Removing sex and gender bias to improve care, starting with COVID-19

Tackling gender inequalities and noncommunicable diseases – a call for win-win ideas

The COVID-19 pandemic has deepened gender fault lines in our societies, and increased women’s exposure to the drivers of chronic diseases. As we mark International Women’s Day on 8 March, the NCD Lab on Women and Girls is reaching out for solutions.

Life in lockdown - the global impacts for women

I dash up the stairs for another work call, after a fraught hour spent trying to explain how to divide fractions to my son. I tiptoe past my daughters’ bedroom doors, knowing that if they hear me, I will find myself fielding questions about gravity, Macbeth, why the WiFi has dropped out again and ‘When’s lunch?’, while the messages in my inbox continue to mount exponentially...

Thankfully, by the time you read this, life will have changed. Today (8 March) is not only International Women’s Day, but the day that schools in England reopen after the latest two-month closure. This coincidence in date may not have been front of mind for the UK Government, but it won’t be lost on millions of mothers who – despite unprecedented efforts by some fathers - have in general been bearing the brunt of home schooling and additional housework during the lockdown.

However, while mothers in England breathe a heartfelt sigh of relief, lockdowns and school closures continue in COVID-ravaged countries around the world. The result, for too many women, is not just greater burdens of care (for older family members as well as for children), but a host of other impacts, including lost livelihoods, food insecurity, restricted movement and elevated levels of gender-based violence. All have significant implications for women’s physical and mental health.

NCD drivers and gender - the pandemic effect

The leading causes of death and disability among women globally are noncommunicable diseases (NCDs), including cardiovascular disease, cancer, chronic respiratory disease and diabetes. The impacts of the pandemic on key drivers of NCDs – including unhealthy diets, physical inactivity, tobacco use and the harmful use of alcohol – are still playing out, and are affecting women in many different ways; particularly women experiencing poverty and marginalisation, and who face power imbalances rooted not only in gender, but in race, ethnicity, age and other factors.

For example, a lack of access to healthy food or the refrigeration needed to store it during lockdowns, coupled with an increased reliance on food parcels or support from food banks that provide poor nutritional quality, may have led to changed eating behaviours and weight gain, particularly in women. Being overweight or obese is a major risk factor for NCDs, and one that already affects more women than men in low- and middle-income countries.

COVID-19-related lockdowns have also seen levels of physical activity sink in many contexts and sedentary behaviour soar, with women hardest hit; they may be unable to exercise as a result of increased caring responsibilities, and more affected by the suspension of group activities such as exercise classes. This lack of physical activity has a knock-on effect on mental health: women exercising less due to COVID-19 report lower social, emotional and psychological well-being, and higher generalized anxiety.

Data suggests levels of smoking and alcohol consumption have also risen as a result of the pandemic, with increased drinking among women more pronounced. Some alcohol companies have exploited the pandemic to target women, by associating their brands with gender equity campaigns. For example, AB InBev – the company behind brands including Budweiser - launched a WhatsApp helpline in South Africa in response to a sharp rise in gender-based violence during national lockdown.

Solutions needed – innovators please apply

Well before the world had heard of COVID-19, progress towards Sustainable Development Goal (SDG) target 3.4 – a third reduction by 2030 in the probability of dying from an NCD between 30 and 70 years of age – was already off track; just 17 of 176 countries are expected to achieve this target in women. With the pandemic serving to deepen inequalities along gender, race and other lines, this is the perfect time to launch a new initiative seeking solutions to the challenges of NCDs and mental health conditions that will also address gender power imbalances.

The NCD Lab on Women and Girls, which The George Institute for Global Health co-chairs with the World Health Organization (WHO), is a virtual platform that aims to accelerate progress towards achieving the NCD and NCD-related SDGs. We and our expert Steering Group are looking for innovative submissions that promote gender equity and recognize and address the role of gender in the determinants and impacts of NCDs, as well as the links between NCDs and gender inequalities and how these reinforce each other.

“This exciting initiative has the potential to boost our impact by addressing a range of NCD challenges at country level, including their risk factors and determinants,” says Dr Svetlana Akselrod, Director of the Global NCD Platform at WHO. “We have brought together key stakeholders across many different sectors to guide and review the successful submissions, targeting change at the individual, policy or systems level.”

The first cycle of the Lab is now open, and any individual or group of individuals can make a submission. This might be an ongoing research project, an advocacy campaign, or a community-based intervention. Your idea might focus on health promotion, behavioural science or policy development. It might be a digital health product, or an educational training programme. It might be none of the above, but we’d still like to hear about it! Please check out the Terms of Reference to understand the selection criteria. A shortlist of 10-20 submissions will be created, and the winner will be announced in May 2021. All shortlisted submissions, including the winner, will be highlighted on the WHO Knowledge Action Portal.

The first cycle of the NCD Lab closes on 8 April 2021, and we’re looking forward to seeing what you come up with. By that time, I may even have cleared my inbox…


This blog was first published by the NCD Alliance and is cross-posted here with their kind permission.