Transforming global health at WHA76: are inclusive voices truly heard?

As a Women in Global Health (WGH) delegate at the 76th World Health Assembly (WHA) in May 2023, I had the privilege to witness critical discussions and policy developments that shape global health. I also had the chance to engage in powerful conversations and witness the transformative impact of inclusive global health governance. In roundtable discussions and side events, I had the honor of listening to women from diverse backgrounds, each with their own stories of resilience and unwavering dedication to improving gender equitable health systems and leadership. One such example is Catherine Menganyi from WGH Kenya, who talked about her experiences in the frontlines at the height of the COVID-19 pandemic as a nurse, feeling voiceless as a healthcare worker, and questioning if we as a society are ready to protect healthcare workers in health emergencies. The power of diverse perspectives and lived experiences became evident, reinforcing the need to create spaces that amplify women’s voices to recognize their invaluable contributions in health.

However, it is also important to recognize existing gaps in women’s representation, especially women from low- and middle-income countries (LMICs), in participating in the WHA. In their annual Assembly gender count, WGH reported a 9% increase in women chief delegates, from 23% in 2022 to 32% in 2023. This is the highest representation of women since WGH began its gender count in 2017. While progress has been made, women’s representation at the WHA still falls short of achieving gender equity. It saddened me to think that despite the majority of healthcare workers being women, their perspectives continue to not be fully reflected in the decision-making processes that shape global health policies. It was a stark reminder that women hold only 25% of leadership roles in health and that work still needs to be done to achieve true gender equity in the field. 

Women from LMICs have additional burdens when it comes to attending events like these. Being a delegate from an LMIC myself, I understood the privilege and challenges that came with attending the WHA on-site, annually held in Geneva, Switzerland. While I was thankful for the opportunity to be present, my participation was only possible due to some travel and visa support from my organization. Even with this support, on-site participation still incurred a considerable personal cost. It’s easy to rationalize this cost in retrospect, since the experience of being an on-site delegate was invaluable. But I couldn’t help but reflect on the many deserving women who couldn’t participate due to financial constraints, bureaucratic barriers, and visa restrictions. As I saw luxury cars queue up daily to get into the Palais de Nations, it only reinforced this deep sense of irony. Who really gets to meaningfully participate in the world’s most important health policy-setting proceedings?

These observations prompted me to reflect on the importance of advocating for greater inclusivity and meaningful participation within global health governance. There are currently 218 non-State actors (NSA) in official relations with WHO who advocate for a wide range of marginalized populations. During WHA76, the already small NSA section was cut in half in one of the Committee sessions, limiting their participation. It is not enough to recognize the existing gaps in representation. We must actively work towards dismantling the barriers that prevent meaningful participation of individuals from all corners of the world. By fostering an environment that welcomes diverse voices and perspectives, we can ensure that the decisions made at the WHA truly reflect the needs and realities of people from all walks of life.

As I left the WHA with a wealth of knowledge and a renewed commitment to advancing equity in health, I realized that our collective efforts are instrumental in creating a more equitable future. In WHA76, several governments highlighted WGH’s messages and demands, focusing on leadership roles, fair pay, and improved conditions for community health workers. Over 60 governments and organizations endorsed gender-responsive statements on Universal Health Coverage in a strong show of progress for gender equity. These remarkable developments reflect the increasing importance of women’s representation and the need for gender equity in global health governance. We must continue to push for progress, amplify the voices of marginalized communities, and advocate for gender-responsive policies. By harnessing the transformative power of global collaboration, we can strive towards a world where every individual has equal opportunities to thrive, and where the decisions made at the WHA truly reflect the values of inclusivity and equity.

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About the author:

Kim Sales is a health policy and systems researcher in the Philippines. She is Co-Convener of Women in Global Health Philippines and Board Member of the Alliance for Improving Health Outcomes. You can follow Women in Global Health Philippines at @WGHPhilippines. For more information please contact wghphilippines@womeningh.org or  ksales@aiho.org.ph

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