“If we don’t put gender equality at the forefront of the COVID-19 response, we will all lose,” said Dr Princess Nothemba Simelela, Assistant Director-General (ADG) and Senior Advisor to the DG on Strategic Programmatic Priorities WHO, speaking at the 65th Commission on the Status of Women (CSW65) side event: Ensuring Gender Equality in the COVID-19 Vaccine Roll Out, Therapeutics and Care in March 2021.
“With the over 500 million doses of COVID-19 vaccines already distributed, the inequity is obvious. Very few of these vaccines are reaching the most vulnerable. Those at the forefront of service delivery are not receiving the benefits of their hard work in responding to the pandemic,” Dr Simelela added.
During the largest global vaccine deployment in history, COVID-19 vaccination rollout must reach women, men, and gender-diverse people quickly and efficiently. Equitable distribution is essential for widening the vaccines’ protective reach, curbing COVID-19 morbidity and mortality, and lessening the existing burden on health systems.
Addressing gender barriers
Understanding how gender roles, norms and relations and gender inequality influence access to, and demand for, vaccines in different contexts is critical for expanding reach. Gender-related barriers must be addressed in the planning and rollout of vaccine distribution to reach everyone, especially those most marginalised.
In many settings, women face limited mobility to reach health facilities or vaccination sites, restricted decision-making power in their health seeking as well as limited access to and control over resources needed for advancing their health, including information about vaccines and vaccine safety. Women and gender-diverse groups are also often at risk of experiencing sexual harassment and other forms of gender-based violence when seeking health services, including vaccination.
“Women are on the frontlines being exposed to the virus. Women need vaccines to prevent COVID-19 but they also need access to tests and treatments. We need to listen to women about how their interrelated vulnerabilities could become barriers. A gender lens can help us respond to all of their needs as the essential workers in the fight against COVID-19,” said the Honourable Karina Gould, Minister of International Development of Canada, speaking at the CSW65 side event.
Vaccine delivery and logistic planning must be based on context-specific knowledge of women, men and gender-diverse groups’ health-seeking behaviours, addressing their mobility challenges to access vaccination sites as well as their preferred channels and sources for trusted health information. Employing women vaccinators is key, along with ensuring safe and inclusive work environments.
Dr Choolwe Jacobs, Leader and Founder of the Zambia chapter of Women in Global Health, highlighted the importance of grassroots women’s movements in addressing vaccine hesitancy and increasing equity in access to vaccines and testing.
“Women, particularly in lower and middle income countries, including in Zambia, do not have access to tests and many of them lack knowledge and awareness of testing. This is particularly the case in remote and rural areas. Empowered women community health workers can play a huge role in scaling testing to ensure it is available to everyone,” Dr Jacobs said.
Women at the centre of the response
Women comprise 70% of the global health workforce but hold only 25% of leadership positions. In addition to ensuring that women are part of vaccine rollout plans, their equal and meaningful participation in leadership and decision-making is critical.
“Women are not adequately represented in decision making forums, at a time when global strategies for vaccine procurement, distribution, treatment and care are being developed and agreed upon on their behalf. Without women’s inclusion in decision making, we risk further exacerbating deep-rooted unequal access to healthcare,” said Nena Stoiljkovic, Under Secretary General for Global Relations, Humanitarian Diplomacy and Digitalization, International Federation of Red Cross and Red Crescent Societies (IFRC).
Women and girls have suffered disproportionately during the pandemic, especially of its secondary impacts, as seen for example in the increased levels of gender-based violence, girls being forced to drop out of school and women’s increased unpaid caretaking in the home. Job losses and school closures have worsened existing gender inequalities. Successful rollout and fair access to COVID-19 vaccination programmes contribute to equality.
“As long as the virus continues to circulate anywhere, recovery will be further delayed and women will continue to shoulder the disproportionate effect of the vaccine inequity. The huge disparity not only between countries but also within countries is a challenge for equal access and for women benefiting from the vaccines. While we have seen progress, too many challenges in the way of gender equality still exist,” said Dr Mariângela Batista Galvão Simão, Assistant Director-General, Access to Medicines and Health Products at WHO.
“When women have access to health services and can lead healthy lives, the whole country benefits. By now, we all know that no one is safe until all of us are safe,” said Minister Gould.