PHA-Exch> Gender equality and the right to health

[Claudio Schuftan]

From: Meghana Bahar meghana at haiap.org

The Lancet, Volume 372, Issue 9655, Pages 2008 - 2009, 13 December 2008
doi:10.1016/S0140-6736(08)61786-9

Gender equality and the right to health

Hedia Belhadj a, Aminata Touré a
Expanding access to health is fundamental to human security and human
rights. People who are poor daily face health-related insecurity, from food
shortages to limited access to drinkable water, physical violence, or
ignorance about disease prevention. In our globalised world, the
transnational flows of ideas, people, and new lifestyles, but also diseases,
have created new challenges for those who are already left behind in the
journey of human development. The vast majority of them are women.

Gender dynamics and power balance between men and women in communities and
households have a heavy bearing on the health condition of millions of women
and girls around the world. Women account for half of the 30•8 million
adults above 15 years old currently living with HIV. In sub-Saharan Africa,
61% of adults living with HIV and AIDS are female.1 In young women and girls
aged 15—24 years in South Africa, nearly 15% are living with HIV and AIDS,
compared with 4•5% of young men.2 One in three women around the world will
be raped, beaten, coerced into sex, or otherwise abused in her lifetime.3

In developing countries, about one-fourth of pregnancies are unintended.4 As
a result, every year, 19—20 million women had no other choice than recourse
to unsafe abortion.5 Many of these women die as a consequence; many more are
permanently injured. Maternal health is the largest inequity in health.
Every year, more than half a million women die from complications of
pregnancy and childbirth.6 Large disparities exist between rich and poor
countries and within countries. A woman's risk of dying from the
consequences of pregnancy or childbirth between the poorest countries and
parts of Europe is several hundred-folds.7

The persistent violations of women's rights through harmful practices on the
basis of gender, such as female genital mutilation or cutting, early
marriage, sexual violence, or forced prostitution, further affect women's
health. Violence is heightened during conflicts and natural disasters. All
these findings show that the right to health is largely influenced by the
double jeopardy of age and gender.

In the countdown to 2015 (the deadline for the Millennium Development Goals
[MDGs]), governments and development partners must take accelerated and
coordinated action to meet the health-related MDGs. Progress on the
health-related MDGs is a good proxy for measuring the advancement of women's
rights. The promotion of gender equality and women's empowerment are crucial
interventions to improve women's health and human development, especially in
least-developed countries, where the health MDGs will be difficult to meet
by 2015. It is not only necessary to develop gender-responsive health
policies and programmes, but gender gaps must also be closed in other areas
of development, such as primary and secondary education, women's access to
economic opportunities, or equal participation to governance.

Concentrated, sustained, and long-term investments are required to allow
women to realise their human rights and improve their social status. All
development actors, including donors and national governments, must live up
to their commitments and deliver for women. Ensuring access to reproductive
health for all, including family planning, could help avoid up to 35% of
maternal deaths.6 Yet funding for family planning has dramatically dropped,
especially in low-resourced countries, where it is most needed.8

HIV-positive women support each other in a community in Nairobi, Kenya,
December 2006

The world must commit to an international health framework that shapes
universal access to health care. This framework should include provisions
for health education and knowledge sharing, as well as north—south
technology transfer and negotiations to waiver drug patents. The framework
should also emphasise the importance of sexual and reproductive health as an
essential step towards the MDGs.

Today's challenging financial situation calls for cost-effective development
initiatives and international solidarity that includes communities and women
themselves, as elements of change. The right to health implies concomitantly
investing in both health-system strengthening, including sexual and
reproductive health and gender equality, and in women's empowerment. This
dual approach of addressing health-system challenges and empowering women
would give a high return on the wellbeing of all and development at large.
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