Breaking Barriers to Leadership for Women in Medicine: Dr. Roopa Dhatt, Co-Founder of Women in Global Health

Michael Carrese

Hi, I’m Michael Carrese, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and healthcare.

According to the Bloomberg School of Public Health at Johns Hopkins University, women make up seventy percent of the global healthcare workforce but hold only about twenty-five percent of leadership positions.

Our guest today, Dr. Roopa Dhatt, has been a leading voice in the movement to correct that imbalance through co-founding an organization called Women in Global Health, which has established chapters in over sixty countries since it started a decade ago. She is also pursuing that agenda and addressing other pressing issues in healthcare as a Young Global Leader at the World Economic Forum.

In addition to her work on the world stage, Dr. Dhatt is a practicing internal medicine physician in the Washington, D.C. area, an assistant professor at Georgetown University, and serves on multiple high-level advisory boards.

Thank you so much for joining us today.

Dr. Roopa Dhatt

It's wonderful to be here with you.

Michael

So we always like to start by learning more about our guests and particularly what got them first interested in medicine.

Dr. Dhatt

Yeah, so for me it was really a childhood dream. I was nine years old, and not necessarily a pleasant dream that kicked it off. I have dualities. I was born in India but was being raised in the U.S. Around that age I was visiting my grandparents for the summer and ended up getting really sick to the point where I needed to go to a hospital.

Multiple doctors had seen me outpatient and couldn’t figure out exactly what was going on, so I ended up needing to go to a hospital. It was there that it was discovered I had appendicitis — septic appendicitis that had burst in my stomach — and I needed emergent surgery.

This was in the early nineteen nineties. India looks very different today than it did then, in that particular part of the country. I was very fortunate there was a pediatric surgeon able to perform the surgery.

My parents unfortunately couldn’t make it in time, so I was with my grandparents and went through this life-changing experience. It was less the surgery but more the weeks that followed, when I was spending time in a pediatric clinical ward — one of those wards with at least twenty other children, beds all in one very large room. It was a very formative time for me as I learned about the life stories of other children, some younger, some older, and how much inequity surrounded us.

A few months later, after I’d healed, I flew back to the U.S. and continued my recovery. I kept thinking, how can we live in a world with such stark differences in the realities children face, and in the strength of health systems? That inspired me to go into medicine.

I was that nine-year-old girl determined to say, “I’m going to be a doctor. Since someone saved my life, I’m going to do the same.” It’s been an unrelenting journey for me since then.

Michael

That’s a wonderful story — I mean, unfortunate circumstances. Had you given a thought to medicine before that at all?

Dr. Dhatt

No, I think my top dream at the time, like most kids, was one of those classic professions. I wanted to be an astronaut. I was always fascinated by science. In one way, you could say the path was already being written, but at that time I was very focused on space.

Michael

So you obviously go to medical school and you’re exposed to all these different specialties. You ended up with internal medicine, I believe, and have been a hospitalist. Talk about that path.

Dr. Dhatt

Yeah, so my first pick in medicine — I wanted to be a pediatric neurosurgeon. That was probably around the age of thirteen. I even printed out business cards with that title.

Michael

My gosh, that’s adorable.

Dr. Dhatt

So how did I go from that pathway in surgery into internal medicine? In medical school I recognized that providing health for our communities is really a systems issue. Internal medicine gives you the skill set to connect with every specialty, to know enough about how each approaches things, and to have that broad understanding.

When you think about the people you take care of as a physician, people are interconnected. It’s not just one organ or one specialty — their health and wellbeing are all linked. Internal medicine gave me the skill set and ability to approach whole-person care and really get to know my patients.

I probably would have taken the pathway of primary care since that’s where you can build lifelong relationships with your patients. But I turned to hospital medicine at a time when I was trying to integrate a career in global health while also remaining clinical. It was important for me to stay grounded in patient care, to be part of a health system.

Hospital medicine gave me that ability — to work shifts, come into the hospital, provide critical services, and yet not disrupt the wellbeing of patients I was caring for. That’s how I ended up in hospital medicine.

I knew it was the right fit during COVID-19. I had been letting go of my clinical appointments to focus on building the international NGO I’d co-founded, and in December 2019 we received our first seed grant. I thought, “Alright, this is a sign to shift focus.” Three months later, the pandemic was announced.

Seeing what was happening in New York City and talking to colleagues around the world, I said, “I have the skill set. I’m a recent graduate. It makes no sense to work on global health issues while not being in the hospital system during a pandemic.”

That’s when I joined hospital medicine at two different hospitals in Washington, D.C., to help prepare for the surge and be part of the COVID-19 response.

Michael

My goodness, what a time to dive in like that. But at that point, you’d already started forming the NGO or laying the groundwork for it. When did you start latching onto the issue of women and leadership in healthcare?

Dr. Dhatt

I was in clinical training in my internal medicine residency in the International Health Track. I’d already come from student leadership globally. I was president and vice president of the International Federation of Medical Students Associations — a federation that’s been around for over seventy-five years. I’d been involved for five years and was already introduced to the global health scene, doing advocacy on climate change and sustainable development goals.

When I entered residency in the Midwest, I found myself asking similar questions I had in global health advocacy: how can we be in a field with so many talented women — health workers, physicians, advocates — and yet see almost no women in leadership? It was that pattern we talk about: women deliver health, men lead it.

As an aspiring young leader wanting to help shape solutions, I wondered, what can we do about it? That’s what sparked Women in Global Health. I connected with three early-career women — two online and one I already knew. Two were at a global health conference tweeting about an all-male panel, but instead of just complaining, they were discussing solutions.

This was back when X was still called Twitter. We started talking about ideas and within a few days hopped on Skype — before Zoom — and found ourselves connecting weekly, asking, “What can we do?”

A few months later we went to the World Health Assembly in Geneva, organized by the World Health Organization. We used our connections to attend and held a consultation at a coffee table in the UN office in Geneva. About twenty-five people came by over the session.

As we brainstormed how to approach gender equity in global health leadership, one thing became clear: we needed a movement, not just another report or panel. It takes movements to transform societies. So Women in Global Health was launched at that coffee table — sparked by online conversations, showing that women are already in the field and highly qualified. The question became, how do we change the equation so women delivering health are also viewed and valued as leaders?

Michael

So what did you identify as the biggest barriers, and how did you go about tackling them?

Dr. Dhatt

It’s a great question. We went back to our roots as health professionals — doing research, convening, analyzing. Our landmark report with the World Health Organization, *Delivered by Women, Led by Men: A Gender Equity Health Workforce Analysis,* outlined several key areas.

First was leadership. The health sector has a pervasive gender norm where women are expected to deliver care but not seen as leaders. We wanted to transform that mindset and bring visibility to women’s contributions at every level of the health system.

We quantified women’s contributions and built a leadership pyramid: at the base, ninety percent of those delivering health — community health workers, nurses, midwives — are women. But as you move up into academia, policymaking, government, or the private sector, representation drops dramatically.

We also identified the gender pay gap, and the even more pervasive issue that half of women’s work in health is unpaid or underpaid. A Lancet Commission quantified this at 1.5 trillion U.S. dollars annually. This inequity is a key driver of why women aren’t valued or viewed as leaders.

Another barrier is the high level of violence, harassment, and exploitation in the health sector. Many systems don’t even track the prevalence of workplace violence. Countless women face these risks and leave the workforce as a result.

Finally, occupational segregation. Women are often channeled into bedside and primary care roles — vital but lower-paid and less influential positions. There are fewer women in surgery and other higher-status specialties. These patterns keep women from decision-making power.

Michael

So take the case of primary care. What’s the connection between being in that field and being blocked from leadership?

Dr. Dhatt

It comes down to how we value specialties. Procedure-based and surgical fields are viewed as technically the most demanding, though as an internist I’d argue generalists have equally challenging breadth.

Primary care physicians must understand every body system, detect problems early, and stay current across disciplines. Yet historically, more value and status have been given to surgery and subspecialties — those are the people invited to national committees.

There’s also a broader societal issue. Super-specialized, tertiary care is more esteemed than primary care, despite the Alma-Ata Declaration over forty years ago emphasizing primary health as the foundation. That shapes perceptions and devalues generalist leadership.

Michael

You’ve done this analysis and identified the barriers. What traction have you gotten, and what’s working?

Dr. Dhatt

The greatest success of Women in Global Health is how it’s inspired women everywhere to see this issue as theirs — something they can help change.

From a coffee table conversation, it’s become the fastest-growing women’s movement in health, with over sixty chapters worldwide — most of which doubled during the COVID years. Even as women carried double or triple caregiving burdens, they still prioritized gender equity.

That’s powerful. The movement continues to grow, helping shift global norms. Now, when people discuss the health workforce, there’s widespread recognition: seventy percent are women, but only twenty-five percent hold leadership roles. That acknowledgment alone is a huge step.

Our advocacy led to the first World Health Assembly resolution on the COVID-19 response including sections on women’s contributions and leadership — encouraging governments to include women in decision-making bodies and adopt gender-responsive approaches.

We also helped shape the UN’s high-level meeting on Universal Health Coverage. When that agenda launched, it was completely gender blind. We led a “seventh ask” campaign that resulted in one of the most gender-transformative UN health documents ever passed.

But the real heart of our success is local. Women community health workers — often unpaid or underpaid — have begun to see themselves as leaders. Through our engagement, we’ve seen mindsets shift from “We’re not leaders” to “We are leaders. We are delivering vaccines, reducing maternal mortality. We are the heroines of health in our communities.” That’s profound change.

Michael

In the long game, part of this is getting women to see themselves in those positions — reaching middle and high school girls, helping them see what’s possible. Is that happening?

Dr. Dhatt

Yes, that’s an important point and one I heard often early on — that women just need to “lean in.” But what we’ve consistently found is that there’s already a deep talent pool of women ready for leadership. The real problem is systemic barriers.

Our message became “fix the systems, not the women.” Institutions need to commit to gender equity, to diverse expert panels, and to equitable representation in leadership.

We did research across over one hundred fifteen countries on COVID-19 task forces and found fewer than five percent had gender equity. That’s a structural problem.

We also can’t ignore that sixty to seventy percent of women in health report facing harassment or exploitation at some point. Creating safe workplaces is essential — no one can thrive in unsafe conditions.

In our paper we use the ecological model to map these barriers and the solutions needed at different levels — institutional, community, and societal.

Michael

Unfortunately, we’re now seeing pushback against diversity, equity, and inclusion — particularly in the U.S. How is that affecting your work?

Dr. Dhatt

It’s deeply affecting the global health sector. Living in Washington, D.C., I see firsthand how decisions here impact billions of lives around the world. We made huge progress from the Millennium Development Goals to the Sustainable Development Goals, even through COVID. Watching that progress unravel is heartbreaking.

For organizations like ours, it means partners who’ve long championed DEI are now wondering how to continue without losing funding or being targeted. Women in Global Health began as a volunteer movement and remains rooted in that spirit, but the broader sector is under tremendous stress.

We continue to be a voice for women’s leadership, social justice, and health justice — that will never change. But we’re also witnessing a dangerous rollback of women’s rights, especially bodily autonomy.

Bodily autonomy means the ability to decide if, when, and how to have children. The erosion of those rights has led to rises in unintended pregnancies, limited contraception access, and unsafe abortions — all costing lives. That’s the tragic human cost behind the headlines.

We remain committed to bringing visibility to these realities, amplifying stories at the highest levels so the world understands that this backlash isn’t abstract — it’s costing women their lives.

Michael

Before we run out of time, tell us about your role as a Young Global Leader with the World Economic Forum. What does that involve?

Dr. Dhatt

I joined the World Economic Forum’s Young Global Leader program three years ago — I just graduated this week, actually. It’s an incredible, multi-sector community that includes leaders from technology, human rights, education, innovation, and the arts.

It’s a place that promotes bridge-building and open dialogue at a time of polarization. For me, it’s been an opportunity to remind other sectors that health is a human right and a shared global value — foundational to everything else societies strive for.

Communities like Young Global Leaders are vital because they foster connection and collaboration, even as institutions like the UN struggle under political division. It’s a thriving space where leaders can find common ground and keep global cooperation alive.

Michael

We’re fortunate to have people like you continuing this work despite the obstacles. As we close, we always ask guests for advice to our audience — mostly learners and early-career professionals in the health fields. What do you tell them about approaching their careers and tackling these issues?

Dr. Dhatt

First, I love connecting with young people, so feel free to reach out to me anytime.

In these times more than ever, take the time to figure out what inspires you and go deep with it. Once you find that source — whether it’s a problem in health or a broader societal issue — use it to fuel your impact.

Don’t do it alone. Collective action drives change, whether within an organization, community, or globally. Be part of networks. You get out what you put in, so engage actively and bring others along.

When you dream big, there will be challenges and setbacks. Those moments define you. Take your time, reach out to supporters and even strangers, and get back up.

We need all of you activated in these difficult times — visionary leaders committed to collaboration, to caring for one another, and to protecting our planet.

Michael

That’s wonderful advice and encouragement for our audience. I want to thank you for spending so much time with us today, Dr. Dhatt. It’s been a pleasure.

Roopa Dhatt

Thank you so much for having me. It’s been my privilege as well. I’ll be heading to patient care in a few minutes, so it’s always nice to feel connected to this global community — knowing others are also finding commonalities and staying committed to advancing health equity.

Roopa Dhatt

Yeah, so I’ll send the link to the two WHO papers I mentioned. There’s also a Women in Global Health report that’s not a WHO one, but it’s a great technical source for anyone wanting to go deeper. I’m happy to connect on LinkedIn or another platform for those who’d like to reach out.

Michael Carrese

I’m Michael Carrese. Thanks for checking out today’s show, and remember to do your part to raise the line and improve the healthcare system. We’re all in this together.