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

Treatment effectiveness in LICs and LMICs is difficult to understand when clinical trials are not conducted in those countries or communities. The Forum and MHI analysis did not identify any clinical trials in LICs for 67% of the selected conditions: migraine, menopause, PMS, endometriosis, breast cancer and ischaemic heart disease. The answer is not “more trials for trials’ sake”, but to evaluate whether clinical trials consider globally representative samples of the disease burden and whether or not their results can be extrapolated across populations and geographies. Additionally, research and funding for a selected condition do not imply that unmet need no longer exists. Post-partum haemorrhage and maternal hypertensive disorders have the greatest proportion of trials in LMICs and LICs out of the selected conditions, yet significant morbidity and mortality from these conditions persist across these countries.The first step in LMICs and LICs is more funding for wide-scale infrastructure, training, quality improvements and implementation that can enable successful clinical trials to take place. Investment in local primary investigator-led trials can improve local participation and ensure that the research questions and end points are aligned with local relevance and community needs.105 In HICs, the outsized proportion of funding and clinical trials may mask disparities and inequities within those countries. Publication and funding bias may affect the rate of trials completed in LICs and LMICs,106 but even when clinical trials are conducted in HICs, patient access to these trials and representation across minority racial and ethnic groups remains imbalanced107,108Global research distribution in the past 12 months based on WHO International Clinical Trials Registry Platform and clinicaltrials.govFIGURE 6 Sour ce: The Forum and MHI analysis, based on clinicaltrials.gov , Institute for Health Metrics and Evaluation. Data r etrieved June 2024LICs and LMICs UMICs and HICs% of clinical trials per income archetype, per condition compared to burden (DALY)While most of the women's health research is concentrated in higher-income countries, more disability burden is found in lower-income countries. 23 48 77 52Premenstrual syndromeTotal number of trials36 6490 1027 7386 1411 50 50899 48 52918 9249 516 9442 586 40 60944 38 629623 54 4677Post-partum haemhorrageMaternal hypertensive disordersEndometriosisCervical cancerMenopause MigraineIschaemic heart diseaseBreast cancer Average 1,697 666 264 147 292 148 105 44 62Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Clinical trialsBurden Blueprint to Close the Women’s Health Gap: How to Improve Lives and Economies for All 21