A Call to Action: Women’s Health and Gender Equality

Lead Authors: Janet Fleischman, senior associate, CSIS Global Health Policy Center; J. Stephen Morrison senior vice president and director, CSIS Global Health Policy Center.

Signatories: Katherine Bliss, senior fellow at the CSIS Global Health Policy Center; Admiral (ret.) Raquel Bono, former head of the Defense Health Agency; Ambassador Johnnie Carson, former assistant secretary of state for African affairs; Charlie Dent, former congressman (R-PA); Roopa Dhatt, executive director of Women in Global Health; Mark Dybul, former head of the President’s Emergency Plan for Aids Relief (PEPFAR) and the Global Fund; Patrick Fine, CEO of FHI 360; Jendayi Frazer, former U.S. assistant secretary of state for African affairs; Bill Frist, former senator (R-TN) and former senate majority leader; Helene Gayle, president and CEO of the Chicago Community Trust; Julie Gerberding, co-chair of the CSIS Commission on Strengthening America’s Health Security and former CDC director; Mike Gerson, Washington Post columnist; Margaret “Peggy" Hamburg, former commissioner of the U.S. Food and Drug Administration; Carrie Hessler-Radelet, president and CEO of PCI and president of Global Communities; Karl Hofmann, president of PSI; Dana Hovig, director, Global Development and Population, the William and Flora Hewlett Foundation; Kathryn Kaufman, former managing director for global women’s issues at the Overseas Private Investment Corporation (OPIC); Vanessa Kerry, physician and CEO of Seed Global Health; Beverly Kirk, director, Smart Women Smart Power Initiative at CSIS; Jimmy Kolker, former assistant secretary for global affairs at the U.S. Department of Health and Human Services; Amy Lehr, director of CSIS Human Rights Initiative; Olivia Leland, founder and CEO, Co-Impact, the Rockefeller Foundation; Nancy Lindborg, president and CEO of the David and Lucile Packard Foundation; Florizelle (Florie) Liser, president and CEO, Corporate Council on Africa (CCA); Michelle Nunn, president and CEO of CARE USA; Rajiv J. Shah, president, the Rockefeller Foundation; Jeffrey L. Sturchio, chairman, Rabin Martin; Frances Townsend, former homeland security advisor to George W. Bush; Caitlin Welsh, director of the Global Food Security program at CSIS.

The results of the 2020 elections have brought the United States to a pivotal juncture. The Biden-Harris administration should capitalize on the window of opportunity of its first months in office to establish key pillars that will guide its tenure; a priority should be to reimagine U.S. global leadership on women’s health and gender equality. This will require Americans from diverse political persuasions to come together to promote a new vision and proactive strategy for the reinvention of the U.S. international agenda on these issues. With unprecedented domestic and global mobilization around women’s health and gender, this moment calls for decisive and inclusive action.

We represent a range of political views, but our engagement on women’s health and gender equality draws from a series of high-level activities organized by the CSIS Global Health Policy Center: the CSIS Commission on Strengthening America’s Global Health Security (2018–2022), the CSIS Women’s Health Policy Forum (2017–2020), and the CSIS Task Force on Women’s and Family Health (2015–2017). All these endeavors have shown that advancing women’s health and gender equality as fundamental rights is not only critical for global health and development, but also serves U.S. national security interests; in particular, this includes reaching long-standing U.S. goals on global health, poverty reduction, economic development, conflict prevention, and humanitarian response. Our purpose is to cut through the divisive partisanship and congressional deadlock to promote the renewal of a common sense, bipartisan approach to women’s and girls’ health, empowerment, and gender equality, building on points of continuity from prior Republican and Democratic administrations. Now is the time to bring people together, to look forward, and to rebuild consensus.

To meet this challenge, the new administration should adopt a signature focus on women’s health and gender equality as a fundamental pillar of U.S. foreign and development policies and programs. The time has come to restore U.S. leadership and capacity, repair frayed alliances around the world, and renew U.S. commitments to support a robust strategy to promote women’s health, development, and gender equality. This means adopting a new style of U.S. leadership, characterized by greater multilateralism and humility, learning from others and joining them as a supportive partner, and using U.S. power and influence to lift up and amplify voices from the Global South and women’s movements. To accomplish this, the new administration should adopt a bold approach to elevate this agenda and galvanize bipartisan support, while simultaneously reaching beyond Congress to forge a coalition that heightens the visibility of the private sector, health care providers, and the faith community to join with nongovernmental organizations and advocates for women’s and girls’ health and rights and gender equality. Such an approach would advance U.S. interests in saving lives while promoting prosperity and stability, and could help overcome the reluctance among more moderate voices in Congress.

We recognize that the new administration will be consumed with addressing the Covid-19 pandemic, its economic and social fallout, and vaccine distribution at home and abroad. Yet Covid-19 has dramatically revealed gender inequities around the world, signaling that the broader impact of Covid-19 cannot be tackled in isolation, but should be grounded in renewed U.S. leadership in promoting women’s global health and gender equality. Issues such as access to voluntary family planning, maternal health services, and vaccines to prevent cervical cancer, preventing gender-based violence and early marriage, promoting education for girls and economic empowerment for women—all of which have been seriously undermined by Covid-19 around the world—did not used to be seen through a partisan, political lens. This moment calls for a recommitment to this agenda across the political spectrum.

This will not be easy. The Biden-Harris administration will face unprecedented political and financial obstacles and transformed global and domestic landscapes. At home, the United States remains deeply divided on women’s health and gender-related issues, with many moderate voices silenced and bipartisan consensus eroded. Abroad, the United States has ceded its long-standing international leadership and impeded progress around issues related to women, girls, and gender equality. Moreover, U.S. government prestige, personnel, and programs across key agencies have been damaged and hollowed out, and trust in U.S. commitments has been shaken. The rising toll of the Covid-19 pandemic compels the new administration to examine how the coronavirus is exacerbating the health, economic, and safety risks that women and girls face around the world in ways that are expected to reverse decades of health and development gains.

Despite these challenges, a broad, bipartisan coalition in the United States supports access to women’s health services—from availability of a range of contraceptive methods, to maternal health care, to cervical and breast cancer screening, to STI and HIV prevention and treatment—as well as access to programs to support education for girls, to prevent and respond to gender-based violence, and to prevent child marriage. We should acknowledge that there are differing views on abortion rights, but there is much on which we can agree to promote gender equality. And there has been a history of bipartisan consensus that the best way to prevent abortion is to ensure access to voluntary family planning services and methods. We need to rely on evidence-based policies to guide health programs, not politicized responses. These stark realities cannot be met through piecemeal approaches, but rather demand a concerted U.S. strategy with high-level leadership.

This agenda should benefit from bipartisan consensus and should build upon progress made under prior Republican and Democratic administrations. This includes: the focus on preventing HIV in adolescent girls and young women through the President’s Emergency Plan for AIDS Relief (PEPFAR); the Trump administration’s work on women’s economic empowerment through the Women’s Global Development and Prosperity Initiative (W-GDP) and the bipartisan Women’s Entrepreneurship and Economic Empowerment Act; the Trump and Obama administrations’ strategies on Women, Peace and Security, which recognize the roles women play in conflict prevention and post-conflict stability, and include the protection of women’s and girls’ human rights and safety from violence and abuse; and the bipartisan congressional support that has ensured that U.S. bilateral funding for international family planning has remained remarkably stable.

In its first 100 days, the Biden-Harris administration should establish high-level U.S. leadership on global women’s health and gender equality, charged with developing a new U.S. strategy, in coordination with the U.S. Agency for International Development (USAID), the State Department, and other relevant agencies. To garner bipartisan public and congressional support, this will mean reaching across the aisle and building on platforms for renewal. At the same time, the administration should signal its commitment to this agenda with concrete actions: prioritize women and girls and gender equality in the global response to Covid-19; restore U.S. diplomatic leadership to promote women’s health and gender equality in bilateral and multilateral programs, and to support voices from the Global South and women’s movements; champion robust funding for women’s health, economic empowerment and education for women and girls, and gender equality programs; and review and rescind policies that impede access to women’s health and gender equality, notably Protecting Life in Global Health Assistance (PLGHA), and any requirement to enforce PLGHA through existing grants, contracts, and cooperative agreements.

The advent of the Biden-Harris administration offers a unique opportunity to tone down the divisive rhetoric and to focus on the crucial task of advancing women’s health and gender equality as a strategic priority. U.S. leadership and investments, focusing on results and working with local, national, and global partners, would save lives, promote healthy families and communities, and advance a more peaceful and prosperous world.

Janet Fleischman is a senior associate at the CSIS Global Health Policy Center; J. Stephen Morrison is senior vice president and director of the CSIS Global Health Policy Center. The work of the CSIS Women’s Health Policy Forum has been made possible by the generous support of the William and Flora Hewlett Foundation.

Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

© 2021 by the Center for Strategic and International Studies. All rights reserved.

Janet Fleischman
Senior Associate (Non-resident), Global Health Policy Center