Comment on: Key factors contributing to gender inequity in global rheumatology awards: a global survey analysis: reply

Dear Editor, We thank Annamalai et al. [1] for their thoughtful correspondence regarding our recent study on gender inequity in global rheumatology awards [2]. We appreciate their validation of our findings and their effort to contextualize these global challenges within the specific framework of Indian rheumatology. Their insights highlight a critical dimension of the equity conversation: the necessity of viewing gender disparities through the lens of intersectionality and cultural specificity. We wholeheartedly agree that, while the ‘glass ceiling’ and ‘sticky floor’ are global phenomena, their mechanisms vary significantly across regions. This is truly a global initiative, and we deeply value the contributions from colleagues worldwide who help us understand how barriers manifest differently across cultural contexts. Annamalai et al. correctly identify that our initial survey had limited representation from low- and medium- human development index (HDI) countries [1]. The Coalition of Health and Gender Equity (CHANGE) group has been working diligently to expand our global reach, and we are pleased to report that we gathered responses from 1945 rheumatology health-care professionals across 105 countries [3, 4]. Of these respondents, 36.2% were from the Asia-Pacific region, with significant representation from India. This growing diversity in our dataset strengthens our understanding of how gender inequity plays out across different health-care systems and cultural contexts, though we recognize the continued need for enhanced participation from resource-limited settings.