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Commentary
Symptoms of a broken system: the gender gaps in COVID-19 decision-making
  1. Kim Robin van Daalen1,2,
  2. Csongor Bajnoczki3,
  3. Maisoon Chowdhury2,
  4. Sara Dada2,4,
  5. Parnian Khorsand2,
  6. Anna Socha3,
  7. Arush Lal2,
  8. Laura Jung2,5,
  9. Lujain Alqodmani6,
  10. Irene Torres7,
  11. Samiratou Ouedraogo8,9,
  12. Amina Jama Mahmud10,11,
  13. Roopa Dhatt2,
  14. Alexandra Phelan12,
  15. Dheepa Rajan3
  1. 1 Cardiovascular Epidemiology Unit, Cambridge University, Cambridge, UK
  2. 2 Women in Global Health, Washington, District of Columbia, USA
  3. 3 UHC2030 Alliance, Health Systems Governance Collaborative, World Health Organization, Geneva, Switzerland
  4. 4 Vayu Global Health Foundation, Boston, Massachusetts, USA
  5. 5 Leipzig University, Leipzig, Germany
  6. 6 Education and Agriculture Together (EAT) Foundation, Oslo, Norway
  7. 7 Fundacion Octaedro, Quito, Ecuador
  8. 8 McGill University, Montreal, Quebec, Canada
  9. 9 Institut National de Santé Publique du Québec (INSPQ), Montreal, Quebec, Canada
  10. 10 Women in Global Health, Garowe, Somalia
  11. 11 Department of Women’s and Children’s Health, Uppsala University Department of International Maternal and Child Health, Uppsala, Sweden
  12. 12 Center for Global Health Science & Security, Georgetown University, Washington, District of Columbia, USA
  1. Correspondence to Ms Kim Robin van Daalen; krv22{at}cam.ac.uk

https://doi.org/10.1136/bmjgh-2020-003549

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    Summary box

    • Despite numerous global and national commitments to gender-inclusive global health governance, COVID-19 followed the usual modus operandi –excluding women’s voices. A mere 3.5% of 115 identified COVID-19 decision-making and expert task forces have gender parity in their membership while 85.2% are majority men.

    • With 87 countries included in this analysis, information regarding task force composition and membership criteria was not easily publicly accessible for the majority of United Nations Member States, impeding the ability to hold countries accountable to previously made commitments.

    • Lack of representation is one symptom of a broken system where governance is not inclusive of gender, geography, sexual orientation, race, socio-economic status or disciplines within and beyond health – ultimately excluding those who offer unique perspectives and expertise.

    • Functional health systems require radical and systemic change that ensures gender-responsive and intersectional practices are the norm – rather than the exception.

    • Open, inclusive and transparent communication and decision-making must be prioritised over closed-door or traditional forms of governance.

    • Data collection and governance policies must include sex and gender data, and strive for an intersectionality approach that includes going beyond binary representation in order to produce results that are inclusive of the full gender spectrum.

    A growing chorus of voices are questioning the glaring lack of women in COVID-19 decision-making bodies. Men dominating leadership positions in global health has long been the default mode of governing. This is a symptom of a broken system where governance is not inclusive of any type of diversity, be it gender, geography, sexual orientation, race, socio-economic status or disciplines within and beyond health – excluding those who offer unique perspectives, expertise and lived realities. This not only reinforces inequitable power structures but undermines an effective COVID-19 response – ultimately costing lives.

    By providing quantitative data, we critically assess the gender gap in task …

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