This article was written by Dr. Roopa Dhatt, co-founder and executive director of Women in Global Health

Covid-19 has shattered the world we lived in just months ago. This tragedy is also giving us an opportunity to re-imagine the future.

The good news is that there is a vibrant global movement of women working in health care actively organising around Covid-19, sharing evidence and resources across borders in a spirit of sisterly solidarity. Globally, women make up the vast majority of workers in health and social care. They are leading the fight against Covid-19 in hospitals, health centres, care homes, labs and in parliaments all over the world. The woman power is out there.

Women are the frontline soldiers in this pandemic

It is inspiring to see the energy of women mobilised around Covid-19 but the risk is that there are just larger numbers of us in the same echo chamber talking to each other. Global and national organisations continue to publish Covid-19 strategies and plans that are gender blind — meaning they do not account for the different ways Covid-19 will impact women and men. Lockdown policies requiring families to stay at home failed to predict the increase in gender based violence that have been seen wherever such policies are in place. Women’s organisations, however, warned about this fatal outcome from the outset. Our messages are not being heard by those who need to hear them.

If you’ve read this far, stick with us. This is what you need to know if this Covid-19 response is going to be equitable, responsible — and stronger:

1. Women are the health and social care workforce but their needs are ignored

If this is a war — as some politicians have been eager to say — then women are the frontline soldiers in this pandemic. They account for 90% of all nurses worldwide and 90% of frontline health workers in Wuhan were women. Yet when our local chapters of Women in Global Health raise gender equity and challenge Covid-19 decision-making bodies with no women, we are told “now is not the time for special pleading on gender”.

Women are 70% of the health workforce, but hold only 25% of senior roles. Women from the Global South are particularly underrepresented in global health decision-making. Women are the experts in health; they know the solutions we need. Midwives, for example, will know how best to reach pregnant women and ensure safe deliveries in a lockdown.

This pandemic shines a harsh light on the low social value we put on women's work, the superhuman expectations we have for women, especially women from lower socioeconomic groups

The systematic side-lining of women's expertise and experience in health weakens health systems and our response to Covid-19.

2. Applause is welcome, but safe and decent work is better

Women health workers are quite rightly being applauded in this pandemic for their extraordinary resilience and commitment. But health systems established by men for men have been slow to acknowledge that the default health worker is female and that women have different needs. A rare exception came when UNFPA sent sanitary towels for health workers in Wuhan.

The immediate needs of female health workers in Covid-19 include ensuring their safety as they move about communities, personal protective equipment (PPE) that fits women and policies that don't assume women working long shifts in hospitals can also home school 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. In a world with a shortage of 40 million health and social care workers projected by 2030 we need to enable women in the health workforce to balance professional and personal commitments. That includes redistributing domestic work at home between women and men.

This pandemic shines a harsh light on the low social value we put on women's work, the superhuman expectations we have for women, especially women from lower socioeconomic groups who face poverty if they cannot work. Although men face higher mortality from Covid-19 and robust sex-disaggregated data are hard to come by, we know from previous emergencies such as the most recent Ebola outbreak in West Africa that women have a higher infection rate because they are on the frontlines in health and care, often in low-status jobs. The severity of this pandemic means we must also consider the impact on the mental health of frontline workers, mainly women.

3. Our health systems rely on women’s unpaid work

Half of the work done by women in the health and social sector — a staggering $1.3 trillion per year is unpaid. During a pandemic, women in unpaid but vital roles such as vaccinators and community health workers, will be the first to leave the health system, fearing infection. And then the health delivery house of cards, that global health security depends on, will come tumbling down.

Women's unpaid health and social care work must be valued, recorded and brought it into the formal labour market if health systems are to be both equitable and effective.

4. Without gender-disaggregated data we fight the virus in the blind

Only 29 countries out of 193 are reporting sex-disaggregated data on Covid-19. Without sex-disaggregated and gender-responsive data, we are working blind in this pandemic and not documenting the lessons that will help combat future health challenges.

We are calling for equal representation of women from all geographies as a standard in all health decision-making bodies, including Covid-19, from global to community — not just for women — but to enable women to deliver better health for all genders.

Twice as many men than women are dying from Covid-19 and we need to know why. We also need to document the deaths of women from gender-based violence and in childbirth, unable to access maternal and reproductive health services. Increased maternal deaths were recorded in Ebola outbreaks. We don't need to keep making the same mistakes with women’s lives.

5. We need global leadership — now

Women are organised but governments are not.

Covid-19 urgently requires one coordinated global vehicle at the highest political level to lead the pandemic response and to build back better, gender-responsive global health. Global pandemics ignore national borders and nowhere in the world will be safe from Covid-19 until it is eradicated everywhere.

The United Nations, as the convening body for the world’s 193 nations must form a high-level task force to work with the UN General Assembly and lead a coordinated approach to share research, evidence, equipment, treatments, diagnostics, vaccines, policies that work and resources. And that coordinated effort must be led by at least 50% women to ensure women’s perspectives, expertise and experience from the Global South and North, are represented. And it must operate on principles of global collaboration, compassion, social cohesion, equity and human solidarity.

We are calling for equal representation of women from all geographies as a standard in all health decision-making bodies, including Covid-19, from global to community — not just for women — but to enable women to deliver better health for all genders.

We do not need to seek permission. Commitments on gender equality, data, the health workforce and women’s unpaid work already have a framework and a set of indicators — they were made and adopted by the world's governments in the Sustainable Development Goals (SDGs) — and reinforced just eight months ago during UN High Level Meeting on Universal Health Coverage. The delivery date is 2030. There’s no time to waste. — Dr. Roopa Dhatt

(Picture credit: Unsplash)