Scientific innovation is driving hope for progress in women’s health, but experts warn of headwinds

Scientific breakthroughs — from next-generation vaccines to long-acting medications to prevent HIV — are fueling new hope in women’s health. But experts warn that persistent gaps in funding and access could stall that progress. 

At a STAT event this week, Ruanne Barnabas, chief of the division of infectious diseases at Massachusetts General Hospital, described the potential for progress following a 2022 study she helped lead, in which researchers found that a single dose of the HPV vaccine could be just as effective as two. She said it was “no accident” or simple stroke of luck that the vaccine performed so well. 

“We can now do bespoke antigen design to make new vaccines — we can make vaccines in a room just about the size of this stage — and they can be highly efficacious,” she said.

The results of Barnabas’ study, which was backed by the Gates Foundation, led the World Health Organization to recommend a one-dose schedule of the vaccine against the human papillomavirus, which can lead to cervical cancer, as well as two-dose schedules — a breakthrough that reduced costs and simplified vaccine delivery worldwide. 

At the same time, however, gains in women’s health are being threatened by funding issues. Five of Barnabas’ grants were affected by federal funding changes and by cuts to Harvard University. She said that the hardest part for her has been losing the partnerships and connections she has developed over years of working together.

“The hardest things are all the deep relationships and partnerships that you build over many years in order to move science forward. To have those stopped — in the midst of clinical trials and other things — that is very hard for participants, for partners, for being able to safely transition people out,” Barnabas said at the event, which was held at the Broad Institute in Cambridge, Mass.

Jo-Ann Passmore, a professor at the University of Cape Town in South Africa, pointed to another recent innovation: the development of lenacapavir, an injection that provides six months of protection against HIV infection. The drug is particularly promising for women and girls in sub-Saharan Africa, who bear a disproportionate burden of new HIV infections.

“That felt like a really transformative, good news story for women’s health in sub-Saharan Africa,” Passmore said. “All of the research we do focuses on the major drivers of that, but until game-changers come along, like lenacapavir, all of the work we do seems to be incremental in how we solve the problem. I came into 2025 with this real sense of optimism and pride in what the field had achieved.”

But there are open questions about how the drug will get to people in need. While the drug’s manufacturer, Gilead, has agreed to provide the treatment at cost to 2 million people in lower-income countries, with the help of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the agreement does not include the U.S. government’s President’s Emergency Plan for AIDS Relief, or PEPFAR, which has long been the world’s leading provider of HIV prevention drugs.

PEPFAR funding has been slashed by the Trump administration. In 2024, South Africa received $332.6 million in funding from the program, which accounted for 17% of the nation’s HIV treatment and prevention budget. Although some funding has resumed, many programs have had to find new financial support, or else shut down. 

“Coming into 2025 with this vision of hope, only to have massive cuts to the USAID, NIH funding, PEPFAR … it completely crippled, in the blink of an eye, things that people have fought hard for 30 years,” Passmore said. “So, I’m sitting here humbled. We’ve survived. Six months later, we’re trying to rebuild programs that are rebuildable, but many of them will be lost.”

While there has been enormous advancement in medicine, research and funding specifically targeted toward women’s health still lag far behind. In an article published in the BMJ last week, Ru Cheng, the Gates Foundation’s director of women’s heath innovations, noted that globally, only 1% of research and development funding is allocated toward women’s health issues outside of oncology, and just 2% of all venture capital health investments are focused on women. The Gates Foundation announced Monday that it will pledge $2.5 billion through 2030 to support dozens of different approaches for improving women’s health, particularly focusing on research and development. 

Scott Johnson, CEO and co-founder of Comanche Biopharma, which will receive some of that funding, explained that historically, there has not been enough money for novel drug development in women’s health.

“We’ve had too many efforts, at least in the pharmaceutical industry, in drug development, to simply repurpose drugs,” he said. “To take drugs that are already available, and ‘Let’s give it a try, they seem to be safe, so maybe they’ll be effective.’”

His startup is developing an RNA-based therapy for preeclampsia — a pregnancy-related condition that can lead to serious complications for both mother and fetus. Currently, there are no targeted treatments available for it. Johnson hopes Comanche’s drug will be the first. 

“We need more true successes,” Johnson said. “Success attracts capital. Success attracts interest.”

Bisola Ojikutu, Boston’s commissioner of public health, emphasized the importance of funding for behavioral science and implementation research — studying how lifesaving interventions can actually reach patients. 

“If you don’t do this research, if you don’t invest in that, it sits on the shelf,” she said. “For many women, they don’t know anything about lenacapavir, and they are at very high risk of HIV infection.”

Community research and engagement must come hand in hand with drug development, Ojikutu said. 

“There’s some amazing things that are happening that could be appropriate in sub-Saharan Africa, versus here in Boston, versus rural Georgia, rural Mississippi. But I think that we need to be spending time, effort, energy, money, building infrastructure in behavioral science research,” Ojikutu said. “We need to get into communities and actually know whether we’ll use any of this research, any of the interventions that are being developed.”