Biden’s  billion for women’s health should be just the beginning
Biden’s  billion for women’s health should be just the beginning

On Monday, President Joe Biden signed an executive order that will create a $12 billion fund to improve our understanding of — and ideally, treatments for — women’s health. This is a welcome, if extremely overdue, investment by the US government. And while that sounds like a lot, there’s a lot to catch up on.

For example, one analysis found that conditions that predominantly affect women, such as migraines, headaches, endometriosis, anxiety disorders and chronic fatigue syndrome, are severely underfunded compared to conditions that predominantly affect men.

Researchers call this the health gap, and it has serious social and economic implications: A recent McKinsey & Company report found that reducing the time women spend in poor health by 25% could cost $1 trillion, largely because health disparities disproportionately affect women during their working years.

The funds made available by this executive order, which covers a wide range of agencies and areas of health care, are beginning to address the problem. The next step will be for Congress to approve Biden’s larger 2025 budget, thereby funding the order. The ultimate test will be whether basic research in women’s health can attract more interest from an industry that has not paid enough attention to the field.

“I hope we are at the beginning of a fundamental shift in recognizing the importance of this much-needed funding and research,” said Lisa Larkin, president of The Menopause Society. “It’s not enough yet, but I’m really excited.”

A recent RAND Corporation report commissioned by the nonprofit WHAM (Women’s Health Access Matters) found that a relatively small investment in studying women and Alzheimer’s disease, cardiovascular disease, and rheumatoid arthritis would yield economic and societal dividends, says WHAM President Laurie Frank. Doubling the modest portion of research dollars directed at women under these three conditions—an investment that would amount to about $300 million—could increase life expectancy and productive time in the workforce while saving society about $13 billion. calculated in the report.

Notably, Biden’s women’s health initiative pays special attention to midlife, an area where the health disparity feels most critical. “The most important time for me to evaluate a woman is between 40 and 60,” Larkin says, and yet that’s when they’re most often lost in the health care system. They are of reproductive age and have not yet presented with symptoms of serious illness. But that’s when the first signs of serious illnesses begin to appear. The lack of good, evidence-based information and supportive care from the medical community has led many women to seek answers on their own.

Companies are more than happy to fill the void. But that means that instead of evidence-based care, we get menopause home tests that most experts believe aren’t actually helpful. Instead of clear guidance and support on HRT, we get meager supplements from Drew Barrymore. Instead of sensible sexual health advice, we get Gwyneth Paltrow’s jade eggs.

Yes, there are reasons to be hopeful about women’s health. The past year has brought several major breakthroughs, including a new treatment for postpartum depression, the first drug for menopause-related hot flashes, and a rare biotech startup focused on treating preeclampsia. There is a palpable sense among physicians focused on women’s health that momentum is building around conditions that have been ignored for too long. Biden’s $12 billion can build on that success.

But forgive me if my excitement is tempered by deep disappointment given the long history of neglect. When I look around at what’s happening in the rest of the biomedical universe—like the deep investments that have led to amazing new technologies like Crispr or that have changed the course of some cancers—you might feel like I’m celebrating getting crumbs from a three-tiered cake.

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