Gender Gap in Healthcare: Why Women's Health Needs More Research

In an interaction with India Pharma Outlook, Vivek Soares, Country Lead, India and South Asia, Organon, discusses the progress and gaps in women’s healthcare, emphasizing the need for gender-specific research, improved access, policy reforms, and greater investment to address overlooked health conditions like PCOS. With over two decades of expertise in biopharma, Vivek Soares excels in business transformation, strategic partnerships, and market expansion. He has led high-impact teams across geographies, driving innovation in brand lifecycle management and operational efficiency at Organon, MSD, Wockhardt, and Bharat Serums & Vaccines.

What are the challenges in women's healthcare?

While significant progress has been made in medical research, a more comprehensive understanding of diverse physiologies, particularly regarding how diseases manifest and progress differently in women, remains an important area for development. Addressing this knowledge gap has the potential to improve diagnostic accuracy, treatment effectiveness, and overall understanding of critical areas in women's health. According to the World Health Organization (WHO), approximately 800 women die every day from preventable causes related to pregnancy and childbirth. This statistic underscores the opportunity for continued research and innovation to improve maternal health outcomes globally.

Specifically, for India, the challenge is multifold. Many women still lack basic knowledge about reproductive health and access to contraception and family planning services is limited, leading to unintended pregnancies and unsafe abortions. In addition, social norms, religious beliefs, and gender roles restrict women's access to healthcare, especially regarding reproductive health.

Despite these challenges, India has made significant strides in family planning. As one of the first countries to establish a National Family Planning Program in 1952, India has a long history of commitment to reproductive health. The policies and programs of the Indian Government are highly inclusive and progressive. In 2023, the country successfully stabilized the total fertility rate (TFR) at a replacement level of 2. This achievement is a testament to the government's efforts and the dedication of the development sector, which has been actively working to improve family planning solutions and raise awareness.

Despite women constituting 48% of India’s population, only 4% of medical research funding is allocated to women’s health. What systemic barriers continue to hinder gender-specific medical research advancements?

When it comes to the health and well-being of women, India has made continuous progress. For us, the ideal state for women’s health is where women have high levels of awareness, they are empowered to make choices and are actively seeking healthcare services.

When we invest in women’s health, we’re not only investing in individual women but their families and their communities, as well as their country’s economy and future. Research shows that:

• An estimated $300 million investment into research focused on women could yield a $13 billion economic return and lead to reduced healthcare costs, better quality of life, and years of productivity returned to the global workforce.

• For every $1 spent on improving access to family planning services, society yields $120 in health and economic benefits.

• Higher rates of maternal mortality and morbidity have significant negative effects on GDP through both medical costs as well as non-medical costs such as lost work time.

• Societies that prioritize women’s health show increased productivity across generations.

• If all women in low- and middle-income countries had access to contraceptives, unintended pregnancy would drop by 68% globally.

• Furthermore, data collection on women's health is often more complex. Consider the full spectrum of a woman's life –from menarche to menopause – each presenting unique physiological changes that require specific research methodologies. This complexity can be perceived as a barrier, leading to underinvestment.

Government health schemes rarely address gender-specific needs beyond maternal care. What policy changes are necessary to bridge this critical healthcare gap?

Over the years, the Government of India has made huge progress in improving the maternal mortality rate (MMR) and infant mortality rate (IMR). While the global rate of decline for MMR in the past 30 years — between 1990 and 2020 — has been 42%, the decline has been 83% for India. India has a strong foundation of public health programs dedicated to improving the health and well-being of its citizens. Programs like National Health Mission (NHM), and initiatives such as National Family Planning Program, Mission Parivar Vikas, have made significant strides in areas like family planning and maternal health.

However, women face a variety of other health challenges throughout their lives that often go unaddressed due to limited access to information, financial resources and participation in decision-making. Social and economic barriers disproportionately affect women's ability to access vital healthcare. Universal Health Coverage offers a pathway to bridge these gaps, ensuring equitable access to quality services for all women, regardless of their background. Through Ayushman Bharat, the Government of India is also moving towards universal Health Coverage, and I believe women will significantly benefit from these schemes. While progress has been made, a renewed focus on healthcare concerns specific to women, such as PCOS, anemia, infertility, nutrition-related issues, cardiovascular diseases, metabolic syndrome and diabetes among women.

Access to infertility treatments is an emerging public health issue. With changes in the age of marriage, education, and participation in the workforce, an overall demographic shift is expected. Increased access to fertility treatments in both the private and public sectors, coupled with wide awareness among men and women, is needed to ensure access to affordable treatments.

To bridge the healthcare gap, it is important that we expand insurance coverage for gender-specific preventive care and increase funding for women's health research beyond reproductive and maternal care. Apart from this, implementing workplace policies that address women's unique needs can also prove to be critical to bridge this gap.

The future of healthcare must be more gender-responsive. By making these policy changes, we're not just improving health outcomes; we're investing in a better future for women. The time for change is now, and we're ready to lead this transformation.

PCOS affects 1 in 5 Indian women, yet research funding remains disproportionately low. What factors contribute to this persistent disparity?

PCOS affects over a fourth of the Indian female population – roughly 25%, as you mentioned. Despite the burden, there is no conclusive treatment available for PCOS till date. The disparity is multi-faceted and stems from a complex interplay of factors:

Traditionally, public health programs in India, understandably, have been heavily focused on maternal and child health, infectious diseases, and communicable diseases. While crucial, this has often meant that chronic conditions like PCOS, which are perceived as less immediately life-threatening, receive less attention and funding. PCOS, while impacting fertility, metabolic health, and mental well-being, is often perceived as a "silent epidemic." Its symptoms can be varied and may not always be immediately debilitating, leading to a lower sense of urgency among policymakers and funding agencies.

Secondly, sexual and reproductive health (SRH) remains a taboo topic, particularly affecting young girls. This stigma creates a significant barrier, discouraging them from seeking timely medical help and information. Most women remain unaware of the serious long-term health outcomes associated with undiagnosed and inadequately managed PCOS. These include increased risk of type 2 diabetes, cardiovascular disease, infertility, and endometrial cancer.

The need of the hour is the development and accessibility of youth-friendly health services that provide confidential, non-judgmental, and comprehensive SRH information and care. These services should be designed to overcome the barriers created by stigma and taboo.

At Organon, we recognize the unmet needs in women's health, including PCOS. We are committed to supporting awareness campaigns and educational initiatives to empower women with knowledge about PCOS and encourage early diagnosis and management. We’re working to deliver new innovations that could one day become a potential treatment option for women.