"Developments in Gender and Public Health and Managing Gender Equity in Staffing within WHO"
International Women's Day Seminar
On this day, it always strikes me how far we have come in improving the position and lives of women during my professional lifetime - and yet how short. For ourselves and our daughters, the lives and opportunities are truly different than that of our mothers.
And yet, despite a century of struggle for gender equality, there isn’t a single country or institution in the world where men and women fully enjoy equal opportunities.
In many countries, women have not even achieved the most basic of rights and opportunities. In many countries, women own nothing, inherit nothing and earn nothing. Three out of four of the poorest billion people of the world are women. Discrimination, combined with poverty, prevents women from getting out of situations of abuse and exploitation. Poverty leads to ill health and additional strain on already over-stretched households. When women are ill, gender-based discrimination further limits their access to care and treatment.
The work we do in the World Health Organization is crucial for the efforts to improve the lives of the poorest women of our world. We cannot advance women’s standing in society without improving their health. We need to ensure that she survives and maintains her health.
That means protection from HIV/AIDS. It means safe pregnancy and childbirth. It means freedom from violence and sexual abuse. It means access to health care for her and her children.
WHO is engaged in literally dozens of initiatives targeted at women’s health – either directly or indirectly. “Making Pregnancy Safer” is central among them. It represents a concrete step towards achieving the Millennium Development Goal target of reducing by three-quarters the maternal mortality ratio by 2015. The goal is that all women go safely through pregnancy and childbirth and that their infants are born alive and healthy. “Making Pregnancy Safer” clearly emphasizes the importance of improving health systems in order to advance the health and well-being of women and their infants.
I am also proud of our efforts to help women protect themselves against HIV/AIDS. The challenges are great. Women's abilities for protection are much less than men's. Men can use a condom without a partner’s cooperation - women can’t. Women too often are not free to refuse sex; men usually are. Women are at higher risk both of physical and sexual abuse within intimate relationships, as well as forced sex and sexual coercion by others. Moreover, women often risk physical abuse and abandonment if they report a positive HIV test - men generally do not. In addition, women, not men, must take drugs to prevent mother-to-child transmission - but often men, not women, have financial and other forms of control over whether women are able to take them.
More and more girls and young women under the age of 24 are becoming infected with HIV. The results are tragic – they are transmitting the virus to their babies, they are dying early as a result of obstetric difficulties or AIDS, and leaving young orphans behind. WHO’s approach makes an explicit link between HIV prevention and care, and focuses on the needs of the mother and her immediate family. Healthy mothers and healthy babies are key if we are to ensure healthy futures.
Over the past few years, WHO has also directed attention to other threats to women's health. We have shown how women's smoking rates have remained stable in wealthy countries, while they have fallen among men. In Denmark, Germany and the United States, more young women than young men now smoke.
We have shown how the epidemic is shifting to low- and middle-income countries, not only among men but, increasingly, among women. Women also suffer from passive smoking, as their husbands and fathers smoke.
The toll is substantial. We are seeing that lung cancer, for example, now is surpassing breast cancer as a leading cause of cancer deaths among women in several countries. No doubt the Framework Convention on Tobacco Control, which we finished negotiating just last week, is also a step on the road to improving women's health.
The World Report on Violence and Health has put the spotlight on the substantial burden of violence women suffer around the world. The WHO campaign against violence is to a large extent a campaign to improve the lives of women.
We should not consider the health of women in isolation from men, fathers, brothers, husbands and sons. Women live in complex social contexts, and gender roles and relations are embedded within that context. In order to improve the health of women, we have to analyse the determinants of women’s health status within the reality of their lives. I have been committed to incorporating a gender perspective in health across WHO’s work.
So, how have we fared in carrying out the ideals of gender equality within our own Organization ? Compared to many other international organizations, we have not done badly. We are in the middle of the field, but in terms of recent increases in women representation and new recruitment over the past few years, we out-perform most - if not all the other agencies.
In 1997, the World Health Assembly instructed WHO to have 50% representation of women in professional and higher categories. The Resolution did not set a timeframe, but we chose to issue a Cluster Note in 1999 that set a target of 60% recruitment rate of women, and specified the year 2010.
In practice, implementation has not been easy. Today the percentage of women in professional and higher categories in the Organization is 33% (as of December 2002) up from 22% a decade ago and close to the UN system average of 34%. The percentage of women appointed into new positions in professional and higher categories during 2002 was just over 48% (vis-à-vis a 60% target). That is not enough to celebrate yet, but it is a significant improvement over 34.6% in 2001. We are moving in the right direction.
We are facing a number of obstacles in achieving a better gender balance in the Secretariat. Among our Member States, gender balance often takes a back seat to concerns over geographical distribution. It is a rare occasion when a country's ambassador comes to me complaining that there are not enough women in the Organization !
Progress will only come if we can focus on finding more qualified women from under-represented countries. We also have to look at the great variation among our Regions in the employment of women. SEARO, for example has exceeded the target of 60% new recruits being women, while some Regions are lagging far behind.
We need women to be more involved in the events and processes that shape their lives. A world where men and women share more equally in political and economic decision-making will translate into a world that pays greater attention to health, education and social outcomes for all.