Governor and Vice-Governor,
Ladies and gentlemen,
I am happy once again to be here in Japan, this time in the beautiful city of
Shimano-Seki. Over the past half-century Japan, as well as many other parts of
the world, has made some great achievements. People live longer. They live
better. They have more choices than before, both in their private lives and in
the societies they are part of. There is great reason to celebrate these
Yet, there is still a long way to go before we can say that the successes of
the past fifty years are shared by everyone all over the world. And there is
still a long way to go before we can say that men and women have shared those
To change this, we need the resourcefulness of a society that knows how to
rise from destruction to prosperity, we need the power of science properly
linked to the economy, and we need the ability to pursue a just cause until it
succeeds. Japan has an important international role to play: as an example and
as a partner.
The UN international conferences, the last one in Beijing four years ago,
have highlighted the key role of women in ensuring sustainable development. No
doubt much of the impetus for this came from the international women’s
movement which may be the largest social movement in human history.
The issues we all have to address are at the heart of human development and
equity. Briefly, let us review some of them:
First, poverty: 70% of the 1.3 billion people living in poverty are women;
Then there is the issue of illiteracy: of the 900 million illiterate people,
women outnumber men, 2:1;
What about malnutrition? Women are twice as affected by iron deficiency
anaemia as men;
The tragedy of maternal mortality: women continue to die in childbirth, an
unacceptable situation given our advances in technology. Today, there are more
than half a million pregnancy-related deaths every year. One key reason is this:
the majority of poor women in developing countries do not have access to a
skilled health care provider during labour and delivery ;
Then there is the issue of wage inequality: on average, women are paid 30 to
40% less than men for comparable work;
Not to forget the issue of economic power: In developing countries, only
one-seventh of administrators and managers are women. Developed countries have a
long way to go to achieve gender parity as well;
In the key area of political power, how is the situation? Only 10% of seats
in the world’s parliaments and 6% in national cabinets are held by women. No
wonder the news hit around the world, and not least here in Japan, when in 1986
a women’s government took office in far-away Norway, a rich elderly gentleman,
struck by this symbolic and, in his view, fundamental change in history,
announced that he would raise a monument to the event! A monument that can be
seen today in a little town here in Japan.
Let me expand further on gender equality, using health as a first example.
The health of women matters, foremost to women themselves. It matters to
their families, communities and societies. Indeed, the health of women is a
fundamental pillar that underpins sustainable human development.
Of course, we cannot consider the health of women in isolation. Men, fathers,
brothers, husbands, sons are important. 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. This is why I am committed to
incorporating a gender perspective in health across WHO’s work.
Why is a gender perspective important and what does it mean? A gender
perspective focuses on the roles and relations between men and women. It is also
important to remember that gender not only refers to the relations between the
sexes at the individual, personal level. It also takes into account the values
and norms that permeate societies and institutions, organizational systems,
including the health and legal systems.
If we do not design health programmes and policies with a gender perspective,
we may reach only half the population.
It may seem unbelievable that in some parts of the world, mothers give
preference to ensuring that their male infants are immunized, yet this is so.
It may seem equally surprising that women in many cultures feed the men and
boys in the family first, and will give the bigger and better portions to males.
This practice may have arisen when men traditionally were involved in heavy
labour, but it stays on, and we need to address it and take it seriously.
We all need to think carefully about our own societies and how our own ways
of living may harm the health of girls and women. Depression for example affects
women twice as often as men. Some of this may be due to biological factors. But
women’s lack of control over their lives can be an important factor.
What about education? Access to education for girls, as well as the type of
education they receive, is also often affected by gender norms. Despite
undeniable proof that educating women is one of the most important health and
development investments a country can make, girls are still prevented from
completing even primary education in many countries.
Further up the scale of economic development, gender biases affect women’s
choice of studies, and there is still a tendency in many countries to encourage
boys towards careers in sciences and mathematics, and girls towards careers in
the sectors associated with caring, such as teaching and nursing. This limits
choice and limits the expression of resources, both in men and women. But first
if all, it is to the disadvantage of girls and women in our societies.
Fortunately, we have seen a marked increase in the number of women who become
doctors in many countries around the globe. This is important not only because
many women prefer dealing with a woman doctor – and in some countries are
required to only see woman doctors. It is also significant because women doctors
can bring a better understanding of women’s problems and special needs into
the hospitals and health ministries. This can over time influence
decision-making in a way that favour women and children.
In Japan, where women are highly educated, equal opportunity for entrance
into careers of choice, on the same footing as men, still remains elusive. We
have a long way to go, in most countries.
Even at the top, women face barriers all over the world. At this level, they
are often more subtle and difficult to see. One is talking about the "glass
ceiling" on the corporate ladder, to try to illustrate why only two out of
the world’s five hundred largest companies are headed by a woman. Stereotypes
and misconceptions which work against women are often made worse by practical
difficulties, like inadequate child care and maternity leave.In my country, we have had the experience that
change really helps. From 1986, with a new era in politics, and a
woman-friendly, child-friendly, family-friendly political reform agenda, more
women entered the labour market; more children had an opportunity to have a
place in a kindergarten and enjoy play and education with their peers; more men
spent more time with their children and took paternity leave for at least four
weeks. Mothers could stay home with 80% pay for a whole year after birth, or
choose to work half-time for a full two years: And a new era and spirit of
optimism created a change in the downward trend for decades of women choosing to
have fewer children. Now, birthrates increased, as women and families found
reasonable solutions in a more family-friendly society.
There are several other ways to counter gender bias. At WHO, I have decided
to require that 60% of all new appointments should be women. Already, five of
the ten Executive Directors of the Organization are women. Affirmative action
like this can be a necessary agent to initiate change. This is what we did in
Norway in the early 80s.
Despite the problems, in Japan, women’s lives have changed dramatically as
a result of low mortality and low fertility. Consider the following which give
women greater freedoms for playing new roles in society:
- In 1920, a Japanese woman had her first child, on average, at 23, spent just
over 12 years pregnant and giving birth and 27 years raising children. By 1992,
her first child was born when she was 28, she spent slightly less than 3 years
pregnant and giving birth and 22 years raising her children.
- Her period of retirement from remunerated work has increased almost
threefold, from 6 years in 1920 to 17 years in 1992. And her years as a widow
have doubled since 1920, from 4 to 8.4 years.
We also should be aware today of the threats that women can experience in
their new roles. Nowhere is this as evident as in the threat that tobacco poses
to Japanese women, indeed, to Asian women in general. Smoking has become a
misplaced symbol of women’s liberation and freedom. The rates of smoking among
Asian women are increasing dramatically, in large part due to the fact that
transnational tobacco companies have identified women and girls as a potentially
lucrative target for their market strategies. The proliferation of seductive
tobacco advertising worldwide, and the use of themes related to body image,
fashion and independence, are in fact luring many girls and women to become
addicted to tobacco.
WHO, together with governments, NGOs such as Japan’s Women’s Action on
Smoking, and media groups, are working to raise women’s awareness about the
deadly effects of tobacco on women and their children. Tomorrow I will be
speaking in Kobe on this very topic.
What are the messages that we can draw from all of these examples across all
We need to recognize that women need to be involved in the events and
processes that shape their lives. A world where men and women were to share more
equally in political and economic decision-making might be a world where health
and social welfare were given greater weight and where education for all was
We must learn from, and draw upon, the myriad of initiatives that women are
undertaking worldwide to overcome economic hardship, and gain recognition of
their rights to insist on making public a discussion of universal values and
dreams that ultimately influence our societies.
We need to go away from this symposium with the idea that these things do not
happen by chance. It takes committed people and far-sighted leaders to push at
the closed doors and to ask why things should not change. There is ample
evidence now to show that all of our lives and futures will be better if men and
women have the opportunity to play an equal part in society.