Black women in America face maternal mortality rates over three times higher than white women. Nearly 100 million people worldwide are pushed into extreme poverty annually due to health expenses. Meanwhile, biotechnology companies develop treatments that launch with $26,500 price tags, accessible primarily to affluent patients.
These disparities represent more than moral failures—they signal massive untapped opportunities. The question facing biotech is whether breakthrough treatments will continue serving only privileged populations, or whether the industry can embrace what Leen Kawas calls intentional innovation designed to close healthcare gaps.
“One of the main goals I aspire to achieve is accessible treatments,” explains Leen Kawas, Managing General Partner at Propel Bio Partners. “I enjoyed the potential positive impact of reaching everyone.” This philosophy drives an investment strategy evaluating companies on their capacity to serve underserved populations globally, not just scientific merit.
The Clinical Trial Representation Crisis
Healthcare equity problems begin in clinical research. Between 2000 and 2020, 21 percent of trials included zero Black participants, while Hispanic participants comprised just 6 percent of median enrollment and Asian participants 1 percent—far below population shares. White participants were overrepresented at a median 80 percent.
These aren’t statistical curiosities—they create medical consequences. Fewer than 20 percent of new drugs approved between 2014 and 2021 included trial data on treatment benefits or side effects for Black patients. The U.S. Preventive Services Task Force couldn’t issue specific colorectal cancer screening guidelines for Black Americans, despite their higher mortality rates, because studies lacked sufficient participants to provide evidence.
Medical devices demonstrate similar problems. Pulse oximeters showed lower accuracy in patients with darker skin—an issue unaddressed until COVID-19 highlighted racial discrepancies in oxygen readings. This representation crisis perpetuates cycles where treatments may be less effective or harmful for excluded populations.
Economic and Geographic Barriers
High costs create systematic exclusion. Alzheimer’s treatments like Leqembi require Medicare patients to pay over $5,000 out-of-pocket annually. Gene therapies exceed $2 million per patient. Innovative obesity medications cost over $1,300 monthly, yet Medicare and Medicaid exclude them despite obesity rates being highest in communities of color and low-income populations.
Geographic disparities compound financial barriers. Rural Americans, representing 15-20 percent of the population, comprised fewer than 5 percent of clinical trial participants. Advanced treatments like CAR-T cell therapy initially launched at fewer than 100 hospitals, mostly in metropolitan areas, excluding rural patients from cutting-edge care.
Propel Bio Partners: Targeted Solutions
Leen Kawas has structured Propel Bio Partners to address these gaps through investments in companies serving underserved populations. Her approach reflects patient-centric innovation: “We built a team that did not think about barriers. We only thought about solutions and how we can do things better, differently, with a mindset that we are serving the key stakeholders, which are the patients.”
Persephone Biosciences tackles infant health equity through microbiome research. Ninety percent of U.S. infants lack beneficial bacteria like Bifidobacterium infantis, potentially contributing to rising allergies and chronic conditions. Their My Baby Biome study—the largest infant gut health investigation ever—uses mailed collection kits to reach diverse communities, creating what the CEO describes as a future where “all babies can develop a healthy gut microbiome.”
Inherent Biosciences addresses reproductive health gender gaps. Up to 50 percent of infertility involves male factors, yet women historically shouldered diagnostic burdens. Inherent’s SpermQT test uses epigenetic analysis to uncover hidden causes of male infertility, shifting care to be more equitable between partners while serving couples across economic levels.
OmniVis demonstrates global health innovation through smartphone-enabled cholera detection, diagnosing infections in 30 minutes versus days for traditional testing. Designed for vulnerable communities in developing countries or disaster zones, the technology costs significantly less than laboratory setups and operates without specialists.
The Economic Imperative
Healthcare disparities impose enormous costs extending beyond affected individuals. Analysis suggests the United States could lose hundreds of billions over 25 years through reduced productivity and higher expenses. Modest equity improvements—reducing disparities by just 1 percent—would yield over $40 billion in benefits for diabetes care and $60 billion for cardiovascular disease.
This transforms equity from moral imperative to strategic necessity. Companies designing products for diverse populations avoid costly post-launch discoveries of efficacy issues in untested groups. The FDA’s decision to limit Medicare coverage for Alzheimer’s drug Aduhelm, partially due to trial diversity concerns, signals regulators increasingly expect innovations to serve actual user populations.
When biotech companies embrace inclusive design, they unlock new markets while improving success probability. “Removing barriers for marginalized patients means reaching new patient populations that we can’t currently treat,” notes Fritz Bittenbender of Genentech, explaining how expanding access creates win-win scenarios that save lives while expanding customer bases.
The Sustainable Advantage
“I’m not just investing in women or minorities—I’m investing in diversity because this will bring the best innovation and the best returns,” Leen Kawas emphasizes. Her investment decisions demonstrate how capital allocation tied to social impact drives both profits and positive change.
The biotechnology industry faces an inflection point where continued focus on affluent populations may limit market opportunities and scientific advancement. Companies embracing equity by design—through inclusive trials, accessible pricing, and targeted innovation for underserved communities—gain competitive advantages in an increasingly global healthcare marketplace.
Public and philanthropic sectors direct growing resources toward equity-focused projects. Large healthcare coalitions bring together payers, providers, and pharmaceutical companies for equity initiatives. Biotech startups positioning themselves as disparity solutions access these resources while building sustainable advantages.
The Path Forward
The evidence is clear: closing healthcare gaps isn’t just morally necessary—it’s economically imperative and scientifically essential for developing treatments that work across human diversity. Healthcare costs continue rising while disparities persist, suggesting the biotechnology companies that thrive will follow Leen Kawas’s model of intentional innovation designed to serve everyone.
As she continues backing companies that prioritize global health accessibility, Leen Kawas pioneers an investment approach measuring success not just in financial returns, but in lives improved across all communities. The future belongs to biotech leaders who understand that the most transformative innovations are those that serve the broadest populations, turning equity by design from aspiration into competitive advantage.