Argument

Don’t Let Health Hold Women Back

A focus on women’s health care should be the basis of any plan for equality.

A woman reacts as a medical worker collects a swab sample for a Rapid Antigen Test for the novel coronavirus in Srinagar, Jammu and Kashmir, on Sept. 11.
A woman reacts as a medical worker collects a swab sample for a Rapid Antigen Test for the novel coronavirus in Srinagar, Jammu and Kashmir, on Sept. 11. Tauseef Mustafa/AFP/Getty Images

Even in a year as bad as this one, there are still a few things worth celebrating. August marked the 100th anniversary of women gaining the right to vote in the United States. September is also the 25th anniversary of the Beijing Declaration on the status of women, a global plan for women’s equality under the auspices of the United Nations. And no less remarkable will be the 20th anniversary in October of U.N. Security Council Resolution 1325, which calls for all actors to raise the profile of women and gender perspectives in security and peace processes. Resolution 1325—as well as the related U.S. Women, Peace, and Security Act of 2017—have moved the ball forward significantly in ensuring that women have equal participation in public life.

However, barriers to women’s full participation still abound. Among these challenges is the fact that women are disproportionately affected by infectious diseases—from COVID-19 to AIDS, tuberculosis, and malaria—which holds them back from advancing in society. In large part, this higher disease burden is due to a lack of access to health care, including to treatments for AIDS, tuberculosis, and malaria, as well as for Ebola and COVID-19. By promoting access, then, health aid helps support women’s equality. And by empowering women, such aid can shore up regional stability, improve economic outcomes, and ensure access to enablers of prosperity such as education.

Women are key to developing solutions to gender-based health inequality. Afghanistan is instructive. Women there are making slow gains in challenging existing norms about their role in public life, particularly the Taliban’s resistance to the inclusion of women in peace talks and the inclusion of women’s issues in the parameters of an agreement. In a 2019 survey of Afghanistan, the Asia Foundation found that “while gender equity is enshrined in the Afghan constitution, this year’s talks have exposed the distance between what was promised and what has been done. Women have been present in peace talks only twice since 2005.”

At the same time, limited access to quality health care, coupled with poor security, has prevented women’s empowerment—economically and politically. Even before the COVID-19 pandemic, tuberculosis cases in Afghanistan had been on the rise, with more than 70,000 new cases in 2018, of which more than half were in women. HIV is also a problem in Afghanistan, where only about 14 percent of people living with the virus have access to antiretroviral medication. Of those with access to treatment, only 34 percent are women or children. Those who want long-term stability and peace in Afghanistan must prioritize health as a way to ensure that women are able to fully participate in the public sphere.

For policymakers concerned with women’s health, there is a virtuous loop to look forward to as well: More women in leadership can lead to improved health outcomes for the women—and men—they represent. A healthier public is also more economically productive and able to access the benefits of improved governance.

Women’s participation as community leaders can also create real progress in highlighting the health needs of women, including preventing gender-based violence. South Sudan is a good case study. It has a dramatically high rate of domestic violence, with more than half of all women having experienced some form of it. Forced sex, limited safe-sex practices, and heightened risk-taking behavior has led to higher rates of infection of HIV in women: The infection rate among young women is nearly double that of young men. The spread of HIV is unlikely to slow without addressing the underlying issues affecting women.

Institutions in South Sudan are making efforts to tackle the core problems. The U.N. Mission in South Sudan, in collaboration with the South Sudanese police, has run workshops designed to train women to combat gender-based violence in their communities. These women, in turn, are able to educate their broader communities to counter gender-based violence. Since only 9.8 percent of South Sudanese women 15 to 24 years old are able to correctly identify ways to prevent transmission of HIV, education is key to stemming the tide of the epidemic.

Just as conflict and health challenges compound one another, increased access to health care leads to broader empowerment for women. In Mali, women are taking leadership roles in the fight against malaria. The President’s Malaria Initiative, launched by the United States in 2005, is working with the Africa Indoor Residual Spraying (AIRS) project to encourage women to participate on teams that go from house to house to spray for mosquitoes and to highlight women in leadership positions on existing teams. AIRS hopes that women will see these projects as valuable to the health and safety of their communities, as well as opportunities for economic advancement. While AIRS’ projects have largely been put on hold or modified to prevent the spread of COVID-19, in the long run, initiatives like these empower women to address health risks and access all aspects of public life.

Increasing access to health care must be a key component in any agenda for supporting women. Fundamentally, healthy women are more able to participate fully in their communities and advocate for their needs in political life. In the United States, this means that Congress and policymakers of all stripes should ensure that foreign aid programs include a focus on women. If reinforced by prioritization from donor countries, the role of women will be crucial in stopping the spread of COVID-19 and ensuring better health outcomes for all. And that will mean a more stable, better-off world.

Shannon Kellman is the policy director at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria.

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