When pandemics strike, world leaders and health responders must adapt quickly to the looming threat. Often the last factor they consider – if it makes their to-do lists at all – is gender.
As advocates for the health and rights of girls and women, we’ve heard the excuses time and time again: “Gender isn’t a priority right now,” leaders say. “Maybe when things calm down,” they claim. “It’s not the right time,” they insist. If we are to pursue the most effective responses to COVID-19 – or any health emergency – this must change.
Girls and women experience outbreaks differently than boys and men. A gender lens highlights the specific risks and vulnerabilities girls and women face because of deep-rooted inequalities and traditional gender roles. And the facts such a perspective uncovers can save lives and ensure that nobody is left behind in our emergency responses.
To reframe our pandemic response with gender at the centre, we need, first, to protect and support the global health workforce, 70 percent of whom are women. It is crucial that these health workers are trained, resourced, and equipped, which means filling global shortages in protective gear like medical masks and gloves, so that they and their patients are adequately protected.
It also means tackling the 28 percent gender pay gap in the global health workforce and ensuring decent and safe working environments with proper protective equipment. This will prevent interruptions in service delivery by ensuring health workers themselves don’t fall ill and by promoting retention as they work around the clock to fight COVID-19. Additionally, we must dismantle the discriminatory system that excludes women health workers from the decision-making bodies that initiate life-saving emergency protocols in health-care settings.
Likewise, it will be impossible to provide reliable evidence about COVID-19 to health workers, policymakers, and the media without investing in the timely collection of gender- and age-disaggregated data in all surveillance and monitoring efforts. Past health emergencies such as the 2014-16 Ebola epidemic and the 2012 cholera outbreak in Sierra Leone show that the absence of gender-disaggregated data seriously impedes smart decisions, strong responses, and swift recoveries. While these health emergencies may have challenged us in different ways than COVID-19, the need for evidence-based solutions, backed by quality data, remains the same.
We must also ask how traditional gender roles shape how people of all gender identities and backgrounds experience COVID-19. This means going beyond preliminary data from China that suggests COVID-19 infections are slightly higher among men than women. It also means that we need to assess what makes girls, women, boys, men, and non-binary people vulnerable in the first place.
For example, past health emergencies demonstrate that women’s traditional role as caregivers for sick family members often increases their exposure to infectious diseases through person-to-person contact. This occurred during the 2014-16 Ebola outbreak, the 2002-03 SARS epidemic, and India’s 2018 fight against the Nipah virus in Kerala. In all these cases, large numbers of caregiving girls and women were infected. Knowing this enables caregivers to understand the importance of reinforcing preventive measures in their households, as outlined in the World Health Organization’s (WHO) COVID-19 prevention guide, and of reporting cases when symptoms first appear.
While we bolster our medical and epidemiological response to COVID-19, we also must ensure that essential maternal, sexual, and reproductive health services are not disrupted. The West African Ebola outbreak showed that containment efforts can divert staff and supplies from other services women need. This can have disastrous consequences: maternal mortality in the region increased by 75 percent during the epidemic, and the number of women giving birth in hospitals and health clinics dropped by 30 percent.
The need for access to skilled birth attendants, protection from gender-based violence, contraception, and safe abortion often becomes more acute during outbreaks. COVID-19 is no different in that respect. Domestic violence reportedly rose in Wuhan, China, during the city’s two-month lockdown. And people still have sex, experience puberty, menstruate, become pregnant, and give birth during public-health emergencies, so meeting these needs must remain a high priority.
That requires promoting women to leadership roles. Women are skilled service providers, epidemiologists, caregivers, community leaders, and more. Above all, they are the best experts on their own lives and must be meaningfully engaged in all preparedness and response efforts. That means ensuring the participation of girls and women in all local, national, regional, and global task forces on COVID-19. Women must serve on local community councils and in legislative bodies where important decisions are made. At the international level, gender imbalances in global health leadership, where men hold 72 percent of the top positions, must urgently be addressed.
With sufficient resources, we can avoid past mistakes and devise responses that apply a gender lens at the outset. While the US$15 million and the US$14 billion in emergency aid pledged by the United Nations (UN) and World Bank, respectively, is a great start, we need additional investment to implement the policies that an effective COVID-19 strategy requires.
For too long, excuses for not using a gender lens during health emergencies have impeded the responses we most need. To protect us all, this time must be different.