The marginalised can not continue to be penalised for circumstances beyond their control.

The Wellbeing Foundation Africa joins Women in Global Health, and the World Health Organization member states and non-states in the timely and important discussions regarding the Pandemic Treaty this week. For the Treaty to strengthen pandemic prevention and responses, it must also recognise the consistent inequalities faced throughout COVID-19 and ensure equitability is highlighted. Gender equity in particular must be at the forefront of our post-pandemic rebuild. Creating a healthier, safer, and fairer world, means advocating for the most vulnerable through prioritizing human rights, gender mainstreaming, universal health system strengthening and improved funding mechanisms.  

As the 16 Days of Activism against Gender-Based Violence continues, we have seen first-hand how the pandemic increased the care workload, obstructed access to sexual and reproductive health services, and increased violence for women and girls primarily. Yet, women’s experiences and voices continue to be marginalised.

The WHO must promote gender parity and diversity in COVID-19 leadership. Women and girls in the Global South have been disproportionately impacted throughout the pandemic and this has penetrated into the healthcare system as well. Women make up 70% of the health workforce yet are still overlooked, with COVID-19 task forces globally only having 24% representation from women. Women must be participants in all stages of decision-making processes, and mainstream a gender perspective in the COVID-19 response and recovery. This extends to scientific advisor groups, panels and consultations as they have the first-hand experience to provide an insight that will design a resilient, accessible and quality care health system. This evidence-based policy making and advocacy, paired with enhanced data collection and analysis will enable better health and social outcomes to occur. 

These critical issues filter into establishing a human rights first approach. Equitable universality principles must be embodied throughout our future preparedness and response so that we can properly assess and provide support to infection and incidence. This includes collaboration with human rights and civil society groups in preparedness, as they are at the frontlines bearing the brunt of the epidemic lifecycle on the most vulnerable groups. A well-assessed treaty will improve human rights obligations while augmenting the existing international human rights law and standards. 

Currently, fewer than 6% of people in the African continent have been fully vaccinated against COVID-19, with health workers and vulnerable populations still waiting for their first dose. This is due to a lack of funding and inequitable access, which plays a critical role in the surveillance of emergent variants. We cannot ignore the hardest hit and most vulnerable populations during a public health emergency. Funding mechanisms must be expanded to reach low-income countries, possibly with a system in place for high-income countries to support low-income countries in an accountable manner. By the end of 2022, over 12 billion doses of vaccines will have been produced, enough to vaccinate the entire world, yet we still face such low-rates due to accessibility and information access issues in the Global South. 

We are exhibiting first-hand the global inequality that has led to a grossly uneven distribution of vaccines, vital healthcare tools and PPE which has made fragile health systems crumble throughout developing nations. To tackle this, the Treaty must commit to sharing knowledge, data, information, and resources to create a worldwide health system that is ready to respond to the next pandemic. This One Health approach will foster trust and accountability, allowing pandemic preparedness to become standard. 

Of all Wellbeing Africa Foundation programming across Nigeria, the 2 programs that were most prophetic of the skills and capacities needed to combat COVID-19 during the restrictions of socially distanced physical lockdowns, were the organic introduction of Mamacare360 and MaternalMonday Whatsapp Groups to continue the conversations in our Mamacare360 antenatal and post-natal classes, along with WASH For Wellbeing program, teaching clean hygiene to mothers and medical workers in HCF, and its counterpart Primary and Adolescent PSHE-WASH in Schools.

These focused platforms were initiated in April 2018, as responsive commitments to both the UN Secretary General’s call for improved WASH, the WHO Resolution on Hygiene in Health Care Facilities, and the WBFA stark finding that only 22% of Delivery Rooms in Nigeria had direct access to a basin, soap, and clean water. As Covid-19 appeared, WBFA was positioned in 670 communities, to ramp up the key learnings for social behavioural change, right in the communities and households, schools and marketplaces where trusted learning needed to reach.

The Wellbeing Foundation Africa continues in its quest to develop a concrete Nigerian-wide public health informed approach that looks at the factors and responds with key actions for individual women, children, their families and the schools and health facilities within their communities in which they live that make it more or less likely that vulnerability and adversity in childhood has a lasting impact on their lives. A holistic inclusive approach, that takes the community midwifery approach further into a school nurse-visitor information, education and learning approach, and a reporting index will address inequality and the broader causes of vulnerability which might otherwise be overlooked to support decision-making and prioritisation.

The Wellbeing Foundation Africa is leading a Call-To-Action for: Implementation of Gender Mainstreaming Strategy: Vaccine Equity; Funding Stronger Healthcare Systems and Consistent Respect for Human Rights. Universal Health Coverage must be assessed by the states in Nigeria as primary health services should be accessible to all during all health crises. 

Women health workers are our global health security, they deserve better, they need better pay and leadership opportunities. As the pandemic persists they continue to be mentally exhausted and undervalued. 

For this Treaty to produce viable outcomes, it must recognize that our global health emergency responses cannot be constructed on the most vulnerable and marginalized women. It is clear that an equity-first approach will be needed to tackle these severe disparities, and those with a voice must advocate for that equity so that we may rebuild and re-envision a stronger healthier world.