Have you ever had a conversation with RFK Jr. about your concerns, given this sort of anti-vaccine rhetoric that he seems to, I think, perpetrate?
I have not directly, but certainly the foundation has engaged in that discussion and it has not gone well.
First of all, Melinda, it's so nice to see you again. I wish you were here in person, but it's nice to see you virtually at least.
Oh, it's great to see you, Katie. Glad we could do this.
Well, I'm so excited that you continue to focus on women's health, which is so important given the fact that we're more than half the population, but have historically not really gotten enough attention. And you're announcing that you're increasing your funding, your already significant funding, I might add, to women's health, with an additional $215 million to address women's reproductive years and midlife menopause. So, tell me about this latest initiative and why you decided to focus on those chapters of a woman's life.
Well, this additional 215 million brings me up to 600 million in women's health and I believe that women have to be well to do well. That is to reach their full potential to step into their power. Our health is completely connected to the rest of our lives. So, I've been focusing for a long time in my career on reproductive health and that whole reproductive cycle that women go through whether they choose to have a baby or not. I'm now and I'm doubling down on that. But now I'm adding on this transition that women go through at midlife which happens to many women starting in their early 40s actually of perimenopause and menopause because this area has been so underfunded and underresearched and underrecognized for forever for all the years and as you said yet we go through it. We go through reproductive years and then we go through midlife and half the population goes through it.
You know, it's interesting to me, Melinda, that we've seen a huge amount of attention suddenly on menopause and perimenopause and people, it seems, women in particular, are talking about it much more than they used to. It really used to be a taboo topic that people felt embarrassed to discuss. Do you think that that is moving the needle in any way? All the conversation that we've seen online or just in person about quote the change.
I think it's beginning to me it's the beginning of what needs to happen. We always need to speak in public our truth which is for too long this time in layman's life has been invisible and you now have enough women who have gone through it who are saying no no no no I want to be seen during this time I want to get the health care service I deserve. Now what needs to come is credible information everybody trained in the right way when you touch that medical system primary care doctor mental health professional your OB/GYN, they need to be trained. And quite frankly, we need more money in this space, a lot more money to then be able to also do research. There's so much we do not know about women's hormones.
In fact, how do you make a decision, Melinda, with your incredible philanthropy where the money is going to go, what research you're going to fund?
Well, for this period of women's life, what I'm doing initially is focusing on where I see the biggest gap at the moment, and that is one-third only one-third of OB/GYNs coming out of medical school are trained about perimenopause and menopause. So, your chance of getting credible information right now is low. So, again, they need to be trained properly. Primary care doctors, nurses, mental health providers. So, I'm focusing first on the training that needs to happen so that a woman when she touches the health care system for the very first time can get what she needs, the right information for her body, not have to touch many, many, many different doctors to go on this journey to figure out exactly what's happening to her with her hormones. And in fact, studies show that women, it takes four years for women to be diagnosed with a whole variety of diseases or illnesses versus men.
So you're right, women are so often dismissed. Their pain, their discomfort, their concerns are often blown off by these medical professionals, which is so frustrating for so many women.
It's very frustrating. And women, we are seeing women, one in 10 drop out of the workforce in our country when they go through this transition because what's happening is they're touching the medical system. They're not getting an answer. And so they're dealing with chronic insomnia, which can lead to depression. They're dealing with all kinds of hormonal changes that all have long lasting effects for their cardiovascular system, for some cancers, you know. So, we need to reverse that trend. Even for me, Katie, I am unbelievably privileged when I go into a health care system, right? But it took me three doctors to get the proper care I needed during that time in life, right? And so we know if a woman gets the right care at the right time, the outcomes are completely different for her. And these are just critical years in a woman's life. She's often finally reached the place she wants to be in her career. She might be about to launch her kids to college or just have launched them. They amazingly can be productive years if she's not dealing with all these background issues that are unseen by the medical profession.
And some of these unseen and untreated illnesses, it sort of results in a cascading effect, if you will, where it can lead to other problems if they're not mitigated, you know, immediately. I really appreciate that you're also focusing on mental health, both physical and mental health. With this commitment, you've cited that roughly one in five mothers experience a mental health condition during or after pregnancy. And additionally, that women experience higher rates of depression during menopause. And I'm curious if we fully understand why.
I don't think we fully understand why. I think there are many many factors, some of them for sure hormonal, but also we have to admit where we are as a country, right? I was just in Alabama a few weeks ago talking with a woman named Asia who'd had one her first child. She'd gone through severe depression, postpartum depression. Nobody diagnosed it. It went undiagnosed. She said the way she cared for her child. She said, 'I loved my child, but I couldn't care for her in the right way.' Then she went to have a second child and had not good medical system experience. She miscarried. And finally, with her third pregnancy, she went to the right clinic. They screened her the minute she walked in the door for her mental health. And they got her on the right anti-anxiety medications. They got her to the right counselor. She said, 'I felt seen all the way through my pregnancy, and when this baby was born, the way I could care and love for it and show my care and love is completely different than my experience back here.' And so, we need to look at all of the things going on for women. They come into these clinics and they say, 'Look, I'm worried about groceries. I'm worried about feeding a new child. I want this new child. I'm worried about child care and what it will do to my job.' So, there are also many background factors going on in our economy and our society that are also affecting women's anxiety and depression at all these stages in life.
So, how are you hoping to change these statistics? Obviously, this program in Alabama, which sounds fantastic, might be a role model for other states. Are there things that you're thinking about that where this money might go that will help women like the one you just described?
Yes. I'm trying to show ways to move forward by putting wraparound mental health services in all healthcare clinics. We should be doing it everywhere. Whether it's a young woman who's a teenager and dealing with an eating disorder, right, right as she's entering her reproductive years, whether it's a mom who's dealing with anxiety or postpartum depression, she needs to be cared for all the way through, or whether it's a woman who's going through midlife and she has huge insomnia because her hormones are changing. Every single place a woman goes, she should be touched and screened for her mental health. It's not that hard. So, I'm trying to show places we can do this and ways of doing it in hopes that we can get all healthcare to take this up.
There are dozens of alarming stats that illustrate how evident the women's health gap is. As you well know, two-thirds of Alzheimer's patients in the United States are female and yet just 12% of Alzheimer's research funding goes to women focused studies. Erectile dysfunction, which affects 19% of men, has gotten five times the amount of research dollars as PMS, which affects 90% of women. And it wasn't until 2016 that the NIH even required researchers and scientists to differentiate between men and women in their studies. You know, when you hear these statistics, it does make you wonder how did we get to this place where women are so ignored and their diseases so underfunded?
Well, I think you have to go back in the history of the United States and the world like who was making the decisions first of all who was applying for the research it was often men back in the day. Who was making the decisions about what gets funded? That was men. Who was graduating from medical school and understanding the human body? It was men. So the men's body got treated as the default body even in research. And the women's was, you know, a slight differentiation from that. Let's maybe titrate the medicines differently. No, no, no. We have different systems, different hormones. We're actually different cardiovascular systems. So, what you're finally seeing is enough women have graduated from medical school now. It's on par with men. You're seeing women like you who have a really big advocacy platform speaking out. You're seeing women who are stepping into their power with more resources say, 'No, this isn't right. I am going to bring others in and we're going to fund these areas.' It is time, Katie. And I, you know, I think of what you did with many others on Stand Up to Cancer, right? We look at cancer differently in our country. We look at colon cancer differently because of what you did. We look at breast cancer differently because of what Susan G. Komen Foundation did that was one woman who started that Nancy Brinker because her sister died of breast cancer at age 36. It happened to be the year I graduated from high school. Now women wear pink ribbons. We do the races and the walks and we raise money. But we also know to screen ourselves and we go in and get mammogram screenings. And so this is possible. And that's what I want people to know. We need to step in with our voices, with our money, with our power and say women's health matters.
Amen to that. I wanted to take a step back and talk with you a little bit, Melinda, about what you've done with the Gates Foundation. In 2000, you and your ex-husband, Bill, founded the organization to combat infectious disease globally. And I'm curious as you traveled around the world, what were some of your most formative experiences that shaped your understanding of the health disparities that exist not only in this country but all over the globe?
I traveled, as you said, Katie, for 25 years, and I would often be out in very remote rural places or townships three times a year in Southeast Asia and also on the continent of Africa. And what I saw was actually the great length people will go to save their child. Great length. So they will walk miles to line up in the heat to get a vaccine. They will go miles to get that baby delivered in a healthy way. If there's a clinic available, they will stand in line to get treated for, you know, eye diseases. People want to be healthy and they want their children to be healthy and yet the disparity in the care around the world is just pretty unbelievable when you go out and see it. And I will say the US over time had been extraordinarily generous starting with President George Bush, his enormous investment in AIDS. I watched those clinics being built and visited many of them and they not only provided HIV services but they were often attached to the clinic and they made sure another clinic that was already there became more high quality because when people come into the system they don't come in for one thing they come in for full services. So, it's tragic to see what's been pulled back by our country.
And of course, those are disparities caused by poverty, but when it came to disparities in and how women globally were cared for, treated, etc., versus men, and sort of the patriarchy honestly that you witnessed around the world, I wonder if anything struck you about that as well.
Women are around the world up against many different things depending on, you know, which country or community they live in, but they know how important their health is and their kids' health. So, I've had a woman who was basically yelling at me and she said, which was fine. She said, 'I have five children. I can't have another one. Do you see that clinic?' And we could see it from her house. She said, 'I go there. It used to have contraceptives. It doesn't. Now, what am I going to do?' And again, it had to do with how the funding was flowing. I've had women who had to deliver at home because there wasn't the transport fees or no one believed her how much pain she was in in giving birth and they kept telling her to push and in fact she got in a terrible situation and lost her baby. So the system needs to work for women. We are the bearers of the children. We are the center of the family and we go to great lengths to care for our children. And even the way women spend their resources when they do have a modest or a modicum of an income, they spend it. We have great health research. They spend it on their children, feeding their children and on their children's health. So getting behind women, what I know about women, what I've learned over these 25 plus years is that when you support a woman or you invest in a woman, she supports and invests in everyone around her. And that lifts up her family, it lifts up communities, it can eventually lift up whole countries and whole economies, right? I mean it's whole economies, whole economies.
I imagine the situations have gotten even worse given the dismantling of USAID by the second Trump administration. I know in November the Harvard School of Public Health estimated that at that point hundreds of thousands of people had already died because of the moves to get rid of USAID. How devastating has it been for you to witness the impact of this agency shutting down and basically the abandonment if you will of soft power around the world?
It is tragic. It is tragic to see like I have been out in places where you would see the you know the bags of seeds or food that said USAID people or this clinic is sponsored by USAID. People knew that the US government was the one that was helping fund these health clinics or some of these feeding programs. And so to see something that was over 30 years in the making, to see these health clinics, I was in Botswana before there was an AIDS clinic and then we helped set up one as a foundation and then another one came in. You could see the transformed lives. You could see men and women. I would stand with men and women who were in line with their children and ask them, you know, why did you come to this clinic? They knew about the vaccines and they knew that hey these are coming from other countries like they were so grateful. So to roll that back when it was such a fraction it was less than 1% of the budget of the US government and it had so much goodwill and it allowed people to stay in their communities. People when they can raise healthy children and have some economic means, which they could if they had seeds and were farming, they want to stay there. But now we've created a crisis because we cut this tiny little piece of the US budget.
We are seeing the ramifications play out in this current Ebola outbreak. Since the WHO declared a public health emergency last month, there have been about a thousand cases and hundreds of deaths from the Sudan species of the virus in the Democratic Republic of Congo and Uganda. What is your assessment of the response so far and how concerned are you about it?
