Confronting gender inequality in healthcare & biomedical science

Women’s specific medical needs are widely overlooked in traditional biomedical R&D. In addition, women are often under-represented among those leading research in this field. We are working to upend this persistent and harmful status quo.

In our 2021-2028 Strategic Plan, DNDi has made a commitment to implementing best practices in gender-responsive drug development, identifying and tackling gender-based barriers to treatment access in our programmes, supporting maternal health, and advancing women’s scientific leadership.

Building a proactive agenda for maternal and child health and gender-responsive R&D

Despite representing half of the world’s population, women are a neglected population when it comes to drug development. For example, women are often excluded from clinical trials, resulting in a lack of important data on physiological differences – especially data concerning medicine safety and efficacy in pregnant or breastfeeding women.

We are committed to implementing best practices in gender-responsive drug development and access by promoting the inclusion of women in clinical trials and, where it is safe to do so, including pregnant and breastfeeding women.

Addressing the gender gap in access to clinical trials and access to treatment

Women and girls are disproportionately affected by neglected tropical diseases (NTDs) and yet often have less access to medical care. For example, there are disparities in care for women in contexts where their caretaking role undermines their ability to get timely diagnosis and access to treatment, and this especially affects poor, rural women. This inequitable access extends to clinical trial participation.

As part of our activities to increase equitable trial participation and treatment access, we are working with our partners to better understand context-specific barriers, which vary by country and by disease. Such issues need to be considered and addressed from the earliest stages of drug development.

Based on DNDi’s experience across four continents, DNDi researchers have developed and published a proposal for a safe ethical framework for the inclusion in clinical trials of women who are not pregnant but could potentially become pregnant during a clinical study. This framework addresses the ethical aspects of safely collecting the data needed about new medicines to apply for regulatory approval.

By proactively factoring gender into the design of our clinical studies and programmes to increase access to treatment, DNDi can contribute to advancing knowledge and, ultimately, increasing the number of approved drugs available to treat NTDs in all people, including pregnant women and women of child-bearing potential.

Advancing women in science to promote equitable pharmaceutical R&D

Medical science that addresses the specific needs of women is partly dependent on developing pathways for more women to contribute as principal investigators and science leaders. DNDi has created a cross-team gender-responsive R&D and access steering group to advance this agenda and take forward recommendations presented by our diversity, equity, and inclusion working group. Internally, DNDi continues to work to ensure equal opportunities for women and men, including through initiatives to ensure equitable compensation and access to training and promotion, and to remove biases in recruitment practices.

Acknowledging the multiple social, political, and economic determinants of health and disease

A commitment to gender equality means also looking at risks specific to men. For some diseases, men may be at higher risk due to occupational exposure or because they are not diagnosed promptly when working hours prevent them from seeking medical care quickly. In many communities, transgender people and sexual minorities may avoid seeking medical care entirely, due to stigma and discrimination, resulting in late diagnosis and poor treatment outcomes. At DNDi, we apply a broad gender and intersectional lens to access strategies, acknowledging the multiple social, political, and economic determinants of vulnerability to diseases and access to healthcare – for all people, whoever or wherever they are.