2 Yet until 2020 the issues of women and gender in health emergencies were ‘conspicuously invisible’: 3 while women are evident at every level of global health work, and successful interventions rely on their paid and unpaid labour and compliance, issues of gender were either token or absent from policy and strategy around pandemic preparedness and response.
These issues have long been documented in research on HIV/AIDS, Ebola and Zika. 1 Gender can therefore determine who gets sick and how, who makes decisions in a health emergency and who performs the front-line response, and who suffers the long-term consequences of an outbreak. Public health emergencies of international concern (PHEIC), disease outbreaks and pandemics are gendered with regard to the differential impact they can have on prevalence and mortality among males and females, the differential socio-economic burdens that fall to women on account of social norms, the exacerbation of female insecurity and threat of violence, the feminized health care workforce, and the dominance of male representation in decision-making and pandemic response and planning. Combined these factors make gender equality incompatible with global health security. What unites neglect and visibility of gender in global health security is that gender is understood as solution rather than threat. To the contrary, such visibility reinforces the inherent problems of global health security evident in the 2014–16 Ebola outbreak that create and reproduce binaries of neglect and visibility, and hierarchies of the global health issues that matter, the people that matter and the women that matter. The article argues that the change in visibility, research and advocacy around gender equality during the COVID-19 outbreak does not demonstrate an advancement in gender equality in global health. The article then looks in detail at the research efforts, funding, epistemic community activism and impact of COVID-19 to explain why gender received high profile political attention and acknowledgment.
The article explores the question of neglect by drawing on original research into the 2014–16 Ebola outbreak in Sierra Leone, its aftermath and implications for future pandemic preparedness. This article explores why gender was neglected in previous health emergencies, what led to change in visibility of gender issues during the first six months of the COVID-19 pandemic, and the implications of such change for understanding the relationship between gender and global health security. COVID-19 had led to long overdue visibility of the gendered determinants and impacts of health emergencies and global health security.
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