“We have the science, we have the technology—now we need the political will and investment to match.”
Dr. Ru-fong Joanne Cheng, Director of Women’s Health Innovations, Gates Foundation
The Gates Foundation on Monday announced a $2.5 billion commitment through 2030 to advance a wide range of innovations aimed at improving women’s health spanning new medicines to prevent maternal deaths to vaccines targeting infections that disproportionately impact women. To explore the significance of this investment, Africa.com Founder and Executive Editor Teresa Clarke connected with Dr Ru-fong Joanne Cheng, Director of Women’s Health Innovations at the Foundation.
Africa.com: This is the largest investment the Gates Foundation has made in women’s health R&D to date. Why now? What shifted—scientifically, politically, or socially—that made this the moment to act at a larger scale?
Ru Cheng: For decades, women—particularly those in low- and middle-income countries—have endured preventable suffering because of systemic neglect in health research and development (R&D). Across my career as both an OBGYN clinician and as a drug and device developer in the biomedical industry, I’ve seen the toll this takes on women: delays in diagnosis, outdated or inadequate treatments, and a disconnect between what exists and what women actually want from their healthcare.
These gaps have real consequences. Despite living longer, women spend 25% more of their lives in poor health compared to men. It’s time to change that.
Our commitment to women’s health R&D is rooted in a simple but urgent belief that women all over the world deserve access to the care, tools, and innovations that can protect their health and unlock their potential. With emerging technologies like AI diagnostics and new understanding of the microbiome, we have real scientific momentum. But we also need political will and financial backing. Now is the time to match scientific potential with bold action and collective commitment.
Africa.com: Many of the areas you’ve targeted—like endometriosis, heavy menstrual bleeding, and menopause—have long been neglected despite affecting hundreds of millions of women. What structural or systemic barriers have kept these conditions under-researched for so long?
Ru Cheng: Historically, women’s health has been sidelined in R&D. Just 1% of global health R&D funding goes toward female-specific conditions outside of oncology. Diseases like preeclampsia, heavy menstrual bleeding, endometriosis, and menopause have been mischaracterized as niche or secondary, despite affecting hundreds of millions of women and significantly impacting quality of life. And for too long, women’s experiences have been left out of the design and delivery of health solutions—leading to tools that miss the mark because they were designed for men.
These failures are even more acute for women in low-income countries, where diagnostics and treatment are already limited. For example, heavy menstrual bleeding, an important cause of anemia for women in LMICs is reported by up to 48% of reproductive aged women. Too many women are managing chronic gynecological conditions such as uterine fibroids, a cause of HMB, without adequate care, and the tools that do exist are often outdated or inaccessible due to cost or limited availability. This is a systemic issue, not just a data gap. It reflects decades of underfunding, biased priorities, and a lack of urgency to solve problems that affect women every day.
Africa.com: The foundation is urging co-investment from governments and the private sector. How are these stakeholders incentivized to move from philanthropic interest to concrete investment in women’s health innovation?
Ru Cheng: Investing in women’s health is not only a moral imperative—it’s also an economic opportunity. Every $1 invested in women’s health yields up to $3 in economic growth, and according to a study by McKinsey, closing the gender health gap could boost the global economy by $1 trillion annually by 2040. When women are healthy, they can thrive—which results in healthier families, communities, and economies. That’s not just a return on investment—it’s a clear reason to act now.
At the Gates Foundation, we’re funding low-cost, scalable innovations like self-injectable contraceptives and point-of-care ultrasounds that are designed for low-resource settings but relevant everywhere. These are not just lifesaving tools—they’re investable solutions with strong social returns. But our contribution is only one part of the equation. We’re actively calling on governments, investors, philanthropies, and the private sector to step in—to co-invest in the research, help develop and introduce proven tools, advocate, and ensure these innovations reach the women who need them most.
Africa.com: How are women—especially those in low- and middle-income countries—being involved in shaping the R&D agenda? Can you give an example of how women’s lived experiences influenced a specific innovation or funding decision?
Ru Cheng: Women’s healthcare preferences must be central to research and development decisions. Innovations succeed when they reflect what women want and need—when they’re shaped by real-world preferences, not assumptions. That’s why we’re working with partners around the world to co-design tools that align with women’s lives, including in low-resource settings where access and discretion are critical.
One promising example is the development of a self-administered microneedle contraceptive patch—a small, painless device that looks like a clean Band-Aid and delivers six months of pregnancy protection using progestin, a hormone already found in many oral contraceptives. Women globally are seeking options that provide more autonomy, fewer side effects, and greater convenience. For those in low- and middle-income countries, these needs are further shaped by barriers like limited access to clinics, stigma, and the importance of discretion. This patch was designed with those realities in mind—it can be self-administered, in a private, user-controlled setting. By grounding innovation in women’s lived experiences, we can ensure new tools are not only effective but used by women looking for the right solution to meet their health needs.
Africa.com: Which scientific breakthroughs and innovations related to women’s health excite you the most? Which matters related to women’s health still keeps you up at night?
Ru Cheng: What excites me most are breakthroughs that unlock equitable access to care in previously neglected areas. AI-enabled tools are transforming how women receive diagnostic services in low-resource settings, which, for example, is making point-of-care pregnancy monitoring feasible even in rural clinics; I’m excited about bringing that technology to diagnose gynecologic conditions too. Meanwhile, research into the vaginal microbiome offers transformative potential: it may improve pregnancy outcomes, reduce rates of preterm birth, and lower susceptibility to STIs by better understanding the microbial ecology around the reproductive tract.
Yet what keeps me up at night is the stark reality that we still lack robust data on chronic conditions impacting women that are entirely preventable. Without better data, stronger diagnostics, and a fundamental shift in how we prioritize women’s health, these gaps will persist, and women will continue to suffer. That urgency must drive everything we do.
Africa.com: This initiative is clearly about more than health—it touches economics, equity, and empowerment. How do you measure success in a program like this, and what does the world look like if the vision is fully realized by 2030?
Ru Cheng: Success means more than just products in the pipeline—it means systemic change. It means women’s health R&D is visible, valued, and well-resourced. It means more women influencing research priorities, more funding flowing into historically overlooked areas, and more women leaders represented at the decision-making table. It won’t happen on its own—it must be deliberate, sustained, and inclusive. If we get this right, we’ll see not only a pipeline of new innovations reaching women around the world, but a lasting shift in the global system—one that starts with girls’ health and then is supported with dignity, science, and care at every stage of a woman’s life.
