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Earlier this month, an Australian-government commissioned report warned that the country’s R&D sector needs bold and urgent reform at a time when public investment has fallen to just 1.69 per cent of GDP, less than two-thirds of the OECD average of 2.7.
On the surface, the Ambitious Australia: Strategic Examination of Research and Development final report reveals a fragmented, underfunded and unsustainable system. It outlines a proposed roadmap to counter a 19 per cent decline in competitive grant funding over the past 12 years, as well as rising indirect research costs to 20 cents per dollar and an urgent need to strengthen the research workforce in priority areas.
All these are worthy and not unexpected recommendations. But when it comes to the causes of Australia’s negative R&D trajectory, what the report fails to include is just as significant as what it includes.
Look closely – you really have to look closely – and you will see that across the report’s entire 126 pages, the word “women” is mentioned only once (or twice if you count the figure legend). How is it possible in 2026 for such an important government report to fail to advocate for more women to be recruited as both conductors and subjects of medical research?
This omission reflects (and reinforces) the woeful current state of gender equality in Australia’s R&D space. Although women made up 37 per cent of Australian university STEM enrolments in 2024, they represent only 15 per cent of Australia’s STEM workforce and less than 20 per cent of STEM leaders.
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These statistics are not accidental. They are the result of biased funding models and inadequate retention and promotion processes. And they directly impact the health of Australian women, who experience distinct challenges and disparities compared with men.
For instance, in a 2024 Australian government survey, two in three women reported experiencing bias or discrimination in healthcare, particularly diagnosis and treatment. The survey found that women’s symptoms were often dismissed as “stress”, “hormones” or “just menopausal”, leading to late diagnoses and insufficient treatment.
A long as we have fewer women in positions of influence in medical research, conditions that disproportionately affect women will remain underfunded and under-researched. The likelihood will remain low of Australia developing better treatments for female-specific conditions such as ovarian cancer, endometriosis and menopause-related health changes – even though the impact of these on the health budget, as well as on women’s health, is very significant.
In addition, conditions that disproportionately affect women, such as autoimmune diseases and chronic pain, will remain underfunded – or, as with heart disease, one of the leading causes of death in Australian women, much of the research underpinning diagnosis and treatment will continue to be conducted primarily in men.
All this has a trickle-down effect. Medicine becomes distorted in the way it sees women’s health issues or women as patients – which, in turn, must influence community values. For instance, only 40 per cent of respondents to a survey conducted for Research Australia’s Women’s Health Research Roadmap, published last November, agreed that research is driven by women’s lived experiences.
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There are, however, encouraging signs of change.
On 3 March, Research Australia – the peak body representing the entire health and medical research pipeline – submitted its pre-budget 2026-27 submission calling for equitable funding to tackle gender inequity in health research, greater female representation across the medical research workforce – from early and mid-career researchers through to senior leadership – and full implementation of the roadmap.
That document advocates for coordinated, long-term investment in research systems, alongside targeted initiatives such as mentorship, flexible work support and dedicated funding streams to tackle the fragmented, short-term funding systems that disproportionately disadvantage women – leading to approximately A$300 million more in funding being awarded to men between 2019 and 2021 by the National Health Medical Research Council (NHMRC), Australia’s largest biomedical funding body.
The NHMRC itself is also moving in the right direction. Last year it co-authored a document with the Department of Health, Disability and Ageing aimed at promoting the consideration of “sex, gender, variations of sex characteristics and sexual orientation in health and medical research”. That document’s provisions have been embedded since 1 January in NHMRC and Medical Research Future Fund grant applications.
This raises hopes that longstanding evidence gaps will be closed and that inclusive, accurate consideration of sex, gender and diversity will be embedded across all stages of research, in partnership with under-represented communities and people with lived experience. Together with Research Australia’s pre-budget submission, which rightly links workforce equity to research outcomes, this represents a meaningful step toward systemic reform.
When more women lead research teams, clinical trials and medical schools, the questions change. The outcomes that are measured change. The patients who are prioritised change. And, ultimately, the health of an entire population improves.
Jessica Borger is associate professor in the School of Translational Medicine at Monash University and a member of the Monash Women’s Health Alliance.
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