Melinda French Gates Pledges $1 Billion to Address Chronic Underfunding in Women’s Health

Billionaire philanthropist Melinda French Gates announced a two-year pledge of $1 billion to women’s health on Monday and committed an initial $50 million for new research, saying the field has been "chronically underfunded, chronically under-researched, and, as a result, not well understood."

The $50 million grant from Ms. Gates’s Pivotal Ventures organization will go to Wellcome Leap, a U.S.-based non-governmental organization founded by the Wellcome Trust. Wellcome Leap — which describes itself as a large global health research network with more than 160 partner institutions across six continents — will use the funds to support studies into conditions that disproportionately affect women or affect them differently, including autoimmune disorders, mental health, cardiovascular disease and risks for Alzheimer’s disease.

Advocates and researchers have pointed to longstanding gaps in knowledge about women’s health. Autoimmune diseases affect women at far higher rates than men; Xavier University School of Medicine estimates roughly 80% of people living with autoimmune conditions are women. The World Health Organization reports that depression is about 1.5 times more common in women than men globally. Studies presented at the European Society of Cardiology scientific congress have also found that women are more likely than men to experience worse outcomes after a heart attack, in part because of delayed diagnosis, different symptom presentation and less timely treatment.

Those disparities have been traced in part to historical exclusions in medical research. In the United States, women of childbearing age were largely excluded from early-phase clinical drug trials between 1977 and 1993 — a policy born from concerns about fetal harm after the thalidomide tragedy but one that left significant gaps in knowledge about how medicines affect women. Female animals were also often omitted from preclinical studies because researchers were concerned hormonal cycles could complicate results. As recently as 2019, women made up about 42% of participants in clinical trials for cancer, cardiovascular disease and psychiatric disorders, according to Harvard Medical School.

Wellcome Leap said it plans to fund a range of studies designed to yield “breakthroughs” that can be implemented at scale. One of the organization’s priorities is research into whether initiating hormone therapy around menopause might protect brain health and reduce women’s lifetime risk of Alzheimer’s disease; women are about twice as likely as men to develop Alzheimer’s, the Alzheimer’s Society reports. Regina Dugan, chief executive of Wellcome Leap, said the organization aims to accelerate progress. "We need more breakthroughs, and we need them faster," she said.

Critics cautioned that the announcement, while significant, does not erase decades of underinvestment. Health experts have argued that putting medical research historically conducted on the male body on par with women’s health will require sustained, widespread funding and systemic change. Some frontline and community organizations also warned that large, Western-led funding initiatives can bypass local groups doing critical work on the ground.

Serley Eises, executive director of the Lidar Community Foundation in Windhoek, Namibia, said her organization has not received Western donor funding and that sustained impact for women’s mental health often depends on community-led programs that provide safe spaces, psychosocial care and opportunities for education and income. A Wellcome Leap spokesperson responded that the organization works with local teams in about 30 countries and that its programs are designed with scalability and local implementation in mind.

Researchers and economic analysts have emphasized broader consequences of underinvesting in women’s health. A 2024 report by McKinsey and the World Economic Forum estimated that closing the global women’s health gap could add as much as $1 trillion to the global economy annually by 2040 through lower healthcare costs, higher productivity and stronger workforce participation. Other studies cited by advocates show that, on average, women spend more years in poor health than men, a disparity attributed in part to underrepresentation in research and a higher likelihood of misdiagnosis.

The Pivotal Ventures grant to Wellcome Leap is the first announced tranche of Ms. Gates’s $1 billion pledge, which she said will be invested over two years. Wellcome Leap’s network and stated approach aim to combine scientific research with pathways to implementation, but observers say accountability for equitable distribution of funds and collaboration with grassroots organizations will determine how effectively the investment narrows long-standing gaps in knowledge and care.

Ms. Gates said she hopes the investment will accelerate discoveries and reduce delays in translating research into better health outcomes for women worldwide. Wellcome Leap and other funders now face the task of converting the pledge into research that addresses clinical differences, improves diagnosis and treatment, and reaches communities that have historically been left out of research and care.