The Canadian Partnership for Women and Children’s Health (CanWaCH) is pleased to submit this written contribution as part of the Global Affairs Canada: Feminist Foreign Policy Dialogue.
In an Unequal World Canada must continue to “Lead On” as a Global Leader in Women and Children’s Health and Rights
Canada’s bold commitment to gender equality, health and rights comes at a critical moment as the world contends with regressive policies against women and girls on top of the destabilizing effects of climate change and the COVID-19 pandemic. We cannot achieve a prosperous, safe and secure world without health for all at its core. Our local, Canadian and global economies depend on prioritizing and investing in robust public health systems around the world. Placing health rights at the centre of a Feminist Foreign Policy is critical to its success.
Comprising 70% of the world’s health workers and 82% of health workers in Canada, women are fundamental to building and maintaining a resilient health system. Canada must continue to champion universal health coverage (UHC) with sexual and reproductive health and rights services as requisite in order to build robust health systems, save lives and maintain a stable global economy. The COVID-19 pandemic has demonstrated both that care work is critical to a well functioning health system and global health is a cornerstone of foreign policy-making. For better or for worse, women’s health rights have become a feature of many world leaders’ foreign policy, evidenced by President Donald Trump issuing an executive order to reinstate the Mexico City Policy only days into his first term as President.
Canada’s leadership in global health emphasizes the value of evidence and partnerships, drawing upon the collective efforts and expertise of governments, civil society organizations, research institutions, medical practitioners and more. CanWaCH, a proud membership of 100 Canadian non-governmental organizations, academic institutions and health professional associations, works to leverage the power of partnerships to improve health outcomes for women and children in more than 1,000 communities worldwide.
As Canada sets forward its foreign policy agenda in the coming decade and beyond, health must be a fundamental cornerstone, laying the groundwork for success across all areas of global interests. To do so, CanWaCH puts forward the following recommendations:
Recommendation 1: The Government of Canada must fully realize its funding commitment of June 4, 2019 to scale up its investment to $1.4 billion annually by 2023 through to 2030 in order to advance the health and rights of women and girls around the world. Through this funding, it is critical that the Government take an integrated, ‘non-siloed’ policy approach to global health programming for women and children that reflects a comprehensive multi-sectoral package of interventions across the life course, encompassing Canada’s suite of expertise in newborn, child, adolescent and women’s health, rights and nutrition.
Only 32% of countries have and enforce laws that protect all dimensions of sexual and reproductive rights, and yet, we know that these rights are constantly at risk. COVID-19 has had inequitable effects on different populations, exacerbating existing gender and social inequalities for women girls, adolescents, LGBTQI2S+ people, people with disabilities, and many other marginalized groups. Lack of access to sexual and reproductive health and rights services is expected to result in the deaths of an additional 253,500 children and 12,200 women in the next six months – and that’s under the least severe scenario projections. It is also estimated that COVID-19 will result in 117 million missed child vaccinations.
Healthcare providers are overwhelmed and in many areas unavailable to support patient services due to travel restrictions, redeployment to COVID-19 response duties or because they have been infected themselves. In Ghana, for instance, the number of healthcare workers infected in the line of duty jumped from 779 at the beginning of July to over 2,000 by the end of that month. Insufficient and inadequate PPE, slow testing, and limited institutional capacity are cited for this trend.
Healthy women are the cornerstone of healthy societies. And yet, women and girls’ health does not come innately to any society. As identified by the World Bank, deliberate policies and programmatic strategies aimed at nurturing women’s health and well-being across the life cycle are vital for realizing the full potential of women and girls.
Recommendation 2: The Government of Canada must acknowledge unpaid care work as a fundamental determinant of health through investments in the care economy. These investments should recognize, redistribute, and reduce women’s unpaid care work as well as represent the rights of care workers in order to achieve gender equality and the empowerment of all women.
Women spend disproportionately more time on unpaid care work than men, performing 76.2% of the total amount of unpaid care work, 3.2 times more time than men. Women are the majority of providers of both paid and unpaid health care, amounting to more than 5% of global GDP. Working on the frontlines, as community health care workers and medical professionals, the Lancet Commission on Women and Health estimated women’s contributions to health and the health sector in Canada to be between 6.2% and 7.2% of GDP in 2019. Furthermore, a report by Thomas N. Chirikos in the Review of Economics and Statistics found that poor health history is one of the single largest determinants of annual hours of work for employed individuals. In the context of major health emergencies, such as COVID-19, the healthcare system relies on unpaid care work to ensure that it is not overwhelmed. This has led to disproportionate numbers of women staying home to look after children, taking care of sick family members, and generally reducing the spread of the virus and the burden on health systems. As a result, women have been edged out of the labour force.
Weak health systems harm economic advancement of a country. As the world has become more reliant on globalized forces of labour over the past decades, adopting health systems strengthening as part of foreign policy goals is a key way to improve trade relationships, strengthen health systems and boost the global economy. In order to achieve the sustainable development goals by 2030, a feminist, rights-based, intersectional, and integrated approach must be adopted for the immediate and long-term responses to the global pandemic. The WHO Director General, Dr. Tedros Ghebreyesus recognizes that nurses and midwives are the backbone of every health system and called on all countries to invest in nurses and midwives as part of their commitment to health for all.
Recommendation 3: The Government of Canada must recognize that health is foundational to achieving a feminist foreign policy, as it leads to greater stability and security globally. Furthermore, by promoting the effective and meaningful participation of women in leadership and decision-making processes, the Government of Canada can support improved outcomes in both global health and peace and security.
Currently, 21 women sit as the head of state or government out of 193 countries around the world. From the onset of the pandemic, countries with women leaders have suffered six times less confirmed deaths from COVID-19 than male-led countries. Investing in women’s leadership leads to a more gender equal world as well as a healthier, more peaceful and prosperous society. Furthermore, studies have shown that when women are involved in the peace process leading up to the agreement, peace agreements are 35% more likely to hold for at least 15 years. Just as peace is a prerequisite for health equality and human security, health is also a prerequisite for peace. Without strong, reliable health systems, fragile and conflict-affected states and regions often struggle to build sustainable peac and the absence of adequate health care has been shown to drive violent extremism, fostering recurring cycles of conflict. In order to achieve a just recovery, the participation and protection of all women must be at the center of response efforts.
Conclusion
From the HIV/AIDS pandemic to re-emerging infectious diseases like SARs and now COVID-19, we see how national public health issues transcend borders, with countries becoming more interconnected and interdependent. As health care workers around the world continue to risk their lives to contain COVID-19, we call on Canada to lead and protect Canadians by protecting the most vulnerable people across the globe – fulfilling its global commitment to universal health care, following through on its commitments to scaling up investments in the health and rights of women and girls around the world, recognizing care work as a key determinant of health and prosperity, and promoting the meaningful participation of women in leadership and decision-making processes globally. We are in this together: Canadians will only truly be safe and healthy when everyone is safe and healthy.
