By Roopa Dhatt, Joannie Bewa, Jennifer Martin and Ann Keeling, Women in Global Health

COVID-19 knows no borders and it does not discriminate. Societies, however, do discriminate and the impact of the virus is increasing inequalities globally. The recovery from this pandemic will take years and for many, a lifetime.

COVID-19 has thrust global health and health security into the spotlight of even the popular press in most countries. Women political leaders from New Zealand to Germany and Taiwan have been lauded for their exceptional management of the pandemic, in contrast with the dismal performance and rising death toll in countries led by some of their male counterparts.  

Who leads global health? Not women

We applaud women political leaders and women health workers, yet rarely ask who leads global health?  The answer is that although women make up 70% of the health and social care workforce, they hold only 25% of leadership positions. In this pandemic, women are the majority of frontline health and social care workers. Despite this, the minority of men working in global health are more likely to make it into leadership than the majority of women, more likely to be asked for media comments and to have their research cited. Women from low-and middle-income countries are particularly underrepresented in global health leadership.

The picture is the same with leadership of the COVID-19 pandemic. On average, 80% of members of COVID-19 national task forces are men. The obvious question is why the people (majority women) who know most about global health and health systems, are not driving decisions when they are the experts in this field? Most of us getting on a plane would want an experienced pilot in the cockpit. COVID-19 prompts us to ask why we have put global health security and our own health, into the hands of the B team (majority male)?

Women leaders and the triple gender dividend

With equal numbers of women in global health and COVID-19 leadership we believe we would have seen:

Health

• Lockdown measures that anticipated and mitigated an increase in gender-based violence    
• Continuation of safe delivery and reproductive health services – women died in childbirth during Ebola outbreaks as they were unable to reach safe delivery facilities

Economics

• An end to the reliance of health systems on women’s unpaid work – around half the $3 trillion USD women contribute to global health is in the form of unpaid work
• Priority given to girls’ education and keeping them safe – there are reports of very young girls being abused and left pregnant during lockdown
• Funding for the women’s organizations providing critical support at community level

Gender Equity

• Personal protective equipment (PPE) essential for keeping health and social care workers safe from infection, based on women’s (not men’s bodies), that actually fit women
• Sex disaggregated data for both infections and mortality so policy responses can be evidence based – only 53 countries are reporting sex disaggregated data on COVID-19

Although there have been examples of gender responsive COVID-19 policy measures in some countries, they remain the exception, and women and girls continue to suffer preventable harm.

Working towards more women leaders in global health

Since the start of the pandemic, the Women in Global Health network has worked with our national chapters, supporters and partners to advocate for gender equity and diversity in global health leadership. In March we launched a COVID 50/50 campaign with Five Asks for Global Health Security, Now and In the Future, the first ask calling for inclusion of  “women – particularly women from the Global South – as 50% of global health security decision-making bodies and expert groups.”  And together with Women of Color Advancing Peace and Security (WCAPS), we launched Operation 50/50, a crowdsourced list of 100 women in global health security experts, intended to address the myth that ‘there are no qualified women’ and put right the glaring lack of women in COVID-19 leadership.

We remind the world’s leaders that nothing we are asking for is new. Commitments have been made on gender equality, data, the health workforce and women’s unpaid work by the world’s governments in the Sustainable Development Goals (SDGs), and at last year’s UN High Level Meeting on Universal Health Coverage – to be delivered by 2030. We are calling for equal representation of diverse women from all geographies as the norm in all health decision-making bodies, including COVID-19 from global to community – not just for women – but to enable women to deliver better health for everyone.