Blueprint to Close the Women%E2%80%99s Health Gap 2025

Five of the selected conditions contribute to mortality for women in all regions of the world: ischaemic heart disease, cervical cancer, breast cancer, maternal hypertensive disorders and post- partum haemorrhage. Ischaemic heart disease is the leading cause of mortality for all women, crossing all geographies and ethnicities and resulting in the deaths of more than 4 million women per year.14 Despite a decline in overall deaths from ischaemic heart disease, women are more likely than men to die from an acute cardiovascular event.15 In the United States alone, closing the cardiovascular disease gap between men and women could let women regain at least 1.6 million years of higher-quality life and add $28 billion to the country’s economy by 2040.16 Ischaemic heart disease represents potential estimated gains of 9.1 million annual DALYs and $43 billion in annual GDP in the women’s health gap.17 Cervical cancer, while less common than breast cancer, leads to more than 350,000 deaths each year.18 The prevalence and deaths from cervical cancer are disproportionately high in lower-income countries: around 85% of cervical cancer deaths occur in low- and low-middle-income countries (LICs and LMICs).19 The highest rates of incidence and mortality are in sub-Saharan Africa, Central America and South-East Asia.20 In the US, cervical cancer causes two deaths per 100,000 women;21 in Tanzania, cervical cancer causes 42 deaths per 100,000 women.22 Globally, a 2022 analysis found that two in three women aged between 30 and 49 had never been screened for cervical cancer; rates of cervical cancer screening ranged from 1% in Bangladesh to 73% in Brazil.23 Despite the existence of a vaccine that can prevent almost all types of cervical cancer, some estimates predict that cervical cancer could rise by almost 78% between 2018 and 2030 (130,000 additional cases annually).24 Cervical cancer represents potential estimated gains of 2.4 million annual DALYs and $10 billion in annual GDP in the women’s health gap. Breast cancer is the most common cancer diagnosed in women, leading to the deaths of 670,000 women globally every year.25 The number of newly diagnosed breast cancers is projected to grow by over 40%, leading to around 3 million annual new diagnoses by 2040.26 Education, early diagnosis and advanced treatments have reduced breast cancer mortality, alongside the availability of generic treatment options. A variety of efforts outside of care delivery – including grassroots advocacy – have led to monumental changes in funding and policy.27,28 Yet major disparities remain within and between countries: five-year breast cancer survival is more than 90% for women in high-income countries (HICs); in India, five-year survival is 66%; in South Africa it is 40%.29 In underserved populations within HICs, the five- year survival for metastatic breast cancer is 30%, highlighting a need for better differentiation of the types of breast cancer, earlier access to stage- appropriate treatment and health and social systems that enable treatment adherence.30,31 Breast cancer represents potential estimated gains of 1.2 million annual DALYs and $8.7 billion in annual GDP in the women’s health gap. Maternal hypertensive disorders, which are variations on high blood pressure, are leading causes of pregnancy-related complications and fatalities for mothers and infants.32 For example, pre-eclampsia – one type of maternal hypertensive disorder – accounts for 70,000 maternal deaths worldwide each year.33 These “silent killers” may have few early symptoms and often go undiagnosed, particularly in women who lack access to adequate prenatal care.34 In addition to putting a woman at greater risk of post-partum haemorrhage after birth, maternal hypertensive disorders are considered a risk factor for many conditions later in life such as chronic cardiovascular disease, stroke, atherosclerosis and chronic hypertension.35,36,37,38 Maternal hypertensive disorders represent potential estimated gains of 0.85 million annual DALYs and $1.4 billion in annual GDP in the women’s health gap. Post-partum haemorrhage is the leading cause of maternal mortality globally, accounting for around 20% of all maternal deaths:39 Annually, 14 million women worldwide have a post-partum haemorrhage, leading to around 70,000 maternal deaths each year.40 A majority of women with post-partum haemorrhage are estimated to suffer from “near-miss” maternal mortality, leading to long-term complications,41 including brain disorders, chronic cardiovascular disease and other disabilities such as severe anaemia. Almost all post-partum haemorrhage deaths occur in LICs and lower- middle-income countries (LMICs) and are largely preventable.42 Experts have cited barriers in LICs and LMICs that include poverty, a lack of transport/ poor road conditions, inadequate communication networks and a dearth of qualified health professionals.43 In HICs, post-partum haemorrhage is still among the leading causes of complications in pregnancy. Post-partum haemorrhage represents potential estimated gains of 0.25 million annual DALYs and approximately $200 million in annual GDP in the women’s health gap.1.1 Five conditions affect women’s lifespan Blueprint to Close the Women’s Health Gap: How to Improve Lives and Economies for All 11