By Johanna Meszaros, Alumna of the RUG LLM International Human Rights Law ‘25

Introduction

From rumors about women’s saliva reacting badly with toothpaste to claims that women face higher fatality risks in car crashes due to male-designed crash test dummies, growing evidence points to deeper bias in health research [1]. This blog explores how such disparities systematically endanger women’s right to health within medical research.

It does so along the line of three angles, ranging from the general right under Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) to two other human rights that support the execution of the right to health; namely the right to be protected from discrimination as a basis for the right to health (Article 2 Convention on the Elimination of All Forms of Discrimination against Women, from here on: CEDAW) and the right to scientific progress as a tool for the right to health (Article 15 ICESCR) [2]. The blog only superficially touches upon these three angles, as well as limits itself to these angles. In a next blog, the right to scientific progress as a tool for the right to health will be dealt with at a deeper level.

The right to health

Article 12 (ICESCR) establishes the right to health “without discrimination of any kind,” requiring states to secure equality between population groups, including between women and men [3]. When disparities arise from research neglect rather than biological difference, they call the legitimacy of these health gaps into question. Women-specific conditions remain dramatically underfunded: only about 7% of biopharma innovation targets them, and less than 1% focuses on conditions beyond women’s cancers [4].

Endometriosis, affecting around 10% of women and girls worldwide, still lacks effective treatment despite decades of evidence on its disabling nature [5].

Historical exclusion worsened the gap. After medication prescribed to pregnant women in the 1950s–60s caused severe birth defects, regulatory backlash led to barring women of childbearing age from clinical trials for nearly forty years [6]. This created a vacuum in sex-specific data that still shapes medical practice today. Even now, women of colour and post-menopausal women are consistently underrepresented.

Because sexual and reproductive health is recognised as an integral part of Article 12, these research failures also hinder the enjoyment of interrelated rights [7].

The right to scientific progress as a tool for the right to health

Article 15 ICESCR guarantees the right to enjoy and benefit from scientific progress. In 2020, the General Comment No. 25 on Article 15 highlights the urgency to uphold a gender-sensitive approach, whether in the stages of research or funding [8]. Yet over 80% of pregnant patients receive therapies never properly studied in pregnancy or lactation [9]. Only about 5% of medications used in pregnancy have been adequately tested.

When sex differences are finally considered, the benefits become obvious: for example, new data on Novartis’s heart-failure drug Entresto revealed substantially different outcomes for women, prompting revised dosing guidance and demonstrating how delayed attention costs lives [10].

The right to be protected from discrimination as a basis for the right to health

CEDAW was created as targeted protection to prohibit sex-based discrimination, with Article 12 focusing specifically on women and health [11].

It focuses on access to health-care services, specifically in “areas of family planning, pregnancy and confinement and during the post-natal period” [12]. While the Committee stresses the importance of preventing, detecting and treating illnesses specific to women, persistent patterns, women being dismissed as “anxious,” pain minimised, or symptoms attributed to stress, reflect structural misogyny rather than clinical reasoning [13].

Reproductive health illustrates this dynamic vividly: contraceptive responsibility overwhelmingly falls on women, while male contraceptive innovation remains chronically underfunded and societally resisted [14]. This fuels a culture that excludes men from shared reproductive responsibility yet re-includes them when abortion is debated. As Ruth Bader Ginsburg observed, such debates ultimately concern “the roles women are to play in society” [15].

Concluding remarks

Women’s right to health cannot be realized while research frameworks, funding structures, and clinical practices continue to sideline them. These are not isolated scientific oversights but violations of clear human rights obligations. Ensuring women benefit equally from health systems requires confronting bias at its structural roots.

Endnotes

[1] DermNet NZ, ‘Contact reactions to toothpaste and other oral hygiene products’ https://dermnetnz.org/topics/contact-reactions-to-toothpaste-and-other-oral-hygiene-products
accessed 4 April 2025; New York Post, ‘Should women be using a different toothpaste than men?’ (31 October 2025); M Abrams and C Bass, ‘Female vs. male relative fatality risk in fatal motor vehicle crashes in the US, 1975–2020’ PLOS One 19(2) (2024); quoting A Linder and MY Svensson, ‘Road safety: the average male as a norm in vehicle occupant crash safety assessment’ Interdisciplinary Science Reviews 44(2) (2019) 140–153.

[2] Convention on the Elimination of All Forms of Discrimination against Women (adopted 18 December 1979, entered into force 3 September 1981) art 2.

[3] International Covenant on Economic, Social and Cultural Rights (adopted 16 December 1966, entered into force 3 January 1976) 993 UNTS 3, art 12(2).

[4] Evaluate Pharma, Kearney analysis, as cited in World Economic Forum and Global Alliance for Women’s Health, Kearney and the Gates Foundation, Prescription for Change: Policy Recommendations for Women’s Health Research (White Paper 2025) 9.

[5] World Health Organization, ‘Endometriosis’ (Fact Sheet, 24 March 2023) https://www.who.int/news-room/fact-sheets/detail/endometriosis
accessed 4 April 2025.

[6] National Institutes of Health Office of Research on Women’s Health, ‘History of women’s inclusion in clinical research’ (2024) https://orwh.od.nih.gov/toolkit/recruitment/history
accessed 4 April 2025.

[7] UN Committee on Economic, Social and Cultural Rights, General Comment No 22: The Right to Sexual and Reproductive Health (Art 12 ICESCR) (2 May 2016) UN Doc E/C.12/GC/22.

[8] Committee on Economic, Social and Cultural Rights, General Comment No 25: Science and Economic, Social and Cultural Rights (Art 15 ICESCR) (April 2020) UN Doc E/C.12/GC/25, para 7.

[9] Innovative Medicines Initiative, ‘Background’ IMI ConcePTION https://www.imiconception.eu/background/
accessed 4 April 2025; AL David, H Ahmadzia, R Ashcroft and others, ‘Improving development of drug treatments for pregnant women and the fetus’ (2022) 56(6) Therapeutic Innovation & Regulatory Science 976–990.

[10] Novartis, ‘Novartis Entresto granted expanded indication for chronic heart failure by FDA’ (Press Release, 16 February 2021) https://www.novartis.com/news/media-releases/novartis-entresto-granted-expanded-indication-chronic-heart-failure-fda
accessed 4 April 2025.

[11] Convention on the Elimination of All Forms of Discrimination against Women (adopted 18 December 1979, entered into force 3 September 1981) art 12.

[12] Committee on the Elimination of Discrimination against Women, General Recommendation No 24: Article 12 of the Convention (Women and Health) (1999) para 1.

[13] Elinor Cleghorn Comen, All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today (2024).

[14] ‘Sexual discrimination in contraceptive methods’, Encyclopedia of World Problems and Human Potential (2024) https://encyclopedia.uia.org/problem/sexual-discrimination-contraceptive-methods
accessed 4 April 2025.

[15]   Ruth Bader Ginsburg, ‘Sex Equality and the Constitution: The State of the Art’ (1978) 4 Women’s Rights Law Reporter 143.