As a member of the International Union of Immunological Sciences (IUIS) Gender Equity Committee, together we identified the same patterns of inequity emerge across countries, disciplines and career stages of women in medical research. Women remain underrepresented in senior leadership roles, despite their substantial contribution to the scientific workforce. Most persistently, women receive less research funding both in the amount awarded and in the number of grants secured limiting their capacity to build sustainable research programs and progress into leadership.

These disparities are not confined to any one region or funding system. Across global contexts, women experience structural disadvantage that accumulates over time: reduced access to large, multi-year grants; fewer opportunities to lead high-profile programs; and funding criteria that reward uninterrupted, linear career trajectories. The COVID-19 pandemic further exposed and intensified these inequities, disproportionately disrupting the research careers of women and those with caring responsibilities.

Our review "Global perspectives to enhance strategies for advancing women in healthcare and STEMM leadership" in Immunology and Cell Biology, aimed to move beyond describing inequity and instead interrogate why it persists. Gender inequity in medical research leadership is not solely the result of bias at the point of promotion or funding. It reflects a complex interplay of systemic barriers, socioeconomic disadvantage, cultural norms and institutional practices that shape who is supported, who is visible and who is trusted to lead. These factors are magnified by intersectionality, with women from lower socioeconomic and culturally and linguistically diverse (CALD) backgrounds experiencing compounded barriers to education, professional networks and mentorship.

Crucially, this is not only an equity issue, it is a scientific one. Leadership diversity directly influences research priorities, study design, clinical trial inclusion and the translation of discovery into healthcare. Inequitable leadership structures ultimately limit innovation and patient outcomes.

We sought to identify practical, evidence-informed strategies to improve gender equity in medical research leadership through policy reform, organisational change and cultural shift that can be applied now, by the reader. We also call on academics, particularly those with job security and influence, to engage in advocacy. Structural change requires more than data; it requires voices willing to challenge systems, inform policy and help shape a more inclusive future for medical research.