Over the last year and a half we have seen a great deal of pandemic-related research published. This includes a fantastic new book – Feminist Global Health Security – by our colleague Clare Wenham. The book is set against the backdrop of the Zika pandemic and relays the experience of a tired Clare; exhausted by the way Zika was portrayed in global health security. She witnessed a complete disconnect in what was written and reported about the pandemic at the global level and what was happening on the ground in Brazil. The book is a result of four years of deductive feminist international relations building on the work of peers – feminists engaging in global health security.
Clare recalled how in 2018/2019 gender suddenly seemed to have gained traction in global health, through movements such as Women in Global Health. Global Health 5050 pushed organizations to become more gender aware. Firm commitments were made by institutions like the Lancet; to ensure equal representation in authorship. However, this change only seemed to be happening at the global level. This global conversation around gender wasn’t trickling down to the everyday women who were living the experiences of global health policy and global health security. Clare’s book looks into why this disconnect exists and what can be done.
Global health security has a become a very dominant policy frame in global health. In the wake of outbreaks, global health security prioritizes jumping in, preventing, detecting and responding to the pandemic. This approach can take little to no consideration of the broader issues of how policy impacts different people. Global health security is very state-centric and looks at how government policies affect health.
Clare argued that global health security has never been about protecting the individual – particularly women – and it neglects their realities. Potential policies expect women to absorb all the additional costs associated with implementing interventions. For example, during COVID-19 women were expected to take on additional burdens for example home schooling and domestic labour. Yet governments have not adequately acknowledged this contribution.
The book argues that there is need to re-conceptualize how health security is looked at and introduce a feminist approach. This can be done in three main ways:
- Recognize women in health security and policy making. The Zika epidemic revealed that policies did not recognize women, but rather protected mothers. As a result the policies that were formulated, focused on protecting mothers rather than supporting women who did not want to become mothers in the first place and preventing infection. There was disjuncture between the white rich women in the United States and the United Kingdom who were advised against going on holiday in the Caribbean and those most affected in Brazil who were the poor, black, rural women living far away from where policies were being made.
- Recognize women’s burden and labour. During the Zika epidemic, governments advised people to clean the house and not get pregnant. This meant that women had to absorb most of the labour in the household. It was unfair and unrealistic for governments to give women the burden of asking them not to get pregnant, without providing the mechanisms for them to avoid the pregnancy. The dynamics were different among richer women who were able to afford contraception or pay for a private clinic to procure abortions. On the other hand, poorer women who were more likely to be bitten by mosquitoes because of their poor conditions, could not access these services.
- Recognize the structural violence within society which disproportionately affects women during epidemics. In Brazil the poorest, the blackest and those women in the most rural regions are most affected by Zika and COVID-19. Tensions heighten for these groups of people because besides dealing with the pandemic, they have day-to-day challenges in relation to providing food, taking care of children, going to work in the midst of rife violence and hostility in the household and the larger communities. Women in these settings end up not paying attention to issues like the ‘small mosquitoes’ causing Zika. Their focus remains on surmounting everyday challenges. This kind of structural violence is a part of the lives of many women across the world because governments have failed to do anything about it.
Feminist global health security asks pertinent questions like, ‘Who is recognized in policies and their formulation and who is not?’ It investigates why this matters. Clare argues that women should be repositioned and placed at the center of health security. Rather than having a state centric conversation where the focus is to protect economies from the risk posed by pathogens; it should be about protecting women from the risks posed by policies introduced to mitigate against these pathogens. Reframing what is important will give birth to very different policy pathways.
Please do read the book and let us know what you think.