Women leaders and global health

One of the 19th-century fairy tales written by the Grimm brothers was Snow White and the Seven Dwarfs. In the story, a magic mirror would unfailingly tell the truth when asked a probing question. An evil queen always made the same inquiry, “Mirror, mirror on the wall- who’s the fairest of them all?” The mirror would consistently reply that her stepdaughter Snow White was the fairest in all the land. Not to be outdone, the queen ordered the killing of Snow White. The hunter assigned to carry out the heinous act could not and that was how Snow White became self-banished to live with the seven dwarfs.

Let’s fast forward to the 21st Century. While I’m not an evil queen, but an unbiased medical doctor, I would ask the question, “Mirror, mirror on the wall, who makes the greatest impact in global health? The mirror would answer, “Women leaders make the most impact in global health.”

The 8th of March was celebrated around the world as the International Day for Women and the 14th of March was also celebrated as mother’s day although mother’s day would be celebrated much later in the USA on the second Sunday in May. Throughout the history of humanity, women have been given a bad name even when they were not the source of the misfortune. Chronologically, we are in the 21st century but advancements in women’s strides are yet to catch up. Patriarchal institutions still try to relegate them to their supposed proper place. Examples abound from academia to entertainment and to sports. Two female administrators sued their university and won after realizing that their male counterparts were being paid much higher salaries than they were. Elite female athletes are made to sign a contract clause that their agreement would be terminated if they get pregnant. In 2019, when Italian volleyball player Lara Lugli got pregnant at 38 years of age, she was fired and then sued by her club for breaching her contract when she asked for back pay. She had been the captain of the team. She had a miscarriage a month after she was fired.

The diminishing of female achievement is not new but it struck a new low when three Swiss newspapers announced to the world that “This grandmother will become the boss of the WTO”. While the headline was a truism, it was sarcastically dismissive that the Harvard graduate, World Bank veteran, and twice Nigeria’s minister of finance, Dr Ngozi Okonjo-Iweala, was announced to the world as a grandmother when it was not her biological role as a woman that gave credence to her appointment. Perhaps, there’s a little bit of the evil queen in perpetrators of such invectives. The group’s newspaper foreign editor apologized after female leaders, United Nations Women Leaders, and 124 Ambassadors in Geneva signed a petition against the news organization.

The appointments of octogenarian men to international organisations are not captioned in newspaper headlines as grandfathers. The 83-year old Yoshiro Mori, former president of the 2021 Tokyo Olympic Organizing Committee had to resign from his position because of controversial comments he made about women. He said meetings would go on for too long if the number of female board members was increased because women were talkative. Research has shown that in personal relationships, women talk more but in public speaking like at meetings and other formal places, men talked more. Although Japan is industrialized and one of the G 7 countries, it has not progressed in gender equality. Japan was placed 110 out of 149 countries examined for the gender gap.

When Dr. Jill Biden became first lady (in waiting) of USA, 84- year old Joseph Epstein wrote an opinion piece in The Wall Street Journal. He opined that she should not use the Dr. title even though she has a doctor of education degree. The American author advised her to be addressed as Mrs. Biden, Madame First Lady or Jill kiddo. He even went further to minimize her dissertation work on student retention in community colleges as “unpromising.”

When the 67th Secretary of State, Senator Hilary Clinton, was running for president of the United States, she tried to placate some conservative voters at the time and resonated her biological achievements by coming forward first as a wife, mother, and grandmother. That too did not please many people. It’s difficult to please both sides of the argument.

Turkey recently withdrew from the Istanbul Convention, a treaty that was first signed by Turkey in 2011. The International Accord Treaty was to protect women against violence. President Erdogan’s government said the official reason for withdrawal was to protect family values although many see it as a result of pressure from his conservative base. In 2020, Turkey recorded 300 femicides so withdrawing from the treaty was not in the best interest of the women. Apart from the reported femicides, some female deaths were recorded as suicides because of a lack of political will to exhaustively rule out femicide.

So how do women leaders impact global health? Education. When women are educated and placed in leadership positions, they affect change. Women have the leadership instinct that is not only beneficial to themselves and their immediate families but to their country and the world. In 2020, when the onslaught of the coronavirus began, female-headed countries like New Zealand, Taiwan, Germany, Denmark, and Finland had better outcomes. This was evidenced by earlier lockdowns and lower death rates when compared to countries led by men. The analysis was conducted on 194 countries. While the male-headed countries were thinking of the economy, the female-headed countries were thinking of saving lives.

Brazil, a male-headed country has the second-highest number of deaths in the world, surpassed only by the United States. President Bolsonaro of Brazil has not ordered a national lockdown. The 66-year-old president is against mask-wearing and social distancing. He insisted on keeping the economy open and since the pandemic started, he has changed health ministers three times. The number of deaths due to coronavirus in Brazil reached 292,752 on the 20th of March, 2020. Since the pandemic began, Brazil has had about 12 million confirmed coronavirus cases and daily deaths sometimes reaching 3000. The total deaths from COVID-19 in Nigeria have not reached the daily death average for Brazil. Last year, the Brazilian president was infected with the coronavirus and later recovered. Not all non-mask-wearing, COVID-19 non-compliant world leaders were as lucky.

The level of formal education of the country’s leader also correlates to its economic growth. German Chancellor Angela Merkel holds a doctoral degree in physical chemistry specializing in quantum chemistry. She has ruled her country for 15 years during which time Germany’s economic growth has expanded to $4.2 trillion, a growth of more than a third and one and a half times more than France. Her tenure has also seen a drop in the unemployment rate. The living standards of Germans have increased on an average of 20 percent since she came into power. It is the world’s fourth-largest economy following the USA, China, and Japan. Coronavirus deaths in Germany are much lower than in other European countries with comparable population sizes; Spain, Italy, Britain, and France. Between 2015 and 2016, she allowed more than one million Syrian refugees and other migrants into her country. Her humanitarian approach to the Syrian refugees has saved millions of lives.

Our very own Dr. Okonjo-Iweala, the first African and first female Director-General of the World Trade Organization (WTO), has already begun to make her impact in health. She has expressed her plans to rejig the Safe Schools Initiative, a push originating in 2014 during the World Economic Forum. The initiative is to protect our schools from attack. If we can keep our children in school and our girls are not married off as child brides, then the new WTO boss like Angela Merkel would be directly and indirectly saving millions of lives.

Vaccines are a way out of the pandemic. Low-income countries are getting a trickle of the vaccine. However, if there was an open-source to the production of authorized vaccines for the duration of the pandemic, it will reduce shortage, decrease the number of deaths and the world would get to as near normal as possible within a shorter time. While the rich countries are saying they will donate vaccines, they will rather not have an open-source because of patents, which international laws can override. Patency laws ensure that the pharmaceutical company has exclusive rights to its production; the ingredients, source code, and resources in the vaccine. The countries that are against open source are mostly male-headed. Open Source would allow decentralization of vaccine production. Vaccines could be manufactured in low-income countries provided they have the infrastructure. Open Source would have reduced inequality in vaccine access. Oxford University wanted to have an Open Source vaccine.

Nigeria was recently declared polio free. We used the Oral Polio Vaccine (OPV) developed by Sabin. Salk, the developer of another type of polio vaccine; the Inactivated Polio Vaccine (IPV) did not patent it. In 1955, when the American virologist, was asked why he did not patent the Salk vaccine he gave his reasons; that the people owned the patent. Millions of dollars had been raised in charitable donations and so he was not going to patent it. Paraphrasing his response, the medical researcher said patenting the Salk vaccine would be like patenting the sun. With the new Director-General of WTO, developing countries could make a case for COVID-19 vaccines to be free from patents so that there will be more equity in the accessibility of vaccines. When women are put in leadership positions especially during these pandemic times, it can save lives. If our women can overcome the evil queens in their paths, they can achieve much more.