The world will not reach the United Nations’ Sustainable Development Goal 5–global gender equality–until at least 2108, against the target year of 2030, per the Goalkeepers Report, 2022, released on September 12 by the Bill & Melinda Gates Foundation.
One explanation is that the global economic shock wrought by the Covid-19 pandemic disproportionately affected women’s livelihoods, said the report, which noted a 25% gender gap in labour force participation rates globally in 2022, in favour of men. The pandemic shock alone, however, is not enough to explain growing gender inequality, Melinda French Gates, co-chair of the Gates Foundation, told us in an interview.
Covid-19 has only exacerbated and highlighted existing inequities, said Gates, a philanthropist, businesswoman, computer scientist, economist, published author and global gender equality advocate. The pre-existing root causes of gender inequality, a key one being economic inequality, will have to be addressed in order to meet the global gender equity goal, she said.
What the data show in your report is not very encouraging. Is that frustrating for someone who comes from a business background and is used to seeing growth happening at a certain rate, given your investments over the past 22 years since you started the Gates Foundation? How did you feel as you wrote this report a few months ago, on the back of two years of the Covid-19 pandemic?
It’s a great question. There had been so much progress up until Covid-19 hit. Reduction in poverty, reduction in childhood deaths, reduction in malaria deaths, and more people getting HIV-AIDS treatment. I’ve seen that firsthand. I’ve been out in these places where [the foundation is] making a difference. So to see so many of these indicators have been set back feels almost like a gut punch.
But my real feeling is sadness, not for us as an organisation, but for the people whose lives are affected, for the person who wants HIV-AIDS treatment and it’s not available, or the woman wanting to deliver a baby during Covid-19 but doesn’t feel safe going to the healthcare clinic. Those numbers mark where we are, but they’re really stories of people’s lives. So for me, it was sadness that Covid-19 has not only affected people directly, it’s also had a lasting impact on people’s health. Also, the economic scarring that’s there, particularly when you visit countries on the continent of Africa, is profound.
You also said that even before Covid-19, things were not going in the right direction. Now that the data are being readjusted for Covid-19, what’s your sense?
Some things were going well, but [others] like gender inequality – I wrote about this – that’s not because of Covid-19. Yes, Covid-19 exacerbated it and made it worse, but it just took the problems we had and [placed] them right before us. It’s helped us and many of our partners realise that what we have to really work on are the root causes of gender inequality, that were already there before Covid-19. If we don’t get to those, we’re never going to make the progress we want on things like gender equality.
You’ve talked about treating the symptom and not the disease. Can you elaborate on that?
Take cash transfers during Covid-19. It’s absolutely fantastic that those social protections were there, whether it was in India or in the United States, or many other countries around the world. But we know that unless a woman actually has control over that cash, it doesn’t make the same difference to a family.
So countries that didn’t have gender data and digital wallets, unlike India, if they put cash out, quite often it went into the man’s hands and we don’t really know exactly how he spent it. But we know that where it’s targeted, goes into a woman’s bank account and she has the full decision-making authority over it, to decide who she spends it on, when she spends it, or does she save it, that’s working on a root cause. That’s where we need to go as an entire community.
You’ve talked about human ingenuity rising to the fore every time there’s a crisis. There are a lot of illustrations of why human ingenuity has worked very well in this pandemic. What can trigger human ingenuity on a more sustained basis to address the problems that you’ve talked about?
When I think about development, we didn’t have this tool called a digital cell phone 15 years ago. The difference it starts to make when a woman actually has such resources in her hands, it actually starts to change family norms. Women in India will tell you, ‘my mother-in-law looks at me differently’. Women around the world will say ‘my husband looks at me differently’, ‘my son looks at me differently when I can not just help pay the school fees, but help buy a bike to get him to school’.
So, when you get money in a woman’s hands, money is power. We often don’t want to talk about that, that it actually can change and unlock social norms. We also have to get women to a place where they’re not just recipients of policy, but actually have a seat at the table. Because when they have a seat at the table, they start to make the right policies on behalf of women and on behalf of families.
That seems to be a new, relatively different way of looking at it, moving from empowering to, as you wrote, full power.
It is. One of the things that I say about us as a foundation, I hope it’s true with me, is that we’re a learning institution. We all had a lot of time during Covid-19. I did lots of Zoom meetings, just like everybody else, but I had more time to just sit back and look at some of the data and to think about it and to watch what was happening. And I started to realise, why are we just talking about empowerment. It’s kind of a development jargon.
But money is power. Let’s talk about what we can really do. Some things in the United States are not going so well, partly because we don’t have more women in the Supreme Court and in our House of Representatives. I thought, until we get that done, we’re just going to see things move forward and then roll back. I grew up with a mother who said to me – she’s still alive, both parents are still alive and married – ‘set your own agenda, otherwise somebody else will’. And I thought, how many years have I got left to work on this stuff? I’m going to set the agenda: let’s put money in women’s hands, but make sure they have the decision-making authority over it.
Let’s talk about collectives for a moment and the power of collectives to achieve exactly the things that you mentioned. That’s an area that you’ve focused on a lot. How do you assess, broadly, where collectives stand today in terms of progress so far and then on what needs to be done?
Just for a minute, because words matter, take the difference between what we used to call them – self-help groups – and women’s empowerment collectives [now]. That’s a big, big shift. I’m a huge believer in these. It’s the Indian government that deserves credit. We’ve worked with NRLM [National Rural Livelihoods Mission] for a long time on self-help groups, but the government deserves a lot of credit for not only setting these up, but also collecting data. That was the piece we were involved with, how to collect the data to learn which groups are making progress.
But look at what happened during the pandemic, when the only tools we had early on were information on washing your hands and wearing a mask. Who was out giving that information? It was those women’s empowerment collectives. So there’s huge power in them. I’ve seen [women’s empowerment collectives] all over the world now, not just in India, but in multiple places in Africa. When women band together and start to save and start to talk about money and get financial literacy, that is hugely powerful.
When you sit and talk with the women, it’s all the other things they talk about, like ‘what’s really going on in your home’, or ‘how did you deal with this’. Women have told me, ‘look, just by showing up, all of a sudden, I matter. Nobody in the village knew my name and now all of a sudden, 10 other women know my name’. Women start to get their voice and start to say, ‘wait a minute, I deserve to get this’, or ‘I should expect more in my household’.
So there is an enormous power in the [collectives] in terms of women understanding their voices and gaining their full voice, but also learning financial literacy. One of the places that we’re going with this is, how do you start to build those groups so that the data collection is easier, and [women] can start to have more credit. Once they start to have credit, wow, then can start a business, put their money into their business. It makes a huge difference.
How are you thinking about accelerating women’s empowerment collectives from the top-down, policy point of view, and from bottom-up? You quoted some interesting bottom-up examples in childcare, such as how women could set up new things which actually empower their own communities and themselves.
I think both are important. You need a top-down, good policy that says these are the right ways we’ve learned to set these up, that they work, and what’s the organisational structure. It takes a budget, money from the government. But then the bottom-up is to let the women decide what they want to do with their own collective. They don’t all have to do the same thing.
I’ve seen some of them start with their rights. I’ve seen some of them start with getting clean water in their village, or cleaning up sanitation because too many kids were dying of diarrhoea. So let them start and then just keep bringing in bits of information and let them organically grow where they see the need in their community, and they will systematically start to tackle the different issues in an order that they see as important.
Let’s say there are these problems, for instance sanitation, that you mentioned. From a top-down point of view, do you wait for something to happen, for collectives to form, or is there some gentle intervention that you can do?
I think top-down, you can make sure that the collectives are starting to form and then bottom-up, you can insert information. It’s a learning journey for these women. So teaching them about their rights, teaching them how other villages went about getting clean water, seeing what they know about family planning and how interested they are in that. So bringing information to them, but then letting them decide, I think that’s a huge part of this.
The role of technology has become much bigger than any of us could have thought of even a few years ago. How do you see that playing out, including in the context of financial inclusion?
Technology is a tool we didn’t have 15 years ago. I happened to be out in Kenya just a couple of years after they rolled out M-Pesa, which was really the first mobile money on the continent of Africa. I have seen the transformation of so many countries, in terms of people being able to get some economic means by saving, and then when there’s a health shock, they have the savings for health, or for school fees.
I think that cell phones give us opportunities that are going to be powerful that we don’t even realise yet. Like we see kids starting to learn different languages on their phone, or getting some form of education on that phone during Covid-19. The cell phone can unlock [so much]. Think about it. So many women aren’t even on registries, but they’re part of a collective, you get them registered, you get them an ID, [with a cell phone] they can have their own [savings] account, they start to save money and build up credit. And we know when women put money into their own businesses, they’re getting a higher profit than they would otherwise. We saw that in Uganda during the pandemic. So I think [cell phones] can be huge.
You’re announcing a $200 million investment into digital public infrastructure (as part of $1.27 billion in health and development commitments). Is that linked to what you’ve just said?
It is, because I think the lessons that are learned in certain countries, particularly some of the lessons in India, about how do you get the regulatory environment so [digital] accounts are safe for people to use, a lot of that is transferable knowledge. Other countries are asking for it. But instead of them all having to fly to India to learn, how do you spread those lessons so that other countries can move more quickly? So yes, that’s definitely part of that.
How do you see the next round of investments going into areas like HIV-AIDS, where in the past you warned that despite having achieved much success, we are now slackening. What are the lessons we could take away for Covid-like diseases?
I think some of the lessons that we’ve learned are, first of all, you need a global [health] surveillance system. We would not have had a worldwide pandemic if we had built a global surveillance system. We have elements in different places, but these need to be networked and connected. And then you need a strike force that can go into an area and say ‘let’s cordon it off, clean it up, make sure we do all the right things’. So that’s a huge lesson coming out of Covid-19.
The other lessons coming out of Covid-19 are that institutions like the Global Fund work and so continue to invest in them. I mean, 44 million people are alive because of the Global Fund. People in South Africa still got their HIV-AIDS treatment [during Covid-19]. There had to be some switches pretty quickly to make sure that [patients] knew where to come, that it was safe, that there was social distancing. Again, it’s the global architecture that makes the world get better faster, as opposed to each country, one at a time, having to learn the lessons.
When you started the foundation, the inspiration seemed to be how to reduce the number of preventable deaths for children under five. That seems to be the one metric where you’ve had maximum success. How do you look at the priorities that you’ve stacked up, versus the one big success? And any thoughts going forward?
We started with all lives have equal value and we wanted to work on health inequities. We certainly started with childhood deaths but we very quickly knew we also wanted to work on adult deaths. We felt like we needed to get good at something as a foundation first, and we just keep refining what we do on childhood health. But it’s allowed us to take the lessons that we’ve learned about how to collect data, what interventions work, how to work with partners, and how difficult the last mile is, to adult diseases like HIV-AIDS, or both childhood and adult diseases like malaria.
Then we also started to say we want to help people with their lives and livelihoods. It’s not enough to start life healthy, you also need to grow up in a healthy way, which means working on the agriculture system and good nutrition, and then having some economic means. So I would still say the under-five deaths is our biggest win as a foundation. But I would also say the contributions we’ve made in the deep work with the Global Fund around malaria, or HIV-AIDS treatments, is work that I’m incredibly proud of.
Last question. In the year ahead, what are the metrics that you’re going to be tracking more closely than anything else?
Really tracking childhood and malaria deaths still, for sure. But also gender equality, looking around the world at what’s going on in different countries. For me, that’s a huge priority.
This article first appeared on IndiaSpend, a data-driven and public-interest journalism non-profit.