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Equity also depends on leadership. Who leads matters, Kedia and colleagues argue.6 Women’s health will not be transformed by systems still dominated by men. The global health ecosystem remains heavily skewed toward male decision makers, even in organisations focused on women’s rights and maternal health.7 When women do lead, they often face resistance, tokenism, or the expectation that their leadership should come at a discount. The result is predictable: the priorities of women are still being filtered through the lens of others. We must confront this imbalance directly. Institutions should not just appoint women to advisory roles but give them the authority to allocate budgets, set research priorities, and define success.8 Funders must invest in female led organisations and research groups, especially in low and middle income countries, where innovation can be informed by women’s lived experience as well as expertise.9 Around the world, we are seeing the erosion of reproductive rights, the policing of women’s bodies, and the defunding of gender programmes. These reversals are not isolated—they are signals of a broader regression in how societies value women. The scientific community cannot be neutral on this. Journals, funders, and health institutions must defend evidence based policy, protect women’s rights to health and autonomy, and ensure that “innovation” does not become a cover for inequity.

lated—they are signals of a broader regression in how societies value women. The scientific community cannot be neutral on this. Journals, funders, and health institutions must defend evidence based policy, protect women’s rights to health and autonomy, and ensure that “innovation” does not become a cover for inequity. Further, innovation in women’s health should be disruptive in the truest sense: it should challenge power, shift resources, and recognise that women’s health is shaped as much by social norms and economic policy as by medical technology. The investment in women’s health research is welcome, but it must deliver differently. We cannot afford another cycle of well intentioned initiatives that overlook who benefits, who leads, and who is left behind. The test of progress will not be in the number of innovations launched but in whether women’s lives, health outcomes, and agency improve as a result. If innovation does not shift power, it is not innovation.