 - Um olhar sobre o diagnóstico do câncer do colo do útero no Brasil " Volume N° 2 - Um panorama da vacinação contra o HPV no Brasil " Volume N° 1 - Um retrato do câncer de colo do útero no Brasil

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A Fundação do Câncer apresenta a sua publicação info.oncollect, um boletim periódico sobre o câncer no Brasil. Através de dados, análises e discussões mostraremos um retrato epidemiológico da doença em nosso país. Esta publicação vem se juntar a outros esforços da Fundação do Câncer para alertar a sociedade e orientar profissionais sobre a importância da prevenção e do combate ao câncer em nosso país.

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O Atlas de Mortalidade por Câncer tem como uma de suas principais finalidades auxiliar os profissionais de saúde pública na determinação de prioridades necessárias à prevenção e ao controle do câncer.

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O Atlas de Mortalidade por Câncer tem como uma de suas principais finalidades auxiliar os profissionais de saúde pública na determinação de prioridades necessárias à prevenção e ao controle do câncer. Para melhor visualização recomendamos estes navegadores abaixo: Clique aqui para baixar a ultima versão do Internet Explorer.

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An ambitious 10-year action plan to achieve equitable access to quality cancer care in Canada and ensure a sustainable system for the future

View your jurisdiction's progress towards the cancer strategy priorities

View progress

How is the Strategy helping me and those I care about?

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Cancer Strategy - Canadian Partnership Against Cancer

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Le Partenariat canadien contre le cancer a publié la version actualisée de la Stratégie canadienne de lutte contre le cancer - une feuille de route sur 10 ans visant à améliorer l'équité au sein du système de lutte contre le cancer et à soutenir ceux qui ont le plus besoin d'aide, tout en se concentrant sur la mise en place d'un système de santé durable pour l'avenir.

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nationalcancerplan - National Cancer Institute

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The President's Cancer Panel monitors progress toward the goals of the National Cancer Plan.

We know that our continued progress against cancer is the direct result of advances made possible by investment from federal, state, and local governments, along with private investment, and by the sustained efforts of researchers around the world and millions of people with cancer, their caregivers, and advocates.

Building on these tremendous efforts and to realize the vision laid out by President Biden and First Lady Biden as part of the Cancer Moonshot℠, the National Cancer Plan provides a framework for everyone-across the federal government and all of society-to collaborate in ending cancer as we know it.

What's in the National Cancer Plan?

The plan has three elements:

Eight goals that we must achieve to prevent cancer, reduce deaths from cancer, and ensure the best possible quality of life for people living with cancer

A set of strategies associated with each goal, describing essential research and other activities needed to maximize benefits for everyone

A call to action that is also at the center of the Cancer Moonshot: that everyone-every organization and individual-do their part to help end cancer as we know it

Importantly, this plan is a living document that will evolve over time as research continues, advances are made, and lessons are learned across the cancer care community.

How does the National Cancer Plan relate to the Cancer Moonshot?

The plan outlines goals designed to support the aims of the Cancer Moonshot and provides a framework for ways to meaningfully contribute to achieving these goals. Projects currently under way as part of Cancer Moonshot are featured through the plan and connected to other cancer research efforts.

The plan considers the entire landscape of cancer in the United States and is a foundational effort to align the cancer research and care community in the fight against cancer. Just as the White House has invited people far and wide to share their stories and actions, so too will the National Cancer Institute (NCI) be calling on everyone to share what they are doing to meet the goals of the National Cancer Plan.

Why is now a good time for the National Cancer Plan?

The National Cancer Act of 1971 gave broad authority to the director of NCI to develop a National Cancer Program to include NCI, other components of the National Institutes of Health, and other federal and nonfederal cancer programs. More than 50 years later, this program has come to represent a far more complex ecosystem of people from across the cancer community working to create a world where cancer does not significantly impact someone's life.

NCI stands ready to collaborate across the federal government and beyond to accomplish more together than we can separately. With unprecedented scientific opportunities, passion, and commitment from diverse areas of our society, the time is right for a comprehensive National Cancer Plan to advance the National Cancer Program and demonstrate international leadership in meeting the global challenge to reduce the impact of cancer.
"The National Cancer Plan represents a commitment to achieving a society where most cancers are prevented and where every person diagnosed with cancer lives a full and active life." -NCI Director Monica M. Bertagnolli, M.D.

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Learn about what's in the National Cancer Plan and why it's needed.

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The NHS Long Term Plan (LTP) was published in January 2019. It sets out stretching ambitions and commitments to improve cancer outcomes and services in England over the next ten years.

The key ambitions in the NHS LTP for cancer are:

by 2028, 55,000 more people each year will survive their cancer for five years or more; and

by 2028, 75% of people with cancer will be diagnosed at an early stage (stage one or two).

The ambitions will be delivered in a way that:

improves quality of life outcomes;

improves patient experience outcomes;

reduces variation; and

reduces inequalities

The NHS Cancer Programme is responsible for delivering on the LTP for cancer. The LTP ambitions build on and accelerate the significant progress already made through delivery of the recommendations of the Independent Cancer Taskforce published in 2015. You can read more about the we've made to deliver the Taskforce's recommendations in our progress reports.

You can also read the NHS Cancer Programme's latest update report which sets out the key achievements from October 2019 to January 2020 in delivering the NHS Long Term Plan for cancer.

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The NHS Long Term Plan (LTP) was published in January 2019. It sets out stretching ambitions and commitments to improve cancer outcomes and services in England over the next ten years.