Who drives global and national COVID-19 decisions? Mostly males, according to a new study and commentary by an international group of researchers.

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Males dominate the White House Coronavirus Task Force. Image credit: Jim Watson/AFP via Getty Images

In the wake of the COVID-19 pandemic, the world looked to hastily established expert task forces to develop public health policy and strategies to mitigate the impact of the new coronavirus.

The authors of a new article in the BMJ Global Health recently analyzed the gender composition of decision making bodies and task forces from 87 countries.

In their scathing commentary, the collaborators from across the globe point to a dichotomy between those who make decisions and the demographics that these decisions affect.

The first author is Kim van Daalen, a Ph.D. student at the University of Cambridge’s Department of Public Health and Primary Care, in the United Kingdom.

Medical News Today got in touch with van Daalen to find out more about the reasons behind the research.

“In the beginning of the COVID-19 pandemic, we noticed that many of the national task forces created were dominated by men, but there was no data yet that tried to quantify this on a global level,” she explained.

“Meanwhile, women with similar or more expertise are largely ignored and passed over for inclusion in decision making, advisory task forces, and media coverage. This undermines the response in COVID-19, as well as public trust in science.”

To obtain data about the members of COVID-19 decision making bodies and other expert committees, the team used crowdsourcing in combination with requests for information from governments and local World Health Organization (WHO) offices.

“Information regarding task force composition (who is on the task force) and membership criteria (how and why experts were chosen) was not easily publicly accessible for the majority of countries,” van Daalen explained to MNT. “This lack of transparency is impeding the ability to hold accountable countries that previously made commitments to gender equality and transparent governance.”

Overall, van Daalen and her team could piece together information about the members of 115 groups in 87 countries. Among them, 85.2% were made up of mostly males, while 11.4% predominantly contained females. The team found that 3.5% of the groups had gender parity, which they define as being 45–55% female.

When they compared decision making groups with expert groups, they found that the latter were more likely to have higher numbers of female members or achieve gender parity.

“In the [United States], for example, the White House Coronavirus Task Force consists of 9.1% women, whereas the chief public health agency’s COVID-19 Response Team contains 82.4% women,” the authors explain in their paper.

Importantly, van Daalen and colleagues point out, this is not a new development.

“Our data exhibit what has become a disturbingly accepted pattern in global health governance,” they write. “Collective efforts in policy making continue to overlook opportunities to create inclusive and comprehensive decision making, echoing gender inequalities in other areas, such as academia and the sciences.”

Based on their analysis, the group goes on to highlight that “Decision making bodies which are neither inclusive nor diverse can easily overlook the reality that COVID-19 acts as a multiplier of preexisting gender-based inequities.”

They emphasize that many governments did not consider that females would be faced with higher income loss — potentially leading to poverty and hunger — greater responsibilities to care for family members, greater levels of domestic violence, and disruptions to maternal and reproductive care, as well as other essential health services.

In addition, the lack of adequate personal protective equipment, which dominated the early months of the pandemic in some places and is still very much the reality in others, puts members of the healthcare workforce in harm’s way — and females make up the majority of this group across the globe.

“Claiming to not find any qualified women in global health is ultimately an unjustifiably poor excuse for excluding diverse perspectives,” the researchers write.

But it is not just females who lose out in this scenario, the authors point out.

“The situation is even more dire for marginalized individuals, such as those identifying as nonbinary, transgender, or genderqueer, as they are forced to navigate the discriminatory impacts of gender-based quarantine guidelines, which authorize specific days when women or men are allowed in public,” they explain. “As seen in Panama, this often led to harassment, abuse, arrest, and fines of transgender people who were wrongfully profiled.”

Van Daalen and her co-authors call for profound changes and bold solutions in the wake of the COVID-19 pandemic.

She told MNT that while the team was not surprised by the findings, they are not “something we should simply accept.”

“A ‘new default’ mode of diverse and intersectional governance is sorely needed to face future crises head-on and guide a healthy and equitable COVID-19 recovery,” the researchers write.

“Reaching a critical mass of women in leadership — even as [a] result of intentional selection or quotas — benefits governance processes through the disruption of groupthink, the introduction of novel viewpoints, a higher quality of monitoring and management, more effective risk management, and robust deliberation.”
— Kim van Daalen et al.

The team also highlights that countries with female leaderships have, so far, fared better during the pandemic than those with male leaders. They cite research, which has yet to undergo peer review, that analyzed the response to the pandemic in 35 countries.

In countries with governments led by females, such as Taiwan and Iceland, the numbers of deaths have been considerably lower than those in countries led by males.

“Societies who elect female leaders may share a different set of values and perspectives, including gender equality, than more traditional societies,” they offer as an explanation. “Countries where women lead seem to have political institutions and cultures that have prepared for inclusive governance being practiced prior to COVID-19, influencing their COVID-19 response.”

This call for action goes beyond gender. “International and national task forces need to ensure diversity, particularly across gender, but also in terms of ethnic, racial, cultural, geographic and disability groups in decision making and expert advisory bodies,” the team suggests.

“Increasing representation and gender parity is a first step, but functional health systems require radical and systemic change that ensures gender-inclusive and intersectional practices are the norm — rather than the exception,” they continue.

Van Daalen and colleagues also call for transparency and clear communication in governance and decision making processes, two factors that are crucial in crisis situations.

“A future with resilient health systems depends on radical action to establish decision making groups that reflect the populations they represent, in the time of COVID-19 and beyond,” the authors conclude. “Leaving these voices unheard today sets a precedent for continued silence in the years to come.”

Van Daalen also told MNT that the team published their work in an open-access format to allow people across the globe to read it.

“We have written it in a language that hopefully is accessible to a wide audience, including policymakers, scientists, and academics,” she said. “Furthermore, if people have ideas on what else can be done with the data, they are more than welcome to reach out to us.”

“We want you to use this data to ask for greater transparency and gender balance in COVID-19 decision making in your local and national context,” van Daalen urged.

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