The past two years handed women’s health two headlines that don’t belong in the same story.
On one side, the money finally showed up. Capital moved into the sector at levels I couldn’t have imagined five years ago: foundations committing billions, investors who used to wave women’s health off as niche now treating it as a real market. Menopause, cardiovascular disease, autoimmune conditions, maternal mortality, healthy aging: all of it moved from the footnotes to the main stage. After decades of being told this was a nice thing to care about, it started to land as what it actually is: one of the largest clinical and economic opportunities of our generation.
And on the other side of the screen, we nearly lost the most important women’s health research effort this country has. In spring 2025, the Women’s Health Initiative, the largest and longest-running study of women’s health we’ve ever run and the source of a huge share of what we actually know about how disease shows up in women’s bodies, had its federal funding pulled almost overnight. It took a public outcry to reverse the decision within days, and the study survived.
But sit with what that near miss tells us: Decades of irreplaceable data were one budget line from vanishing, and it took a backlash, not a system, to save them.
I couldn’t stop looking at those two things side by side. We were celebrating record checks while watching real scientific ground become collateral in a political fight. And it exposed something I’ve been saying for years: we still treat women’s health as a cause to rally behind versus an infrastructure to protect.
Infrastructure doesn’t run on enthusiasm. Nobody funds the electrical grid because it’s inspiring; they fund it because the lights go out if they don’t. Roads, water treatment, public health labs, telecom: none of it gets awareness campaigns or celebrity champions, and all of it gets maintained, year after year, because everyone understands what breaks when it fails. Women’s health hasn’t earned that kind of standing yet. Instead it runs on a cycle I’ve watched repeat my entire career: attention builds, funding follows, optimism peaks, somebody declares a turning point, and then the administration changes or the market tightens or a new crisis grabs the room, and we rebuild from a few steps back. Infrastructure doesn’t behave that way. This still does.
That’s exactly why the Gates Foundation’s commitment matters as much as it does, and why the size of the check is almost the least interesting part. What I care about is the philosophy behind it: designing for women everywhere, including the low- and middle-income countries traditional product development has always skipped. I’ve spent enough time working globally to know the truth of it: women aren’t short on ingenuity. They’re short on anyone willing to invest in the problems that affect them.
But I’d be doing the field a disservice if I let one generous commitment paper over the bigger picture. Philanthropy can’t stand in for public research. Venture money can’t build longitudinal evidence on its own. Founders can’t out-hustle decades of underfunded science, and private industry was never supposed to carry work that belongs to national research institutions. Every piece plays a different role, and when one gets pulled, the others get weaker, because innovation compounds. Every device builds on the basic science that mapped the biology. Every algorithm is only as good as the data behind it. Pull enough of the foundation out and the whole pipeline narrows, not because anyone lost interest, but because the knowledge stopped accumulating.
Women’s health has been fighting that narrowing for generations. For most of that time it got squeezed into a single lens, fertility and pregnancy, as if a woman’s health were a season instead of her entire life. As I say more often than my team probably wants to hear: women’s health isn’t a moment in a woman’s life. It’s her whole lifespan. That’s finally starting to sink in, and I’m glad. But it raises the bar for the rest of us.
If women’s health is becoming core healthcare instead of a specialty niche, our institutions have to grow up alongside the investment. The scoreboard can’t just be startups launched or dollars deployed. Those are inputs. The real questions are harder: are these discoveries making it into medical education? Is reimbursement catching up so better care actually reaches people? Are national research priorities reflecting the diseases that hit women hardest? Are we building datasets rich enough to power the precision medicine everyone keeps promising? Are the innovations reaching women regardless of geography, income, or race? Those are infrastructure questions, and they’re the ones that decide whether progress compounds or resets every few years.
I’ve worked across devices, nonprofit global health, investing, and commercialization, and the thing I’ve learned is that innovation almost never dies because smart people run out of ideas. It dies because the system around the idea was never built to hold it up. Technologies stall without reimbursement. Evidence stalls without research funding. Access stalls without policy. Founders burn years solving problems a stronger institution should have solved for them long before.
So no, I don’t think the story of 2026 is two contradictory headlines. I think it’s a diagnosis. The private sector has finally clocked the opportunity in improving the health of more than half the planet, and that’s real progress. Our public institutions haven’t caught up, and until they do, women’s health stays stuck in the same boom-and-neglect loop it’s been in for decades.
Real infrastructure looks different. It gets so woven into how a society runs that no one argues about whether it deserves to exist. It’s expected. Protected. Maintained. Improved, precisely because everyone knows what happens when it’s gone. That’s where women’s health belongs: not as a cause worth supporting, but as infrastructure the whole economy depends on.