None of us are safe until we are all safe

Lynda Keeru reports back from the two-day summit, ‘Lives in the Balance: Equity in COVID-19 Response and Recovery’ organized by PMNCH, the Global Financing Facility for Women, Children and Adolescents (GFF), Gavi, the Vaccine Alliance, and CORE Group. This summit revealed the urgent needs of women, children and adolescents during COVID-19, and enabled coordinated action by partners and governments to help meet those needs. The summit sought to: 

• Reflect on how well countries have been able to implement equity enhancing strategies to protect the health and wellbeing of women, children and adolescents, particularly those with the least access to social, economic and political power; 
• Share lessons, tools, and resources on why focusing on women, children and adolescents in national COVID-19 responses is key; 
• Collaborate by identifying ways to promote equity and realize the PMNCH Call to Action on COVID-19, including aligning partners for common action around the seven asks; and
• Act by demonstrating how countries are improving women’s, children’s and adolescents’ health in the context of COVID-19, including making commitments to the COVID-19 Call to Action

“A year into the pandemic, the unique challenges faced by women, children and young people are no longer merely anecdotal. There is abundant evidence of impact and many lessons learned. A universal lesson is that social and economic recovery depends entirely upon our willingness to see inequalities, to seek evidence – and to act upon it. No one is safe until everyone is safe. Equity in vaccine delivery is a core example. How fast can we move from rhetoric to action? How can we turn this unexpected crisis into an opportunity for change?” Conference organizers

The summit sessions aimed to guide participants in reflecting on the lessons learnt and the shared progress made throughout the COVID-19 pandemic and use the opportunity to recommit to action. Elif Shafak, a celebrated Turkish novelist kicked off by saying:

“We can’t talk about equity without understanding the inequalities, the silences, the invisible barriers that keep us divided particularly gender inequality.”

She was raised by two women, her mother and grandmother, who were in their own right very different women. Her mother was more Westernized, while her grandmother was more ‘Easternized’ and more traditional. What stuck with her, irrespective of these differences, was the fact that they supported each other in a very patriarchal world. She learnt from them that when women support and empower each other, the impact goes beyond gender issues. 

Vaccines

Helen Clark reiterated the importance of saving lives and protecting hard earned progress. She talked of how the mass vaccination for COVID-19 is characterized by inequities. High-income countries accounting for only 18% of the world’s population; have bought 4.6 billion doses of vaccines which represents 60% of all confirmed orders. Unfortunately, only 2% of the total number of vaccinations have been administered in Africa. This geographic inequity puts a particular risk on populations in low- and middle-income countries where the greatest number of maternal, child and adolescent deaths occur. However, the very simple truth is: None of us will be safe from COVID-19 until we are all safe. It is therefore very urgent that the production and distribution of vaccines is accelerated so that everyone all over the world has access to them.  

Low- and middle-income countries and small island developing states

The pandemic has disproportionately affected low-income countries and small island developing states. It has also affected middle-income countries in which 70% of the world’s poorest people live. These countries are confronted with the realities of inequities with respect to access to medical technologies, laboratory services, essential medicines and vaccines. These disparities mostly affect women, children and adolescents; who don’t receive the same social services to weather the ravages of the pandemic. It is essential that national, regional and international strategies are developed to support the most vulnerable among us so that no one is left behind. For this to be achieved, it’ll require a societal approach, enhanced by the contributions of Civil Society Organizations, Non-Governmental Organizations, the private sector, religious groups and everyone coming together with a single mission. 

Mia Amor Mottley, the Prime Minister of Barbados explained that we are not living in normal times and that there is a need to develop tailored social interventions that will reach people and communities where they live. In keeping with the Sustainable Development Goals therefore, all countries should focus on extending health services to the most vulnerable populations in order to achieve Universal Health Coverage. Political will at an international level is required to address these existing disparities and the only path for completely mitigating this pandemic is through global leadership and global political goodwill and commitment. 

Global solidarity on gender equity

In support of the need for global leadership to alleviate the pandemic, Wendy Morton gave insight on how global leaders could ensure that equity is advanced and how the COVID-19 response can ensure that the progress made on women’s children’s and adolescents health can be preserved. 

The impact of COVID-19 on women, adolescents and children has been disproportionate. Global leaders must advocate in the strongest possible terms for gender equality and for the needs of women and children to be at the heart of the efforts to rebuild.  This does not mean going back to where we were because where we were had its own challenges; rather, there needs to be vision as well as leadership to rebuild in ways that challenge and overcome the systemic reasons for inequality. Success will only be achieved when the recovery leaves no one behind. When leaders unite, they can give a voice to those who have gone unheard. Women have been at the forefront of the pandemic response and we see more clearly than ever before that women are the backbone of the global health workforce. Their access to vaccines and essential services is critical for the health of the whole population.

Jennifer Klein followed immediately after to elaborate on how equity can be advanced to improve the health of women, children and adolescents and spoke on the strategies the United States was employing to address those inequalities. The first step to addressing the inequities is embedding gender in all that is done. She highlighted that America’s maternal mortality rates are among the highest in the developed world and they are especially high among black and native American women who often die from complications related to pregnancy at two to three times the rates of white or Hispanic women regardless of income or educational level.  She noted that the US government under the leadership of the new administration is particularly committed to addressing these unacceptable disparities and build health systems in the that deliver equity and dignity to black indigenous women and girls of color in the US and this principle is applicable in the country’s foreign assistance as well as far as equity in health is concerned. 

Awa Marie in closing shed light on the need for a gendered response to COVID-19 and the importance of recognizing the special needs of women and girls. She based her presentation on how Senegal has been handling the crisis, what recommendations she has for others including development partners on how to ensure that responses to COVID-19 are gender responsive. She also touched on the barriers that were slowing down these processes. 

Marie stated that the manner in which Senegal has handled the COVID-19 pandemic has been informed by lessons learnt from Senegal’s past epidemics and particularly Ebola. Countries and development partners need to elaborate the gender responsive frameworks and plans with clear indicators adapted to country specificity. These plans should highlight women’s participation in COVID-19 decision making processes as well as national policies particularly those addressing women’s economic and social security. Gender sensitivity should guide policy makers. These frameworks should be financed in country as well as by external partners outside the country. 

She also felt that countries and partners should invest in sex disaggregated data to ensure that impact of the epidemic is managed effectively. There exist huge gaps in data and these barriers have been identified in investments required to collect data statistics. Data collection on issues facing women and girls is often irregular with existing knowledge gaps for new and emerging issues. 

Finally, she felt that governments should engage actionable policy measures such as the expansion of social protection coverage, direct cash transfers and adaptation of existing services for survivors of gender-based violence. Intervention and prevention services for women and girls should be managed as essential services and be an integral part of the national and local response planning for COVID-19. Women are at the forefront of all public health crisis in their different capacities as nurses, doctors, midwives, community health workers but their roles are often overlooked and underpaid. Women and girls carry out most of the care in the house, take care of children and also work back at their professional levels. Authorities must provide adequate social, psychological and economical support. 

In these times, we need global solidarity and sisterhood. Gender equality should be put at the center of all efforts. 2021 is giving us many opportunities to step up our game and build resilient, responsive and inclusive health systems for the future. With smart, compassionate leadership and a will to work together, we can step into a brighter, healthier future for women, girls, children and adolescents everywhere. 

There was a consensus on the need for gendered responses especially for women who have been left in the lurch by insufficient access to essential services like sexual reproductive health services. Inequities must be addressed both domestically and internationally. We need feminism everywhere. We need gender awareness everywhere.

Sessions that were covered in this blog: 

Opening Session

Leadership dialogue: “Looking back, looking ahead: COVID-19 one year on-what does equality mean now?

Music by and Conversation with Neneh Cherry

Importance of health care workers in the COVID-19 response – investing in midwives

Equity enhancing strategies: what works to ensure that COVID- 19 responses do not leave anyone behind 

A conversation between Juliana Matinez and Michelle Bachelet: COVID-19, human rights, and women’s, children’s and adolescents health 

A word from Titilope Sinuga 

Building Partnerships Across Actors and Sectors for Better Health-Kenya 

“Dakar, Senegal” by BobbiLe Ba Photography is licensed under CC BY-ND 2.0