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Sarah Chamberlain is a managing director and partner in BCG’s Seattle office. She supports the firm’s global health care practice area while directing much of her focus on issues of women’s health, including reproductive health, contraception, and maternal and newborn health. She works closely with key organizations such as the Bill & Melinda Gates Foundation, the World Health Organization, and the United States Agency for International Development.

When I was an undergrad, I did the full tour of a liberal arts education: art history, psychology, economics, biology, and neuroscience. I was exploring a bunch of different things. But I had always been drawn to math and science and medicine. I toyed with going to medical school and being a doctor, but I was interested enough in other areas—and particularly in innovation—that specializing didn’t feel right.

I was a junior at Williams College when my grandfather sent me a newspaper article about bioengineering as a discipline. I’d started to get really excited about the ability of technology to transform health care and make an impact on lives and in medicine. Bioengineering brought together a lot of things I was passionate about at the time. With my biology degree from Williams, I went to Seattle and earned a Ph.D. in bioengineering at the University of Washington.

I didn’t know a lot about consulting when I went to a BCG event called Bridge to BCG. It’s for advanced degree candidates. When I learned about what you get to do as a consultant—work with a wide range of clients on various topics that intersect at the point where there’s real impact—I was immediately interested.

I started at BCG in 2014 and became increasingly aware of severe inequities in health outcomes within the United States and around the world. Consider postpartum hemorrhage (PPH). It is the leading cause of maternal death in childbirth, accounting for up to 20% to 30% of maternal deaths. It is the leading cause of maternal deaths—affecting 14 million mothers across the world and taking the lives of approximately 70,000. It is staggering that most of these deaths (~80%) occur in Sub-Saharan Africa and South Asia. When looking within the US, Black women face a significantly higher risk of bad outcomes associated with PPH than do women of other racial groups. These numbers illustrate the problem of inequity. We have the tools to ensure better outcomes, but aren't able to get them to everyone who needs them. 

Enhancing both funding and innovation is a pivotal strategy for fostering change in women's health care. When it comes to funding, pharmaceutical companies allocate approximately 20% of their revenues to research and development (R&D) for new products. However, investment significantly decreases to just 2% for R&D in contraceptive technologies, despite their substantial potential to improve women's lives. A 2021 study by the Journal of Women’s Health found the National Institutes of Health applies a disproportionate amount of its resources to diseases that primarily affect men—at the expense of those that primarily affect women. This underscores the critical need for increased funding to catalyze innovation in areas neglected within women's health. For example, endometriosis, a condition that affects roughly 10% of women and can drastically reduce life quality, still lacks an effective diagnostic method, primarily due to insufficient R&D funding and innovation.

Innovation can help increase access, and increased access opens the door to further innovation. We need to find ways to make today’s standard of care available to all women.

BCG has a real opportunity to make a difference because we can apply a strategic and pragmatic lens to these big, complicated problems. We can use data to isolate the biggest challenges and then, alongside our clients, test solutions, gather more data and, over time, assess what’s working and what’s not.

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Meaningful progress in women's health requires participation from across health care sectors: innovators (biopharma, medtech, academic research), payors (insurance companies, including Medicaid and Medicare), and providers (hospital systems, practitioners, education). All have a role to play, and each needs the other to achieve meaningful change.

And we know it can work. We know that cross-sector investment in women’s health issues makes a difference. Due to a combination of earlier detection, new treatments, and increased public awareness, breast cancer mortality rates decreased 39 percent from 1989 to 2015.

There’s a lot to be hopeful about—and a lot to do. We still know strikingly little about how women’s bodies work, but I think we are also seeing a groundswell of energy and attention being brought to these issues in a way that, at least in my lifetime, I don’t think we’ve seen.

Technologies will continue to evolve and help. One example is the opportunity to pair artificial intelligence with ultrasounds in a way that helps less-trained workers be more effective. That, in turn, could increase the number of health care workers and create more access to services.

I’m optimistic that we will continue to see more money come into the space and more voices—women’s voices along with men who are fighting the fight for access to reproductive and maternal health care. Because this matters to us all. Because improving women’s health care is good from an economic perspective. When women everywhere are allowed to reach their full potential, everyone benefits.

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