COVID-19 and the gender paradox

Back in 2008, David Fidler coined the term ‘the gender paradox’, which he described in the following terms: ‘We perceive that problems concerning women’s health . . . are growing at the same time that gender-informed analysis of global health issues has become more pervasive’ (Fidler, 2008: 148). He goes on to describe an inverted triangle within global health where there are numerous standards related to women’s health, but little incorporation of these into organizational practices or national implementation, and even less evidence of improved health outcomes for women. The response to COVID-19 has taken the gender paradox to a new level. We see unprecedent attention to the gendered effects of pandemics, in terms of not only health effects, but also the disproportionate social and economic impacts on women, yet little progress in rectifying these inequities (Harman, 2021). In this brief comment, I share two examples of how the gender paradox plays out in policy spaces – both global (the World Health Organization (WHO)) and national (Canada) – and then reflect on what can be learned in order to overcome barriers to transformative change. The WHO is mandated by the International Health Regulations to lead and coordinate responses to Public Health Emergencies of International Concern. While not an implementing organization, WHO provides technical guidance and holds normative power in its ability to set standards and champion agendas within global health; as such, its leadership in promoting gender-sensitive health responses is paramount (Wenham and Davies, 2021). The WHO has demonstrated some follow through on its commitments to mainstream gender (adopted in its Gender Strategy in 2008 and continued in the 13th General Programme of Work 2019–2023) in its COVID-19 response. In May 2020, it released a Gender and COVID advocacy brief and issued guidance on monitoring the unintended consequences of public health lockdowns, including gender-based violence and access to sexual and reproductive healthcare (WHO, 2020). Partially in response to pressure from organizations like Women in Global Health, as well as feminist advocates within and outside the organization, WHO Director General Dr. Tedros Adhanom Ghebreyesus met with civil society organizations, in September 2020, and