Biden's $12 billion for women's health should be just the beginning

Last week, President Joe Biden signed an executive order creating a $12 billion fund to improve the understanding and, ideally, treatment of women's health. This is a welcome, if badly overdue investment by the US government. It seems like a huge amount, but there's a lot to do to keep up.

For example, one analysis found that diseases that overwhelmingly affect women, such as migraines, headaches, endometriosis, anxiety disorders, and chronic fatigue syndrome, receive significantly less funding than diseases that primarily affect men. It turned out to be missing. (Anyone who has been following the long coronavirus story knows that this symptom could easily be added to this list.)

Researchers call this “health disparity,” and it has serious social and economic implications. A recent report from McKinsey & Company found that reducing the time women spend in poor health by 25% could be worth $1 trillion. The main reason for this is that health disparities have a disproportionately severe impact. Women in active duty.

The funds allocated by this Executive Order will span a wide range of government agencies and the health sector to begin addressing this problem. The next step would be for Congress to approve Biden's larger 2025 budget, which would fund the order. The ultimate test will be whether basic research on women's health can garner more attention from industry, which has not paid enough attention to the field.

“My hope is that we are beginning to see a fundamental shift in awareness of the importance of this necessary funding and research,” says Lisa Larkin, president of the Menopause Society. “It’s not quite there yet, but I’m really looking forward to it.”

It's no secret that women have historically been at a disadvantage when it comes to medical research. For decades, women have been completely excluded from clinical trials. Although the National Institutes of Health is working to improve this situation, disparities remain.

A recent report commissioned by the nonprofit Women's Health Access Matters (WHAM) and released by the Rand Corporation found that relatively small investments in research on women and Alzheimer's disease, cardiovascular disease, and rheumatoid arthritis are economically viable. and social benefits, said WHAM President Lori. Frank. Doubling the modest portion of research funding focused on women under these three conditions would result in an investment of approximately $300 million, which would extend society's life expectancy and increase the productivity of the workforce. The report estimates that this could save approximately $13 billion in time.

Notably, Biden's women's health initiative pays special attention to midlife, when health disparities are most acutely felt. “For me, the most important time to evaluate a woman is between the ages of 40 and 60,” Larkin says, noting that this is the period when women are most marginalized in the health care system. They are past childbearing age but have not yet shown any symptoms of serious illness. But that's exactly when the first signs of serious illness begin to appear. For example, while men begin to show signs of heart disease in their 40s, many women are unaware that their risk for cardiovascular events, the number one cause of death for women in the United States, rises sharply in their 50s. do not have.

Midlife is also a time when many women fall prey to unproven and often expensive solutions due to the lack of clear information about menopause. A lack of proper evidence-backed information and supportive care from the medical community forces many women to seek answers on their own.

Companies are happy to fill the void. But that means receiving at-home menopause testing, which is not evidence-backed care and which most experts believe is not really helpful. Rather than clear guidelines or support regarding hormone replacement therapy, we're getting sketchy supplements from Drew Barrymore. Instead of sound advice about sexual health, we receive Gwyneth Paltrow's jade egg. (To be clear, I'm all for celebrities who normalize aging, but they're not medical experts, and I don't support experts who provide evidence-based advice.) (We don't necessarily think highly of them, and we should also be very skeptical that their efforts to eliminate prejudice line their own pockets.) )

Yes, there are reasons to be hopeful about women's health. The past year has brought several important advances, including a new treatment for postpartum depression, the first treatment for menopausal hot flashes, and an unusual biotech startup focused on treating preeclampsia. I did. Among doctors focused on women's health, there is a palpable sense of momentum building around a condition that has been ignored for too long. Biden's $12 billion could build on that success.

But please forgive me if my excitement is tempered by a deep sense of frustration, given its long history of neglect. It's also unclear whether Congress will actually approve the money and how quickly it will be spent. (For comparison, the National Institutes of Health's annual budget is $48 billion.)

If you look around at what's going on in the rest of the biomedical world, you'll see the crumbs of a three-tiered cake, including amazing new technologies like Crispr and significant investments that have changed the course of certain types of cancer.

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