Imagine a late 1990s hospital room. A young Black girl witnesses her father’s body becoming more and more absent from the room as it disappears behind a maze of wires and machinery, his kidneys failing. Long after her father’s passing, Daphna Fertil continued to think about that picture. Her mother, a recent immigrant who had sacrificed her health in order to work and support the family, eventually lost significant vision due to glaucoma and required injections to treat early-onset osteoarthritis.
These conditions could have been detected earlier and treated more effectively if access had not been such a stubborn barrier. Drawn by the notion that tiny gadgets like pacemakers, scaffolds, and regenerative materials could transform lives, Fertil continued his studies in biomedical engineering. But nobody had anticipated what she discovered in the lab: while science was advancing, not everyone was benefiting from it.
| Category | Details |
|---|---|
| Issue overview | Medical breakthroughs disproportionately fail to reach Black, Latinx, and other underserved communities due to systemic biases in research, funding, and deployment |
| Annual economic cost | $93 billion per year lost in excess medical-care costs linked to healthcare disparities (Federation of American Scientists, 2024) |
| Core structural barrier | Bias in patient selection, research funding allocation, and lack of diversity in biomedical research workforce |
| Key researcher profile | Daphna Fertil — Black woman in biomedical engineering; worked in Dr. Kaitlyn Sadtler’s lab at the National Institute of Biomedical Imaging and Bioengineering (NIBIB) |
| Research focus area | Immune-compatible biomaterials and muscle regeneration for devices used widely in underserved communities (e.g., pacemakers) |
| Known problem in cardiac care | Inequities in access to cardiac technologies observed across diagnosis, referral, and treatment — even for low-cost, established interventions like statins and beta-blockers |
| Global dimension | Life-saving innovations routinely fail to reach the Global South due to affordability, logistics, and policy gaps — not lack of scientific capacity |
| Initiative addressing the gap | SIGHT programme (Sustainable Innovation in Global Health Technologies) — collaboration between LSHTM, LSTM, and BSMS; aims to move pre-patent health tech to scalable real-world use |
| Equity-focused organizations | NAACP Health Equity Initiative; NSBE (National Society of Black Engineers); LEADERS (Leadership and Enrichment Academy for Diverse Emerging Researchers and Scientists) |
| Harvard finding (2025) | Despite decades of policy advances and medical breakthroughs, vast health disparities persist — experts at Harvard confirm inequities remain deeply embedded in global health systems |
| Key policy concern | Novel technologies may displace or reduce access to adjacent existing services — worsening equity gaps for patients who depend on older, accessible treatments |
This is the aspect of the medical innovation story that is rarely covered by the media. The announcements are exciting. A child’s deafness can be reversed through gene therapy. Patients with heart failure have better results thanks to a new cardiac device. A biomaterial aids in the regeneration of tissue where none previously existed. The images, which show researchers in lab coats, shiny equipment, and grant announcements, are hopeful. The people who are left out are not depicted in the photos. Black patients, Latinx patients, low-income communities, rural populations, and a large portion of the Global South have historically been disproportionately affected.
It’s difficult to ignore the numbers. The Federation of American Scientists estimates that the United States spends $93 billion annually on unnecessary medical care due to differences in healthcare outcomes. The compounded losses—missed diagnoses, delayed referrals, and medications that perform marginally worse in populations that were never sufficiently represented in clinical trials—are not included in that figure. To put it more succinctly, medicine continues to optimize for the patient it has traditionally envisioned, who is typically white, male, and insured.
Fertil encountered a particular form of this issue during her own research at the National Institute of Biomedical Imaging and Bioengineering. She was researching the immune system’s reaction to implanted biomaterials, such as pacemakers, which many patients in underprivileged communities depend on but frequently lack access to the follow-up care or device upgrades that more affluent patients take for granted. The science involved in improving those devices’ immune compatibility is truly fascinating. For precisely the populations with the fewest options, improved materials may be able to lower complications, increase device longevity, and improve outcomes. However, none of that occurs on its own. Instead of retrofitting equity after the fact, someone must choose to design with those populations in mind from the start.
There is more to the gap than just who is treated. It runs deeper and earlier. At a recent panel discussion at Brighton and Sussex Medical School, researchers came to the uncomfortable conclusion that funding or even regulation is rarely the biggest obstacle to global health innovations reaching the people who need them most. It is the lack of a well-defined route from discovery to deployment in environments with limited resources. The panel referred to a number of promising early-stage projects as being in a “valley of death” because they are too early-stage for commercial investment and too applied for traditional academic funding. There is science. There are moments when the will is present. It doesn’t have the infrastructure to support it.
Particularly in cardiac care, it’s difficult to ignore the pattern. ScienceDirect researchers have shown how cutting-edge cardiac technologies, such as minimally invasive procedures that actually improve patient outcomes, can actually decrease the availability of related services, making access more difficult for the very patients who were already having difficulty getting through the door. When an innovation enters the system, it consumes resources and medical care, and the knock-on effect subtly deteriorates conditions for those who required the more accessible, less expensive, and older option. In the same hospital wing, progress and regression are occurring concurrently.
Fertil’s viewpoint is unique because she knew what was at risk when she entered the lab. She wasn’t using scholarly literature to find health disparities. She had observed how they affected her own family. Biomedical research has historically lacked this kind of firsthand knowledge, both in terms of representation and the fundamental questions that researchers consider asking. For whom is this gadget intended? In reality, who will be able to access it? Whose immune response was examined? Who wasn’t?
There are some cautious reasons to believe that the field is beginning to take these issues more seriously. The goal of initiatives like SIGHT, the Sustainable Innovation in Global Health Technologies project created by the London School of Hygiene and Tropical Medicine and affiliated institutions, is to create a link between laboratory research and practical application. There are more and more programs aimed at educating researchers about commercialization routes and how to make technologies logistically feasible in environments with limited resources. The science itself is advancing more quickly than any of it. The issue is that imbalance. The issue has always existed. Furthermore, the communities paying for it aren’t waiting for the field to advance at its own speed.
