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Commentary
Off the back burner: diverse and gender-inclusive decision-making for COVID-19 response and recovery
  1. Sulzhan Bali1,
  2. Roopa Dhatt1,
  3. Arush Lal1,
  4. Amina Jama2,3,
  5. Kim Van Daalen4,
  6. Devi Sridhar5
  7. Gender and COVID-19 Working Group
    1. 1 Women in Global Health, Washington, DC, USA
    2. 2 Somali Institute for Development Research and Analysis (SIDRA), Nairobi, Kenya
    3. 3 Women in Global Health, Mogadishu, Somalia
    4. 4 Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK
    5. 5 Medical School, The University of Edinburgh, Edinburgh, UK
    1. Correspondence to Professor Devi Sridhar; devi.sridhar{at}ed.ac.uk

    https://doi.org/10.1136/bmjgh-2020-002595

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      Summary box

      • Epidemics are a gendered vulnerability, with their socioeconomic impact disproportionately high among women, even when, as it seems the case with COVID-19, mortality is higher among men.

      • However, women are not only a vulnerable population, they can serve as agents of change whose contributions can improve epidemic response and recovery.

      • In COVID-19 response and recovery, existing lack of diversity and gender representation in decision-making means perspectives of some of the most vulnerable communities are left out.

      • The evidence and lessons from peace, disaster and business sectors suggest that lack of diversity and failing to leverage women’s expertise and talent in decision-making can limit an effective response.

      • In addition to being ethical, diverse and gender inclusive decision-making will yield innovation and knowledge dividends, limit group-think and promote greater accountability for an adaptive response and resilient recovery to COVID-19.

      Epidemics function as a gendered vulnerability, and yet gender remains an afterthought in health security and pandemic response, including to coronavirus disease 2019 (COVID-19).1 Emerging data indicate that COVID-19 mortality is greater among men, but past experiences suggest that the socioeconomic impact of epidemics tends to be far greater for women. As a result, it is essential to assess the intersectional and gendered vulnerabilities in health emergencies. In addition, given the gender-skewed landscape of power and decision-making in global health, it is also critical to outline women’s leadership and role in such contexts.

      Women are users of health services, and they are agents of change in health, making critical contributions as parents, front-line responders, health promoters, influencers, researchers, scientists and decision-makers. In China’s COVID-19 response, female nurses and community health workers were the first line of defence against the outbreak.1 Despite their major role, an interplay of power and privilege often results in women—particularly women from minority ethnic groups—being under-represented in …

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