Global Health Meets Gender Equality: Unpacking the Pandemic Agreement

By guest contributors Shubha Nagesh and Magda Robalo

After three years of intense and often difficult negotiations, World Health Organization (WHO) Member States reached consensus on the draft Pandemic Agreement — a landmark global accord aimed at strengthening international preparedness, prevention, and response to future pandemics. Once formally adopted at the upcoming World Health Assembly (WHA), it will become only the second legally binding treaty in the WHO’s 75-year history, following the 2003 Framework Convention on Tobacco Control.

Women in Global Health (WGH) emphasizes that civil society—particularly feminist and grassroots organizations—must not be sidelined. NGOs must be in the room in the lead-up to the WHA and throughout the implementation process. The meaningful participation of civil society is not optional; it is essential for accountability, transparency, and justice.

While the agreement marks a historic achievement in global health governance, its implications for gender equality and the rights of women and girls worldwide are more nuanced. On one hand, it lays the groundwork for a more coordinated global response; on the other, it raises important questions about whether such responses will be inclusive, equitable, and gender-responsive. If implemented thoughtfully, the agreement could help ensure that women’s and girls’ rights, needs, and leadership are central to pandemic preparedness, prevention and management — from shaping inclusive policies and governance structures to equitable access to healthcare and addressing gender-based violence. 

Opportunities for Progress

Despite its limitations, the draft agreement does offer several important opportunities for advancing gender equality in pandemic preparedness and response..

1. Improved Access to Health for Women

One of the core aims of the agreement is to avoid the fragmentation and competition for resources that plagued the global response during COVID-19. By promoting equitable access to vaccines, diagnostics, and therapeutics, the agreement could significantly improve access for women — especially in low- and middle-income countries, where gender-based disparities in healthcare access are most severe.

2. Faster Sharing of Data

The agreement also calls for the rapid sharing of disease-related data, enabling quicker development and distribution of treatments. For women — who often serve as both frontline health workers and primary caregivers in households and communities — timely interventions can be the difference between life and death during an outbreak.

3. Acknowledging Women in the Health Workforce

It is noteworthy that the agreement recognizes the role of women in the health workforce — even if only briefly. According to WHO, women represent 67% of the health and care workforce, and this number rises when social care roles are included. While the recognition is limited, it underscores the fact that women form the backbone of health systems globally. Given that women comprise around 70% of the global health and social care workforce, this acknowledgement, however limited, reinforces their status as the backbone of health systems worldwide.

Persistent Gender Blind Spots in the Agreement

There is increasing evidence of the gendered outcomes and secondary effects of epidemics and pandemics. Women make up a disproportionate share of the global health workforce, often working in frontline roles with limited protection and pay. During health crises, they shoulder the majority of unpaid care work, face increased risks of gender-based violence, and encounter heightened barriers to sexual and reproductive healthcare. These impacts are not incidental — they are systemic and deeply rooted in existing social and health inequities.

A truly effective pandemic agreement must integrate a gender-sensitive approach to every stage of pandemic preparedness, prevention, response, and recovery. However, despite its promise, the current draft reflects persistent gender-blindness in global health policy.

1. Minimal Gender Integration

The agreement includes only limited references to gender equality and lacks a comprehensive gender-responsive framework across its core commitments. Without intentional design, pandemic responses risk exacerbating existing inequalities, disproportionately harming women and other marginalized groups who are already underserved by health systems.

2. Silence on Reproductive Rights

One of the most glaring gaps is the lack of any reference to sexual and reproductive health and rights (SRHR). The COVID-19 pandemic showed how fragile access to these services can be — with disruptions to maternal care, contraception, and safe abortion in many countries. The Beijing Platform for Action, adopted nearly 30 years ago, clearly asserts every woman’s right to bodily autonomy and health, free from coercion and discrimination. By failing to mention SRHR, the draft agreement misses a critical opportunity to reaffirm and protect these essential rights in times of crisis.

The Pandemic Agreement: A Starting Point for Shared Progress

This pandemic agreementt comes at a time when women’s rights are under siege. From gender-based violence and regressive reproductive laws to economic inequality and underrepresentation in leadership, hard-won gains are being reversed. The gender pay gap persists globally, and one in three women has experienced violence in her lifetime. During conflicts and health emergencies, women face disproportionate risks and are often excluded from critical decision-making spaces.

Yet, in the face of these challenges, women have proven themselves time and again as agents of change — as frontline responders, community leaders, caregivers, and advocates. They are not just vulnerable populations, but powerful actors who must be centrally involved in shaping pandemic prevention, preparedness and response systems.

The prospects of adopting the pandemic agreement at the 78th WHA are promising. The agreement offers a silver lining amid widespread setbacks in multilateralism and global health cooperation. Its formal adoption presents a crucial opportunity to push back against rollbacks and advance gender equity across health systems.

A Call to Action: Center Gender in Global Pandemic Governance

As the Pandemic Agreement nears adoption at the World Health Assembly, we face a vital moment — not just to endorse it, but to shape how it’s implemented.Governments, civil society, and global health leaders must ensure gender equity is not sidelined. As prevention and preparedness are set in motion, the recognized gender dimensions should be acknowledged and addressed. Women in Global Health advocates for the following:

• Inclusive leadership that ensures women’s full participation in decision-making bodies at all levels — from community health councils to global forums;
• Comprehensive gender-sensitive policies that guide preparedness, response, and recovery efforts;
• Fair and prioritized access to essential health tools — vaccines, treatments, diagnostics — especially for women and other marginalized groups who often face systemic barriers.
• Guaranteed protection of sexual and reproductive health and rights (SRHR), including  in emergency settings;

We cannot afford to make the same mistakes again. Gender must be embedded at the heart of global health governance — not treated as symbolic, secondary, or optional. This is not just a matter of fairness; it is a matter of effectiveness, equitable  health outcomes  and survival. Gender equality must be the foundation — not the footnote — of pandemic preevntion, preparedness and response.

This is a once-in-a-generation opportunity. The Pandemic Agreement must institutionalize gender-responsive, inclusive systems that protect human rights, promote equity, and empower women as leaders—not just as responders.

A pandemic treaty without gender equality is a treaty half-written.

About the authors

Disclaimer: Views expressed by contributors are solely those of individual contributors, and not necessarily those of PLOS.

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