What does gender equality and climate change have to do with health? Everything.
At the end of May, the 72nd World Health Assembly (WHA) in Geneva brought together global health leaders to discuss pressing issues. The topics covered issues from mental health to eradicating polio and everything in between, but at the core of them all was one clear theme: leave no one behind, as promised by world leaders in the Sustainable Development Goals (SDGs).
While progress on global health is happening – life expectancy has increased in many parts of the world and 6 million fewer children under the age of five-years-old died in 2016 than in 1990 –progress is not happening evenly everywhere.
This focus on addressing inequalities was most strongly seen across two global issues during the Assembly: gender equality and climate change. While these two issues may seem like topics you wouldn’t expect at a global health conference focused on Universal Health Coverage (UHC), both pose significant barriers to ensuring equity in health for people everywhere.
Health Inequalities are Fueled by Gender Inequality
Much of this year’s discussions demonstrated that we cannot achieve health for all without progress on gender equality (SDG 5). For one, the lives of too many women and girls are in danger because they lack access to quality care, including the ability to freely make decisions regarding their own sexual and reproductive health and rights. It’s an injustice that more than 200 million women of reproductive age do not have access to the modern contraceptive services that they want.
One key, and often overlooked, component of gender equality and health is access to clean cooking and household fuels. More than 3 billion people around the world rely on poor, polluting fuel sources to cook their food inside their homes. Women and girls spend up to 10 hours of week gathering this wood, charcoal, and/or coal, bearing a disproportionate burden of labor that stops them from pursuing work and education.
What’s more, because they often stand over indoor fires to prepare food, women and girls make up many of the up to 4 million premature deaths that happen every year from illnesses attributable to household air pollution. A WHA side event hosted by the UN Foundation and the Clean Cooking Alliance on “Cross-Sectoral Collaboration and Leadership in the Energy-Health Nexus” highlighted the need for scaling solutions that ensure reliable, clean energy, including cooking and household fuels, to protect the health and well-being of people and the mitigate damage to the environment.
Another major barrier to health heard throughout the week: the lack of women’s leadership in global health. Women make up the majority — roughly 70% — of the health workforce and contribute nearly $3 trillion to the health and social sector. Yet, women are not proportionately represented in positions of leadership in global health. Without fully harnessing the potential that all people can bring into global health leadership and decision-making, including women, Universal Health Coverage will not be achieved.
Hear from the Founder-President of Wellbeing Africa, Toyin Sarakai on how gender equality needs to reach across leadership in global health at WHA 72.
To help recognize women leaders and recognize the lifesaving contributions they are making in global health, Women in Global Health awarded seven remarkable women the 2019 Heroines of Health honor. You can meet the seven leaders here.
Building on the gender equality conversations at WHA, at the Women Deliver conference in Vancouver, Canada, the Lancet launched a new series on Gender Equality, Norms, and Health, which takes a deeper dive into the multitude of impacts that gender norms and inequalities have on health. As the series discusses, “The systemic neglect of gender norms and inequalities in programme design, implementation, monitoring, and evaluation undermine the health of everyone,” and limit people’s ability to reach their full potential around the world. This series further illustrates that addressing gender equity in health and girls’ and women’s rights to health is one of the most direct and powerful ways to reduce health inequities.
Risks from Climate Change
As the impacts of climate change — from heat stress, poor air quality, and drought exacerbating non-communicable diseases and malnutrition, to extreme weather like devastating cyclones, to changing patterns of infectious diseases — continue to worsen, so do the consequences for health. And they will continue to fall hardest on the most vulnerable.
During a WHA interview, Dr. Diarmid Campbell-Lendrum, a WHO climate and health expert, summed up the links between progress on SDG 3: Good Health and Well-being and SDG 13: Climate Action in two ways: 1) strengthening our health systems to make them more resilient from increasing climate impacts and 2) implementing solutions that work for climate action and health, such as clean energy and more sustainable diets.
Last year’s first WHO Global Conference on Air Pollution and Health took a crucial step in elevating solutions that can drive action on both agendas: It saw some 70 commitments from countries, cities, UN organizations, intergovernmental organizations, and civil society to tackle air pollution, which is responsible for 7 million premature deaths every year.
And this year’s WHA saw key action in the intersection of climate and health: Member States agreed on a new WHO global strategy on health, environment, and climate change, which will cover the transformation needed to improve lives and well-being sustainably through policies for healthy environments.
To help build resilience in communities vulnerable to climate change, Member States also agreed on a plan of action on climate change and health in small island developing states (SIDS). Nations like Fiji and the Republic of the Marshall Islands, which are the least responsible for global emissions, are already facing severe impacts, such as drought, floods and swells, ocean acidification, and tropical cyclones and storms.
Many of these impacts directly threaten their health systems — and their already limited food and water supplies. As a result, a major part of the WHO plan will include preparedness and adaptation for climate risks as well as building investment in climate and health finance.
Watch this space, as work at the intersection of climate, environment, and health will continue to build this year as leaders meet again at the High-level Political Forum in July, and the confluence of several high level meetings during the UN General Assembly in September: the UN Secretary-General’s Climate Action Summit, the high-level check-in on the Sustainable Development Goals, the High-Level Meeting on Universal Health Coverage, and the Small Island Developing State (SIDS) meeting.
Leaving No One Behind Under the SDGs
Ultimately, the many discussions and debates during this year’s WHA reinforced that no progress is safe if we don’t have progress across all SDGs. The challenges facing our planet and people’s health are undeniably daunting. But the novelty of the SDG framework is that all SDGs are interconnected – progress on one drives progress on others. To meet the call of leaving no one behind in our journey for health and well-being for all, it’s clear we will need health advocates to also be gender advocates and climate advocates.