Sometimes, it simply pays to ask. In August 2024, Australian philanthropist Anna Ainsworth was at her alma mater, the University of New South Wales (UNSW) in Sydney, to listen to a conversation between UNSW gynecological cancer professor Caroline Ford and Canadian-American obstetrician-gynecologist Jen Gunter, who was visiting Australia on a book tour. Gunter is known for her frank and myth-debunking approach to women’s health, sex and science.
The closing question from the audience centered on what area of women’s health needed urgent attention. If she were Melinda French Gates and had a zillion dollars, Gunther said she’d throw every cent at endometriosis, an area of research that has, she said, been shamefully neglected.
That comment turned out to be a catalyst for Ainsworth, who thought her family’s fortune could do something significant to address endometriosis, a poorly understood condition that impacts around 10% of women and girls of reproductive age around the globe, or 190 million people. For Ainsworth, it wasn’t simply a matter of public health, it was also deeply personal.
Her daughter, Lily Ainsworth, has suffered for almost 20 years with the potentially disabling condition, which often goes undiagnosed and has few effective treatments or a known cure. “I’ve had endo pain since I was 15 years old. I experience chronic, daily pain and severe flare-ups that debilitate me for days or weeks on end,” Lily Ainsworth, also a philanthropist, said. The severe pain begins in her abdomen and travels to her back, legs and even to her diaphragm. “When I’m having a flare up, I have to shallow-breathe because it feels like someone is stabbing and twisting knives into me,” Lily Ainsworth told IP.
The Ainsworths didn’t muck about. They met with prominent endometriosis researchers and clinicians in Sydney. They also sought the assistance of philanthropic advisor Melissa Smith from the Australian consultancy Noble Ambition, who helped them engage with other philanthropists in the scientific and medical fields and navigate the academic landscape to figure out how much, how and where to launch a major gift toward combatting the condition.
In May this year, three generations of the Ainsworth clan committed AUD $50 million (USD $32.5 million) over 10 years to establish the Ainsworth Endometriosis Research Institute at UNSW through the newly formed Grevillea Foundation.
The public research university described the gift as a world-first initiative, one that could position Australia as a global leader in research toward the diagnosis, treatment and potential cure of endometriosis. The institute plans to tap scientists, clinicians and philanthropists from around the world — including the UK, Canada, Denmark, India and the United States — to accelerate breakthroughs in diagnosis, create improved treatments and collaborate on research.
Gift not without scrutiny
The contribution from the Ainsworths is record-breaking — the largest known philanthropic contribution to endometriosis research globally and to women’s health in Australia, according to the UNSW. It is also the largest single philanthropic gift ever received by that institution, which has a reputation for excellence in the medical, science and health fields.
The aim of the institute is to establish a precision medicine approach to endometriosis detection, treatment and management. Endometriosis is a condition in which tissue similar to the lining of the uterus is found outside the uterus, often causing severe pain, fatigue and, in a third of cases, infertility. Many endometriosis sufferers endure years of symptoms without solutions, waiting six to eight years on average for an accurate diagnosis. Effective treatments and earlier diagnosis could contribute an estimated $12 billion to global gross domestic product, according to the World Economic Forum, which cited the disease as one of nine disorders that most negatively affect women’s lives.
It’s a cruel and chronic disorder. “It’s a pretty intense mental load and it’s impacted school, work, relationships and social life and caused stress, not just to me, but the people around me who care for me. I’m riddled with it and two surgeries haven’t reduced my symptoms,” said Lily Ainsworth, who considers herself fortunate to have become pregnant even though she experienced severe endometriosis flare-ups during her pregnancies.
Since each person’s endometriosis is unique, for the best results, treatment needs to be personalized, according to experts in the field, who also maintain that the current scientific understanding of endometriosis is similar to where breast cancer research was in the 1970s. Targeting treatment — not unlike recent advances in breast cancer protocols — could bring much-needed relief to those who battle with this complex condition. “I can be completely, utterly wiped out for days by endometriosis,” Lily Ainsworth said, “and I have to lean on my colleagues and family during those times. I’ve missed so many opportunities because I can’t trust that my body will show up for me when I need it to.”
Three branches of the Ainsworth family — one of the wealthiest families in Australia — are funding the effort: Anna, Simon, Greg and Lily Ainsworth; Paul and Valeria Ainsworth; and Len Ainsworth, who is a controversial figure there. Known as the “Pokies Patriarch,” Len Ainsworth made his family’s fortune (estimated as of May 2025 at around AUD $6.9 billion or USD $4.3 billion) on slot machines (known as poker machines or “pokies” in Australia), which are ubiquitous in pubs— drinking establishments that play a key role as social hubs in Australia.
Given the source of the money, the pledge has caused controversy within certain academic and public health circles, according to articles in the Australian press. Culturally, Australians have a reputation as a betting nation, and pub pokies are deeply woven into the economic and political fabric of the nation. But gambling addiction, particularly addiction to playing poker machines, is also a pressing societal concern. In the first three months of this year, New South Wales residents lost an average of AUD $24 million a day to the state’s nearly 90,000 machines; across Australia, the daily loss to the devices is about AUD $40 million, according to local news accounts. (They are also, it should be noted, a major revenue source for state governments via a tax on gambling profits.)
Len Ainsworth, who founded what became the world’s largest poker machine manufacturer, Aristocrat Leisure, along with a smaller manufacturer Ainsworth Game Technology, is a major philanthropic figure in the arts, science and health arenas in Australia, where there are gallery wings and research labs named in his honor in recognition of his patronage.
Anna and Lily Ainsworth, who said they preferred to keep the focus on the positives of the institute, declined to comment on concerns raised in the media, including those reported in June by The Guardian.
One UNSW staffer told The Guardian there is a “moral obligation” to use the Ainsworth money to ease the suffering of Australian women living with endometriosis, rather than waiting for “perfect funding sources.” Australian universities typically have strict ethics policies about accepting donations from the alcohol and tobacco industry. Critics argue a similar no-go policy should apply to donations derived from gambling interests, but UNSW also is not the only public university in Sydney to accept funding with ties to gaming companies and casinos, according to this 2023 online news account. A UNSW spokesperson told The Guardian: “All donations are assessed per the UNSW gift acceptance policy, which considers reputational, ethical and legal factors.”
One thing everyone agrees on: the need for more funding for endometriosis research. With current government funding cutbacks for science in Australia, universities are looking to philanthropic investment as a way to continue medical research. As one academic told The Guardian: “In reality, aren’t most incredibly wealthy donors rich off someone else’s back?”
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Complex condition demands long-term funding investment
The institute is funded by the newly created Grevillea Foundation, a family-run public company limited by guarantee. It is a registered charity in Australia and was recently granted approval to accept tax-deductible gifts and donations. The foundation is named after an indigenous plant that sports yellow flowers (the color of endometriosis awareness) and is “bloody hardy” and resilient — like women with endometriosis, said Lily Ainsworth, “who put up with a lot.”
The Ainsworths noted that the 10-year commitment is significant. “Real solutions require real investment,” said Lily Ainsworth. “Endometriosis is not an unsolvable mystery — it simply hasn’t had the dedicated funding and focus needed to unravel and understand it.”
Added Anna Ainsworth: “We asked the researchers what it would take to make a significant difference for people living with endometriosis, and for future generations. Their response was that we needed long-term funding to grow a community of researchers in this space. This became $50 million over 10 years.”
The mother-daughter duo learned from conversations with Australian researchers and clinicians that it’s a challenge for young scientists to have secure careers in endometriosis research. There’s just not enough funding to sustain them past the first year or two, they were told. So they decided that if they were going to make an impact in this area, they needed to make it possible for these scientists to stay in endometriosis research and make scientific progress. Hence the commitment across 10 years, which is a much longer time span than the typical three- to five-year funding cycles for science and medical research.
“We want to ensure that this project is committed to, and funded properly, so it can create the blueprint for a national and international approach to understanding endometriosis better,” said Anna Ainsworth.
But that wasn’t the only consideration for the 10-year gift. Lily Ainsworth has two daughters and learned recently of the strong hereditary link to the disorder. They are at much higher risk (seven to 10 times greater) of suffering from endometriosis. “It made me feel nauseous. You wouldn’t wish this on anyone,” she said. “My girls will be hitting puberty in around 10 years. Hopefully, we will have some better treatments and solutions by then.”