A power gap in healthcare defines whose health needs receive attention and funding

Globally, female healthy life expectancy at birth increased from 59.3 years in 2000 to 63.0 years in 2021, reflecting better healthcare and disease prevention. Other health indicators, such as maternal mortality, births attended by skilled health personnel, adolescent childbearing and access to modern contraception, have seen significant advances, even if they are far from the 2030 targets. Visible progress in HIV prevention among women and girls has driven declines in new HIV infections among women aged 15–49, from 0.74 per 1,000 uninfected women in 2000 to 0.24 in 2025. Yet the recent defunding of global health programmes, research and data collection threatens to reverse these gains. Development assistance for health is projected to fall by 29–46 per cent from 2024 to 2026, with population and reproductive health (down 54.1 per cent) and the control of communicable diseases most exposed to cuts.

Aside from funding declines, persistent inequalities in bodily autonomy and decision-making power impede progress. These are particularly acute for women and girls facing intersecting forms of discrimination, along with poverty, or living in countries with weak health systems. Data from 2017 to 2020 show that less than half women of reproductive age participate in decisions about their own healthcare in several countries, including Pakistan (50.5 per cent), Sierra Leone (43.9 per cent) and Tajikistan (45.7 per cent). These disparities extend beyond the household into healthcare governance. In 2026, women held just 26.3 per cent of ministerial positions in health.[1] Persistent gender biases in health leadership and research influence whose health needs receive attention, funding and research. Globally, women’s health attracts only around 6 per cent of private healthcare investment. Critical evidence gaps in medical research persist with sex-disaggregated results rarely reported in some major areas of clinical trials. Reversing health financing cuts, putting women in health leadership and mandating sex-disaggregated research is much needed– the health gains so far are at risk without all three.