Good afternoon. Thank you for the invitation to speak with you today.
There are many strategic documents that have been developed in Canada and globally since the recognition of the importance of sex- and gender-based research into many conditions, including, as mentioned previously, cardiovascular diseases; cancers; metabolic diseases; mobility issues, including sports-specific studies; infectious diseases specific to women; mental health conditions and conditions of aging. In addition, as previously mentioned, there are very specific conditions: gynecologic and breast cancers; menstrual cycle disorders; endometriosis and pelvic pain; and management of fertility, preconception, pregnancy, postpartum, menopause and post-menopause.
This is a daunting and entirely incomplete list of conditions that have only been partially addressed through attempts to increase women’s inclusion in clinical trials, cohort studies and female-specific approaches in fundamental science. In addition, the disparities in Canada experienced by rural and remote populations, indigenous peoples and those experiencing poor socio-economic challenges are amplified in the women’s health space.
Instead of bombarding you with more statistics, I'd like to share three specific anecdotes from my experience as a women’s health researcher. My first example draws on my experience where I had the privilege of participating in a bold trial studying the impact of the first licensed HIV drug, AZT, in pregnancy in a placebo-controlled study. The interim analysis came out in February 1994, and we immediately received the data in our clinic showing that the transmission rate of HIV from mother to infant was only 8% in the treatment group compared to 25% in the placebo group. This was the first demonstration that HIV drugs could be used for treatment as prevention. It was an extraordinary moment in medical research, and it was globally pivotal. I returned to Canada in September 1994, and we launched routine antenatal screening for HIV and standard treatment to prevent the transmission of this then-deadly virus. I was forever convinced of the value of pregnancy-specific and women’s health-focused research.
My second example is that of the HPV vaccine and HPV screening towards the elimination of cervical cancer. The discovery of the HPV virus as the near-universal cause of cervical cancer was not only pivotal for women’s health but also brought us to the opportunity to have a vaccine-preventable cancer. Despite major advances in understanding the biology and in how to prevent this disease, it continues to kill relatively young women worldwide—one every two minutes and still more than one death per day in Canada.
Canadian research has, however, contributed to understanding the two key strategies: vaccine programs and HPV screening instead of Pap smears. This is a proven strategy. We've just deployed it in British Columbia and will hopefully move across the country soon. This is a research success story that has driven global strategies from Canadian-based research.
The third example is from our recent pandemic experience. You will recall that, at the beginning of the pandemic, most of the focus—probably appropriately—was on the general population and vulnerable elderly. However, we didn’t know the impacts on women, pregnancy, the fetus and the newborn infant. We were able to pull together many experts across Canada to form a network to study this. Our data showed that pregnant women had a substantially higher rate of hospital and ICU admission and preterm birth rates. This immediately informed clinical care, and when the vaccine became available, Dr. Theresa Tam recommended specifically offering pregnant women the COVID-19 vaccine to prevent these adverse outcomes.
Now our data shows not only that the vaccine is safe but that adverse outcomes are substantially reduced in vaccinated versus unvaccinated women. The key point here is that without Canadian teams ready and able to pivot to study diseases in women and in pregnancy, we would not have even appreciated the substantive differential effects.
Finally, I would like to propose some recommendations to move women’s health research forward in a strategic and focused way. I believe we need to develop a strategic plan for women's health research in Canada. Part of that, in my opinion, is that we need to invest in key scientists who will focus on women's health research, and we can do this by creating more salary awards for scientists and clinician scientists. Ultimately, we need to break down barriers between provinces to share data and understand cofactors.
To conclude, I would like to quote the ambassador for women's health for the U.K., Dame Lesley Regan. "When we get it right for women, everyone in our society benefits."
Thank you.