Gender Inequities in Global Health Leadership in Pursuit of Health For All

Reflections from the “Leadership in Global Health: Making 2019 the Year of the Woman” event on Universal Healthcare Day, December 12th, 2018.

This past year, 2018, has been a tumultuous year in many respects, but specifically it has seen the upsurge of the #MeToo and #TimesUp movements, both among rising global calls to draw attention to gender inequity, abuse, and disparities. People around the world have taken this opportunity to look at similar themes in their own settings – for us, namely, that is the field of global health. We know that while timing certainly has a lot to do with the ability to capitalize on political will and popular attention, leadership is also critical.

On December 12th, International Universal Health Coverage Day (#UHCDay), a diverse audience gathered at the Center for Strategic & International Studies (CSIS) Global Health Policy Center to discuss Leadership in Global Health: Making 2019 the Year of the Woman. The event was organized by CSIS and endorsed by Women in Global Health (WGH) at a time where the gender pay-gap is still, on average, larger in global health than in all other sectors. While 75% of the global health workforce is women delivering care to over five billion people and while the field depends heavily on women to function, women still only represent 25% of leadership positions.

The event opened with a video message from Women Leaders in Global Health (WLGH) steering committee chair, Prof. Heidi Larson. Just one month before, the London School of Hygiene and Tropical Medicine held the second annual WLGH conference, where WGH was a key partner. Prof. Larson shared her summary of what she called the deeply “moving experience” of the conference. She reported that the main themes of the event were female leadership, mentorship, and gender equity. Those themes, she said, received an electric response and expanded as 900+ attendees from 80 nationalities connected with each other in informal exchanges and conversations throughout WLGH.

From L to R: Sara Allinder, Dr. Mariam Claeson, Dr. Athalia Christie, Dr. Thomas Quinn, Prof. Lanice Williams. Photo: CSIS. Moderated by Sara Allinder, Executive Director and Senior Fellow at the CSIS Global Health Policy Center, the event moved to a phenomenal panel of people with profound reservoirs of experience. Panelists who represented senior, mid-, and emerging careers in global health reflected on what it means to purposefully make space for women on the rise, how to change the demographics of established global health organizations, and how to continue to create entirely new spaces where equity is more organic. New themes of role-modeling and mentorship were woven throughout the conversation, especially when the audience engaged through questions and commentary from their own individual experiences.

Dr. Mariam Claeson, Director of the Global Financing Facility for Every Woman Every Child of the World Bank Group, brought her expertise in addressing health challenges faced by women, newborns, and children as well as global advocacy in family planning and reproductive health, especially in the context of sustainable financing efforts.

Dr. Athalia Christie, Senior Science Advisor at the Centers of Disease Control and Prevention (CDC) Center for Global Health was a welcome breath of fresh air and put forward real experiences from her extensive fieldwork, workplace and leadership dynamics, the reality of speaking up, and the lack of visible female role-models. Dr. Christie noted that there are very practical reasons to have women in the field, especially in cases where other women might be more, or only, comfortable reporting information to someone of their own gender. She emphasized that women in leadership positions should consistently be looking be looking out for one another–namely those who are in more vulnerable positions in the power dynamic.

Dr. Thomas Quinn, Director of the Center for Global Health at Johns Hopkins University, spoke about the male role in active participation and being part of the solution, as well as the gender drop-off in career advancement and equity problems that are endemic in the global health leadership hierarchy. He was an enthusiastic attendee of the two WLGH conferences and strives to be someone who makes space for those coming up in the field and called for all of us to be aiming for equity.

Prof. Lanice Williams, Advocacy and Partnerships Manager at Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria, adjunct professor at Howard University, Global Health Corps alumna and WGH Washington DC Chapter Executive Committee member spoke about the opportunities available–or not–to women and minorities in the global health field. She spoke about what it takes to establish a career as a young professional and overcoming the gender bias and discrimination common in many workplaces. Prof. Williams put a spotlight on the intersectionality of gender equity and racial discrimination, and the fact that not everyone has the same resources or financial basis to take on major moves or unpaid internships in order to find the best stepping stones for one’s chosen path.

Sara Allinder brought the conversation around to each panelist’s experience in their own careers, obstacles, challenges, and the opportunities therein to promote women’s leadership in the field of global health. Dr. Claeson spoke of female drop-out rates that begin as early as secondary school and continue throughout women’s careers due to lack of agency in structuring their school and work environment and the expectation of capitulation, first to their menstrual cycles and childbirth, and, in general, as caregivers for their families and societies. We must pay attention to the voices of the marginalized and resolve where their agency is interrupted. This means bringing all women along.

Ultimately, it’s not a hard argument to make: that gender parity in the workforce in terms of pay, in healthcare provision and solutions, and especially in terms of leadership, is the single most sustainable investment you can make in the future. Dr. Claeson spoke plainly on this point and remarked that the nexus of society, gender, economy, and value for money is one of the ultimate, positive, propulsive interventions. On the other hand, it is all too easy to ignore this argument in favor of easier battles, and we, as a global community, have sidelined it for far too long. A path forward proposed by Lanice Williams is to organize in mentor/mentee relationships and in peer solidarity. She specifically invited the audience to engage with Women in Global Health and join a local WGH chapter.

The audience in attendance was primarily, but not exclusively, women. While it is clear why women showed up, it is also so important for men to be brought, or to bring themselves, into these rooms and to actively engage in these conversations. This includes men just starting their careers in global health and men at every level of the career hierarchy. We should be redefining global health in our own image from the beginning and strive to fully represent in leadership those who are on the ground, and those who face the biggest barriers to their own health and wellbeing. Ellen Starbird, Director of the Office of Population and Reproductive Health at the US Agency for International Development (USAID) Bureau for Global Health closed the program with a simple call to prioritize “‘generosity of voice and space’ as a personal and organizational responsibility.”

We know from those at the fore of the movement for gender equality in global health, the presentations of the panelists, and from the topics brought up by the event attendees that ultimately gender equality supports smarter global health in all respects and for all participants. After the event, Executive Director and Co-Founder of WGH, Dr. Roopa Dhatt amplified the call to make 2019 the global health “Year of the Woman” and asked participants to contribute to solving existing systemic imbalances with gender transformative leadership by all; fundamental in the international pursuit of universal health coverage and to achieve the goal of #HealthForAll. Make your own impact: be part of the 2019 #YearOfTheWoman and support women’s leadership in global health by joining, or starting, a local WGH chapter here.