by Adele Benzaken, Medical Director for Global Programs, AIDS Healthcare Foundation (AHF); Consultant for PAHO, WHO, and UNAIDS

These are troubling but interesting times. On June 25, I was panellist at the Ahimsa Renaissance Movement’s 2021 virtual event Fostering a New Movement for Health Access for the Most Vulnerable People –, in its “Women and Leadership”  session. The session – focused on ways of combining femininity with performance and promoting a femininity/masculinity balance in the  contemporary workplace – was very special to me. During the session, panellists were provoked by the following questions: “have you ever been invited to join a discussion about men and leadership?”;  “how may we contribute as women, not leaders?”; “how must love be valued in leadership?”; and “what do women have that men don’t?”.

These compelling questions were posed during a roundtable – in the same way and format as much of the world’s feminine intelligence was advanced by different cultures and native communities along history. Ahimsa Fund’s idea of bringing together a network of people to think together is very powerful, and I am extremely grateful to have been invited to become a part of this dialogue, alongside other extremely committed participants. 

In essence, the central goal of this event was to try to reduce the distance between all of us fellow humans, in order to reconcile all the structurally opposite elements of contemporary speech. Men and women. Rich and poor. I had never before been invited to join this kind of discussion, but I am glad that the pandemic inspired me to do so.
It is undeniable that we should try to use this terribly sad covid-19 pandemic as a learning experience as to how to work together – so crucial if we hope to control it at all. The Sars-CoV-2 virus is giving us the opportunity to overcome the idea of categories of human beings, or of national boundaries or countries. 

We have to act as one planet!

As a matter of fact, our differences are our very strengths; they shouldn’t create distance between us. Different points of view multiply the chances of reaching a smarter answer to a problem – and I think this is where the power of equality between men and women is so evident: we can create a community and work together for better responses to any problem, however challenging it may be. Since gender is a social construction, men and women experience life from different angles, and we should all agree that having different perspectives concerning a challenge or opportunity affords us a more accurate view of the world.

Vulnerable populations – which evidently harbour powerful examples of women’s leadership – are an example of the strength that is inherent to working from different perspectives. Over the last few decades, for instance, transgender people have earned their unquestionable right to be elected as political leaders in many parts of the world. Transgender women have different life experiences which can help advance valuable and impactful political initiatives that benefit us all, ranging from health care to protection against discrimination and violence. Thus, electing and appointing transgender women can potentially change discrimination legislation and health policies, ultimately making this world a lot better for all of us.

Another compelling example is given by female sex workers: when working with them in a peer-to-peer methodology (sex workers talking/working with other sex workers) for HIV/STI prevention, we observed an increase in individuals’ self-esteem and leadership skills, and in their ability to organize NGOs to fight for their own rights.  

In the late 1940s, French philosopher Simone de Beauvoir claimed that no one is born a woman but becomes a woman. In this famous construct, she challenges late 19th-century deterministic thinking, which used biology to justify alleged female inferiority and social inequalities between genders. As female and male leaders, therefore, we should work to create a social context in which women are taught – from an early age – to be the leaders of our societies.

This leads us to another of the session’s questions: “what do women have that men don’t?”. To answer it, I will share some of my experience as a woman in a leadership position, and a few aspects of the path that brought me here. 

My personal goal as a physician and a public health worker, and eventually leader, has always been focused on turning scientific-based evidence into public health policy. This was my natural path. I worked from the point of view of a woman and researcher to validate a rapid test for syphilis diagnosis, studying if it worked adequately in high burden communities, and then also in low burden settings. Then I worked for its implementation within indigenous health services in Brazil – and all scientific evidence was then published, so the results could be used to inform health policy and health managers.

From that point on, I was able to use my leadership position to work towards making this new, scientifically-tested health technology into a health policy available to everyone. To this end, I used political influence and advocated for the incorporation of this diagnostic tool into the Brazilian public health system, SUS. 

I realized that trust was a more important issue than gender

From this professional experience, I would like to share an insight: in some cases, I realized that trust was a more important issue than gender. People would listen to my ideas because they knew my career path, and acknowledged the work I had already done. But still, there were times when I would leave a meeting devastated – not because of a directly sexist offence against me, but because sexism is so ingrained in our culture that there was often a lack of care in the way other leaders, mostly men, addressed me, or other women in those meetings.

I believe that a world with more women in power would be a better word, for the simple reason that we would be using all available human intelligence, instead of just a part of it. We would also allow our girls – and not only our boys – to see themselves as leaders. 

It is important to consider that women are half the people on the planet. It should only be natural that women also take the seat in at least 50% of any and all discussions – including leadership. Or at least 50% of countries should be led by women; or 50% of the world’s greatest CEOs should be women. But we are still not there. We still exist in a sexist world, with fewer leadership opportunities for women.

Whether we admit it or not, we all harbour unrelenting sexist stereotypes at the back of our minds; this is still our shared cultural background. We need not talk about this sexist reality that we all face at some level, from a place of sadness, or as an excuse for not getting things done. 

However, it would also be unfair to speak here from a place of heroism, since I am a woman in a position of leadership. We are also many, and there were many female leaders before me who inspired me and crossed countless boundaries to make way for the women who came after them.

Every woman who steps forward advances for the women who come after her
Ngozi Okonjo-Iwealla, former Minister of Finance for Nigeria

For those women who are already in a position of leadership, we must also be supporters of change, using these positions to build bridges that will eventually overcome the structural barriers that keep women at the margins of power.

To carry out this task – of expanding women’s participation in power –, I would like to answer one more question suggested by Ahimsa’s event: love is needed. There should always be a loving perspective between these two powers, masculine and feminine. It is not enough that only women defend their participation; given that men still hold power disproportionately, we will not see change unless they work with us to create a better, more equitable world. And they can do this by calling out sexism when they see it, for example, or by simply respecting dialogue, by making space for women. It is particularly important to also discuss a more equitable share of domestic work and care. As a matter of fact, as a gynaecologist and obstetrician, I must point out a simple fact: it is completely unacceptable that, to this day, men are not wholly sharing the care and upbringing of their children. 

On another occasion, when I was the director of Brazil’s HIV, STI and Viral Hepatitis programme, within the country’s Ministry of Health, I had to convince the Minister to incorporate dolutegravir into the Brazilian protocol for HIV treatment. At the time, dolutegravir was the newest – and best – antiretroviral drug for HIV treatment. My arguments in defense of incorporating this specific medication into our public health system portfolio were its price and the fact that Brazil would be one of the first countries in the world to do so – a positive political fact that the Minister could be proud of sponsoring.  

Before the official ministerial launch of the incorporation of DTG, I remembered a conversation I had had with the director of the World Health Organization’s HIV department, Gottfried Hirnschall. He had called me to congratulate Brazil on the implementation of DTG, and I thought: well, this could be a great opportunity. If this strategy about pride and political function of incorporating a new technology worked, we needed to take the next step and implement Pre-Exposure Prophylaxis in Brazil. And PrEP, as many of you may know, is the use of antiretroviral therapy to prevent HIV infection. So I asked the WHO HIV director to make a video congratulating the Brazilian Health Minister for the DTG implementation, and specifically asked him to introduce the PrEP topic to Brazil’s goals. In the end, Brazil was one of the first countries in the world to introduce PrEP into its public health system.

A leader must have a sense of purpose that drives her/him. We, women, should aim especially high and avoid the “glass cliff phenomenon;” women in leadership roles, such as executives in the corporate world and female political election candidates, are often likelier than men to achieve leadership roles during periods of crisis or downturn, when the chance of failure is strongest. If you have a clear goal, you will be able to take advantage of the opportunities that come your way – or to make opportunities appear as you go along. Side with scientific evidence, be fearless, negotiate. Invest your time in fruitful conversations. That is how I believe good leadership is performed. And, as Julia Gilliard, first female Prime Minister of Australia, stated: there is joy in being a leader and in having the opportunity to put one’s values into action. There is no right way to be a female leader, but it is important to prepare oneself to deal with gendered and sexist moments: forewarned is forearmed. 

With this in mind, we should have more roundtable conversations like this to reconcile this man x women structural opposition, and to find a more comfortable and productive space in between. We should work together to change the rules that keep girls, adolescents and young women at the margins of society.

I really like the idea that our differences are the strengths on which we must build our future, and that the Ahimsa Renaissance Movement is responding to a leadership deficit that was made even more clear by the covid-19 pandemic. 

Technology can help us by bringing us far closer, by enabling a greater sense of community and convening people from such different backgrounds as us, in this meeting. But I know that, to truly feel empathy, we must feel with our five senses, and I hope a vaccinated world, a world free of covid-19, will be a reality soon enough. Then we will be free to hold these wonderful roundtables in person.