Africa is a continent with strong female leadership, we must use it!

Women in Global Health Statement on The Health and Socioeconomic Impacts of COVID-19 on Achieving Universal Health Coverage at the roundtable hosted by Organisation of African First Ladies for Development (OAFLAD) and Global Fund.

Address by Dr. Roopa Dhatt, Executive Director of Women in Global Health at the African First Ladies Roundtable:

Excellencies and esteemed fellow guests, it is a privilege to be invited here today to discuss "The Health and Socioeconomic Impacts of COVID-19 on Achieving Universal Health Coverage", hosted by Organisation of African First Ladies for Development (OAFLAD) and Global Fund.

Let me start by acknowledging that Africa is a continent with strong female leadership, we must use it.

I want to make six headline points today:

1. Ask women, ask health workers, especially community health workers and midwives how best to serve the health needs of girls and women during COVID-19. Women are 70% of the health workforce, but hold only 25% of senior roles. The expertise and the woman power is out there but the world does not make best use of women’s talent and knowledge. We must listen to the women who know health systems best. They are the experts. It’s their time to lead.

2. Be gender responsive, value the lives and well-being of girls and women by treating safe maternity services and sexual and reproductive health services as essential services that must be maintained during a pandemic. We must learn the lessons from Ebola when services were disrupted and women’s lives lost in maternal deaths and in illegal abortions due to the rise in unwanted pregnancies.

3. COVID-19 is causing more deaths amongst men than women in most countries but the indirect impact will be greatest for women and girls:

Global estimates are that the COVID19 Pandemic will lead to:

2 million girls subject to Female Genital Mutilation. Governments must provide support services, continue peer to peer services to support and counsel young people (UNFPA). 

7 million unintended pregnancies. Governments must ensure access to SRHR services, including access to testing, contraceptives, safe delivery, maternal and neonatal care (UNFPA).

31 million cases of Gender Based Violence, almost all perpetrated by men against women, with huge loss of life and injury to women and children (UNFPA).

47 million women will lose access to contraceptives and the result will be unwanted pregnancies, illegal abortions and girls forced to abandon their education and their dreams. During lockdowns governments must ensure the safety of girls and young women or we will lose a generation of progress for girls and women (UNFPA).

100 million people pushed into extreme poverty, the majority likely to be women who are more likely to be in informal and insecure work (World Bank). 740 million women work in the informal economy. Many older women without social pensions will be very hard hit.

An expected loss of $1 Trillion in Human Capital (World Bank).  

4. Applause is great, but safe and decent work for health and social care workers is better. Women health workers are being applauded as heroines in this pandemic and we too applaud their extraordinary resilience and commitment to their profession. But health systems established by men for men have been slow to recognize that the default health worker is a woman and that she has different needs.

The needs of female health workers in COVID-19 include ensuring their safety as they move about communities, personal protective equipment that fits women and policies that don’t assume women can work long shifts in hospitals while at the same time homeschool children, care for elderly relatives and carry the full burden of domestic work. For too long women have been the social shock absorbers in times of crisis.

Governments must turn today’s applause into decent and safe work for women in health and social care, equally paid and with equal say in decision making. There is a danger that after this pandemic, women will be expected to return to their gender roles, undervalued, uncompensated, and unprotected. And that will leave us all vulnerable.

We must recognize the value of women’s unpaid health and social care work and bring it into the formal labor market. Almost half the $3 trillion women contribute to health annually, is unpaid. Health systems will remain fragile while they rest on the unfair burden of unpaid work by women.

5. Stop working blind. Data matters, especially sex disaggregated data.

Only 53 countries out of 193, in Africa alone, only 5 out of 55 countries (only 4 out of 55 countries (Burkina Faso, Kenya, Liberia and South Africa) are reporting sex disaggregated data on COVID-19 infections and mortality to the WHO. Without sex disaggregated and gender-responsive data, we are working blind in this pandemic and will not document the lessons that will help combat future health challenges.

13 countries reporting sex-disaggregated data on COVID-19 infections report that 70% or more infections are in men. Without further gender analysis we do not know why these countries buck the global trend of roughly equal infections in women and men but these figures suggest women have less access to testing, less access to treatment and that their deaths from COVID-19 will go unrecorded. 

6. Fund women’s movements to unleash capacity to address critical gender issues and health

The women’s organizations on the frontlines of the community response, especially those in the low- and middle-income countries most at risk – are underfunded; only 1% of gender-focused donor aid to civil society went directly to women’s NGOs in low income countries in 2017-18.

With adequate funding, women’s organizations and networks from global to community levels, will make a significant impact in prevention, health literacy and practical support for communities facing COVID-19.

In summary, this is not a gender war. There is only one health system that must respond to all genders. Gender equality in health will benefit everyone.

COVID-19 has disrupted business as usual on a global scale, causing tragic loss of life and widespread social and economic devastation. Major catastrophes, however, can act as a break in history, giving us an opportunity to re-imagine the future and build back better. Even in the middle of this pandemic, let us stand back, learn the lessons COVID-19 is exposing, look to the future and ensure that future includes gender responsive health systems.

In return, we all stand to gain the unparalleled benefits of a ‘triple gender dividend’- stronger health systems, greater gender equality and autonomy for women which together will result in the economic growth all economies will need after this pandemic.

Thank you.

Women in Global Health

Interventions from

First Lady of Zimbabwe, H.E. Madam Auxilllia Mnangagwa

Mr. Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria

Kenyan Ambassador to Ethiopia, H.E. Ambassador Catherine Mwangi

Dr. John Nkengasong, Director of Africa Centres for Disease Control and Prevention

First Lady of the Republic of Botswana, H.E. Jane Masisi

First Lady of the Republic of Niger, H.E. Aissata Issoufou

First Lady of the Republic of Congo, H.E. Antoinette Sassou N’guesso