“The global health architecture is shifting—now is the time to design it for and with the Global South.” 

Laura Herman is a Partner at Dalberg’s New York office with over 20 years of experience in global development, specializing in Global Health, Gender Equity, and Inclusive Business. She collaborates with corporations, foundations, multilaterals, and NGOs on strategy, stakeholder engagement, and new market entry, to drive social change. Her work spans Africa, Asia, and Latin America, where she has conducted in-country research, evaluated operations, and developed long-term public-private partnerships.

Before Dalberg, Laura was VP of Strategy and Advocacy at Essilor in Singapore, leading efforts to expand access to vision care for 2.5 billion underserved people through innovative business models, strategic philanthropy, and advocacy. She was also a founding team member and Managing Director at FSG, where she spearheaded the Global Health and Gender Equity practices and contributed to thought leadership on Collective Impact and Shared Value.

A former term member of the Council on Foreign Relations, Laura was a Senior Advisor to AshokaU and has served on the boards of VillageReach, the Global Health Council, and US Pharmacopoeia. Recognized as one of the “50 Most Influential Social Innovators” and “Women Super Achievers” by the World Sustainability Congress, and a “Who’s Who” by Marqui, she holds an MBA and MA from Stanford University and a BBA from the University of Michigan.

In this interview, Laura offers a compelling analysis of the urgent systemic changes needed to improve maternal health, highlights the untapped potential of the women’s health market, and calls for cross-sector collaboration and inclusive business models to shape a resilient, equitable global health architecture—one led by and serving the Global South.

This year’s World Health Day focused on “Healthy Beginnings, Hopeful Futures,” with an emphasis on improving outcomes for women and newborns. What systemic shifts do you believe are most urgent to ensure safe pregnancies and equitable care—especially in underserved communities?

While we’ve seen great progress on the global maternal mortality rate since 2000, it has flatlined or even increased in some regions over the past decade. Ninety-five percent of preventable maternal deaths occur in low- and middle-income countries, and several nations account for the lion’s share. The systems that influence maternal health and newborn survival extend far beyond health. Nutrition, safety, and a stable community all play a critical role. It’s not surprising that in times of war, famine, or when women face violence, outcomes are tragic. So, the call to action is broader than just health system reforms; it requires coordination across sectors to create a supportive environment for pregnant women and new babies to thrive.

Within the health system itself, access to quality care remains essential. Given the increasing role of the private sector in healthcare delivery, accreditation for delivering quality services becomes crucial. We saw that when our client, Merck for Mothers, supported the quality accreditation and integration of private facilities in Nigeria, the maternal mortality rate dropped by 66%. Those accreditations and standards need to be implemented broadly and enforced.

Where a business case doesn’t exist for private service provision, governments need to step up, especially for rural women, and invest in the infrastructure and clinicians required to reach them.

But even while improving service delivery and infrastructure is essential, we also need continued innovation in the tools themselves. Additional therapeutics to address pre-eclampsia and to build on the new heat-stable carbetocin will be important given the disproportionate role pre-eclampsia and postpartum hemorrhage play in maternal deaths.

In short, we need to see change within and beyond the health system to meet our aspirations. No mother should die giving birth. The Gates Foundation’s continued commitment to this issue is critical given other cuts the field is facing and the recent announcement reaffirming and expanding on those commitments represents a tremendous source of optimism in the field.

The World Economic Forum’s recent blueprint identifies a $1 trillion economic opportunity in closing the women’s health gap. Why has this business case taken so long to gain traction and what could accelerate the process?

In part, women’s health isn’t well understood and isn’t even universally defined. Foundational data, as called for in the WEF report, will be critical in establishing the market size for new innovations.

Most early-stage investors are men, who haven’t experienced first-hand the health issues that arise across a woman’s life. And medical research has largely overlooked women’s hormonal health. It’s astonishing that something as fundamental as hormonal health isn’t widely taught in medical schools. Who runs your hormone panels? It’s rarely your GP or OB-GYN, and not typically an endocrinologist either. The specialist ecosystem needed to deliver insights and advice is still emerging even in the most “sophisticated” healthcare markets. This is a tremendous opportunity.

I’m encouraged by the growing openness to talk about women’s health in its entirety, including menopause and sexual wellness, which only very recently gained mainstream attention. Hopefully that openness will translate into investment.

But recognition of the opportunity isn’t enough. We need an ecosystem to support new product development and address structural barriers, too. Many women’s health products are routinely barred from advertising on social media as they are flagged as pornographic. Both the Center for Intimacy Justice and the Hustle have reported on this. If you can’t advertise, your path to market uptake is severely hampered and investors walk away. We convened a panel on this topic on the sidelines of UNGA in 2023. It was a great session and readers could learn more here. There is a path forward, but it requires intentional support for innovators to unlock this immense market opportunity.

What is the “hard” business case for companies and investors to prioritize gender equity? Are there specific data points or market signals you wish more leaders paid attention to?

The data is already well known. Reports from HBR, IFC, the World Economic Forum, and numerous academic journals and consulting firms show that companies prioritizing gender equity outperform across ROI, innovation, revenue per employee, speed to market, employee engagement, recruitment costs, and turnover.

The real question is how companies can achieve these great outcomes. We recently developed a toolkit with UNICEF for CEOs, focused on ‘family friendly’ policies that can drive these metrics. This toolkit recognizes the diverse conditions in which women work—farms, factories, office jobs, retail jobs—and the differentiated needs women have, most explicitly around pregnancy and caregiving responsibilities.

But these same policies benefit men, too. Men of course also care about their families. The policies that support workers in these roles are fundamental and deliver performance gains across the board. I’m hopeful that the private sector will move its dialogue from why to how on gender equity.

With the World Health Assembly under way, how are actors across sectors positioned to help shape a resilient primary healthcare system?

WHA is hosting an interesting set of conversations. It’s the first major global health convening since the largest shocks to Overseas Development Assistance (ODA) were announced earlier this year. Dalberg’s analysis reveals a 44-60% drop in ODA between now and 2030, driven by redirected funds to Ukraine, already-announced cuts, and likely political shifts. The health sector is feeling this deeply.

Stakeholders in Geneva will have urgent questions and perspectives to offer:

The WHO is in crisis. Its dramatically reduced budget raises critical questions about its future role and capacity. Ongoing internal reviews must lead to clear prioritization in its next program of work.

Ministers of Health across the Global South are looking at what funding remains so that they can prioritize their efforts. They will have more control now, arguably, than ever before, since they will hold the purse strings and allocate funding directly to their national priorities. Seeing what rises to the top across countries will be a strong signal in terms of what matters most and where the major gaps remain. This will drive new accountabilities for those Ministers to deliver on their priorities.

Ministers of Finance across the Global South are looking at budgets to see where they can find additional investments for health. Nigeria completed this process and came up with $200M, which isn’t huge given the size of their funding gap but is critical as domestic resource mobilization is more urgent than ever. Global philanthropic and corporate donors are re-evaluating portfolios, especially those that complement government investment.

The long-term market shaping work that the Global Fund, GAVI, and others take on is critical to incentivizing pharmaceutical companies to invest in R&D for infectious diseases. Pharmaceutical companies that currently sell to these global purchasers will have many questions now about the viability of this path to market, with long-term funding in jeopardy. As pharma contends with the US administration’s goals related to reduced pricing in that market, CEOs will be further diverted from investments to serve patients living in low-income markets.

At the same time, the broader private sector is confronting global tariff volatility, disrupted supply chains and a potential global recession. I worry that these issues will overshadow the social impact agenda in the short term, unless they can be tied to business outcomes.

For the last 25 years, we’ve seen growth in health budgets and creative new mechanisms for improving health outcomes for a whole generation. To the extent that the field is ready to start reimagining the long term, I’m eager for us to be in conversation about the next iteration of the global health architecture. Input from all sectors is needed as no one perspective can address the many challenges we face. There has been lots of discussion around localization, community-led models and decolonizing global health over the last ten years. Now is the time to make those principles real and build a system that truly serves the Global South.

Connect with Laura to know more about her work: