Empowering Women & Girls - Q1 2020

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ROYAL COLLEGE OF OBSTETRICIANS AND GYNAECOLOGISTS Showcasing the importance of global women’s health » p4

SARITA NAYYAR, WORLD ECONOMIC FORUM Helping more women rise up into leadership roles » p6

ALEX DELANEY, ROSA The need for a renewed focus on gender equality in the UK » ONLINE

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“Even though there has been progress, no country has yet achieved gender equality” Phumzile Mlambo-Ngcuka UN Women p2

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2020 is the year for women 2020 is a massive year for gender equality. It’s the year of what we call “Generation Equality”. With the leadership of civil society the whole world is mobilising to realise women’s rights and mark 25 years since implementing the Beijing Platform for Action.

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e do not have an equal world and women are impatient for change.

The Generation Equality campaign is about enabling women to influence the decisions about their future by tackling the issues facing women across the generations, and putting young women and girls at the centre.

Celebrating the changes so far We do have some positive changes to celebrate. For example, there has been a 38% drop in maternal deaths since 2000. Meanwhile, 131 countries have passed legal reforms to support gender equality and address discrimination.

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before, and more women globally are in tertiary education than men.

Even though there has been progress, no country has yet achieved gender equality.

While 25 years ago, discrimination against women was legal in many countries, today, more than threequarters of countries have laws against domestic violence in place.

More girls are in school than ever

No country is yet to have gender equality But even though there has been progress, no country has yet achieved gender equality. Our best has not been good enough. Challenges remain for all countries, although many of them are surmountable.

Three-quarters of all parliamentarians in the world are men. The same goes for women at the peace table, where the vast majority of the negotiators and signatories are men.

Women and girls use triple the time

WRITTEN BY PHUMZILE MLAMBO-NGCUKA Executive Director, UN Women and energy of boys and men to take care of the household, costing them equal opportunities in education, the job market and earning power.

Young women raising families are 25% more likely than men to live in extreme poverty, affecting millions of young children.

Partnerships helping to make the changes for the future We are impatient, we are not giving up and we are hopeful.

We have growing support from allies and partners who are ready to tackle the barriers to gender equality.

We see the driving will for change

across generations and countries, and are locating issues that unite us and offer opportunities to disrupt the status quo.

Lessons learnt in the last 25 years have shown us what is needed to accelerate action for equality.

Generation Equality is one of our answers, and together, we are that generation.

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THIS PAGE WAS SPONSORED BY MMV, DNDI, FIND AND TB ALLIANCE © DAMIEN SCHUMANN

Closing the gender gap in medical research How an innovative business model can help increase gender-inclusive data and research for the development of drugs and diagnostics.

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he science that informs the prevention, diagnosis and treatment of disease has often failed to include women.

The reason is simple: historically women just haven’t been studied as much as men.

Even if adequate numbers of women are enrolled in clinical trials, the extra steps of separating data by gender, and publishing that data, are not systematically pursued. This results in a knowledge gap, making it difficult to understand whether medicines act differently in men and women.

Closing the gender knowledge gap in clinical development The knowledge gap is even wider when it comes to pregnant and lac t at i ng women. D u r i ng t he clinical development of most new medicines, it is considered high-risk to test on women of childbearing age and pregnant women are actively excluded from trials.

This practice aims to protect mother and foetus, but it also prevents the generation of much needed data and hampers our understanding of how medicines interact w ith women’s bodies, including during pregnancy.

The delay in availability of medicines for pregnant and lactating women Data to support the use of medicines specifically for pregnant women are often collected only after a product is first introduced to the market and its efficacy is fully established, in order to balance benefit with risk.

This delays the availability of

medicines for pregnant and lactating women, and healthcare professionals a re f requent ly a sked to ma ke treatment recommendations with little or no data to guide them.

The PDP model The Un ited States Cong ress is working to tackle this challenge with a dedicated task force, and so are other organisations, including non-profit product development partnerships (PDPs).

The PDP model, created to address the lack of market incentives for meeting the needs of neglected patients, is uniquely positioned to help increase much needed genderinclusive medical data and research.

During the clinical development of most new medicines, it is considered high-risk to test on women of childbearing age and pregnant women are actively excluded from trials

The mo del u s e s p ubl ic a nd philanthropic funds to engage both academic institutions and companies in finding solutions they would be unwilling or unable to pursue on their own, without additional incentives. PDPs have a history of success in areas where the traditional market has failed, such as povertylinked diseases.

For example, Medicines for Malaria Venture (MMV) was established in

1999; when malaria was killing over one million people each year and the antimalarial pipeline was virtually empty due to lack of commercial i ncent ive. M M V a nd pa r t ners currently support 13 medicines that have saved over two million lives.

PDPs helping to fill the gender gap Just as PDPs are filling the gap for neglected diseases, they are well placed to help fill the gender gap as well. The Drugs for Neglected Diseases Initiative (DND i) invests in gender-sensitive research and capacity strengthening and facilitates the participation of women of childbearing age in clinical trials.

The Foundation for Innovative New Diagnostics (FIND) embeds gender dynamics at the start of the diagnostic R&D process and ensures appropriate use of diagnostics in the gendered contexts in which people first seek care. TB Alliance enrols women in all its clinical trials to evaluate new treatments for tuberculosis and analyses findings

for gender differences in treatment, which informs efforts to treat women with TB. Finally, MMV is helping to improve access for preg nant women to malaria prevention and treatment medicines. It is generating data on existing medicines to inform their use during pregnancy, including t h rough t he establ ish ment of p r e g n a nc y r e g i s t r ie s, a nd i s developing approaches to safely expedite the development of new medicines for this population.

Shifting the mindset towards inclusive research and development No one should be excluded from access to effective medicines and diagnostics.

In order to see real change, we must advocate for shifts in development that promote the inclusion of women in clinical studies safely, and as early as possible.

To address the gender gap in medica l research, let ’s ensure

sustained public support for the i n novat ive PDP model, wh ich has already delivered over 27 new me d ic i ne s a nd 2 4 d i a g no s t ic technologies in the last decade.

More info This article has been authored by David Reddy, CEO, Medicines for Malaria Venture; Mel Spigelman, CEO, TB Alliance; Bernard Pécoul, CEO, DNDi; Catharina Boehme, CEO, FIND For more information please visit: www.mmv.org, www. dndi.org, www.finddx.org, or www.tballiance.org

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Snapshot on gender equality There have been important gains since the adoption of the Beijing Platform for Action: Laws Over the past decade, 131 countries enacted 274 legal and regulatory reforms in support of gender equality Education More girls are in school than ever before. Parity in education has been achieved on average, at the global level, yet large gaps remain across and within countries.

Maternal mortality The global maternal mortality rate is still too high (211 deaths per 100,000 live births) but has fallen by 38% between 2000 and 2017.

But there is still work to be done:

Labour force participation The gender gap in labour force participation among adults aged 25 to 54 has stagnated over the past 20 years, standing at 31 percentage points.

Gender parity in the workplace Women are paid 16% less than men and only 1 in 4 managers are women.

Youth 31% of young women aged 15 to 24 are not in education, employment or training in 2020, more than double the rate for young men (14%)

Politics One in four seats are held by women in national parliments

Violence against women 18% of ever-partnered women aged 15 to 49 experienced sexual and/ or physical violence by an intimate partner in the previous 12 months.

Poverty Globally, women aged 25 to 34 are 25 more likely than men to live in extreme poverty (living on less than US$1.90 a day)

Health 190 million women of reproductive age (15 to 49) worldwide who wanted to avoid pregnancy did not use any contraceptive method in 2019.

Unpaid care and domestic work Women on average do three times as much unpaid care and domestic work as men, with long-term consequence for their economic security.

Source: UN Women - https://www.unwomen.org/en/digital-library/publications/2020/03/womens-rights-in-review.

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Tackling stigma in gynaecology care globally

WRITTEN BY: DR RANEE THAKAR Vice President, Royal College of Obstetricians and Gynaecologists

Gynaecology is a neglected area of global health with conditions often highly stigmatised, investment inadequate and millions of lives lost as a result.

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h i s is compounded to devastating levels in lowr e s o u r c e e nv i r o n m e nt s with many conditions known to be highly preventable and often ea si ly ma nageable. The RCOG (Royal College of Obstetricians and Gynaecologists) believes all women have the right to a healthy life, throughout their life course.

Why the focus on gynaecology?

Maternal mortality is discussed widely as a global epidemic, and with 810 women dying from preventable causes related to pregnancy and childbirth every day in 2017 1, this is no surprise.

H o we ve r, g y n a e c o l o g i c a l conditions have a higher mortality rate than maternal causes, especially in low-resource contexts, and they also contribute to significantly greater life impairment.

Moreover, we must keep in mind that women living in many lowresource contexts are often battling not just one, but many of these potentially life-limiting conditions, throughout their lives.

I recently heard a story about a woman in India suffering from anaemia, who was forced to sit in a corner, exhausted and unable to even dress her children, because she had heavy periods.

This common problem could have been addressed with medication, or long-acting reversal contraception, but instead she was given a hysterectomy.

She was just 25 years old.

Robbed of her choice to have more children, she also has to live with fistula, causing debilitating health

problems, because the surgery was not performed correctly. I know that we can stop women and girls suffering like this.

Further education in gynaecological training for lowresource contexts Improving the quality of gynaecological care is the most effective and immediate way of preventing such suffering, especially in places where a lack of investment, infrastructure and training can exacerbate poor health outcomes.

Solutions are often preventative, low-cost and evidence based. They include advocacy and training, but these need to be implemented in a way that is sustainable.

With all this in mind, the RCOG created an essential gynaecological skills training programme that aims to improve the clinical care skills of multi-disciplinary, frontline, staff working in low-resource contexts.

It focuses on conditions responsible for large burdens of morbidity and mortality, including cervical cancer, contraception, abnormal uterine bleeding, infertility, fistula as well as gender-based violence. It also supports health professionals with clinical auditing to improve the quality of their services.

The impact so far In 2018, the training was delivered during a pilot initiative in Nigeria. This pilot programme trained 78 healthcare providers with extra assistance given to six local ‘master trainers’ who were equipped with teaching advice. It included information on prevention

and methods that could be utilised to minimise women presenting at a late stage of disease, including addressing stigmatisation that inhibits early diagnosis.

Qualitative analysis conducted after the pilot saw an increased focus on patient-centred care and quantitative analysis demonstrated an increase in positive responses about healthcare provider w il ling ness to prov ide key gynaecological services, such as contraception and post abortion care.

Taking the programme forward Our focus now is to develop the programme further because we know it will contribute to health system strengthening for gynaecological services by enabling staff to deliver high quality gynaecological care and developing local teaching capacity.

Our ambition is to roll out this programme more widely, across the globe, to ensure that no women or girls are left behind.

References: 1: WHO data - https://www.who.int/news-room/fact-sheets/ detail/maternal-mortality

More info For more information on the RCOG’s global work, visit: www.rcog.org.uk/en/ global-network/centrewomens-global-health/ Read more at globalcause.co.uk MEDIAPLANET

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“Gender equality at the top can translate to higher profits in the bottom line. More diverse companies, which draw from a broader range of information when they make decisions, have better long-term performance1.”

Sarita Nayyar, World Economic Forum 1. https://www.weforum.org/agenda/2020/01/5-ways-companies-can-progress-more-women-into-leadership-roles/

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How to support more women in leadership roles Five ways we can support more women to rise to leadership roles, including building an inclusive talent pipeline and ensuring flexible work arrangements.

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he continued gender gap in leadership roles around the world is well-known and striking. Women make up half the world’s workforce and the majority of college graduates, yet they hold only about a quarter of leadership roles1.

In politics, women around the world last year held just 25.2% of parliamentary seats and 21.2% of ministerial positions, according to the World Economic Forum’s Global Gender Gap 20202. Only 68 of the 153 countries covered by the report have had a female head of state in the past 50 years.

Gender gap in business The lack of representation at the top is also evident in business. According to a recent study3, there has been some progress of women gaining seats on corporate boards in the US, with a share of 25.9% of seats in 2019, up from 18.9% in 2015. Yet, the share of women in top board leadership roles remained almost unchanged at low levels at 7.5% in 2019, up only slightly from 7.4% in 2015.

L eaders in governments and business must take immediate action to address the systemic causes of gender inequality and empower more women to hold leadership roles.

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Hurdles to advancement Studies show that women often get stuck in gendered career paths or support roles that don’t always lead to career advancements.

They are also underrepresented in the fastest-growing roles – such as those in STEM fields including computer science, cloud computing, data and artificial intelligence – as well as those where wage growth is the most pronounced.

Women in general often receive fewer important responsibilities and assignments that could lead to promotions4. Studies5 have shown that women tend to receive lower salaries and fewer recommendations, which can also hamper advancement.

In addition, gender biases6 create hurdles7 for women rising to leadership positions. These barriers8 can include perceptions that management is a male role, stereotypes against women in recruitment and promotion, and masculine corporate cultures.

Five ways we can support more women to rise to leadership roles: 1. Top-down commitment to building a pipeline for women to access key growth positions.

This can be done with efforts

WRITTEN BY: SARITA NAYYAR Chief Operating Officer, USA, World Economic Forum,

including ensuring half of all candidates are women, posting salary ranges9 and committing to fair pay. For example, Salesforce has commissioned salary reviews10 and used them to adjust salaries of employees who were not receiving fair pay, which have turned out to be mostly women.

more women to rise to the top.

For example, tech company, Dell, offers a range of flexible and remote work options15, including allowing employees to work remotely some or all at the time at various hours, as part of the company’s efforts to increase the share of women in its workforce.

2. Companies must ensure that women have equal opportunity to gain the skills, experience and mentorship needed to rise to leadership positions. For example Hilton, ranked first in Fortune’s list of the top large workplace for women in 201911, has programmes that enable employees to enroll in training, among others.

5. There must be a focus on creating inclusive work cultures and combatting unconscious biases that hold women back. For example, management consultancy Bain & Co. has made efforts to avoid systems that tend to favour men16, such as self-reporting for promotion.

3. Supportive policies around parental leave, including offering paternity leave so both genders can share caregiving responsibilities. For example, Finland recently announced a plan12 to extend paternity leave to seven months. Big tech companies, such as Amazon, Microsoft and IBM have also made commitments13 to ensuring paid parental leave.

4. Flexible, family-friendly arrangements14 can also enable

The benefits of women in power Gender equality at the top can translate to higher profits in the bottom line. More diverse companies, which draw from a broader range of information when they make decisions, have better long-term performance17. Research18 has shown that having women in the C-suite increases net margins.

Increased gender parity at the top could also serve to create a role-model effect 20 to encourage more girls and women to pursue leadership positions and counteract unconscious societal biases about

women in leadership roles.

Only with women at parity in top positions can we work together to build a more inclusive sustainable future for all.

References: 1. https://www.weforum.org/agenda/2020/01/5-wayscompanies-can-progress-more-women-into-leadership-roles/ 2. https://www.weforum.org/reports/gender-gap-2020-report100-years-pay-equality 3. https://www.reuters.com/article/ us-usadirectors-women/womens-share-of-us-corporate-boardseats-rises-but-not-top-roles-study-idUSKBN1ZX1K3 4. https:// hbr.org/2013/09/women-in-the-workplace-a-research-roundup 5. https://www.forbes.com/sites/janetwburns/2017/09/22/2016proved-women-are-great-for-business-yet-still-beingpushed-out/#7fcd8398188b 6. https://hbr.org/2013/09/ women-rising-the-unseen-barriers 7. https://www.forbes.com/ sites/pragyaagarwaleurope/2018/10/23/not-very-likeable-hereis-how-bias-is-affecting-women-leaders/#5e5566c7295f 8. https://www.forbes.com/sites/pragyaagarwaleurope/2018/10/23/ not-very-likeable-here-is-how-bias-is-affecting-womenleaders/#2d7a3274295f 9. https://hbr.org/2019/11/how-torecruit-more-women-to-your-company 10. https://www.wired. com/story/how-salesforce-closed-pay-gap-between-men-women/ 11. https://fortune.com/best-workplaces-for-women/2019/ search/ 12. https://www.weforum.org/agenda/2020/02/finlandgender-equality-parental-leave 13. https://www.techrepublic. com/article/10-tech-companies-with-generous-parental-leavebenefits/ 14. https://www.weforum.org/agenda/2019/07/4-waysto-build-family-friendly-policies-parental-leave/ 15. https:// www.inhersight.com/blog/interview/dell-flexibility-remotework-goals-delight-you?_n=65689220 16. https://www.ft.com/ content/87586758-99a0-11e8-88de-49c908b1f264 17. https:// www.weforum.org/agenda/2019/12/how-to-close-gender-gap2020s/ 18. https://www.cnbc.com/2018/03/02/why-companieswith-female-managers-make-more-money.html 20. https:// www.theglobeandmail.com/life/globewe/article-why-puttingwomen-in-leadership-roles-is-good-for-everyone/

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SOURCE: WORLD ECONOMIC FORUM GLOBAL GENDER GAP REPORT 2020

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