By Roopa Dhatt and Ebere Okereke
WASHINGTON DC / LONDON, Mar 16 2023 – Women health workers are more than two thirds of the health workforce and represent 90% of the world’s frontline health workers, yet hold less than a quarter of senior leadership roles – a situation which is unfair and a significant risk for global health security.

Despite five years of ad hoc commitments, our new report The State of Women and Leadership in Global Health shows few and isolated gains, while overall progress on women’s representation in global health governance has remained largely unchanged.

The report, launched on March 16, assessed global data together with deep dives into country case studies from India, Nigeria and Kenya. It found that women lost significant ground in health leadership during the COVID-19 pandemic.

A Women in Global Health study calculated that 85% of 115 national COVID-19 task forces had majority male membership. At global level, during the World Health Organisation’s Executive Board meeting in January 2022 just 6% of government delegations were led by women (down from a high point of 32% in 2020).

It appears that during emergencies like the pandemic, outdated gender stereotypes resurface with men seen as ‘natural leaders’.

A key and disturbing finding in the report was that women belonging to a socially marginalized race, class, caste, age, ability, ethnicity, sexual orientation, gender identity or with migrant status, face far greater barriers to accessing and retaining formal leadership positions in health.

Without women from diverse backgrounds in decision-making positions, health programs lack insight and professional experience from the women health workers who largely deliver the health systems in their countries.

Expanding the representation of diverse leaders in health is not just a matter of fairness, it also contributes to better decision-making by bringing in a wider range of knowledge, talent and perspectives.

Further, the report shows there is a ‘broken pipeline’ between women working in national health systems and those working in global health. As long as men are the majority of health leaders at national level and systemic bias against women continues, the global health leadership pipeline will continue to funnel more men into positions with global decision-making power.

The issues women face in national health systems are then reproduced at the global level where women are excluded from political processes and marginalized from the most senior appointments.

A deep dive of case studies in India, Nigeria and Kenya confirms that women are held back from health leadership by cultural gender norms, discrimination and ineffectual policies which don’t redress historic inequalities.

The similarities in the barriers faced by women health workers from very different socio-economic and cultural contexts are marked, indicating widespread systemic bias right across the global health workforce.

The consequences of locking women out of leadership represents a moral and justice issue, and also a strategic loss to the health sector. Through the pandemic, we saw how safe maternity and sexual and reproductive health services were deprioritized and removed from essential services in some countries, with catastrophic consequences for women and girls.

We saw women health workers unpaid or underpaid, and we saw dangerous conditions escalate as community health workers were sent to enforce lockdown, do contact tracing or provide services in unsafe conditions with no forethought given to providing security.

The findings of our report show that systemic change goes beyond numbers in gender parity leadership. What is needed is a transformative framework for action involving all genders from institutional, to national and global level.

Recommendations to drive transformative approaches include:

● Men must ‘lean out’ and become visible role models in challenging stereotypes to make way for qualified women
● Normalization of paternity leave to shift gender norms and reduce the burden of care of women
● Governments taking targeted actions to fast track the number of diverse women in health leadership roles through quotas and all-women shortlists, particularly for senior global health leadership roles that have never been held by a woman
● Institutions must be intentional about creating and maintaining a pipeline for women to move into leadership
● Measurable actions such as mentorship, shadowing / pairing and deputizing opportunities should be created and monitored to ensure women are visible for promotion opportunities
● A zero tolerance of discrimination towards pregnancy
● Supported flexible working options for all parents and carers

Investing in women is not only the right thing to do, but it also makes good business sense. When we get it right, we can unlock a “triple gender dividend in health” that includes more resilient health systems, improved economic welfare for families and communities, and progress towards gender equality.

The lessons of the pandemic have taught us much about the value of the health workforce and even more about the value of health workers. They are mostly women. It’s time for them to take their rightful roles in leadership.

Dr Roopa Dhatt is Executive Director and Co-Founder Women in Global Health, Washington, DC and Dr Ebere Okereke is Snr Health Adviser Tony Blair Institute London & incoming CEO Africa Public Health Foundation, Nairobi

IPS UN Bureau

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By Thalif Deen
UNITED NATIONS, Mar 16 2023 – When Secretary-General Antonio Guterres addressed the UN Commission on the Status of Women (CSW) last week, he said the annual meeting takes on even greater significance at a time when women’s rights are being “abused, threatened, and violated around the world.”

Progress won over decades is vanishing before our eyes, and gender equality is growing more distant, he told the CSW, the principal global intergovernmental body exclusively dedicated to the promotion of gender equality and the empowerment of women (and which concludes its two-week session on March 17). And he quoted the dire prediction from UN Women that “gender equality is 300 years away”.

Hopefully, that prediction does not apply to the United Nations which has failed to elect a woman Secretary-General during the last 77 years while asserting male dominance in one of the foremost international institutions—even as it ceaselessly continues to advocate gender empowerment worldwide.

Guterres said last December that overall, “we have come a long way”, and achieved some notable firsts, such as reaching parity within the senior leadership group, for the first time in UN history, two years ago.

“That’s also true now among heads and deputy heads of peace operations. Five years ago, the proportion of women in those roles was just 25 percent”, he noted.

Parity was reached in 2018, among the 130 Resident Coordinators, and the representation of women at headquarters locations has now reached parity, while the number of UN entities with at least 50 percent women staff, has risen from five to 26.

Still, the male/female ratio for the Secretary-General stands at 9 vs zero. And the Presidency of the General Assembly (PGA), the highest policy-making body at the UN, is not far behind either: 73 men and four women.

The upcoming election for a new PGA –Dennis Francis of Trinidad and Tobago—will bring the total to 74 men and four women. Score another one for men.

PassBlue said last week that Some diplomats are rightly furious that this means that there will be a 74th man elected out of the 78 people to hold that role, but they have been unable to organise a rival to run against him.

“Pressure has at least caused Mr. Francis to publish a vision statement, although that is perhaps a generous term for a short document containing only four paragraphs on policy”.

“We wish Mr. Francis the best of luck in this important role but regret that the process wasn’t strengthened by meaningful competition and a thorough policy platform,” said PassBlue, a widely-read independent, women-led nonprofit multimedia news company that closely covers the US-UN relationship, women’s issues, human rights, peacekeeping and other urgent global matters playing out in the world body.

The nine Secretaries-Generals so far include Trygve Lie from Norway, 1946-1952; Dag Hammarskjöld from Sweden, 1953-1961; U Thant from Burma (now Myanmar), 1961-1971; Kurt Waldheim from Austria, 1972-1981; Javier Perez de Cuellar from Peru, 1982-1991; Boutros Boutros-Ghali, from Egypt, 1992-1996; Kofi A. Annan, from Ghana, 1997-2006; Ban Ki-moon, from the Republic of Korea, 2007-2016 and António Guterres, from Portugal, 2017-present.

https://archives.un.org/content/secretaries-general

The only four women elected as presidents were: Vijaya Lakshmi Pandit from India (1953), Angie Brooks from Liberia (1969), Sheikha Haya Rashed Al-Khalifa from Bahrain (2006) and Maria Fernando Espinosa Garces from Ecuador (2018).

But the blame for these anomalies has to be shouldered, not by successive secretaries-generals, but by the UN’s193 member states who are quick to adopt scores of resolutions on gender empowerment but fail to practice them in the highest echelons of the UN totem pole.

Ben Donaldson, speaking on behalf of Blue Smoke – described as “a new initiative shining a light on UN appointment processes”—told IPS progress on gender parity at the UN has been mixed.

“Gains have been made within the SG’s senior management group but this is not the full story. There is no avoiding the fact that an unbroken chain of nine male SG’s will have led the organization for 80 years by the time the next SG is due to be chosen and just two of the last 50 Presidents of the General Assembly have been female”.

https://www.passblue.com/article/blue-smoke-2023-02-12/

And like Guterres’s reappointment, the male candidate for the next PGA has a blank slate before him – unchallenged by any candidate, female or otherwise, he pointed out.

In both cases, he argued, states have failed to nominate female candidates despite the plethora of highly qualified women out there.

“Sexism still pervades the international system, stacking the deck against women from early career onwards resulting in our current predicament: just 25% of UN ambassadors are female and parity remains well out of reach in field operations, peacekeeping and in global health leadership despite 70% of the health and social care workforce being women,” said Donaldson.

“The most frustrating thing about the UN for those of us trying to understand this issue is the lack of transparency”.

“It remains impossible to obtain a readout of the gender balance of, for example, all D1 and D2 positions across the UN system, or a geographic breakdown for that matter. This is why we launched Blue Smoke – a monthly email shining a light on UN appointment processes and calling for inclusivity every step of the way,” he declared.

Mandeep S. Tiwana, Chief Programmes Officer at CIVICUS, told IPS the gender imbalance in the election and appointments of the UN Secretary General and President of the General Assembly “is symptomatic of a larger malaise in our societies”.

“States in particular need to make progress on diversity, equity and inclusion but are often found to be lagging behind non-governmental actors,” he noted

Meanwhile, reflecting on Guterres’ statement on gender equality, one of the questions at the UN press briefing on March 6 was whether the Secretary-General would “consider making some kind of grand gesture to underline his point by stepping aside and giving his job to a woman”.

Responding to the question, UN Spokesperson Stephane Dujarric said “resigning is not something the Secretary-General is contemplating doing in any way, shape, or form.”

“He will continue and has, I think, shown demonstrable results in improving and reaching gender parity in the senior post that he appoints, right? Because he doesn’t have the authority over the whole administration”.

But he has been putting in place a strategy to reach gender parity at the professional levels to ensure that there is more equitable and clearer representation.

“And I think what he has done in terms of appointments was done extremely quickly, within UN standards. I think within two years he had reached the parity, also including the resident coordinators on the ground. And that is a policy he will continue with a lot of energy,” declared Dujarric.

Under the Guterres administration, gender empowerment has been on the rise at senior staff levels, at UN agencies, and in peacekeeping and field operations worldwide.

Mathu Joyini of South Africa, Chair of the CSW, said “gender-based discrimination is a systemic problem that has been interwoven into the fabric of our political, social and economic lives and the technology sector is no different.”

While digital technologies are allowing for unprecedented advances to improve social and economic outcomes for women and girls, new challenges may perpetuate existing patterns of gender inequalities.

She called for more opportunities to be available to women leaders and innovators and for the public and private sectors to make more available funding that enables the full participation of women and girls in the technology ecosystem.

IPS UN Bureau Report

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By External Source
HAMILTON, Canada , Mar 16 2023 (IPS-Partners)

The rapidly-growing bottled water industry can undermine progress towards a key sustainable development goal: safe water for all, says a new United Nations report.

Based on an analysis of literature and data from 109 countries, the report says that in just five decades bottled water has developed into “a major and essentially standalone economic sector,” experiencing 73% growth from 2010 to 2020. And sales are expected to almost double by 2030, from US$ 270 billion to $500 billion.

Released a few days prior to World Water Day (March 22), the report by UN University’s Canadian-based Institute for Water, Environment and Health concludes that the unrestricted expansion of the bottled water industry “is not aligned strategically with the goal of providing universal access to drinking water or at least slows global progress in this regard, distracting development efforts and redirecting attention to a less reliable and less affordable option for many, while remaining highly profitable for producers.”

Says Kaveh Madani, UNU-INWEH’s new Director: “The rise in bottled water consumption reflects decades of limited progress in and many failures of public water supply systems.”

When the Sustainable Development Goals were agreed in 2015, he notes, experts elsewhere estimated an annual investment of US$ 114 billion was needed from 2015 to 2030 to achieve a key target: universal safe drinking water.

The report says providing safe water to the roughly 2 billion people without it woulds require an annual investment of less than half the US$ 270 billion now spent every year on bottled water.

“This points to a global case of extreme social injustice, whereby billions of people worldwide do not have access to reliable water services while others enjoy water luxury.”

Tap water perceptions

The study quotes surveys showing bottled water is often perceived in the Global North as a healthier and tastier product than tap water – more a luxury good than a necessity. In the Global South, sales are driven by the lack or absence of reliable public water supplies and water delivery infrastructure limitations due to rapid urbanization.

In mid- and low-income countries, bottled water consumption is linked to poor tap water quality and often unreliable public water supply systems – problems often caused by corruption and chronic underinvestment in piped water infrastructure.

Beverage corporations are adept at marketing bottled water as a safe alternative to tap water by drawing attention to isolated public water system failures, says UNU-INWEH researcher and lead author Zeineb Bouhlel, adding that “even if in certain countries piped water is or can be of good quality, restoring public trust in tap water is likely to require substantial marketing and advocacy efforts.”

Not necessarily safe

Dr. Bouhlel notes that the source of bottled water (municipal system, surface, etc.) the treatment processes used (e.g. chlorination, ultraviolet disinfection, ozonation, reverse osmosis), the storage conditions (duration, light exposure, temperature), and packaging (plastic, glass), can all potentially alter water quality. This may be inorganic (e.g. heavy metals, pH, turbidity etc.), organic (benzene, pesticides, microplastics, etc.) and microbiological (pathogenic bacteria, viruses, fungus and parasitic protozoa).

According to the report, “the mineral composition of bottled water can vary significantly between different brands, within the same brand in different countries, and even between different bottles of the same batch.”

The report lists examples from over 40 countries in every world region of contamination of hundreds of bottled water brands and all bottled water types.

“This review constitutes strong evidence against the misleading perception that bottled water is an unquestionably safe drinking water source,” says Dr. Bouhlel.

Water bottlers generally face less scrutiny than public water utilities

Co-author Vladimir Smakhtin, past Director of UNU-INWEH, underscores the report’s finding that “bottled water is generally not nearly as well-regulated and is tested less frequently and for fewer parameters. Strict water quality standards for tap water are rarely applied to bottled water, and even if such analyses are carried out, the results seldom make it to the public domain.”

Bottled water producers, he says, have largely avoided the scrutiny governments impose on public water utilities, and amid the market’s rapid growth, it is “probably more important than ever to strengthen legislation that regulates the industry overall, and its water quality standards in particular.”

With respect to the industry’s environmental impacts, the report says there is “little data available on water volumes extracted,” largely due to the lack of transparency and legal foundation that would have forced bottling companies to disclose that information publicly and assess the environmental consequences.”

“Local impacts on water resources may be significant,” the report says.

In the USA, for example, Nestlé Waters extracts 3 million litres a day from Florida Springs; in France, Danone extracts up to 10 million litres a day from Evian-les-Bains in the French Alps; and in China, the Hangzhou Wahaha Group extracts up to 12 million litres daily from Changbai Mountains springs.

Regarding plastic pollution, the researchers cite estimates that the industry produced around 600 billion plastic bottles and containers in 2021, which converts to some 25 million tonnes of PET waste – most of it not recycled and destined for landfills – a mass of plastic equal to the weight of 625,000 40-ton trucks, enough to form a bumper-to-bumper line from New York to Bangkok.

According to the report, the bottled water sector used 35% of the PET bottles produced globally in 2019; 85% wind up in landfills or unregulated waste.

By the numbers

Among the report’s many insights, derived from data analysis and other information assembled from global studies and literature:

• Over 1 million bottles of water are sold worldwide every minute

• Annual spending per capita worldwide is US$ 34

• Worldwide annual consumption of the three main bottled water types – treated, mineral, and natural – is estimated at 350 billion litres

• The estimated US $1.225 trillion in bottled water revenues represent 17 to 24% of the global market for non-alcoholic packaged beverages

• The biggest market segment (with 47% of global sales) is treated bottled water, which could originate from public water systems or surface water, and that undergoes a disinfection treatment such as chlorination

• Citizens of Asia-Pacific are the biggest bottled water consumers, followed by North Americans and Europeans

• 60% of global sales are in the “Global South” (Asia-Pacific, Africa, Latin America and the Caribbean)

• By country, the USA is the largest market, with around US$ 64 billion in sales, followed by China (almost US$ 45 billion) and Indonesia (US$ 22 billion). Together, these three countries constitute almost half of the world market. Other top countries by sales: Canada, Australia, Singapore, Germany, Thailand, Mexico, Thailand, Italy, Japan

• The average cost of a bottle of water in North America and Europe is around US$ 2.50, more than double the price in Asia, Africa and LAC ($0.80, $0.90 and $1, respectively). Australia, the fifth largest market, has the highest average price: $3.57 per unit.

• Bottled water per litre can cost 150 to 1,000 times more than the price a municipality charges for tap water.

• Biggest per capita consumers: Singapore and Australia. Citizens of Singapore spent $1,348 per capita on bottled water in 2021, Australians $386

• According to previous studies, about 31% of Canadians, 38% of Americans, and 60% of Italians use bottled water as their primary drinking source. In the Dominican Republic, 60% of households use bottled water as their primary water source, with a strong correlation between income and bottled water consumption. About 80% of Mexicans use bottled water, and 10% use home-purified water as their primary drinking water source; roughly 90% cite health concerns for doing so

• Egypt is the fastest-growing market for treated bottled water (40% per year). Seven other countries from the Global South are among the top 10 fastest-growing markets: Algeria, Brazil, Indonesia, United Arab Emirates, India, Morocco, and Saudi Arabia.

• In Europe, Germany is the biggest bottled water market; in Latin America and the Caribbean, Mexico is the biggest market; in Africa, it’s South Africa.

• Treated water appears to be the market’s largest component by volume, while natural waters appear to generate the most profit.

• Five companies – PepsiCo, Coca-Cola, Nestlé S.A., Danone S.A, and Primo Corporation have combined sales of $65 billion, over 25% of the global total

• Earlier studies of water withdrawals declared in India, Pakistan, Mexico and Nepal showed total estimated withdrawals by Coca-Cola and Nestlé in 2021 at 300 and 100 billion litres, respectively

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