PERSPECTIVE: A New Vision for Global Health Leadership

The complexity of global health problems demands leadership that represents the pluralism in society. The absence of gender parity in the leadership of key global health institutions in academic, governmental, and non-governmental organizations is evidence that this aspiration for diverse and inclusive leadership is not yet a reality.

Women continue to represent most of the health workforce worldwide yet remain the minority in global health leadership. For example, only thirty-one percent of the world’s ministers of health are women, and among the chief executives of the 27 health-care companies in the 2017 global Fortune 500, only one is female.

To address this gap the inaugural 2017 Women Leaders in Global Health Conference (WLGH) at Stanford University brought together more than 400 leaders, mostly women, from sixty-eight countries, representing more than 250 organizations and institutions. The attendees reflected on current gaps and barriers to the advancement of women in global health and the steps needed to achieve gender equity in leadership. A number of key themes emerged.

First, the need to diversify leadership is not only an aspiration for inclusivity but is also supported by evidence for better outcomes. Gender diversity in decision making and participation in the workforce results in stronger economies, more productive institutions, and more stable governance. In global health, women bring insight and ingenuity to complex problems, leveraging their service on the front lines as caregivers for their families and communities and often improving outcomes.

Second, the barriers that impede gender parity in leadership are often deeply embedded in cultural norms, historical events, and stereotyping. Young emerging leaders in fields such as law, engineering, and health face stereotypes based on gender, culture, and discipline even as they tackle critical global health issues. For countries recovering from periods of struggle or hardship, the challenges women face in reaching leadership positions can reflect the reaction of leaders who were oppressed and are now reluctant to share their power having finally experienced freedom. Gender equity in leadership may come as these nations heal from conflict and women’s roles in the struggle are acknowledged.

Third, creating capacity for gender parity in leadership will require engaging all genders and generations. This principle requires the strengthening of civic education and reinforcing the values of diversity and pluralism for all young people. The next generation of women need to be equipped with leadership skills. Another step is support for conferences, such as this inaugural WLGH event, where young women can access the guidance, inspiration, and wisdom of peers and senior leaders in global health. Welcoming men to such conferences is important to ensure they develop a better understanding of the barriers women face. The next WLGH meeting is planned for November 9, 2018, at the London School of Hygiene & Tropical Medicine in the UK, with Rwanda, Peru, and India being considered as future venues.

Fourth, transformation of institutions is crucial to ensure that structural barriers do not block women from leadership positions. Greater transparency and accountability are called for, with clear and aggressive targets for inclusivity and a commitment to seek out inequities and incentivize change. One approach is to catalyze institutional investment in advancing the careers of young women by predicating grant funding on institutions’ performance on gender-equality benchmarks, as the UK’s National Institute for Health Research has done. 

Institutional flexibility can allow women opportunities to advance. For example, raising the age limit for women seeking early-stage investigator awards because family responsibilities can delay contributions to research. On the global stage, a WHO report on gender in health leadership could engage policy makers in a data-driven, outcome-oriented mission to transform institutions.

The need to engage partners in this quest is clear. This movement is not about preventing men from holding women back, but about collectively embracing a new vision for leadership across many axes, not just gender. Continued efforts should be intergenerational and inclusive of all disciplines. Women need to be courageous and assertive, embracing opportunities when they arise. Men and women should work together to integrate family and career, so that responsibilities in both realms are mutually embraced. We all need to listen more, understand unconscious bias, and call it out when it is seen. Those who have a seat at the table should use these opportunities to diversify and expand the circle of influence.

As the first WLGH Conference closed, a collective Call to Action emerged. Global health enterprises are invited to take up this ambitious and necessary call in the pursuit of a new vision for leadership in global health.