Leadership and culture change to advance innovation in women’s health

Sapna Kedia and colleagues argue that equitable leadership, supported by training and systemic reform and rooted in marginalised groups’ experiences and community insight, can transform the innovation cycle, from research and development to delivery, making health technologies more inclusive and impactful When women are excluded from leadership, women’s health innovation is incomplete and inequitable and will continue to fall short. Women, especially those from low and middle income countries, remain under-represented in senior positions across global health institutions, research leadership, and innovation funding, even when the research and innovation concerns their own communities.1 Grant making mechanisms often favour institutions with extensive administrative infrastructure and previous funding experience, limiting access for women from under-resourced settings.2 Furthermore, institutional cultures reflect gendered expectations around leadership style, mobility, and availability. Historical systems that reward linear and uninterrupted career trajectories are misaligned with the realities of many women researchers, who may be balancing care giving responsibilities or facing other gendered constraints. The absence of women, particularly those from low and middle income countries, in research and innovation leadership has profound implications not only for equity but also for the effectiveness and relevance of health innovation and its impact on health outcomes. Clinical and medical research remains predominantly led by men. For example, many cardiovascular drug trials in South Asia have primarily enrolled men,3 resulting in diagnostic and treatment protocols that are based on male physiology and inadequately tested for effectiveness in women. In addition, health conditions that uniquely or disproportionately affect women, such as endometriosis and maternal morbidity, continue to be under-researched and underfunded.4 Beyond this, a broader spectrum of women’s health problems across the life course is often rendered invisible owing to the persistent focus on reproductive health.5 In this article, we argue that equitable leadership in health research …