We are not powerless - despite rising tide of threats to women’s health

There has never been a more important time to rally behind women’s health than in the current challenging environment. Even as cuts to global health spending, climate change impacts, humanitarian crises, loss of reproductive health rights, backtracking of commitments to equity and inclusivity, and entrenched systemic biases in the medical system combine in an unprecedented maelstrom of threats, ‘we are not powerless’ to protect and advance the health of women and girls around the world, say senior researchers from The George Institute for Global Health.

“These intersecting pressures only push us to redouble our efforts on behalf of women everywhere,” said Associate Professor Clare Arnott, Global Director of the Cardiovascular Program at The George Institute for Global Health and UNSW Sydney, and Pagent Family Director of Heart Lung Clinical Research at St Vincent’s Hospital Sydney.

“When things are difficult, researchers and advocates must keep collaborating and supporting each other, and doing what we can do in our own sphere of influence, to push for change,” she said, speaking at an International Women’s Day event supported by Women’s Agenda. “We are even more determined to ensure our research continues, including finding innovative ways to fund it, and to advocate for quick action on the findings to implement change.”

Professor Amanda Henry, Program Head of Women’s Health in Australia for The George Institute and UNSW Sydney, pointed out that women’s wellbeing, including access to good health care, can never be taken for granted.

“Exclusion from medical research, facing violence at home and in places of conflict or crisis, not to mention being subject to social, cultural and economic disadvantage, are all too familiar foes,” she said.

“We must continue our focus on generating high-quality evidence to expose the disparities and find solutions to the real-world problems still holding women and girls back from optimal health. Hard evidence is what enables us to bring about reformed policies and practice, so that women are routinely included.”

Dr Laura Downey, Program Lead in Universal Health Coverage for The George Institute and UNSW Sydney, who focuses on the nexus of climate change and women’s health, says strategies being developed to address emerging issues cannot be ‘gender blind’.

“Climate change is the greatest threat to global health security of our time, and an amplifier of inequity,” said Dr Downey, pointing out that current Australia’s National Climate Resilience and Adaptation strategy * does not refer to ‘women’ once. In addition, the most important global climate change forum, the Conference of Parties (COP), had no women on its organising committee in 2024, and over 70 percent of delegates were men.

“Women and girls are 14 percent more likely to die in a climate emergency and make up 80 percent of people displaced by climate change; rates of violence against women exponentially increase when temperatures rise above seasonal averages; and rates of pre-term labour, stillbirth, and miscarriage increase by as much as 71 percent during heatwaves,” she said.

Already disproportionately impacted by entrenched social and economic disadvantages, “women will bear the greatest burden of inaction on climate change and yet their voices are largely unheard,” she continued. “This has proved to be true across the world in a range of different contexts - but we know very little about what to do about it. We must incorporate the collecting of evidence to inform targeted policies, into National Adaptation Plans.”

George Institute board member and women’s health champion, Catherine Brenner, said a shortfall in public funding for research is nothing new.

“Even in the face of such stark statistics, it’s inspiring to realise that health equity for women and girls, which we know benefits society as a whole, is attainable with attention and investment,” she commented. “For people who have the means and the desire to support women’s health, there are many tangible projects to get involved in at any level, whether that’s through spreading the word, donating or partnering on a larger scale.”

“I’m immensely proud of the multi-disciplinary, intersectional and life course approach we’re taking to women’s health in all our work around the world,” said Professor Anushka Patel, CEO of The George Institute and Scientia Professor at UNSW Sydney.

“Our initiatives in sex and gender equity, and embedding sex and gender perspectives in all our work, including on the health impacts of extreme heat and pollution, in promoting sustainable access to healthy food, and finding ways to cost-effectively tackle chronic diseases like heart disease, hypertension and diabetes, are only possible because of the hard work by our people, and the unwavering commitment of our partners, including governments, collaborators and donors around the world.

“International Women’s Day is a timely moment to pause and thank our supporters, and to recommit to our sex- and gender-inclusive research practices that will lead to better health outcomes for all,” she said.

Women's health research projects at The George Institute

AI in mammography for heart disease prevention

• Dr Arnott and her team, in collaboration with UNSW Sydney and the University of Sydney, are working on a nationwide trial to integrate automated heart disease screening into established routine mammogram services
• This innovative approach could revolutionise heart health screening and intervention for Australian women, who are 12 per less likely to have a CV risk assessment in GP practice, slower to be managed when presenting to hospitals with a serious heart event and women offered less intervention and treatment
• A call for women willing to be involved in the study and had over 500 responses in 10 days
• The team has successfully built a machine-learning algorithm that allows mammogram images to be automatically and rapidly assessed to determine a woman’s risk of a major cardiac event
• Integrating the CVD screening into the established program needs minimal additional infrastructure

Post-pregnancy care must be overlooked no longer

• Prof Henry and team are researching how complications in pregnancy like hypertension, gestational diabetes and preeclampsia can increase risks of serious health problems throughout life, in an ongoing program of work partnering with maternity care hospitals in South-Eastern, South-Western and Central Sydney, associated Primary Healthcare Networks, and NSW Health
• Pregnancy is an underutilised window into women’s future health
• Australia has guidelines for pregnancy and established protocols for babies, but there are no national guidelines for post-partum care for women beyond an initial six-week check-up
• Women who have preeclampsia, even when appropriately treated, face 2X risk of cardiovascular disease and stroke, 5-10X risk of chronic kidney disease and 2X risk of type 2 diabetes (which rises to 10-15X if gestational diabetes was also experienced) compared to those without
• The odds increase when other risk factors like pre-pregnancy diabetes or hypertension, or smoking
• Introducing new Medicare items for post-partum health checks for women would be a simple and cost-effective measure to enable early intervention and reduce the burden

Women’s Health and Climate Justice in the Pacific

• Dr Downey is working to establish a Women’s Health and Climate Change Research Network to drive policy change and protect women and girls from the health impacts of climate change across the Pacific
• The effects of climate change in the Pacific and wider Oceania including Australia will be some of the most extreme, thanks to rapidly rising sea levels, eroding food security, and increasingly frequent and extreme natural disasters
• The network’s first roundtable meeting will take place later this month in Sydney, with collaborators aiming to kickstart work to strengthen capacity, undertake collaborative research, share information and learnings
• The UN Intergovernmental Panel for Climate Change (IPCC) recognises women are a crucial untapped resource when it comes to positive climate action for the benefit of all.
• The plan is to work with women across the region to understand who is most impacted by changing climate, how they are impacted and why, and to generate local policy interventions

*National Climate Resilience and Adaptation Strategy 2021 to 2025

Photo: Cassandra Hannagan