Dr. Nandini Oomman gave a riveting keynote speech at the Triangle Global Health Consortium on September 28 in Raleigh. She opened with a photo of the current European health ministers, highlighting only 9 out of 27 are women. She then flipped to a picture of only men sitting around a table deciding the fate of US health care, provocatively labeled “American Health Care: A Handmaid’s Tale in the Making?” Following that, a photo of an all-male meeting at the World Bank and WHO, which had been tweeted as an example of the exciting brainstorming sessions about the future of global health by leaders in global health. When asked where the women were, organizers said they had all left the room before that photo was taken. Dr. Oomann raised her eyebrows and said dryly that it seemed unlikely.

What are the numbers of women in global health leadership? Dr. Oomann presented some stark statistics. Among the main UN agencies, professional organization, global health institutes (GHIs) and non-governmental organizations that control $92.1 billion in global health budgets, less than 30% have women in a top leadership position. While 39% of global health faculty members are women, only 24% of the leaders of academic global health programs are women.  This is similar to leadership rates at UN agencies (23%), Global Health Initiatives (22%), and Boards of Directors of private-public partnerships (29%).

Why are women not in positions of leadership? Women are working in public health—over 75% of the workforce and 84% of undergraduates in global health are women. While Dr. Oomann did not get into details about factors that limit women’s longevity or leadership trajectories in global health, she touched on the lack of flexibility in many positions that make the balance of work and family difficult or impossible. A commitment to gender equity among the current leadership in an organization is a key factor in ensuring more women are promoted, or hired in leadership positions. Dr. Oomann presented two data-driven examples about leadership commitment to gender equity that can inhibit (as in Silicon Valley) or drive (UNAIDS) the success and upward mobility of women.

Why is this important? Leadership has voice and visibility. Leaders are the key decision makers, and global health leaders define the priorities and set the agenda that will impact the health and well-being of millions of people around the world. When women are not in positions of leadership, half the world is being left out of these discussions. On a more tangible level, leaders determine the working environment and opportunities. This includes the small-picture, but important things that keep women in their job now (the space and time for pumping breast milk; adequate bathrooms; schedules that accommodate family responsibilities) and the big-picture, important things that help women to envision themselves pursuing this career in the future (mentorship for women in their field, role-modeling and decision-making on workplace policies like travel safety, promotions and pay scales).

What can be done about it? Notice and act on disparities. Create or advocate for enabling and supporting environments that include maternity leave policies and flexible working schedules. Seek out (or provide) professional development opportunities for women. Become a leader; and amplify the voices of women leaders. Sign the Owen Barder pledge not to speak at conferences with exclusively all male panels or join a panel that is not at least 50% women.

Dr. Oomani closed with the crucial challenge: how can we expect to achieve health for all, if we do not have all for health? This is a key question, not just for women working in global health, but for all people interested in and passionate about making a positive impact on women’s health. It is also one of many questions want to consider as we move forward developing the interest and expertise in reproductive health at Duke. So, watch for more on this important topic here: Global Reproductive Health at Duke will hold organizations, agencies and individuals accountable. We will report on the progress and the roadblocks, and act as advocates and agents of change in the landscape of women leaders in global health.

 

About Nandini Oomann: Dr. Oomann has over 20 years of experience in global health, and now works as a global health and development consultant in Washington DC. In 2014, she started the Women’s Storytelling Salon to create a community of professional women to celebrate their accomplishments, inspire each other and trigger action through storytelling. She is on the steering committee of the Women Leaders in Global Health group, which held its first meeting in October 2017 at Stanford. Follow her on Twitter @nandinioomann and @thewomenstorytellingsalon.