A call for urgent action:
a renewed commitment to gender responsive research
for health equity and human rights in the context of COVID-19 pandemic
GENEVA, 17 APRIL 2020 – On the 11th March 2020, the World Health Organization (WHO) declared the outbreak of the novel coronavirus (COVID-19) a pandemic. Only four months into the unprecedented global health crisis, we have witnessed the spread of COVID-19 to nearly every corner of the world. The rapidly changing geography of the pandemic has uncovered many challenges that the global community is learning to address.
Our governments and communities have directed response efforts at saving lives and preventing further spread. The global research community has responded with an unprecedented speed in advancing knowledge about the virus and pressing to develop diagnostics, therapeutics and vaccines. These efforts while critical and welcome must account for gender and its intersections with other social markers in order to understand the equity and human rights implications of COVID-19. In the urgency to generate evidence and discover preventive or therapeutic tools to curb the pandemics, we cannot compromise the standard of rigorous and robust research. The emerging body of literature on COVID-19 illustrates that sex and gender across life course are generally being disregarded, despite evidence showing they play a significant role in shaping risks of illness, death or other harms, restricting better understanding of the disease and its impact on lives and livelihoods.
Although attention to the gendered social, economic, and human rights repercussions as well as other health impacts, which deem to be harsh and long-lasting, is growing, evidence on these indicators has so far been scarcely available. This would be necessary to inform mitigation strategies and ensure that all people regardless of gender, age, ethnicity, socioeconomic status, nationality, sexual orientation, gender identity, migratory or any other status have equitable access to testing, quality respectful treatment, social and economic support measures to minimise the damaging consequences.
We have a collective responsibility to shape the trajectory of our present and future efforts to fight global pandemics. With this in mind, GENDRO calls to promote generation of gender-sensitive evidence and forms of knowledge to create more equitable solutions to mitigate the multiple impacts of COVID-19 on women, men and gender diverse persons across all sectors and layers of society. GENDRO welcomes everyone interested in the subject to join our call for action and maintain the momentum to appeal all those involved directly and indirectly in COVID-19 response to act urgently and responsibly:
1. Sex- and age-disaggregated data on COVID-19 must be systematically collected and reported and research must be designed and conducted in a way to allow meaningful gender analysis of safety, efficacy and effectiveness of diagnosis tools, drug or vaccine candidates.
Evidence to date points to gender and age differences in terms of susceptibility and vulnerability to infection, disease progression and outcome. Yet, reported data on incidence, prevalence, symptoms, testing, hospitalisation, ICU care, discharge, recovery or mortality are not systematically provided, nor broken down by sex and age, thus hamper a better understanding of disease and effective policy and programmatic efforts. Our knowledge about the gender and age breakdown of the growing number of infected health workers remains also limited. Furthermore, any ongoing health research, including but not limited to preclinical studies and clinical trials, must be designed to adequately capture sex and gender differences in different age groups and examine the gender implications. Recruitment strategies for trials will need to ensure gender balance of participants to make such analysis feasible.
2. Data analysis and research on social, economic and human rights impact of COVID-19 must systematically consider gender and other dimensions of inequality.
Data collected on access to quality, affordable and equitable healthcare, or on the impact of the quarantine measures on employment rates, gender-based violence, mental health, access to other essential services e.g., sexual and reproductive health services, financial support measures, social protection measures, human rights, or any other indicators must be gender sensitive and be disaggregated by sex and age, as a minimum, to allow for identification of gender and other disparities and devise more equitable mitigation strategies. Ideally, data should also be stratified by other dimensions of inequality, such as ethnicity, refugee status, gender identity, sexual orientation, and disability to identify and address other inequities. Research on social, economic and human rights implications of COVID-19 must equally apply an intersectional gender lens to account for the differential impact of the epidemic of all genders across different layers of the society. Dedicated research must also be carried out to understand the implications on underserved and populations that are underrepresented in research.
3. Peer-reviewed publications of COVID-19 related research must present all data disaggregated by sex and age and articulate other gender considerations.
Editors of scientific journals must require authors submitting research and analysis related to COVID-19 to provide all data (for example, data on recruitment, enrolment, dropouts, retention, completion, adverse effects and all outcomes in clinical trials) disaggregated by sex and age, as a minimum, as suggested by the Sex and Gender Equity in Research (SAGER) guidelines. The fully disaggregated data could be published as part of the article or as supplementary material easily accessible online. Policy research and other research in social, political, economic, and data sciences must report how gender and its intersection with other social markers have been accounted for. All authors should be encouraged to analyse and report any gender implications and justify lack of any such analysis.
4. Research funding agencies and ethics committees must be diligent in ensuring a gender sensitive approach to research.
As key gatekeepers in the research ecosystem, research funding agencies and research ethics committees play an instrumental role in ensuring rigorous and ethical research that benefits all. Hence, they need to continuously emphasise the importance of integration of gender and age dimensions in any research related to COVID-19 and encourage consideration of other important dimensions in research proposals and protocols.
GENDRO continues to observe and monitor publications that address the gendered implications of COVID-19 and we share these on our social media and our website. GENDRO encourages information exchange among and beyond GENDRO’s Gender, Evidence and Health Network. We must be cautious of premature and misleading information and gender-blind interpretations. We must be vigilant that research and analysis are transparent, complete and accessible in a timely fashion to allow for critical examination and scrutiny of information. Now as never before we need robust research and data to address the pressing global health challenges.
Endorsements to date...
Independent Bioethics Advisor
Value for Women
Faculty of Law, University of Copenhagen
University of Oxford
AFPDE DR CONGO
University of the Philippines Los Baños
Maltepe University (Turkey), Center for Women and Family Studies
Centre for Women's Development Studies
International Federation of Physician Assistant/Physician Associate and Clinical Officer/Clinical Associate/Comparable Students’ Association (IFPACS)
University of Victoria
EquiACT, independent consultancy
Nicolaus Copernicus University in Torun
KPMG - International Development Advisory Services (IDAS)
Unity health toronto
The George Institute for Global Health
Global Health Centre, IHEID
Bhartiya Skill Development University
Ludwig Maximilian University
Open University of Catalonia
Istituto Superiore di Sanità
University of Toronto
Positive Council Switzerland
Institute of Applied Economic Research, Brazil
Full Professor of Public Health
Imperial College London
University of Southern Denmark
Global Strategy Lab
The George Institute for Global Health, India
The George Institute for Global Health
University of Southern Denmark
Men's Health Forum (GB)
CIHR Institute of Gender and Health
Professor of Public and Population Health, Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal
London School of Hygiene and Tropical Medicine
Chief Technical Officer What Works Association USA
The George Institute for Global Health, University of Oxford
University of Calgary
Institut Pasteur de Montevideo
Radboud University, Nijmegen, NL
Johns Hopkins Bloomberg School of Public Health
Amsterdam UMC dept Medical Humanities
REPRODUCTIVE HEALTH SUPPLIES COALITION
INSTITUTO NACIONAL MATERNO PERINATAL AND UNIVERSIDAD PERUANA CAYETANO HEREDIA, LIMA PERU
Professor of Preventive Medicine and Public Health, University of Alicante, Spain
Medwave; Universidad de Santiago de Chile (USACH)
Director, Global Action on Men's Health
Scientific Director, Institute of Gender and Health, Canadian Institutes of Health Research
Karolinska Institutet, Sweden