This post originally appeared on the Women in Global Health website. This guest post was written by Kelly Thompson, Ann Keeling, Roopa Dhatt, and Caity Jackson from Women in Global Health. Established in 2015, Women in Global Health (WGH) was founded with the values of being a movement. WGH works with other global health organizations to encourage stakeholders from governments, civil society, foundations, academia and professional associations and the private sector to achieve gender equality in global health leadership in their space of influence.
**Update: The original version of this blog featured data points from 2008 and early 2017. The graphic has been updated to reflect the most recent data from the GFATM Secretariat.
Last Tuesday, without much fanfare, The Global Fund to Fight, AIDS, Tuberculosis and Malaria (GFATM) unceremoniously announced the 4 short-listed candidates for its next Executive Director (ED). In contrast to the World Health Organization’s (WHO) recent attempts at developing a more transparent and open process for the selection of their Director General, the GFATM process has been shrouded in secrecy. The first attempt to select its ED, set to replace Dr. Mark Dybul, who stepped down in May, was abruptly aborted. With rumors swirling and one of the candidates, Helen Clark, suddenly removing her candidacy, the GFATM Board noted that due to problems encountered in the recruitment process they were going to draw that round to a conclusion and restart the process (1). In this new round, 3 men and 1 woman have been shortlisted, also harkening back to the WHO election where gender parity was not reached in the final candidates. There is also a startling lack of geographical diversity in the final candidates with two from the United Kingdom, and one each from the USA and Tanzania.
In one way, we should not be surprised that the shortlist is dominated by men, every previous ED has been a man, with the exception of Dr. Marijke Wijnroks, who is currently serving as the Interim ED. But since women are the majority of the workforce in the sectors of health the GFATM covers it is surprising that the shortlist is not 3 women and 1 man or at least 50/50 women and men. In the lead up to the second round the names of some outstanding women leaders in global health were circulating as being in the race. Talented women are out there and we should be surprised that the final shortlist is not gender balanced. It goes without saying that whoever is selected, regardless of gender, needs to have a strong understanding of the interplay of gender within the three diseases and how to apply a gender transformative approach to their leadership.
The GFATM’s own 2017 report notes the variety of ways in which the three diseases are gendered (2). Some of the key examples include, in some parts of Africa, young women (15-24 years old) are eight times more likely than young men to be living with HIV, and in the hardest hit countries 80% of new HIV infections are among adolescent girls. Those same adolescent girls are also more likely to be impacted by tuberculosis. Whilst malaria greatly affects pregnant women and children under 5, in some areas, like the Mekong, malaria greatly impacts men, who make up the migrant and mobile population. GFATM has adjusted its funding and programming to reflect these gender needs, with 60% of current investments being targeted at women and girls, and the announcement of the HER Voice fund to be launched in November 2017. However, as noted by Hawkes, et al there are still major gaps in transforming this policy into reality and often ‘too few grant agreements are found to specify, fund or monitor gender-sensitive or transformative activities’ (3).
We urge the Board to prioritise these considerations in the ED’s selection:
1) Strong development background and connection with the reality of the context of the GFATM’s work.
2) Strong commitment to gender equality essential to delivering GFATM’s work and Universal Health Coverage (UHC).
3) Commitment to reform of the GFATM including promoting diverse leadership.
4) Commitment to partnerships and building/engaging civil society particularly from the global south.
In closing, we ask all ED candidates, how will you address gender equality in the Global Fund?
(1) Zarocostas, John. Controversy embroils selection of new Global Fund head The Lancet , Volume 389 , Issue 10072 , e3.
(2) Results Report 2017. The Global Fund. https://www.theglobalfund.org/media/6773/corporate_2017resultsreport_report_en.pdf
(3) Hawkes, Sarah. Gender blind? An analysis of global public-private partnerships for health. Globalization and Health 201713:26