On June 4, French Gates announced $215 million in additional funding to Pivotal to focus on women’s reproductive and midlife health, bringing her total support of women's health to $600 million over the past two years. She shared with TIME why she feels investing in women’s health is critical for ensuring women’s power in society.
My inspiration for Pivotal was really wanting to make sure that we lift up all women, because women are the bedrock of society and of their families. What I know is when you lift up women, they lift up everyone else, including their families, so I want to make sure that we get to more equity for women throughout society.
Why has women’s health been so neglected and underfunded?
A woman can't step into her power if we neglect her health. If you think about that on the converse side, if the woman gets the right care at the right time, she can live a full healthy life and do what she wants to do, whether that's having children and raising them and working, whether that's caring for her elderly parents, whether she wants to be an athlete or she wants to be a star in her own life or if she wants to be the CEO of a company or start a business. But if you neglect her health, and she can't get the information or the tools or medicines that she needs, you put her on her back foot, and she's often leaving work, not able to care for her children in the way that she would like, not able to start the company that she would like because she's dealing with her own health conditions. That just shouldn't be, not in this day and time.
You're expanding Pivotal's focus into women's midlife and menopause, an area that's been getting more attention lately from startups, academic research, and more. Where do you hope to see Pivotal having the biggest impact?
First of all, I am thrilled to see that there's more attention to midlife. Women go through their reproductive years—whether they choose to have children or not—and then we all go through this natural transition of midlife. For many women, it starts actually in their forties—sometimes their early forties—and we go through perimenopause and menopause. For too long, it was as if in society this was an invisible issue, and we didn't focus on it. When in fact, all women, 50% of our population, go through it.
We're signaling this is a really, really important area for women's health that has been neglected for far too long. It's been under-researched, it's been underfunded. We should have so many more tools than we have today to be dealing with this time in life. But what we're going to do is work with the Menopause Society. They are the providers of accurate information and training.
How much of the gap in women’s health care is due to a lack of scientific data because it’s been understudied, and how much is due to lack of equitable access to available knowledge or services?
I think they're different by how you segment it. In women's reproductive health, we know a lot. We know a lot about contraceptives, yet that system has been under attack—recently, by the Dobbs decision, which has caused some confusion in that area. That just shouldn't be. We know what to do in that area.
In midlife, I would say we both don't have enough knowledge or tools. The research should have been started more than 50 years ago. We should have had many, many, many studies about this period of life, so that we have different tools, not just hormone replacement therapy (HRT). Then we have a lack of provider training, which is the piece I'm going to work on with this particular amount of funding.
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We're living at a time when commitment and prioritization of health in general in the U.S. is at a low. We've seen cuts to our biomedical research infrastructure. What role do you see philanthropy playing to maintain the momentum and the leading role that the U.S. has traditionally had in innovating in health?
Well, philanthropy can never, never fill the gaps that government leaves behind. One of the reasons the U.S. is a place people do want to come to get our type of health care is because we have a vibrant National Institutes of Health. We have funded it well; we have looked at the forefront of some of these biological issues for the human body, and we are bringing out new medications that people want. So to cut that back just doesn't make any sense. But philanthropy can never fill the gap on any of these issues. They're just so enormous.
What rises to the top for me is who's really doing top-notch work, who's really thinking about these issues in the best possible way, who's bringing out credible information. I did a grant last year in women's health, which is part of an overall $600 million commitment, with Wellcome Leap. And we both committed money to heart disease for women. Women are facing heart symptoms, but they're going into the system and they're not diagnosed well. But Wellcome Leap has a model to come out with tools and solutions much quicker. It's a proven model by DARPA, our government defense agency.
If we were to reconnect in five years, how do you hope women's health will have changed?
I hope to see that in the reproductive health space, we are losing fewer moms in childbirth. I hope to see that women feel that they can get the reproductive choices that they want that are right for their family. And I hope in the midlife stage more women are using HRT if they feel it's right for them, and far more women are saying, "I didn't have to go to as many doctors to get the right information to help me deal with this midlife time."
I think if we do that, we'll say, "Gosh, OK, we have actually made progress in five years."
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