Podcast

Title: Power Of…

Episode Title: The Power of Feminist Civil Society: A Mexican Case of Gender Equitable Access to COVID-19 vaccines

Welcome to the Power Of…podcast, with host Johanna Riha, who works at the Gender and Health Hub at the United Nations University International Institute for Global Health in Malaysia. Johanna is passionate to stimulate conversation about critical, thought provoking, and contemporary content that aim to drive gender equality in global health. In today’s episode, she continues to focus on the power of feminist civil society. Two guests from Mexico join the conversation, Karla Berdichevsky Feldman, Director General of the National Centre for Gender Equity and Reproductive Health in Mexico and Raffaela Schiavon, an obstetrician and gynaecologist, as well as a feminist and public health expert with a long-standing commitment to political activism in reproductive health. In today’s discussion, Karla and Raffaela share their experience of how an effective partnership was formed between government and feminist civil society actors to ensure more gender equitable access to COVID-19 vaccines. Join Johanna, Karla, and Raffaela for this insightful conversation!

Johanna kicks off the episode by asking the guests to talk through how pregnant women were included in Mexico's national COVID-19 vaccination strategy and how an effective partnership formed between the Ministry of Health and feminist civil society actors was a critical driver in achieving this outcome. Karla begins by explaining that COVID-19 quickly became the leading cause of death for pregnant women in Mexico, unlike many other countries worldwide. A technical advisory group for COVID-19 vaccination was rapidly established to guide the national vaccination policy. At this juncture, where pregnant women were significantly at increased risk, it was important to bring in civil society and especially feminist women in this technical group, to inform how the policy can respond to the needs of pregnant women and be built with a gender-sensitive lens.

Raffaela goes on to explain how she was invited into the technical group and emphasises that Mexico has had a long history of collaboration between government and civil society. She explains how she contributed towards justifying the inclusion of pregnant women in the national COVID-19 vaccination strategy, both as a member of the Bioethical National Committee as well as a member of a civil society organisation. Raffaela points out that the lack of data at the beginning of the pandemic, about the safety and effectiveness of the COVID-19 vaccines in pregnant women, is part of a larger problem, namely the exclusion of pregnant women from phase two and phase three clinical trials. This larger problem means pregnant women are always left out of clinical trials and therefore automatically excluded from receiving the benefits of these trials. Instead, Raffaela makes the case for giving pregnant women the autonomy and the capacity to give informed consent to be included from the beginning in these clinical trials to increase both safety and effectiveness. Listen and learn the difference in viewing women as objects to protect, rather than subjects of rights who have their own choices.

Johanna then turns the conversation back to the partnership with feminist civil society and asks what lessons can be learnt from this experience, particularly to avoid tokenist inclusion of feminist groups. The guests reflect on how important it is to move away from simply filling quotas to ensuring the degree of participation and the quality of participation is evident in the process and the end result, especially from a gender equality point of view.

Johanna continues the conversation by asking how the national COVID-19 vaccination policy has been implemented. Karla and Raffaela discuss the challenges of acting with very limited information at the early stage, especially in recognising the national context is very different from USA and Europe—both in terms of the epidemiology of the virus and the impact on pregnant women, but also in terms of the types of vaccines that were available. They stressed the importance of not simply mimicking other countries but really developing contextually informed policies. Other challenges they raised included vaccine hesitancy not only from the population side but also from the healthcare provider, with many being not fully convinced to recommend vaccination despite the epidemiological evidence of the benefits.

Karla then gives a very powerful example of how the pandemic has reinfored siloed approaches to women’s health, lacking a gender, human, and sexual rights perspective, which feminist civil society often brings. The guests call for the development of policies that consider the broader social context and impact of women’s health.

As the episode draws to a close, they discuss where things currently stand, the next steps looking to the future, and how they are seeking to evolve. Don’t miss the importance of the critical role feminist civil society actors are and can play in shaping better health policies to advance gender equality in health. They argue that we need to keep this lense on to provide sustainable solutions for everyone as we rebuild our health

systems!

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