By: Roopa Dhatt, Director Women in Global Health

Acknowledgements: Mehr Manzoor, Kris Ronsin

While the global health community is more aware of gender disparities in the burden of disease,

in the health workforce, in social determinants of health, and even in leadership; the World Health Organization (WHO), as the designated leading global health organization, continues to lag behind when it comes to achieving gender equity and hardwiring it into its leadership, governance, programs, and activities.

WHO’s Commitment on Gender Equality

World Health Assembly (WHA) resolution 34.15, recruitment of international staff passed in 1981, was the first resolution which focused on striving for gender parity in WHO’s highest ranking positions. Subsequent years set targets of 20% (1983), 30% (1985), and 50% (since 1997). Decades later, the WHO still has not reached its target, but unlike many other health targets, this one rarely makes the headlines. When evaluating gender representation at the World Health Assemblies in the past ten years, there is also a stagnation, with only a quarter of the chief delegates of member states being women, which is in stark contrast to the representation women have in the health workforce, estimated average at 75%.  When one looks beyond numbers, there are examples of deep rooted gender biases within health organizations and systems that reveal preferential treatment, discrimination, sexual harassment, and assault continue to be prevalent in high numbers. There is glaring evidence that without achieving gender equality, we will still continue to struggle in addressing health and development challenges. Granted, institutional change is a tedious process. Feminist political leadership or gender transformative leadership can leap frog our progress in addressing sustainable development goals. It is a priority that WHO cannot ignore and one that it must lead in example by, yet it is on the back burner in the surrounding next WHO Director-General (DG) Election.

 

UN Secretary-General vs WHO Director-General Elections on Gender

During the UN Secretary General elections, the dialogue surrounding gender equality was at the forefront, including massive campaigning to have the first woman UN Secretary General. While the election resulted in another male being appointed, there was a clear call and expectation that the next UN Secretary General would be a strong advocate for gender equality and this is being observed through prominent appointments of women leaders within the UN. However, even with the increased public engagement opportunities for the WHO DG elections from the online streaming of panels, use of twitter by all candidates and interviews with all candidates, gender equality and women’s empowerment continues to be underrepresented agenda item.  Not all candidates have provided clear positions on their vision, priorities and implementation plans in achieving gender equality in WHO and setting a standard for the global community. Nor do we know how do they plan to concretely act on the call to action on gender equality and implement change at all levels of the WHO.

 

Attention on Gender

There has been some attention brought to the gender equality in the elections, with the most prominent being through voices on social media, public events and interviews.  A telling example is from The Lancet, which has been a primary source on the #WHOElection, who published earlier this month a short piece Whose agenda for Whom? Analysing the manifestos of the candidates for Director-General of WHO that compared the platforms of all six candidates and marked differences among them. A very notable observation is the omission of any mention of sexual and reproductive health and rights (SRHR) in their agenda by all candidates and limited representation of gender equality priorities across the board. Only one candidate, Sania Nishtar directly mentions gender and health and Flavia Bustreo is also credited with mentioning gender mainstreaming (Lancet: Supplementary appendix). During a Chatham House hosted event, David Nabarro stated: “ WHO should be a feminist organization and fully respect diversity.” Additionally, Dr. Tedros has been credited for focusing on the health of girls and women in Ethiopia. Of note the article’s analysis on the gender platform of the candidates has already been contested on social media. An additional source is the Up Close and Personal with WHO Director General Candidates that Women Deliver produced. It quoted that what is more telling is not what the candidates said, but what they did not say, especially in light of the recent roll back on SRHR in parts of the world.  Most recently, the European Parliamentary Forum on Population & Development launched the #AtLeastOne campaign, which appeals to the WHO Executive Board to at least shortlist one woman candidate “Shortlisting only men for #WHODG would send the wrong message.”

 

 

Survey Findings

Women in Global Health conducted an online survey during the month of December, after most of the WHO DG candidates’ public engagements had taken place, to ask the online global health community about their perspective on the candidates and the elections. The survey was shared through WGH’s and partner social media platforms. The survey was meant to inspire interest and probe deeper into the perspectives of the global health community on the WHO Election. There were a total of 222 participants with 157 completed surveys, with a response rate of 71%. The trends, comments and questions are quite interesting (access full presentation) and highlights can be seen below.

 

The most telling responses were:

  • 78% respondents of the survey felt that “Gender factors into the perceived leadership qualities of the candidates and will impact how the next WHO Director-General is selected.
     

  • 74% respondents based on their previous answer would advocate to the WHO governing bodies for a gender equal short-listing of the candidates during the first round of voting at the January WHO Executive Board meeting.

 

Key Highlights

Respondent Demographics

  • Gender: 78% were women, 22% men, 0% mentioned other

  • Age: 70% were above the age of 30 and 19% were between 18-29 years old

  • Sectors represented were mainly academia (24%), non-profit (23%), and government (19%).

  • Countries: 48 countries represented

Please rate how interested you are in the WHO Director-General. Not at all (0) – Extremely  (100)

Respondents of the survey ranked their interest in the WHO Election to be 85 on a scale of 0 to 100, with 100 being extremely interested.


 

Who should be the next Director-General for the World Health Organization?

Respondents had the chance to comment on their candidate of choice:

David Nabarro’s global vision, relevant qualifications and valuable experience to  work in complex settings made him an ideal candidate for WHO DG position. His commitment towards One Health and gender issues were particularly important factors of consideration.

 

Flavia Bustreo’s strong focus on gender equality, gender sensitive approaches, and maternal and child health were considered strong factors for her selection as WHO DG position.

 

Sania Nishtar’s bold and transformative leadership, along with her knowledge of health systems particularly in low and middle income countries makes her an ideal candidate for WHO DG position. She is known for her good governance practices and is likely to bring fresh perspective to WHO vision.

 

Tedros Adhanom Ghebreyesus’s commitment towards One Health, women’s health, universal health coverage and global health reforms make him a strong candidate for WHO DG position.

 

Phillippe Douste-Blazy’s vision and experience as a professor were considered strong factors.  

 

Miklos Szocska’s analysis was not done due to insufficient survey response for this candidate.


 

Select the top three priority areas for the Director-General for the World Health Organization:

Regardless of which DG candidate one preferred, universal health coverage and gender equality and empowerment of women were the top ranked priorities, with divergence happening among the third choice.

 

Dr. Sania Nishtar

#3 addressing health workforce challenges

 

Dr. Flavia Bustreo

#3 climate change and humanitarian crisis

 

Professor Philippe Douste-Blazy

#3 humanitarian crisis

 

Dr. Tedros Adhanom Ghebreyesus

#3 addressing health workforce challenges

 

David Nabarro

#3 access to essential medicines

 

Dr. Miklós Szócska

omitted due to insufficient responses

 

According to the The Blavatnik School of Government, CFR, Women in Global Health and Women Who Lead, these are the leadership characteristics needed for UN work.

 

The majority of the respondents, regardless of their candidate of choice, agreed that next WHO DG should possess the leadership characteristics of: having a vision and having the ability to set direction.

 

Dr. Sania Nishtar

Inclusive leader who adopts a Feminist, intersectional approach

Leading by listening and leveraging others’ expertise to build a common vision for health

 

Dr. Flavia Bustreo

Inclusive leader, who adopts a Feminist, intersectional approach

Leading by listening and leveraging others’ expertise to build a common vision for health

 

Professor Philippe Douste-Blazy

Technical competence(#1)

Challenging status quos and norms (tied)

Vision/ability to set direction (tied)

 

Dr. Tedros Adhanom Ghebreyesus

Leading by listening and leveraging others’ expertise to build a common vision for health

Challenging status quos and norms

 

David Nabarro

Ability to build consensus (tied)

Leading by listening and leveraging others’ expertise to build a common vision for health

 

Dr. Miklós Szócska

-omitted due to insufficient responses

 

A Call to Action for Gender Equality in Global Health

 

Women in Global Health is launching a Call to Action for Gender Equality in the Global Health, particularly targeting the next WHO Director General for greater leadership on gender equality. The global health community must achieve gender equality and women’s empowerment at all levels, this is the commitment made in 2015 by adopting the Sustainable Development Goals, a commitment unlike any other—a visionary, inclusive global compact, but most importantly a commitment which will improve the health and well being of all people.



 

WHO Elections: what does gender have to do with it?

Download Highlight of Results

Download Questions asked to DG Candidates

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