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The Fred Hollows Foundation has a very clear goal: to end avoidable blindness. We believe that all people should have access to high quality, affordable eye care, yet we know millions are missing out.
A key element of our strategy is ensuring equitable access to care for women and girls. Of the 1.1 billion people with untreated vision loss, 55% are women and most live in low and middle-income countries (LMIC). This pervasive inequality must be addressed.
Vision impairment and blindness have far-reaching implications, not just for the women affected, but also for their families and communities. In industrialised countries this is largely because women live longer than men, but in LMIC, where cataract is responsible for most blindness, it is often because women do not get to access services with the same frequency as men. In some parts of the world, if girls are blind or significantly vision impaired it is almost impossible for them to access education.
The recently published ‘Lancet Global Health Commission on Global Eye Health: vision beyond 2020’ shows the potential for vision to advance the Sustainable Development Goals (SDGs).
Fundamental to the SDGs is equity and inclusion and SDG Goal 5 calls on us to ‘achieve gender equality and empower all women and girls’. At The Foundation, we believe girls and women are at the centre of development and, by investing in girls and women, the world will:
The Lancet states that ‘investing in universal eye health is a realistic, cost-effective way of unlocking human potential by improving health and wellbeing, education, work and the economy.’ Of course, the 2030 Agenda for Sustainable Development is, in many ways, a global call to promote equity in recognition of the disparities that exist and the need for universal action to eliminate these differences.
The arrival of COVID-19 further highlighted and exacerbated the widespread inequities that exist globally. Within months of the pandemic starting, it was clear that COVID-19 is a gendered pandemic. While men are more likely to die, additional burdens have been placed on women all around the world; women who have had most of the responsibility for care giving, both at home, and in the wider health sector.
A key takeaway from a recent WHO report entitled “Delivered by Women, Led by Men: A Gender and Equity Analysis of the Global Health and Social Workforce” found that “health systems will be stronger when the women who deliver them have an equal say in the design of national health plans, policies and systems”.
In that vein, the International Agency for the Prevention of Blindness Gender Equity Work Group, which I co-chair, decided to run a gender equity survey with its members in late 2020. Based on the Global Health 50/50 survey, it will be interesting to see how eye health tracks over time, when compared to the broader health sector surveyed each year by Global Health.
Some of the headlines of our survey were relatively positive – which is great – but challenges remain.
However, I found it a little strange that 65% of organisations have a programmatic strategy on gender equity, BUT only 34% of organisations have a workplace policy on gender equity – why is this? Why are we willing to push for gender equity when working with our partners, but as a sector, we don’t hold ourselves to the same standards?
Our survey found that a little under 30% of CEOs in the eye health sector were female. Perhaps not surprisingly, further research shows that women make up only 17.8% of Chairs and 28.3% of Board positions across the sector. Clearly, we have a long way to go before we achieve gender equity in leadership. While having a seat at the table is important, women also need to be leading conversations that will enable more collaborative discussion to commence. Their voices need to be heard and listened to, as well as acknowledged. Moreover, the importance of intersectionality (coined by Dr. Kimberlé Crenshaw) – the way that different factors such as race, class, gender, and other identities combine to affect lived experiences differently – needs to be a part of the conversation.
We know that gender is fundamentally related to how power and privilege are distributed and maintained. In turn, this shapes people’s life opportunities, health and well-being and careers and directly influences their human rights, including their right to good eye health.
On this, International Women’s Day, let’s urge global health actors and organisations to ramp up action to build a fairer, more equitable global health system and, through gender equity and women’s leadership, unleash its full potential.