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

2.1.4 A deeper look into heart disease and migraines Ischaemic heart disease is the world’s number one cause of death for both men and women, responsible for the deaths of 9 million people annually (in 2019, roughly 4.97 million men and 4.17 million women).81,82 Analysing the results of clinical trials by sex could illuminate sex-specific differences, including different responses to treatment, different side effects and potentially different cardiovascular biological factors. However, Forum and MHI analysis showed only 17% of ischaemic heart disease clinical trials completed in 2022 and open to both sexes published sex-disaggregated results. Funding is needed, alongside regulatory reporting shifts, to publish sex-disaggregated data and analysis and encourage sex-specific research. The Forum and MHI analysis found that in the US, National Institutes of Health (NIH) funding for ischaemic heart disease increased overall between 2020 and 2022, though the share of NIH research funding for women-specific ischaemic heart disease research decreased from 26% to 21%.83 Migraine, which affects almost 21% of reproductive-age women, impedes productivity and quality of life for women around the world and accounts for a large portion of the women’s health gap.84 However, the Forum and MHI analysis found that only two trials out of the 52 (4%) completed in 2022 published sex-disaggregated data.85 The Women’s Health Innovation Opportunity Map,86 among others, has highlighted a need to research sex-related differences in the presentation and evolution of migraine given the sparsity of sex- disaggregated research published. Women who are pregnant and lactating are often excluded from clinical trials for migraine and other conditions. While testing new medications on pregnant women may not be advisable in many circumstances, a consequence of such research safety measures87 is a lack of understanding of how pregnant women may respond to migraine treatments. For example, a knowledge gap exists on how to manage migraines that get worse with pregnancy. Additionally, those with migraine in pregnancy have a higher risk of pre-eclampsia and maternal stroke.88 When pregnant women with migraine who developed pre-eclampsia in pregnancy were followed over time, they were discovered to have a higher risk of stroke later in life as well.89 The lack of knowledge and limited clinical trials around sex-specific research drives the treatment efficacy gap in migraines, particularly for women, throughout their entire lifetimes, and especially during stages of hormonal fluctuations, lactation and pregnancy. Additionally, given the low participation of men in migraine clinical trials and limited sex-disaggregated results, both men and women suffering from migraines could benefit from sex-disaggregated data that can reflect treatment efficacy, effectiveness and side effects. Research on the sex-distinctive elements of the selected conditions is needed.90 Lack of research limits knowledge about differences in outcome in diverse groups (critically, in women and girls) and impairs understanding of the selected conditions and their pathophysiology. Analysis of research funding can be used as a proxy for understanding the research topics being funded and the research priorities of funders. Global research funding is tracked in the NIH’s World RePORT database. This database covers both governmental and non-governmental funding bodies and may not include all funding from life sciences companies, private investors and local funders. Other analyses may be considered for tracking research attention and support, such as cumulative peer-reviewed publications about conditions; within this scope, global research funding was prioritized.The Forum and MHI compared the value of global investment in research to the size of the global disease burden (measured in DALYs) for each of the selected conditions. The result is a metric that estimates the “dollars per DALY” of research funding allocated to the selected conditions. This metric reveals the extent to which research funding reflects the fair allocation of research resources – whether all DALYs were considered equally important. Additionally, disaggregating funding by type – such as basic science research, clinical trials, translational research and implementation science – helps to identify areas of greater investment need. For example, research on how treatment effectiveness changes within the context of a country or community, particularly in LICs and LMICs, is relatively underfunded.2.2 Study women Conditions affecting women could benefit from more research funding and focus. Blueprint to Close the Women’s Health Gap: How to Improve Lives and Economies for All 18