23 May 2020
Editor’s note: A few weeks into the COVID 19 pandemic, United Nations Secretary-General António Guterres urged governments to put women and girls at the centre of their efforts to recover from the virus.
“That starts with women as leaders, with equal representation and decision-making power”, he said. “Gender equality and women’s rights are essential to getting through this pandemic together, to recovering faster, and to building a better future for everyone.”
Since then, women have continued to serve at the forefront of the struggle against the virus, whether as doctors, caregivers, frontline workers, or at the political or organizational helm. In this contribution, eminent medical professional, teacher and writer Dr. Padmini Murthy writes on “Women’s Leadership in Promoting Global Health and Well-being”, an article timely, too, as we mark the 25th anniversary of the Beijing Women’s conference later this year.
Introduction
Women have stood at the helm of leadership, both formally and informally, and across disciplines, in improving the health status of their families and communities around the world. Unfortunately, women often face discrimination and have not been given the opportunity to reach their full potential for promoting global good. Today, as we approach the end of the second decade of the twenty-first century and the global community works to achieve universal health coverage, it is of paramount importance that women’s political leadership in global health is strengthened in order to advance Sustainable Development Goal (SDG) 3, to “Ensure healthy lives and promote well-being for all at all ages,” and SDG 5, to “Achieve gender equality and empower all women and girls”.
Current picture
Globally, women bear the burden of disease disproportionately and face premature death due to gender-based inequities; these negative indicators are reflected in discrepancies with regard to access to basic health care services, nutrition and educational opportunities. In the light of these glaring disparities, it is not surprising that political leadership in the field of global health is skewed: there is no gender balance, as most key positions of authority are held by men. When policies are being formulated on issues of women’s health and well-being, women themselves seldom have a seat at the table.
Worldwide, nearly 1 million young women and girls die prematurely due to complications from pregnancy and childbirth, and diseases specific to women, such as cervical and breast cancer, which, if detected early, are treatable in countries where they have access to screening and preventive services.1 The sorry state of women’s health globally can be attributed to the lack of leadership at the highest political echelons and the non-prioritization of health issues specific to women. In addition, research has shown that neglect of women’s health is causally related to continued gender-based discrimination in access to education, employment, economic opportunities and inflexible gender norms.2
Addressing the gender gap in global health leadership will not in itself solve all women’s health problems but it would be an important step. Studies have shown that women leaders are more likely than their male counterparts to support health facilities, antenatal care and immunization.
The role of women leaders in addressing women’s health and empowerment
According to a recent report released by UN-Women in July 2019, “Only 24.3 per cent of all national parliamentarians were women as of February 2019, a slow increase from 11.3 per cent in 1995”.3 It is interesting to note the status of public health in global communities where women are adequately represented in parliaments. According to data compiled by the Inter-Parliamentary Union in October 2019, the representation of women in parliament constitutes 61.3 per cent in Rwanda, 53.2 per cent in Cuba and 53.1 per cent in Bolivia.4
It appears that the number of women in leadership roles corresponds to positive outcomes as reflected in the health indices in Rwanda. The country has shown considerable progress in reducing maternal mortality rates. In 2012, Rwanda was on track to achieve targets on reducing infant and maternal mortality.5
In another example, a study conducted by Sonia Bhalotra and Irma Clots-Figueras examined whether women politicians in India played an effective role in the provision of equitable and accessible public health care services to women when compared to their male colleagues. The authors concluded that elected women officials were effective catalysts in improving the public health status of their constituents they represented. The study highlighted the social preferences of women politicians in India, who favoured investment in initiatives such as improving access to drinking water and sanitation, which are both direct and indirect contributors to improving women's health and their social well-being. In addition, they prioritized increased access to antenatal and postnatal services for women in their communities.6
The role of women leaders at United Nations in promoting global health
Women appointed to leadership roles in various United Nations agencies have been at the forefront of promoting the health and well-being of populations worldwide.
In 1998, Ms. Gro Harlem Brundtland, former Prime Minister of Norway, became the first woman to be appointed as head of the World Health Organization (WHO). She presided over two important global health programmes: Roll Back Malaria and The Tobacco Free Initiative. Since the early 2000s, the Roll Back Malaria initiative has laid the foundation for more countries to become malaria-free. Under the leadership of Dr. Margaret Chan, work commenced on the concept of universal health coverage. In 2008, WHO and its partners across the private and public sectors reached a landmark agreement, the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, making life-saving medicines more affordable and thus increasingly accessible for the global community.7
Other women leaders at the United Nations who have worked towards improving women’s well-being, particularly through reproductive health and access to contraception, are former Executive Directors of the United Nations Population Fund (UNFPA) Drs. Nafis Sadik and Thoraya Obaid,8 and current Executive Director Dr. Natalia Kanem.
Ms. Carol Bellamy, Ms. Ann M. Veneman, and Ms. Henrietta H. Fore, as Executive Directors of the United Nations Children's Fund (UNICEF), have been instrumental in developing initiatives and programmes to improve the health of children and in strengthening global partnerships to promote the empowerment of adolescent girls.
Dr. Michelle Bachelet and Ms. Phumzile Mlambo-Ngcuka, as Executive Directors of the United Nations Entity for Gender Equality and the Empowerment of Women (UN-Women), have been at the forefront of promoting gender equity.
Women leaders making a difference, past to present
Elizabeth Blackwell
Elizabeth Blackwell was born in the United Kingdom and was the first woman to earn a medical degree in the United States. In 1857, she established the New York Infirmary for Women and Children.9
Anandibai Gopalrao Joshi
Anandibai Gopalrao Joshi had the distinction of being one of the first female physicians in India to train in the United States. She overcame numerous obstacles, including persecution, to fulfil her dream of becoming a physician. Anandibai is today considered a role model who opened doors for many young women in India to study medicine.10
Eleanor Roosevelt
The thirty-second first lady of the United States was one of the most respected woman leaders and icons of her time. Eleanor Roosevelt was an activist who championed equal rights for women and minorities. She also served as the chair of the United Nations Commission on Human Rights and is considered the driving force behind the Universal Declaration of Human Rights.11
Melinda Gates
Melinda Gates is the co-founder of the Bill & Melinda Gates Foundation and a recognized global leader in promoting women’s empowerment and health through the various programmes established by her organization. In 2012, she donated $560 million to increase access to contraception for women living in low- and middle-income countries.12
Conclusion
Since ancient times, women have faced numerous challenges in their quest to become leaders and improve their lives and those of their fellow humans. Over the last two centuries, however, women have achieved prominence as leaders, activists and advocates. In addition to those discussed above, numerous other women have made a difference globally by overcoming discrimination, persecution and gender bias. These include such notable figures as Marie Curie, Leymah Gbowee, Mother Teresa, Rosa Parks, Ada Lovelace, Rosalind Franklin, Florence Nightingale, Wangari Maathai, Gloria Steinem and Malala Yousafzai. All of these women have helped improve the lives of millions and paved the way for current and future women leaders to do the same.
Notes
1Rafael Lozano and others, "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010", The Lancet, vol. 380, No. 9859 (December 2012), pp. 2095–128.
2Karen A. Grépin and Jeni Klugman, "Maternal health: a missed opportunity for development, The Lancet, vol. 381, No. 9879 (May 2013), pp. 1691-1693.
Available at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60981-2/fulltext.
3United Nations Entity for Gender Equality and the Empowerment of Women, "Facts and figures: Leadership and political participation". June 2019. Available at http://www.unwomen.org/en/what-we-do/leadership-and-political-participation/facts-and-figures.
4Inter-Parliamentary Union, "Women in National Parliaments". 1 October 2019. Available at http://archive.ipu.org/wmn-e/world.htm.
5Rwanda, Ministry of Health and others, Success Factors for Women's and Children's Health: Rwanda (Geneva, World Health Organization, 2015), p. 7. Available at https://www.who.int/pmnch/knowledge/publications/rwanda_country_report.pdf.
6Jennifer A. Downs and others, "Increasing women in leadership in global health", Academic Medicine, vol. 89, No. 8 (August 2014), p. 1103. Available at https://www.ncbi.nlm.nih.gov/pubmed/24918761; Sonia Bhalotra and Irma Clots-Figueras, "Health and the political agency of women", IZA Discussion Paper No. 6216 (Bonn, December 2011), p. 3. Available at https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1977802.
7World Health Organization, "Former Directors-General". (2020). Available at https://www.who.int/dg/who-headquarters-leadership-team/former-directors-general.
8United Nations Population Fund (UNFPA), “Previous Executive Directors”. Available at https://www.unfpa.org/previous-executive-directors (accessed on 23 March 2020).
9Debra Michals, Ed., “Elizabeth Blackwell”, National Women’s History Museum. (Alexandria, VA, 2015). Available at from https://www.womenshistory.org/education-resources/biographies/elizabeth-blackwell.
10History of Scientific Women, “Anandibai Gopalrao Joshi”. Available at https://scientificwomen.net/women/gopal_joshi-anandi-112 (accessed on 23 March 2020).
11Betty Boyd Caroli, “Eleanor Roosevelt”, in Encyclopedia Britannica. Available at https://www.britannica.com/biography/Eleanor-Roosevelt (accessed on 23 March 2020).
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