A view of a meeting with the World Health Organization staff in Geneva, Switzerland. Photo by: Jean-Marc Ferré / United Nations

The three remaining candidates vying for leadership of the World Health Organization have all expressed interest in achieving gender parity at the U.N. aid agency, but the question remains: How can they reach that goal when men dominate in most regional offices, in higher positions, and in the applicant pool?

Devex asked the prospective director-generals what concrete policies they would implement to improve the gender balance and how important they consider the issue.

The only female candidate in the running, Sania Nishtar of Pakistan, said it would be an immediate priority from day one as she undertakes the task of appointing individuals to senior management positions. She would review the WHO’s current policies, looking at how the aid agency carries out promotions, performance incentives and evaluation, to ensure staff aren’t subjected to any form of discrimination.

Addressing the gender and geographic disparities at the WHO is part of her manifesto, said Nishtar.

The U.K.’s David Nabarro, the only European candidate left in the race, said every organization addressing health issues should strive to be “feminist,” and that he would like to see equal numbers of men and women among WHO staff, including in senior positions. He stopped short, however, of detailing how he plans to achieve that.

Meanwhile, the race’s frontrunner, Tedros Ghebreyesus of Ethiopia, said he would “intensify” the full implementation of the WHO’s commitments to gender parity, including achieving, at a minimum, a 1.5 percent annual increase in women occupying professional and higher-level categories at the aid agency in the next five years. In addition, he said he would ensure WHO practices are “gender sensitive,” that there are flexible working arrangements for female staff and that female entry level staff advance into leadership positions at “comparable rates to their male counterparts.”

“Despite WHO’s commitment for gender equality in staffing since 1997, the number of WHO female staff in the professional and higher categories was only 38 percent by the end of 2015,” Tedros said. “This is not acceptable and it has to change.”

The problem is even more complicated than that figure belies.

Devex digged into the numbers in the WHO’s latest human resources report, which covered data up to July 2016. As the length of short-term contracts can be unpredictable, Devex only looked at data available for staff holding long-term appointments across grade levels and across WHO offices, except for the Pan American Health Organization, whose human resource information is not included in the report.

Gender breakdown among WHO staff across offices. Click here to view a larger version.

The data reveal stark disparities in gender breakdown among WHO staff across offices and across grade levels. While headquarters, Europe and Western Pacific all have more women than men across offices, the imbalance is so extreme in some regions that it tips the scales for the entire organization. Overall, there are 3,285 men and 2,952 women holding long-term contracts at WHO as of July 2016.    

The biggest disparity in gender breakdown is in Africa. Only 32.41 percent of the 2,157 positions in the region are occupied by women. This imbalance cuts across grade levels in the region: 787 men versus 416 women in general services; 421 men versus 187 women among national professionals; and 250 men versus 96 women in professional categories and director level positions.

But this is not limited to WHO’s African region. Across grade levels in Southeast Asia and the Eastern Mediterranean region, there are more men than women WHO staff.

Gender breakdown among WHO staff across grade levels. Click here to view a larger version.

Cornelia Griss, HR specialist for WHO in Geneva, said a number of factors — including demographics — may explain why women continue to lag behind men among WHO staff.

The bulk of WHO’s workforce are in their 40s and 50s. In the professional and higher category, for example, 80 percent of staff fall within this age range. What this means, Griss said, is that a large percentage of WHO’s workforce came from an era when more men were entering the workforce than women. But while there has been some progress over the years, the imbalance remains. There are still fewer women applying for jobs at WHO. In the first seven months of last year, just 34.4 percent of applicants across the organization were women.

The difference is particularly stark in Africa. Out of 10,414 job applications that the WHO received from the region as of the end of July 2016, only 2,183, or 21 percent, were women. Griss argued that if one were to look carefully, the number of women in the workforce is already relatively high given the low percentage of applicants.

WHO staff applications in the professional and higher categories. Click here to view a larger version. Source: WHO human resources data as of July 31, 2016

Evidence is sparse to explain this phenomenon, but the wider perception has been that women in general still encounter obstacles in terms of educational access and work opportunities, particularly in resource-poor countries. On the International Day of Women and Girls in Science, U.N. Secretary-General António Guterres called for “greater investments” in STEM education for women and girls and opportunities for their professional career advancement.

Griss said there are instances when advertised vacancies are in areas where there’s not a huge pool of women with expertise, such as engineering or information technology.

A 2014 study published in Academic Medicine also identified reasons such as gender biases at work, safety issues, and competing family and career responsibilities as obstacles to women advancing in leadership positions in global health.

“I don't have any concrete evidence on why this is happening,” Kelly Thompson, program specialist at Women in Global Health, told Devex. “But I would hypothesize that it is related to factors that are common across all employment sectors, such as women are generally less likely [to] apply for a position if they do not meet the qualifications 100 percent (whereas I think it's something like men apply at 60 percent), lack of mentors or women role models supporting and encouraging women to apply for positions at WHO, fear/feeling of inadequacies in being seen as a technical expert (and WHO is seen as much more technocratic than CSOs).”

In 2016, while working with an independent advisory group for the Global Fund to Fight AIDS, Tuberculosis and Malaria, Devex Senior Director and Editor for Careers and Recruitment Kate Warren found difficulties in attracting women to technical positions focused on malaria, tuberculosis and sustainable financing.

“It was a lot easier to find women HIV experts, I think because so much of prevention/treatment is done through ‘softer’ approaches like advocacy, awareness, etc.,” she said. “Malaria in particular is known to be a ‘boys club’ because the approach to control is so scientific.”

It would have been useful to have a breakdown of staff by gender and subject area to better understand if this were the case with WHO, but Devex was told such details are not yet available.

Griss assured that WHO is “trying to reach as many diversity targets at the same time as possible,” but admitted that in certain circumstances, the organization is not “always hitting all the boxes.”

Shortage of women in leadership roles

Gender breakdown among WHO staff at director-level positions. Click here to view a larger version.

At the most senior levels, women lag significantly far behind. Out of the 252 director-level positions — which include those in P6 and ungraded posts such as regional directors and assistant director-generals, but don’t include those under special programs — only 68 posts, or 27 percent, are filled by women. There are more male directors in each office than women directors, including at headquarters.

Griss acknowledged there is a significant gap in the number of women in senior management. In 2015, she noted, the agency set up an internal think tank group to explore how to meet the guidelines set out in the U.N. System-Wide Action Plan on gender equality and women empowerment, which included specific requirements and indicators for all U.N. agencies.

The group came up with a strategy and action plans that are specific to each region where the WHO works that Griss said is now in implementation phase. The action plans differ in each region as the organization recognizes potential challenges unique to each region or office. For example, it is particularly difficult to get women in WHO offices in the Eastern Mediterranean region where, given the emergency situation, several duty stations are designated not safe for family.

“You will know from other agencies, if you have non-family duty stations, it’s harder to go there for women than for men,” Griss said. “So if you recognize these differences, that in certain regions maybe there are more emergencies, there are more duty stations that are more difficult for families, then you may also understand why we have potentially less applicants from women for those particular duty stations.”

The actions plans, she said, cover this and other more specific questions on how the WHO can close the gap between men and women in senior management at the aid agency. The situation is almost the reverse at the junior level — where there are far more women than men.

“At the junior level you may have already seen we are already overrepresented with women that almost we have to ask the reverse question: how do we get more men into the lower levels because there we are overrepresented by women,” said the HR specialist. Asked why this surfeit of women fails to move up the ladder, Griss said she was unsure but that the agency was trying to study such questions across the board. The organization has tried to improve its policies around family and paid parental leave in recent years, allowing for flexible schedules and telework in certain positions, providing six months paid maternity leave and one month paternity leave, as well as leave for child care, adoption and family emergencies.

Devex requested copies of the action plans, but the director-general’s office has maintained they are “internal documents and cannot be shared,” according to Griss.

An incoming policy on retirement expected to be implemented across the U.N. system in 2018, however, is likely to add on challenges to boost the number of women in senior roles.

In 2014, all U.N. agencies implemented a new policy that extends the retirement age for incoming staff from 60 to 65 years old, but this policy is now expected to be extended to all staff by January 2018, unless current discussions would allow U.N. agencies to implement the policy at a later date.

WHO staff retirement projections. Click here to view a larger version. Source: WHO human resources data as of July 31, 2016

In any case, when the new policy comes into force, it will be difficult for the WHO to do succession planning. Current projections on staff retirement in the next four years will no longer be applicable, and if those positions are not vacated, the agency would not be able to take on new staff.

“Why this is an issue? [Because] then we would not know when people will retire anymore,” Griss said. “So if you want to do succession planning, it’s very difficult because you don’t know when people are leaving.”

The policy has implications not just on gender parity at WHO, but on WHO’s overall diversity efforts as well as internal planning. Vacancies usually offer the WHO an opportunity to review positions, whether they are still needed or if certain adjustments needed to be made in terms of position functions.

A pervasive problem in the sector

The problem of few women in senior management positions is not limited to WHO. It is a long-standing issue seen in U.N. agencies, governments and the private sector.

The United Nations itself has never has a woman secretary-general, although pressure for advocates last year during the elections led male candidates to brandish feminist leadership throughout the campaign, with some, including current U.N. chief Guterres, committing to appointing a female deputy secretary-general if elected.

Guterres has so far made good on his promise, and organizations such as the Women in Global Health are hoping the next leader of the WHO will embody the same feministic leadership, particularly in senior-level appointments.

But addressing the problem would require changes outside the WHO’s organizational structures, for example that more of its own member states support the rise of women.

In an article published in The Lancet in January, Women in Global Health Executive Director Roopa Dhatt and Thompson together with Ilona Kickbusch, who is director of the global health center at the Graduate Institute of International and Development Studies in Geneva, highlighted that in 2015, only 23 percent of member states’ chief delegates to the World Health Assembly are women.

“In the Eastern Mediterranean Region there has been a reduction in the proportion of Chief Delegates who are women, from 10% in 2005 to 5% in 2015. These trends are striking, particularly when contrasted with the fact that in some countries women make up 75% of the health workforce,” they said in the article.

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About the author

  • Jenny Lei Ravelo

    Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.