The 74th World Health Assembly: Propelling Progress for Girls and Women
By Susan Papp, Divya Mathew, and Darcy Allen De Gracia | 7 June 2021
The 74th World Health Assembly (WHA) was one of the most consequential assemblies in history. As the COVID-19 pandemic rages on, the demands on the World Health Organization (WHO) have never been so significant. This year’s packed agenda reflected this reality, with more than 30 resolutions and decisions on weighty topics including pandemic preparedness and recovery, the health workforce, sustainable financing, and WHO reform. Across all of these issues, we were encouraged to see calls for attention on the needs of girls and women, in all their diversity, who have been disproportionately impacted by the pandemic.
As COVID-19 took center stage, landmark independent evaluations from The Independent Panel for Pandemic Preparedness and Response, the Independent Oversight and Advisory Committee (IOAC) for the WHO Health Emergencies Programme, and the report of the Review Committee on the Functioning of the International Health Regulations (2005) during the COVID-19 response offered recommendations for WHO and Member States to act on during the new phases of this pandemic and how to prepare for the next. The reports highlight the need for increased government funding for pandemic preparedness; rapid deployment of response funding; the establishment of a coordinated and transparent global surveillance and alert system; a voluntary lifting of patents or patent waivers; increased multilateral action and investment through instruments like the ACT-Accelerator; and for the reform and sustainable financing of the WHO in order to allow it to be more independent and agile. One of the most significant WHA outcomes was the agreement to hold a special session on the future of pandemic response and recovery in November 2021. The session will provide an opportunity to take up these recommendations, and we urge Member States to begin this work now so there can be concrete action in November.
In addition to COVID-19 discussions at the 74th WHA, we also kept a close eye on the deliberations that will have the greatest implications on the health and wellbeing of girls, women, and adolescents. Four areas are worth noting:
First, the sessions on Health in the 2030 Agenda for Sustainable Development and the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) highlighted that progress on many of the Sustainable Development Goal (SDG) indicators for the health of women, children, and adolescents, has stalled — or even regressed — as a result of COVID-19. Women Deliver gave a statement stressing how gender equality and sexual and reproductive health and rights are essential in Universal Health Coverage (UHC), and called for increased investments and prioritization.
Second, as rates of gender-based violence have risen during COVID-19 lockdowns, it was timely that WHA presented the WHO global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children, with recommendations for Member States to prevent and reduce interpersonal violence. The United States and several other governments co-sponsored a resolution to complement this report. References to Comprehensive Sexuality Education (CSE) — which provides young people with the knowledge necessary to engage in safe, healthy, and consensual sexual behavior — were included in earlier drafts of the resolution, but were unfortunately removed from the final text due to reservations expressed by some Member States. In response, youth advocates called on Member States to base health policies on evidence rather than ideology. The Generation Equality Forum later this month will hopefully provide a platform to see bold commitments and action for CSE.
Third, gender issues and the rights of girls and women emerged in discussions on the WHO global disability action plan 2014–2021: better health for all people with disability, the global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections, for the period 2016–2021, as well as the social determinants of health. The WHO stressed the importance of incorporating disability- and gender-sensitive approaches in the design and implementation of health policies and plans, particularly related to primary health care (PHC), UHC, and health emergencies. A resolution on the social determinants of health highlighted the inter-related inequalities of sexism, racism, classism, poverty, and conflict that impact health access, stigma, and contribute to poor health.
Fourth, the health workforce was featured prominently with reports on Working for health: five-year action plan for health employment and inclusive economic growth (2017–2021) and Health workforce: global strategic directions for nursing and midwifery. Health and social workers have been tested, strained, and put in harm’s way during COVID-19. WHO Director-General Dr. Tedros Adhanom Ghebreyesus called attention to the 115,000 health worker deaths from COVID-19. Since women make up 70% of the health and social care work force, it is important to recognize the unique strains on female health workers. At the same time, the world is facing a health workforce shortage, with a projected gap of 18 million health workers in low and lower-middle income countries by 2030, including an estimated gap of 900,000 midwives. These workforce gaps present barriers to the realization of PHC and UHC, and they continue to put the lives and wellbeing health workers on the line, as made evident during the pandemic. In two WHA resolutions, Member States committed to filling the health workforce gap in nursing and midwifery and ensuring safe and decent working conditions. Strengthening the health workforce is a win-win for governments because it helps improve national health outcomes and it boosts economic wellbeing through the growth of the health sector.
The 74th WHA showed that both the world and the WHO are at a pivotal moment. How Member States and the WHO respond to the discussions and decisions taken at this World Health Assembly will have massive implications on how the world’s girls, women, and adolescents — and the world at large — fare in this next stage of the pandemic and beyond. We urge Member States to move from rhetoric to action, and to support WHO reform and sustainable financing. We cannot afford to let the lessons from COVID-19 go unaddressed, or worse, be repeated. Now is the time to be bold.