В Канаде могут создать национальную стратегию женского здоровья по инициативе сенатора Даниэль Хенкель

Gaps in women’s healthcare have been a problem in Canada for decades. Unlike most other Western countries, Canada does not have a national framework for women’s health. But that situation could soon change following Senator Danièle Henkel’s introduction of Bill S-243, which would establish such a framework. Support from the Society of Obstetricians and Gynaecologists of Canada (SOGC), the Canadian Women’s Heart Health Alliance (CWHHA), Canadian Cardiovascular Society (CCS), Women’s Health Coalition (WHC), and other stakeholders in women’s health, as well as political parties on both sides of the aisle, suggests that the bill may be enacted. Henkel’s interest in improving women’s health in Canada originated in her professional experience as a women’s health and beauty products entrepreneur, as well as her experience as a breast cancer survivor and mother of cancer survivors. “Our healthcare system often performs well during the acute phase of an illness but steps back too early,” she told Medscape News Canada. Women must “navigate reconstruction, psychological care, and long-term recovery alone.” In addition, access to care depends on where the patient lives, Henkel continued, and women remain underrepresented in research. “In 2025, only 7% of federal research and development funding was dedicated to women’s health,” she said. “Women face delayed diagnosis because their symptoms are misunderstood, minimized, or assessed using clinical models developed primarily around men.…Today, we still train our doctors and our professional healthcare specialists only 10% on women’s bodies.” Clinicians, too, have raised similar concerns. “I’ve seen throughout my career that there are incredible inequities in women’s health,” Nicholas Leyland, MD, SOGC president and professor of obstetrics and gynecology at McMaster University in Hamilton, Ontario, told Medscape News Canada. “It’s often just an unconscious bias that we have.” Sharon Mulvagh, MD, codirector of the Women’s Heart Health Clinic at the QEII Health Sciences Centre in Halifax, put it more bluntly. “In healthcare and the medical sciences, women have generally been either neglected or treated as though they are small men. Women have been poorly represented as research subjects as well as research investigators. This neglect has resulted in a paucity of appropriate research, which then creates deficiencies in clinical care due to a lack of evidence upon which to develop clinical guidelines, which are the cornerstone of clinical preventive, diagnostic, treatment, and management strategies,” she said. A Comprehensive Approach The WHC helped draft Bill S-243 after Henkel shared a stage with Carmen Wyton, the organization’s founder, chair, and president, at a Première ligne en santé conference in Montreal. As Canada’s primary women’s health advocacy organization, the WHC has used its network of partnerships to shape and support the bill. The drafters have sought to produce a well thought-out, comprehensive bill. It addresses areas such as research and innovation, collaboration between the public and private health sectors, national data collection and collaboration, training and education, pay equity, primary care and preventive health, and access to care, particularly for vulnerable and marginalized groups. “What makes it different is the accountability that is imposed on the government when this bill passes, to make sure that women’s health is never left behind again,” Wyton told Medscape News Canada. The bill requires the women’s health framework to be on the agenda at every provincial and territorial health minister’s meeting. It requires a permanent placeholder for women’s health on every budget. If the bill passes, then a women’s health framework must be brought forward for discussion within a year. The discussion must include input from the stakeholders involved in drafting the bill because many of them will be tasked with implementing the framework. The strategy must be renewed every 5 years. Building Widespread Support To garner support for the bill, Henkel and her staff met with researchers, members of Parliament (MPs), and other senators. She successfully secured the sponsorship of MP Lisa Hepfner. Since Canadian healthcare is administered by the provinces and territories, not the federal government, Henkel was careful to get their buy-in. “The requirement is that territories, provinces, researchers, and the different communities will be around the table,” said Henkel. “They will need to have their say, and they will need to help structure this strategy.” Henkel’s efforts to give everyone a voice are paying off. The SOGC is a major supporter of the bill. “We know that this is a good thing going forward, and we need to work together to make it happen,” said Leyland. Lack of funds is no excuse not to support the bill, he said, because a 2025 McKinsey Health Report demonstrated that closing the gap in women’s health could boost the Canadian economy by $37 billion annually by 2040. In her capacity as vice chair of the CWHHA and chair of the Equity, Diversity, and Inclusion Committee at the CCS, Mulvagh is helping to draft letters of support for the bill that focus on “the need for equitable cardiovascular care, emphasis on screening and prevention for cardiovascular disease, support for more research funding for women’s cardiovascular health, and increased multidisciplinary collaboration and engagement of women with lived experience.” Michelle Jacobson, MD, corporate chief of obstetrics and gynecology at the William Osler Health System in Ontario, has been vocal about how lack of access to menopause care in Canada negatively affects women. “Bill S-243 is an important and overdue step toward addressing the longstanding gaps in women’s health in Canada,” she told Medscape News Canada. “It appropriately focuses on several areas that are essential to meaningful change: equitable investment in research, better education for healthcare professionals, stronger primary and preventive care, and improved access for women in rural, remote, and equity-deserving communities.” Moving the Needle Forward? In the fall, the WHC and other partners will gather intelligence throughout the provinces to ensure that the bill meets everyone’s needs. By early spring of 2027, their focus will be on Parliament as they expect that the bill will have passed the Senate by then. “I’ve never seen it work like this before, with this many people working so collaboratively together,” said Wyton. “It’s a sign that people were waiting for this opportunity to have a movement like this happen.” In the long term, passage of the bill could promote more equitable treatment of women’s healthcare, continued Wyton. The bill also could hasten the introduction to the market of products that address women’s health. “Some of the biases will begin to be taken care of because [of the potential to] call out those biases by virtue of the bill,” said Wyton. “Through Bill S-243, when new funding is made available, the federal government would be able to say, ‘We’re going to transfer those funds outside the Master Agreements [with the provincial and territorial medical societies],’ and it will allow for some evolution in pay equity.” Thus, the bill could help bring reimbursement for gynecologic care into greater alignment with reimbursement for other specialties. But while support of the bill is virtually universal, some of those working in the field remain concerned that it does not go far enough. “The bill does not provide granularity in clarification or prioritization in the complexity of multidisciplinary healthcare areas in which women are underserved,” said Mulvagh. “Also, the timeline seems somewhat protracted. There is an urgent need to initiate and implement this strategic plan as part of the government’s Build Canada Strong program to establish and maintain a healthy workforce to contribute to a strong economy. Women represent nearly half of Canada’s workforce, and in 2024, 85% of women aged 25-54 years were employed.” Similarly, Jacobson pointed out that while the bill “requires a framework, it does not itself guarantee funding, services, or measurable improvements in care. Its impact will therefore depend entirely on implementation. The eventual strategy will need dedicated funding, clear timelines, measurable targets, and transparent reporting. It must also be developed with meaningful input from patients and frontline clinicians and translated into practical improvements — such as better professional education, timely access to evidence-based care, and consistent standards across provinces. If those elements follow, this bill has real potential to move women’s health in the right direction. Without them, there is a risk that it becomes an aspirational framework without enough tangible change.” Leyland, Wyton, Henkel, Mulvagh, and Jacobson reported having no relevant financial relationships.