Asha Herten-Crabb and Sara E Davies
The full article Published: March 28, 2020DOI:
https://doi.org/10.1016/S0140-6736(20)30110-0 The Lancet Vol.395 | Number 10229 | Mar 28, 2020
First few paragraphs:
In September, 2019, Alan Donnelly and Ilona Kickbusch
called for a chief economist at WHO. Such a position, they
argued, would enable WHO to better advocate for greater
recognition of, and thus action on, the interdependency
of health and the economy. We support this proposal:
recognition of the interdependence of health and the
economy is vital for WHO to achieve its mandate: “the
enjoyment of the highest attainable standard of health…
without distinction of race, religion, political belief,
economic or social condition”. Given this mandate, WHO
should be more ambitious than the appointment of one
economist. A more strategic and enlightened approach,
especially in the aftermath of the coronavirus disease 2019
(COVID-19) pandemic, would be for WHO to embrace and
articulate a feminist economic agenda.
A feminist economic agenda interrogates power
dynamics and peoples’ relative access to and use of wealth
and resources. A feminist economic lens that incorporates
intersectionality must address the power dynamics
between genders and acknowledge the power relationships
between nation states, ethnicities, ages, abilities,
and other dimensions of diversity, and how they are
interconnected with gender inequality and the economy.
A feminist economic approach is consistent with how
public health is taught and sometimes practised: that
health, and access to health care, is interdependent not
only on the economy but also on all other social and
commercial determinants of health.
WHO has estimated a shortfall of 18 million health
workers by 2030, largely in low-income and middle-income
countries. Women comprise more than 70% of the
global health workforce, but WHO research into the state
of gender equity in the health workforce has revealed
systematic gender biases, inequities, and discrimination.
A feminist economic approach recognises the systems
of disadvantage and discrimination that lead to this
inequality. Minority ethnic status, class, education,
and sexuality determine who is represented in unpaid
community health-care worker roles. The unpaid and low
paid labour of women has contributed to profits for private
health-care providers and saved the bottom line of health
spending in national budgets: capitalism and patriarchy
combine to systematically undervalue social reproductive
labour—ie, unpaid care roles as women’s work.
