For Penilla Gunther, president of the European Patient Safety Foundation, the campaign for equitable healthcare is not a distant policy ambition – it is a deeply personal mission. Her advocacy is shaped by experience: as a two-time cancer survivor and recipient of a heart transplant.
“I also have a story as a patient,” she says. “It’s important to me that we can see the differences, but also close the gap.”
Gunther’s journey began long before her health crises. “It started when I was a teenager,” she recalls. “Even back then, I was thinking about equity, about the differences between boys and girls at school. I became active in the student council.” That early activism came full circle years later when she entered Parliament and became her party’s spokesperson for equality.
Today, one of her focuses is on women’s health – an area where progress has been made, but structural inequities persist. Speaking with Euractiv on the sidelines of the European Health Forum in Gastein, where she joined a panel on ‘Women’s Health 2030: Closing the Gender Gap’, Gunther outlined the challenges that remain.
Clinical trials: Progress, but persistent gaps
One of the most pressing issues, she argues, is representation in clinical research. “We are still lacking,” she says. “Women’s participation in clinical trials has increased, but we still don’t have enough, especially not in cardiovascular diseases, but also cancer.”
Her own medical history underscores the urgency. “I’m a patient in many aspects, not only heart failure, but also a later heart transplant and two periods with cancer, two different cancers as well. It’s essential to see that every person should be treated equally,” she insists, adding that care must be tailored to individual needs rather than a one-size-fits-all approach.
Gunther believes Europe must strengthen cross-border collaboration to make trials more inclusive and competitive. “When it comes to rare diseases, no single country has enough patients to run a trial alone; we need to work beyond borders,” she says. “It should also remain attractive for industry. Otherwise, they’ll go elsewhere.”
She cites an example from a Washington conference on cardiovascular trials: “One of the major points was that we need more female researchers to attract other women, to talk the same language in a way.”
The hidden burden of care
Beyond the clinic, Gunther highlights the social dimension of health inequality: the invisible load of unpaid care. “Women are still taking more responsibilities in their homes, with their families. And it’s nothing unusual,” she observes.
Even in societies that pride themselves on gender equality, the imbalance persists. “In a relatively equal society, like the one I live in, where men take part of the responsibility, we still have that kind of project management for women,” she says, referring to what she calls the “family project coordinator” role.
The consequences often go unnoticed. “I think people around us often don’t realise how stressful it really is,” she explains. “And if your work or engagement isn’t recognised, no one sees you as sick or notices your symptoms, they just see you carrying on.” Women themselves, she adds, often dismiss warning signs because they are accustomed to coping. “A bit of stomach-ache or a headache, we tell ourselves it’s just stress or having too much going on.”
When symptoms are overlooked
Gunther’s own experience illustrates the danger of ignoring symptoms. “I was short of breath and thought I had the winter flu, maybe pneumonia. It was a Sunday evening, and I was supposed to travel for work the next day.” Expecting a quick prescription, she visited a doctor – only to be told to go straight to hospital.
“They ran tests overnight, and in the morning, the doctor came in and said, ‘Penilla, I think you need a heart transplant.’ Our jaws just dropped.” Another doctor later remarked: “‘Haven’t you felt anything before? You should really be almost dead.’ And I said, ‘Not so much.’”
Two years after the transplant, Gunther faced another blow: breast cancer. Fifteen years earlier, she had survived lymphoma. “What I didn’t know at the time, about heart failure, other than it was serious, was that my earlier cancer treatment probably caused the heart failure,” she says. Today, she champions cardio-oncology – the intersection of cancer and heart disease – as a critical area for research and policy.
“When we’re talking about the upcoming cardiovascular plan, together with the cancer plan, I really think we need to understand the connections between these two major areas.”
Policy momentum, frustrating delays
Gunther acknowledges that EU regulatory efforts have gained traction. “Yes and no,” she says when asked if Europe is on the right track. “I think the Cancer Plan has worked well. It opened the eyes of policymakers across Europe that when we improve cancer care, we improve the entire healthcare system.”
She welcomes initiatives such as the Critical Medicines Act, the Biotech Act, the Life Sciences Strategy and the Pharma Package. But implementation remains slow. “When ministers sit in the European Council and make decisions, they must follow through at home. It’s not enough to agree in Brussels and then take years to implement.” Innovation measures, she warns, are “taking too long.”
With the United States exerting pressure on the pharmaceutical ecosystem, Europe has a strategic opportunity – if it can coordinate effectively. “It’s about collaboration between the life sciences sector, patient organisations and regulators.”
Funding gaps and unequal access
Gunther sees another challenge: financing. “Travelling around Europe, I also see that we still lack financing for some very basic healthcare services, like screening.” These gaps, she argues, erode trust. “If people don’t feel safe when they go to healthcare, if they believe they won’t get the right treatment, or the same treatment as in another country, that’s pretty dangerous. Every citizen deserves the right to healthcare.”
Regional disparities compound the problem. A recent Swedish study found women use healthcare 10% more than men – unsurprising, Gunther notes, given maternity care. She also points to stigma around conditions such as cervical cancer. “People who are not aware of the causes speculate that you had this because of some kind of sexual relations,” she says, stressing the need for education and prevention.
Social insurance systems, she adds, rarely feature in public debate. “Across Europe, there are so many different models, and in some countries, private insurers practically decide which treatments people can access. I’m not against private insurance, but when access depends on money, that’s wrong. Equity and equality demand that everyone is treated as equal.”
A call for education and equality
Gunther warns that cuts to sexual education do not save money – they “lose knowledge,” leaving young people vulnerable and normalising abusive behaviour. Social media, she says, amplifies misinformation, posing real risks. “We must continue to educate and remind people of the struggles that were fought to achieve equality.”
Her message is simple: “Women are 50% of the population. Isn’t that a good reason for equality?”
(BM)
