Thomas Ibrahim:
Ask almost any woman, and she will have a story about being dismissed by a clinician. Conditions that primarily affect women are under-recognised; maternity care too often falls short; and women who arrive at emergency rooms with classic cardiac symptoms are, by some studies, roughly twice as likely as men to be told their distress is “just anxiety.” The pattern is not incidental. It is structural.
The failures extend beyond the bedside. It is now widely acknowledged—sometimes with an air of resignation—that women’s health remains profoundly under-researched. There are more published studies on the causes of male baldness than on endometriosis, a debilitating disease that can derail education, employment, and fertility. Pain, too, is gendered. Women are still less likely to receive adequate analgesia, in part because the stubborn myth that women are “oversensitive” remains embedded in the health-care system.
Leadership gaps compound these inequities. Even as the number of women in health and caregiving roles has climbed, the World Health Organisation (WHO) has documented that women across the sector are concentrated in lower-paid jobs and poorer working conditions than their male counterparts. Public-health workplaces are staffed predominantly by women, yet men disproportionately occupy the corner offices. The WHO’s own assessment captured the paradox with unnerving clarity: health care is “delivered by women but led by men.”
That report was published in March 2019, and more than six years on, little appears to have changed. The lack of women in health leadership would be troubling anywhere; at the WHO—charged with coordinating responses to outbreaks, strengthening primary care, and supporting fragile systems from the Sahel to South Asia—it is indefensible.
Rather than modelling the change the field needs, the organisation has too often affirmed the status quo, sidelining women’s voices when they are most needed. Today, only two of the six regional directors are women, and one of those has been placed on indefinite leave with scant public explanation.
Complicating matters further, the WHO is in the midst of a top-to-bottom reorganisation amid a budget crunch. Early assurances suggested savings would come from trimming an over-inflated senior management tier that costs the organisation more than $100 million. In practice, the axe has fallen largely on lower- and mid-level staff. At the very top, women leaders have been the ones left most exposed—some unsure of their futures after the reshuffle, while others have been quietly moved aside.
This is not an abstract governance problem. Excluding women from decision-making in health produces real-world harm. Decades of research and practice demonstrate that smarter systems rely on targeted investments in women’s health and on acknowledging the invisible labour women perform throughout the health ecosystem—preparing food for recuperating relatives, coordinating appointments, providing childcare, and acting as unpaid caregivers. Those contributions save formal systems money even as they prop them up. They deserve visibility, respect, and a place in any holistic approach to health.
To meet its mandate, the WHO must widen its field of vision beyond disease control and clinical protocols to the social conditions that shape health: education, income, caregiving norms, and gendered risk. And that work must be tailored. A woman’s role in community health in rural Bangladesh is not the same as a woman’s role in metropolitan France; programs that ignore religion, culture, and family structure will misfire. The only reliable way to account for those realities is to ensure that diverse groups of women are present—meaningfully and in numbers—where decisions are made.
The goal is not symbolic parity. It is competence. An organisation that remains “delivered by women but led by men” will miss what half the world knows from lived experience. The WHO should be a first mover in correcting the imbalance: publish transparent metrics on gender representation at every level; protect and promote qualified women during reorganisations; channel resources into research on conditions that uniquely or disproportionately affect women; and develop region-specific strategies with women at the table from the outset. Anything less will perpetuate a system that continues to fail the very people who keep it running.
Courtesy: International Policy Digest
