Less than a quarter of the 194 governments of the world sent delegations headed by women to the World Health Assembly this year, continuing a trend of a woman dominated sector, almost completely controlled by men.

The annual count by Women in Global Health, an organisation which campaigns for gender equal leadership, pay and better conditions for women health workers, showed a 3% decline on last year, and a continuing trend of decisions taken at the highest health body being largely made by men.

“Given 70% of health care workers, and 90% of frontline health care workers are women, this is an unacceptable downward trend”, said Dr Magda Robalo, Managing Director of Women in Global Health. “For every woman’s voice in health, there are three men making decisions for her”.

“What it means in practice, is the decisions taken will affect community health workers, nurses, doctors, public health workers, nearly all of whom are women, as they suffer disproportionate, unrecognized and unaddressed impacts in their working conditions. When men control decision making, expert committees and governance seats, programmes have outcomes which largely favour men and are not sensitive to women’s needs, resulting in better paid work and promotions going to men.”

Dr Robalo pointed out that the decisions also influence women health workers at a personal level, with lack of discussion and commitments around reducing work based violence, having enough infection control equipment available or ensuring personal protective equipment was made and purchased in women’s sizes.

“This alarming result is even more disappointing, given commitments from the World Health Organisation during the Generation Equality Forum just last year to promote and encourage gender parity in WHA delegations, WHO panels and advisory groups,” she said. “The World Health Assembly is the highest norm and standard setting body in global health, and as they are operationalised, decisions taken can influence working conditions or affect health workers for years.”

Women in Global Health have been conducting a Head of Delegation gender count since 2015 and have challenged all governments of the world to send women led delegations and have equal representation of women in delegations to the World Health Assembly 76 and its Executive Boards in Geneva in 2023.