• Pharma companies putting greater priority on women makes sense financially and in terms of healthcare impact.

• Women in low-income countries bear a disproportionate disease burden.

• More women in the boardroom should affect drug development and delivery strategies on the ground.

Pharmaceutical companies have a chance to make the world a healthier place by curing gender bias. Empowering women in decisions about drug research and access to medicines can pave the way to truly equitable healthcare.

The business case for promoting gender equity is now widely accepted. Indeed, diversity has been a focus for companies and investors alike for nearly a decade, with the UK's 30% Club launched in 2010, and France having gender quotas for boards since 2011. Investment firms are also watching intently, with Morgan Stanley recently launching a scorecard to assess gender balance within workforces. In healthcare, the World Health Organization now uses a gender responsiveness scale for assessing health programmes.

So how can pharmaceutical companies do a better job of rebalancing their working practices and eradicating gender biases in the way they bring healthcare to the world? To begin with, CEOs and investors need to understand what it means to make gender equity a pillar of strategy – and appreciate how this will benefit them both financially and increase their healthcare impact.

Healthy leadership

Let’s start with women in leadership. Only a few of the biggest pharmaceutical companies – such as GSK, Mylan, Biocon and Biological E – currently have a female CEO, and women make up under 30% of executive directors at the top firms. This is despite the fact that similar numbers of men and women enter the workforce with advanced degrees in life sciences and medicine. While a few companies, like Johnson & Johnson and Pfizer, have women in about 40% of executive committee roles, many more have only negligible female representation. Women at Bayer, for example, make up under 10% of the senior executive team. For better decision-making, gender equity is needed across the company, including country-level teams.

Women make up under 30% of executive directors at top pharma firms
Women make up under 30% of executive directors at top pharma firms

The financial argument for gender equity is strong. Companies in the UK’s FTSE 350 index with no women on their executive committee achieved an average 8.9% net profit margin, while those with at least 25% women executives averaged 13.9%, according to a 2018 report.

Respective profits of FTSE companies with different proportions of women executives
Respective profits of FTSE companies with different proportions of women executives

R&D with gender balance

There are specific reasons why gender matters in pharmaceuticals – starting with R&D. If drug companies are to fulfil their contract with society, they must tackle the most deadly diseases of the world, equitably. But in low-income countries, women and girls bear a bigger burden of disease than men. Some diseases only or disproportionately affect women, such as gynaecological conditions, breast cancer or sexually transmitted infections (STIs). So paying attention to diversity means ensuring that R&D serves both genders equally.

Proportion of women in low-income countries
Proportion of women in low-income countries

In some areas, industry is making important contributions. New contraceptives designed for low-income countries have been prioritized by the likes of Bayer, Merck & Co and Pfizer, while heat-stable carbetocin for post-partum haemorrhage (the leading cause of maternal deaths) has been developed by Ferring Pharma and Merck for Mothers. Two drugs against resistant forms of gonorrhea are also being developed by GSK and biotech firm Entasis. Yet there are still many gaps. A new treatment for endometriosis is desperately needed, as are better drugs for STIs. The message is clear: More companies must get involved and stay committed if we are to eradicate gender as a social determinant of health.

Appropriate female enrolment in clinical trials is also critical. This may be obvious in a disease like breast cancer, but other conditions such as osteoarthritis also disproportionately affect women, and studies need to reflect this by including adequate female numbers.

The US Food and Drug Administration has highlighted the need for better gender balance in trials since 1992, following official reports noting a lack of female representation in federally funded studies of diseases including HIV/AIDS and hypertension. More recently, there has been a push to boost inclusion of cis and transgender individuals. Yet problems persist. In October 2019, a product for pre-exposure prophylaxis (PrEP) of HIV/AIDS was not granted FDA approval for expanded use in cisgender women due to lack of data, while it was approved for men and transgender women, where data was available.

Delivering healthcare to women and girls

Gender is also important when it comes to the way companies deliver products, since women and girls all too often fail to access effective and timely treatment in low-income countries. Even as we celebrate progress in the global response to HIV/AIDS, girls and young women in sub-Saharan Africa, who account for 71% of new HIV infections, are getting left behind. Companies can help with targeted programmes like the DREAMS partnership for adolescent girls with HIV, backed by the likes of Gilead, Johnson & Johnson and ViiV.

Similarly, the Mothers2Mothers initiative, supported by Johnson & Johnson and others, employs women living with HIV/AIDS as community health workers, calling them “Mentor Mothers”, tackling gender inequities in employment in health. And the HALOW scheme, backed by GSK, Marks & Spencer and CARE International, tackles healthcare inequities among workers in the garment industry – mostly impoverished women from rural areas who live in slums and lack access to health services due to their income and gender.

What's the World Economic Forum doing about the gender gap?

The World Economic Forum has been measuring gender gaps since 2006 in the annual Global Gender Gap Report.

The Global Gender Gap Report tracks progress towards closing gender gaps on a national level. To turn these insights into concrete action and national progress, we have developed the Closing the Gender Gap Accelerators model for public private collaboration.

These accelerators have been convened in Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Panama and Peru in partnership with the InterAmerican Development Bank.

In 2019 Egypt became the first country in the Middle East and Africa to launch a Closing the Gender Gap Accelerator. While more women than men are now enrolled in university, women represent only a little over a third of professional and technical workers in Egypt. Women who are in the workforce are also less likely to be paid the same as their male colleagues for equivalent work or to reach senior management roles.

France has become the second G20 country to launch a Gender Gap Accelerator, signalling that developed economies are also playing an important role in spearheading this approach to closing the gender gap.

In these countries CEOs and ministers are working together in a three-year time frame on policies that help to further close the economic gender gaps in their countries. This includes extended parental leave, subsidized childcare and removing unconscious bias in recruitment, retention and promotion practices.

If you are a business in one of the Closing the Gender Gap Accelerator countries you can join the local membership base.

If you are a business or government in a country where we currently do not have a Closing the Gender Gap Accelerator you can reach out to us to explore opportunities for setting one up.

In the third decade of the 21st century, as we strive to meet the UN Sustainable Development Goals, it is unacceptable that problems of access to medicines should be multiplied by gender inequity – and the ability to reach the vulnerable, leaving no one behind, is a key predictor of how companies perform on access to healthcare.