WHO runs the world – (not) girls: gender neglect during global health emergencies

ABSTRACT

During health emergencies, neglect of gender experiences and needs can compromise the outbreak response. Ebola in West Africa and Zika in Latin America had gendered effects that were evident during the crises, yet governments and international organizations failed to prioritize a gender-inclusive response. There is the same risk that gender-inclusive responses and knowledge will continue to be neglected during the COVID-19 pandemic. In this article, we examine the drivers of gender exclusion in health emergency response. We ask: where can we locate institutional responsibility for taking gender seriously to inform and improve sustainable disease control? The article addresses this question by turning to feminist institutional theory to explain why gender inclusion in decision-making processes is vital for effective response and post-crisis recovery. We argue that the institutional responsibility to recognize gender within the global health emergency regime lies with the World Health Organization (WHO). WHO has neglected to mainstream gender in the policies and practices that it promotes for the prevention and detection of, and response to, infectious disease outbreaks. WHO is in a position to support gender-inclusive practices, but this requires the technical agency to recognize the value of having a gender-inclusive framework to inform outbreak response, financial models, and recovery.

KEYWORDS:

• Global health security
• gender
• World Health Organization (WHO)
• COVID-19
• women

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 We recognize that not all readers will agree with our assessment of WHO’s position within global health governance. This is a multi-stakeholder framework that includes states, international organizations, non-state actors, and others. However, while there has been considerable literature considering the waning power of WHO, particularly in health emergencies (see, for example, Kamradt-Scott 2015; McInnes 2015), we do not see that an alternative lead institution will emerge. Indeed, we argue that placing WHO at the center of this piece is not only to create a case study but also to support a normative commitment to the centrality of WHO in global health emergencies.

2 This definition of gender is the same as that provided by UN Women in the Gender Glossary (UN Women Training Centre n.d.) and fails to consider non-binary genders.

3 The WHO HEP grades health emergencies from Grade 1 (low) to Grade 3 (high) according to the scale of WHO’s assistance or response. In this article, we focus on the IHR-declared PHEICs because WHO leads the technical and institutional response to these (see WHO 2018b).

Additional information

Notes on contributors

Clare Wenham

Clare Wenham is Assistant Professor of Global Health Policy in the Department of Health Policy at the London School of Economics & Politics and has over ten years’ experience in research and teaching in global health security and outbreak response. Her research has focused on the politics and policies of health emergencies, including those of pandemic flu, Ebola, and Zika. Most recently, she led a project funded by the Wellcome Trust examining the impact of Zika on reproductive rights and the failure to mainstream women’s needs in global health emergency policy, resulting in the publication of Feminist Global Health Security (2021). For COVID-19, she is Co-Principal Investigator on two projects to understand the gendered effects of the pandemic.

Sara E. Davies

Sara E. Davies is a Professor in the School of Government and International Relations at Griffith University, Australia. Her research is in global health governance, gender, and human security. She has recently published Containing Contagion: Politics of Disease Outbreaks in Southeast Asia (2019) and is co-editor of the Oxford University Handbook on Women, Peace and Security (2018). For COVID-19, she is a Co-Investigator on one project examining the gendered effects of the outbreak in China, Hong Kong, Canada and the UK, and Principal Investigator on a project examining the gendered effects of the outbreak on food insecurity in Myanmar, Papua New Guinea, and the Philippines.