Gender-based Violence, Unhealthy Diets & Climate Need Greater Focus In Light Of COVID-19 Pandemic – WHO Member States
Activism against Gender-Based Violence at the National University of Lao, Dong Dok campus. During the pandemic, violence against women had increased by 25% as early as April in countries with formal reporting systems in place.

WHO needs to focus more work on limiting gender-based violence, increase its programmatic emphasis on healthy diets and lifestyles, and contribute to renewed momentum on climate action, said WHO member states at Friday’s Executive Board session.

The member states were reviewing the WHO Director General’s report on “social determinants of health” – in light of the added health impacts of the ongoing global COVID-19 pandemic.

Social determinants of health is a broad umbrella term referring to a range of socio-economic and environmental drivers that can help prevent diseases from ever occurring – or conversely accelerate more disease if neglected. They range from poverty, which can foster more communal violence and addictions, to unhealthy diets leading to malnutrition and obesity, or air pollution that contributes to the development of cardiovascular and respiratory diseases as well as cancers.

COVID-19’s Gender Gap

Amid mounting evidence that the social and economic toll of the COVID-19 pandemic is to being disproportionately paid by women, member states flagged WHO’s need to do more to assist countries’ attempts to limit gender-based violence and discrimination, WHO member states suggested.

A delegate from Kenya highlighted “increased teenage pregnancies, gender-based violence and substance abuse” as results of pandemic related lock-downs and economic stagnation. He called on WHO for an inter-agency plan to support its Member States, as they struggle to mitigate the “severe social shocks of the pandemic”.

A United Nations report, published as early in the pandemic, highlighted that “many women are being forced to ‘lock down’ at home with their abusers” even as support services typically available for victims continue to be “disrupted or made inaccessible”.

That same report flagged that violence against women had increased by 25% in countries with formal reporting systems in place.

Beyond gender-based abuse, the pandemic-related gender impacts also are evident in the greater difficulties when have had accessing healthcare. And the pandemic has exacerbated pre-existing employment inequalities, member states reflected.

“Gender is a key social determinant of health given the impact of gender roles, norms and behaviours, on how people access health services and information,” a delegate from the United Kingdom said. Similarly, gender also determines how health systems respond to individual patients.

With regards to the pandemic, as such, the WHO report staed that the Organization is developing advocacy and engaging with other UN agencies and actors on “on human rights-based approaches” to gender and COVID-19- although it didn’t provide further details.

The report also notes that internally at WHO: “The Gender, Equity and Human Rights team at headquarters and the regional office network are spearheading efforts to mainstream gender issues across the Organization.” In other comments this past week to the EB, Dr Tedros Adhanom Ghebreyesus has noted that while WHO has gender parity among the ranks os its senior management – but male professionals still well outnumber women in certain WHO regional  and country offices – with the most imbalance in the African region.

Diet and Nutrition

During the board meeting, the UK also flagged diet and nutrition as key social determinants: topics scarcely mentioned in the WHO report.

“Healthy diets and malnutrition are an important element of determinants of health,” the delegate said.  “Action is needed to address unhealthy diets and malnutrition in all its forms.”

The WHO report refers to nutrition only vaguely, listing “food insecurity” alongside “poor-quality housing … insecure employment, and poorly regulated care for the elderly” as “examples of social determinants with devastating impacts on individuals and communities affected by COVID-19”.  However, a growing body of evidence, including other recent WHO reports, point to the double burden many low-and middle-income countries are now seeing from undernutrition and malnutrition- the latter related to an over reliance of fast-urbanizing communities on fast or processed foods, cheap starches, and sugar-  and fat-heavy diets.

Despite arguments that addressing diet would help to improve health outcomes and prevent future pandemics, the WHO report on social determinants of health scarcely mentioned nutrition.

Those forms of malnutrition – leading to micronutrient deficiencies as well as to obesity –  are responsible for a significant portion of the Global Burden of Disease, the UK delegate said.  He reminded the EB that “obesity has shown to significantly increase the severity of COVID-19”.

Meaningfully addressing poor diet, the UK argued, would help to improve health outcomes and enter future pandemics better prepared.

The Climate Crisis & Biodiversity

In the decade before the pandemic, awareness of the health impacts of climate change and loss of biological diversity were growing global health concerns, including at WHO. But the sudden and overwhelming emergence of SARS-CoV-2, however, has meant climate-related health policy has mostly been left to stagnate, some delegates observed.

Pedestrians in Bangladesh cover their faces to keep from breathing in dust and smog. Despite significant advancements before the pandemic, environmental health has largely taken a back seat in policymaking.

While there have been a few significant steps made since the first COVID-19 death — such as the UN including climate measures on its Human Development Report, or the UK registering the first death due to air pollution — there is evidence that the pandemic has led national health ministers to push  environmental health risks to the background of their agendas.

This is despite the fact that environmental risks, notably from air pollution, also contribute directly to more chronic cardiovascular and respiratory health conditions, and thus more COVID-related deaths.

The WHO report acknowledges this, indirectly, stating that “increasing urbanization and climate change risk [as] entrenching existing inequalities and further widening the gap in health outcomes”.

However, delegates noted that more attention needs to be given to the routes by which climate change, biodiversity loss and urbanization are contributing to ill health during the pandemic – as well as increasing future pandemic risks.

In the case of SARS-CoV2, for instance, while the exact route by which the virus reached Wuhan and its seafood market where the first human clusters of infection appeared, most scientists agree that the virus hails from a bat coronavirus that leaped the species barrier. In the past, that has happened when wild animals are hunted, captured, caged, transported and sold alive in crowded urban food markets across Asia.

Similar leaps of animal diseases to humans have led to the rise of Ebola and HIV in Africa, where the capture and consumption of  wild animals as “bushmeat” is a traditional practice that became even more common in conditions of conflict and food insecurity, where wildlife areas also are more vulnerable to poaching and plunder by black marketeers.

“The [COVID-19] crisis we are facing is not only a health crisis, but also a social and economic crisis,” the Austrian delegate told the board. But, vitally, she added that “it cannot be fully understood without considering the ongoing ecological crisis.”

“The poorest and most vulnerable have been disproportionately hit,” she said, “and further action to foster health equity and moving beyond the health sector is urgently needed.”

This was also underlined by the UK delegate, who stated it “will also welcome more attention on to the impact of climate change both on people’s health and on national health systems”.

Image Credits: DANHO/Daniel Hodgso, Sven Petersen/Flickr, Rashed Shumon.

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