Women may live longer than men, but they spend 25% more of their lives in poor health than men do. Every two minutes, a woman dies in pregnancy or childbirth. Women were rarely included in clinical trials until the 1990s, and today, “the medical field still doesn’t know how well many drugs and devices work for women,” according to the Association of American Medical Colleges.
Facts like these — and the gender health gap they represent — animate Melinda French Gates’ new initiative, Action for Women’s Health, announced this week through her philanthropic LLC, Pivotal Ventures. The initiative, a $250 million global open call, will fund organizations promoting women’s mental and physical health.
Action for Women’s Health is part of French Gates’ latest $1 billion commitment, announced earlier this year, just weeks after she made public her imminent break from the Gates Foundation. “Melinda announced in May that Pivotal will begin to deepen our work in health and will do so globally,” said Haven Ley, Pivotal’s chief strategy officer, in an email to IP. “As we engage into the global women’s health space, we want to identify new thinking from perspectives around the world to bring awareness and solutions to the lack of access for women’s health today.”
The global open call is funded by Pivotal Ventures’ 501(c)(3) nonprofit arm Pivotal Philanthropies Foundation and managed by Lever for Change. The application deadline is December 3, and awards will be between $1 million and $5 million. Awardees will be announced by the end of 2025. (See the website for more details).
“Women’s health continues to be an afterthought, and it’s impacting the health of our families, our communities, our economies,” French Gates said in a video included with the announcement. “Thankfully, there are so many amazing organizations around the world working to change that.”
Her own path
Melinda French Gates has already been charting her own path as a philanthropic funder — and a social impact investor — since she created Pivotal Ventures in 2015. Still, since her divorce from Bill Gates and her separation from the foundation they created together, she has been speaking out more forcefully — and backing up her words with dollars.
The New York Times described one element of this evolution: “After decades of carefully scripted neutrality, [French Gates] did what she had wanted to do ever since the Supreme Court overturned Roe v. Wade: She dived headfirst into politics.”
French Gates has endorsed Vice President Kamala Harris and donated to the vice president’s campaign at reportedly close to the maximum allowable amount; she has also spoken out in support of reproductive rights, a key political touchstone since the Supreme Court’s 2022 Dobbs decision ended abortion access. “While I have long focused on improving contraceptive access overseas, in the post-Dobbs era, I now feel compelled to support reproductive rights here at home,” French Gates wrote in a New York Times op-ed. She is now one of several high-profile women philanthropists lining up behind a vision of politics that doesn’t sideline women’s health (Laurene Powell Jobs, reportedly a longtime Harris confidante, is another).
Pivotal Ventures’ $1 billion commitment included grants to the Center for Reproductive Rights, the Collaborative for Gender + Reproductive Equity, the National Women’s Law Center, and The 19th, a nonprofit news organization that covers gender politics and policy, including groundbreaking reporting on reproductive rights.
Pivotal is on the forefront of other prominent issues, as well, as it works to strengthen the U.S. system of care and build women’s political power. In a September blog post, Nicole Sawran, Pivotal’s senior director of advocacy and public affairs, noted that both issues are in the spotlight this election season.
“With the historic nomination of a woman of color for president, our partners are telling us that they’re seeing a surge in interest in their work to build women’s political power,” she wrote. Meanwhile, Harris has promised to revive Biden’s “care economy” agenda, and recently announced a plan to fund in-home care for the elderly.
As she charts her own path, French Gates is also making a break with sector norms that long enforced distance between strictly philanthropic giving and more political forms of engagement. Pivotal is taking much stronger, more direct and outspoken stands on issues considered controversial and on rights under threat, like reproductive rights, than the 501(c)(3) Gates Foundation ever did, and these are still early days.
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Action for women’s health
Where women’s health is concerned, French Gates’ evolving giving doesn’t just reflect new threats to reproductive healthcare in the U.S. post-Dobbs, but also what she says she’s come to realize about the gender politics of healthcare access around the world.
In a September interview with Vanity Fair, French Gates said that the gaping gender health gap was a reality she was first exposed to at the Gates Foundation: “In the early years of the foundation, we just didn’t understand the role that gender played… But things just kept coming up for women — contraceptives, or their health, or what they wanted — that it started to make me realize we were making a mistake. If you came out with a new innovation, you couldn’t assume it got in the hands of men and women equally.”
The new open call will focus squarely on women’s health, but Pivotal Ventures has deliberately kept the focus wide. “Women experience inequities across all aspects of their health,” Ley said. “This open call envisions a future in which health-related barriers no longer prevent women from exercising their full power in society. We’ve intentionally ensured that the criteria for organizations to be eligible are broad and do not exclude any sub-sector, intervention or approach so we can learn more about the greatest needs and the opportunities for women’s physical and mental health.”
Ley pointed to several areas that are of particular interest, including women’s mental health, and the link between mental and physical health. “Additionally, we want to see interventions that focus on women beyond their reproductive years and in aging, as we are interested in new models to support women’s healthy longevity,” she said. Maternal and reproductive health is another area of interest, according to Ley, and as the open call plays out and French Gates’ wider funding develops, it will be interesting to see if that includes funding for organizations providing direct reproductive services.
“There are so many amazing ideas out there”
Some observers, including here at IP, have noted parallels in the philanthropy of French Gates and MacKenzie Scott, another ex-wife of a billionaire tech entrepreneur. The two are friends (“She’s a lovely, lovely person,” French Gates told Vanity Fair) and MacKenzie Scott has also used the open call as a vehicle to distribute her vast wealth to organizations working on an array of causes.
Scott’s inaugural Yield Giving Open Call wrapped up early this year, not long before French Gates started announcing her large funding commitments. The two have also collaborated on funding projects in the past. Most notably, in 2020, Scott and French Gates teamed up for their Equality Can’t Wait grant contest, which wrapped up in 2021 with major backing for four organizations.
Lever for Change, which is affiliated with the MacArthur Foundation and has become pretty much the premier implementation partner for high-profile philanthropic competitions funded by outside donors, is managing French Gates’ open call — and did the same for Scott’s. Along with MacArthur, Lever for Change is supported by funders including Scott, the Gates Foundation and Reid Hoffman.
“Partnering with Lever for Change provides the infrastructure for us to reach a broad network of organizations and leaders who have ideas that will help with that goal,” Ley said. “The $250 million initiative seeks to open access to funding streams to organizations that historically had a harder time accessing funding. With this approach, we’re hoping to lift and elevate the work of community-informed groups around the world that bring deep lived experience of the health interventions they work on.”
Lever for Change already has some experience with issues impacting global women’s health: Last year, it oversaw the Maternal & Infant Health Award, a grant competition to identify community-led projects working to improve the health of mothers and babies.
Philanthropic grant competitions and prizes are often criticized for requiring hopeful nonprofits to do a lot of legwork, and then providing only a small number of awards — or keeping the overall dollar figure low, despite the fanfare such competitions tend to generate. Lever for Change says it tries to avoid such dynamics by working to raise the visibility and increase funding opportunities for all participants in its challenges.
That was Pivotal’s experience after the previous challenge, according to Ley. “We learned from our partnership with Lever For Change with the Equality Can’t Wait Challenge that there are so many amazing ideas out there, and as a result, we launched a new website called the Equality Can’t Wait Challenge Idea Lab to increase the visibility of the top projects, as determined by peers and experts. We hope that this call will similarly draw more attention and resources to qualified applicants and finalists.”
Setting the agenda
What’s next for Melinda French Gates? Certainly, she has a lot to work with. Forbes just increased its estimate of her divorce settlement almost three-fold, and now puts her net worth at $29 billion. That already puts her in similar territory as MacKenzie Scott (net worth around $35 billion, per Forbes) in terms of the potential philanthropic billions she has on hand.
In her interview with Vanity Fair, French Gates called her personal fortune “surreal,” but to date, she has used it to address some very real world problems. As she wrote in the New York Times, “Because I have been given this extraordinary opportunity, I am determined to do everything I can to seize it and to set an agenda that helps other women and girls set theirs, too.”
