Transcript 0:00 Hi everybody, and welcome back to Trendlines. I'm Peter Dury, and I have the great pleasure of stepping in for Elliot Waldman going forward as Trendlines producer. 0:10 As you've no doubt realized, we have taken a short break recently, but we have some new episodes lined up for you in the new year. 0:16 In the meantime, we are republishing three of our episodes from the past 12 months as a way to look back at 2021. This one, titled Addressing Gender Disparities in COVID-19 Recoveries, originally ran on February 3rd. 0:33 The topic remains highly relevant, and I hope you enjoy the discussion. 0:37 [upbeat music] Hello, and welcome to Trendlines, a podcast on global affairs brought to you by World Politics Review. I'm Elliot Waldman. 0:55 Just a quick note before we get started that if you like what you hear on Trendlines, you can stay up-to-date with new episodes by hitting the subscribe button wherever you get your podcasts, if you haven't done so already. 1:05 You can also find a full archive of previous episodes at worldpoliticsreview.com/podcast. Around the world, the coronavirus pandemic has taken an especially high toll on women and girls. 1:17 From public health to education to jobs and livelihoods, studies have revealed a gender disparity in the impacts of COVID-19 that is particularly wide in lower and middle income countries. 1:27 But for all the work that's been done on this issue, there's still a lot we don't know about how these impacts are being felt across different communities. 1:35 To help address this problem, the Center for Global Development in Washington, DC recently launched a new initiative to analyze the gendered impacts of the pandemic and study policy responses around the world with the aim of addressing the long-term causes of gender inequality. 1:50 My guest for today is Megan O'Donnell, a senior analyst at CGD and the center's deputy director for gender, who's leading the initiative. Megan, welcome to Trendlines. Thanks so much for having me. 2:00 I wanna spend a good chunk of time talking about how we make the recovery from COVID-19 more inclusive, but let's start with a question or two about the why of this issue, the rationale of elevating gender concerns as we build back from the pandemic. 2:13 Some of the reasons for this seem fairly self-evident, but others I think are less intuitive. Let's start with the immediate impacts of the pandemic on global public health. 2:23 What do we know about how women's health is affected, and where are there still gaps in our understanding? 2:28 So it's a, it's a big area of priority for us through this new initiative to look holistically at health services, so not just who is getting and who is dying of COVID, um, but as frontline health workers and as health systems writ large turn their attention to fight COVID, uh, what are the unintended consequences or the, the negative implications for the rest of how health systems function? 2:58 And in particular, you know, when we look at all of this from a gender perspective, we're thinking of the fact that, you know, women and girls need steady, reliable access to things like contraception, uh, and related counseling. 3:13 Women continue to have babies every day, right? So they need access to clean healthcare facilities, trained birth attendants, uh, prenatal care, things of that nature. 3:24 And so a big question for us is, is thinking about the disruptions to those wider health systems and, and there were some pretty scary estimates at the start of the pandemic. 3:35 So the World Health Organization, for example, uh, surveyed about 103 countries, and two-thirds of those countries cited initial disruptions. 3:47 So now it's our job to, uh, gauge the extent to which those disruptions have continued. 3:52 Uh, in some cases, you know, we're, we're optimistic looking at some of the data that actually health systems in certain places were more resilient and actually bounced back, uh, quite a bit faster than we might have feared. 4:06 In other places, that hasn't been the case, and so in order to prioritize, uh, where policy and, and donors and other decision makers really need to lend a hand to strengthen health systems, we wanna understand where they've been resilient and where they've been less so. 4:23 Earlier before we started recording, you mentioned that you've gotten some feedback from people who say, "Well, aren't more men dying of COVID-19 than women?" What's your response to that? 4:34 It's a, it's a great question, and I think there are a few different things to unpack, um, when we look at the gender gaps in contraction and in mortality rates. 4:44 I mean, the first thing that, that we're trained to do as researchers is to question the reliability of the data, um, and to see where this data may be coming from gender-biased health systems. 4:56 So there was a pretty extreme case in Afghanistan a few months ago where figures were reflecting that men were 70% of those getting COVID and 74% of those dying from it. 5:11 Um, but this is in pretty stark contrast to the global figures of men, uh, at around 53% of cases, and so we have to ask what is ac- accounting for that disparity? 5:23 Um, and we have reason to believe that that is, uh, because women have less access to health systems, and therefore, when they're getting and dying of COVID, that's not reflected in those statistics, uh, that, that men may be seeking services, uh, more often, right? 5:39 That women, when they get sick, uh, may not be kind of a financial priority, uh, to seek help. 5:46 Now, that's a pretty extreme case, but I'd say the other thing that's, that's interesting to unpack in the data is the fact that, you know, we, we think that the gender gaps in who is getting COVID and dying of it is driven certainly in part by biological factors, you know, differences in immune systems between men and women. 6:08 Um, but we also have reason to believe that it's driven by social factors. 6:12 So norms around masculinity that make men more likely to be at risk of, of really high risk COVID cases because they're more likely to drink or smoke excessively. 6:25 And so when we talk about gender, right, and we wanna challenge the gender norms, that would not only lead to discrimination and harm against women and girls, uh, but also some of those harmful behaviors that are leading men to be more at risk. 6:39 Uh, so I'd say that that's a priority for us as well. 6:42 I know that a lot of leaders around the world, including, uh, Secretary General António Guterres at the UN, have called attention to the uptick in domestic violence during the pandemic as a result of people being trapped at home as well. 6:55 Is that also something you're tracking? Yes. Yes. 6:59 Early on, uh, in the pandemic, before there was really solid data that was COVID specific, uh, myself, another colleague, Amber Peterman, and a number of other co-authors, we thought, "Okay, if we don't have COVID specific data quite yet, uh, but this is really a pressing priority and we want decision-making to be evidence-based, how do we get creative and, and seek to inform it, uh, in the absence of, of current data?" 7:29 And so what we did at first was to look backwards, uh, into historical data from past pandemics, uh, like Zika, Ebola, H1N1, SARS, and other crises, and ask questions around how those types of crises would be likely, uh, to increase violence, both within the household and also outside the household. 7:53 And what we found is that there are a variety of ways that the data shows that, that violence is likely to increase. Uh, one of them is just, you know, fairly intuitive. 8:04 More time spent in the home, uh, means that potential perpetrators are around potential victims of violence more often, and those victims have a harder time fleeing, uh, or seeking help, you know, whether psychosocial or legal counseling or what have you. 8:21 Mm-hmm. Uh, they're less connected to their informal social networks, right, to their friends and families who might be able to lend support or, or intervene. 8:30 Another pathway we've seen is that these health crises have real economic implications. 8:36 And so, uh, job loss, income loss, strained, uh, economic tensions within the household can then lead to, to intra-household tensions resulting in violence. 8:50 And then we saw other pathways outside the household, for example, where women are, uh, the vast majority of frontline health workers, about 70% of all frontline health workers worldwide, uh, and are subject to harassment and other forms of abuse at work, especially during these, these times of crisis that increase stress. 9:12 And then what, what fortunately started to happen is more and more researchers, uh, turned their attention to the COVID context, started to document, uh, whether or not violence was in fact increasing or, or decreasing or staying the same as a result of COVID. 9:28 Now we've got over 100 papers speaking to that effect that we've been able to gather and sort of take key takeaways from, and we see that the vast majority of those papers so far do in fact, um, lend credibility to the initial intuition that, that violence across, across the board is increasing. 9:50 Are there any effective responses that we're seeing to this problem to mitigate the uptick in violence that, that you'd mentioned? 9:58 So we are seeing quite a number of responses, uh, which is positive in the first instance. 10:04 The United Nations Development Program, UNDP, uh, in collaboration with UN Women, they've put out a tracker of gender sensitive policy responses in the COVID context. 10:19 Uh, and the vast majority of the responses they've been able to collect, and this is at national level from, from countries and territories, have been in an effort to support, uh, violence survivors and seek to mitigate the risk of violence occurring. 10:35 So this is anything from an awareness raising campaign, uh, you know, a radio spot that seeks to, uh, provide information on resources that, that a woman could seek out. 10:48 Um, or it may be, uh, bolstering support for a call hotline or making sure that domestic violence shelters can remain open. 10:58 So across the board, you know, regardless of income level, we are seeing countries pay attention to the issue. 11:04 Now the real question that we have top of mind is, to what extent are these policy responses effective, right? 11:12 To what extent are they rooted in pre-COVID evidence of what data suggests is really going to reduce the risk? And so we don't yet have the answer to that question. 11:24 Um, but a team of us at CGD, at UN University, um, and in collaboration with a new Lancet Commission on gender-based violence and, and the maltreatment of young people, that is the question that we've got sort of on our plates right now, is to figure out the extent to which the efforts that governments have made are effective or not. 11:46 Moving to the economic implications of the pandemic, uh, I was surprised to read in your recent blog post that in past crises, male dominated sectors of the economy were actually hit hardest in terms of employment, but now it's the opposite. 12:02 We're seeing more women lose their jobs than men. What accounts for that reversal? It's a great question, and I think one that we are still seeking to tease out, you know, using the data that's coming out day by day. 12:16 Um, but I'd say two things, you know, and it, it's really tied to the distinction between a crisis that is just economic in nature and a crisis that has a health component, right? 12:30 That, that mandates lockdown measures, containment, social distancing. 12:36 Um, and as a result of a health crisis, I mean, we've seen that the containment measures imposed globally have first hit women-dominated sectors harder because women were more likely to be concentrated pre-COVID in sectors like retail and tourism and other services, right? 12:57 Where when you shut down the airline industry, um, women are more likely to be impacted if that's where they're concentrated. 13:05 The second dimension of why containment measures have hit women's work harder is tied to their disproportionate likelihood to do unpaid care work. 13:16 Uh, so caring for children, the elderly, the sick, uh, just bearing the lion's share of domestic responsibilities. 13:24 And so as schools and as childcare centers have closed, right, there needs to be someone at home oftentimes supervising a child, you know, uh, supervising Zoom, uh, school lessons and things of that nature. 13:40 Now, there are still big gaps in the data about how exactly this is playing out in lower income settings, right? Where we're not really talking about virtual work or Zoom school. 13:52 Um, so we definitely need more clarity on how unpaid care burdens have shifted in those settings. 13:58 Um, but I'd say yes, the containment measures are hitting women-dominated industries more, and then also have those implications for increases in unpaid care to the extent that we've seen them. 14:11 You've made the point that a lot of the, uh, disproportionate impacts on women and girls from the pandemic are due to these preexisting gender gaps in employment, wages, educational outcomes, things of that sort. 14:25 What kinds of opportunities do the present moment offer to address those longstanding problems that we were dealing with even before COVID? 14:34 A huge opportunity, uh, to ensure that gender is considered in economic response and recovery measures, and I think this is the thing probably most at risk of getting left by the wayside. 14:51 I'll say, you know, for a concrete example, I was very encouraged to see the new national strategy, uh, on COVID response and pandemic preparedness that President Biden released a couple of weeks ago, and it does a great job of being very explicit in acknowledging the risk of gender-based violence increasing. 15:13 It explicitly acknowledges the disruptions to maternal healthcare, sexual and reproductive healthcare that we were speaking about earlier. 15:22 Where I think, you know, not just the Biden administration, but global decision-makers writ large need to now go a step farther is to acknowledge these disproportionate economic impacts on women. 15:35 When we look in the US, right, we see from the latest jobs report that it was exclusively women, um, and particularly women of color who are losing jobs as we actually start to see a resurgence around white men and white women in jobs numbers. 15:53 And when we look globally, you know, the, the same trends are definitely at risk. 15:57 So I think first and foremost, we need to ground decision-making in data that reflects that reality, and then prioritize response measures that are going to meet the needs and address the constraints of those who are most at risk of getting left behind. 16:14 Now, I'll go back, you know, to the UNDP tracker that I mentioned earlier. I mentioned the vast majority of policy responses are focused on violence. 16:24 There are far fewer labor market measures or fiscal policy measures that are aimed at supporting women-dominated sectors or focused on addressing, uh, unpaid care work burdens or any of these constraints that relate to women's economic recovery. 16:42 Um, so I'd say that it really needs to be prioritized and, and in a data-driven way. 16:47 Are you also looking through this initiative at the disproportionate impacts of the pandemic on LGBTQ communities and how to address that? It's a really great question. 16:57 In every dimension of our work are thinking in what we call sort of an intersectional way, um, and that is to first and foremost realize that this is not just sort of a monolithic divide between all women and all men, right? 17:16 That we have to think about the intersecting forms of discrimination, um, whether those relate to sexual orientation and gender identity, as you mentioned, uh, but also thinking about things like race, ethnicity, migrant status, disability status, class, geographic location, right? 17:37 To really, uh, be able to prioritize who, who is most in need, who is most vulnerable, who needs to be addressed. 17:45 So as we think intersectionally, you know, as, as your question alludes to, we have to think about who is at the decision-making table, uh, whose priorities are being represented and reflected. 17:58 And one of the things unfortunately that we've seen is that COVID response decision-making has not been as inclusive as we would like it to be. 18:08 Uh, an organization called Global Health 50/50 has done a very good job of tracking, uh, the lack of women's representation on COVID task forces and other leadership bodies. 18:22 I think we know less from an intersectional perspective about the extent to which, uh, LGBTQ voices and those of other demographic groups have been reflected. 18:34 Uh, but I think those questions certainly need to be asked, and then we need to prioritize, uh, reflecting on those perspectives, those specific needs and constraints, and taking those into account. 18:46 You mentioned earlier in your, uh, response about intersectionality the need to also factor in, uh, geographic location and the disparity that emerges there, and I know that's one of the reasons CGD decided to launch this in- initiative, is to rectify that sort of imbalance and the, uh, disproportionate focus on the Global North when we talk about these disparities. 19:09 So maybe you could talk a little bit about the gap between the way women and girls in lower and middle income countries have experienced the pandemic compared to those in higher income states. 19:18 So I think the clearest example that we're seeing right now in terms of divides or potential inequalities between higher income countries and lower income ones is around vaccine distribution, and what the UN, the WHO, and others are warning of around vaccine nationalism. 19:42 As of a couple of weeks ago, we had seen, uh, 59 million doses, uh, distributed across the 50 highest income settings, while just 25 had been distributed in one lowest income country, in Guinea, and that was because of the Russian Sputnik vaccine. 20:03 And so you've got the head of the WHO warning that we are on the brink of a catastrophic moral failure. 20:12 You've got others coming out and saying, "Look, you know, this, this cannot be a time where we are complacent once vaccines end up getting distributed in higher income settings," because it really has been lower income ones from an economic and a social perspective that have been hit hardest, even if it's not the case that they've been hit hardest in terms of direct contraction and, and mortality rates due to COVID. 20:37 So when we think about this from a gender perspective, of course it, it adds additional nuance. 20:43 I mean, for, for a while now, for example, we've known that there has been complexity, um, and sort of problematic ways of dealing with, uh, women who are pregnant or who can become pregnant when it comes to, uh, including these women in vaccine trials as they're being developed and in vaccine distribution efforts once they are developed. 21:08 Now, fortunately, there is guidance to say that, uh, pregnant women are safe to, to take the vaccine. 21:14 Um, but for a long time in other crises, this wasn't the case, and so you were effectively, uh, removing large swaths of the population from being protected, uh, because they hadn't been included, you know, in initial research and considerations. 21:30 The issue came up earlier in the conversation of this question of data and how much data we actually have about the gendered impacts of COVID-19 across countries. 21:40 How satisfied are you with the current amount of data that we have, the number of studies that have been done on this, and how can that gap be filled, uh, more effectively so that policy makers have a good foundation on which to make these important decisions? 21:54 There are still a lot of gaps, uh, especially for those populations that, uh, are working informally, that cannot be reached by a rapid response, uh, mobile phone survey, uh, really the people that, that our initiative is seeking to sort of highlight and prioritize in response efforts. 22:17 I definitely commend, you know, the work of, uh, the UN, the World Bank, other similar institutions that have rolled out these mobile phone surveys in an effort to get a quick snapshot of what is happening on the ground to the extent possible. 22:34 But we know, you know, how, 22:36 how much of a gap there still is from a digital inclusion perspective, and there's a specific gender gap there as well, where 200 million fewer women than men in lower income countries have access to a mobile phone. 22:52 So right there, it gives you the understanding of who is being captured by the data, uh, being collected in these surveys and who is not. 23:00 Now, as we were discussing, you know, a moment ago in relation to violence, there are of course ways to get creative using the data we already have at our disposal while we are waiting for data collection efforts to expand and improve over time. 23:17 Just the way we did within the context of violence, we can go back, you know, into historical data about past crises, especially other health crises to some extent, and ask questions around what was effective in, in narrowing gender gaps, uh, in making sure that women and girls were, were prioritized and included. 23:39 And I think, and this came up earlier in conversation as well, the fact that we know that the COVID pandemic has merely magnified or exacerbated preexisting gender inequalities gives us some confidence to say that what we knew in terms of what was effective, uh, in an intervention or a policy response pre-COVID can still apply to the current set of circumstances and in allowing us to build back better. 24:10 So if we knew that there were these gaps in digital inclusion, if we knew that women were less productive in the paid workforce because they were still doing the vast majority of unpaid care and domestic work- If we knew that women and girls, uh, lacking access to contraception and lacking the ability to control their own fertility, uh, was a binding constraint on their ability to finish school, enter the workforce, advance within it, these are lessons that we can still apply to the current moment, uh, and still ensure that we are prioritizing now, uh, to make sure that women and girls aren't left farther behind. 24:52 That brings up an issue that you raised in, in a piece you wrote recently for Devex, where you pointed out that some countries tend to respond by adopting a few specific policies 25:07 for women, in quotes, or setting up a specific government office to address the issue of gender equality while the rest of the government kind of continues on as normal. Why is that insufficient? 25:22 So we have now decades of experience that suggests that 25:28 positioning women and girls in a silo entirely separate from broader health or economic, uh, or social policy is unlikely to bring about, uh, the kind of change at scale that is needed to disrupt gender inequality writ large. 25:49 So exactly as the Devex piece reflects, you know, it cannot just be the Ministry of Women or the gender experts sitting at the World Bank who prioritize, uh, this issue of gender inequality and addressing it through COVID response and recovery. 26:07 And that is exactly what, you know, our new initiative aims to do is to first and foremost partner with those gender champions and experts to ensure that we as sort of a gender-focused community of researchers, practitioners, investors are all on the same page, uh, with an understanding of the extent to which COVID has been a gendered crisis, on the same page about the extent to which decision-makers globally have prioritized gender in response efforts so far, but then ultimately to broaden, to break out of that silo in that specific community to engage folks who on a day-to-day basis are global health decision-makers, you know, those focused on social protection, those focused on infrastructure or public works programs or, uh, any other aspects of economic development, because it really will have to be those decision-makers who consider things from an inclusion perspective, right, or an equality perspective if we are to see all of, uh, response and recovery measures paying attention to these issues. 27:18 Megan, thank you so much for joining us. Thank you, Elliot. Megan O'Donnell is a senior analyst at the Center for Global Development, where she leads the new COVID-19 Gender and Development Initiative. 27:34 If you'd like to comment on the discussion, ask a question, or even suggest a topic for a future episode, drop us a line at podcast at worldpoliticsreview.com. 27:42 This episode of Trendlines was produced by me, Elliot Waldman, and edited by Peter Durrie. You can follow the team on Twitter if you'd like. WPR's handle is at WPReview. 27:53 I'm at Elliot Waldman with two L's and one T, and Peter is at P-E-T-E-R-D-O-E-R-R-I-E. Thanks for listening, and tune in again next week.
