Our Best Shot: Women Frontline Health Workers in other countries are keeping you safe from COVID-19


Executive Summary

Fully realizing the social and economic benefits of halting COVID-19 requires investing in a fast and fair global rollout of COVID-19 vaccines. CARE estimates that for every $1 a country or donor government invests in vaccine doses, they need to invest $5.00 in delivering the vaccine.

Investments in frontline health workers are a critical component in this comprehensive vaccination cost.
Of the $5.00 in delivery costs, $2.50 has to go to funding, training, equipping, and supporting health workers—especially women—who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines. For these investments to work, they must pay, protect and respect women frontline health workers and their rights—a cost that is largely absent from recent WHO estimates on vaccine rollout costs. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.

Investing in a fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. i Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. For every $1 invested in vaccines in less wealthy countries, wealthy countries will see $4.80 of economic benefit because economies can fully re-open sooner. ii Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.

Current global debates are focused so narrowly on equitable access to vaccine doses that they largely overlook the importance of delivering vaccines—and the key role women frontline health workers play in vaccine delivery. Of 58 global policy statements on vaccines, only 10 refer to the costs of delivery at all— and these are primarily technical advisories from the World Health Organization. No government donors are discussing the importance of vaccine delivery systems that are necessary to ending COVID-19. Only one statement—from Norway—refers to the importance of women health workers as part of the solution to ending COVID-19.

As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it—and that those people are ready to get the vaccine when it arrives— are the only way to end this threat. No one is safe until everyone is safe.

Since COVID-19 started, essential workers in hospitals have gotten much well-deserved attention as heroes who have helped control and manage the epidemic, care for the sick, and lose their lives serving others. Those heroes in health centers are only part of the story of how we’ll end COVID-19. Less recognized, but no less important, are the 3.5 million semi-formal and informal health workers around the world who serve the patients at the “last mile” of delivery. At least 70% of these health workers are women - who are risking their lives to get vaccines, services, and supplies to the most underserved and at risks populations in the world.

Appallingly, these women are getting little of the protection, recognition, equality, and pay that they deserve. Women health workers contribute $3 trillion dollars to the global economy every year, but HALF of this work is unpaid and Where they do get paid, they make 28% less than their male counterparts.vii They aren’t getting access to the vaccines, either. WHO estimates that currently 30 million high-risk people are not included in any government vaccination plans, and many of them are community health workers.vIn COVID-19, trauma and overwork are putting millions of healthcare workers at risk and compromising the care they can give. In the US alone, 76% of nurses are reporting burnout and exhaustion, and there are similar numbers in most countries in the world.ix Investing in these women is one of the best ways to ensure we experience the benefits of COVID-19 vaccines. Those investments will continue to payoff for years to come in pandemics avoided, faster crisis responses, and economic growth.

Respecting human rights, equality and leadership for women health workers is the key ingredient to keeping everyone safe from COVID-19. Women health workers have incredible insights about what is working, what patients are experiencing, and where there are gaps in the system that leaders need to quickly pivot to fill. Currently, they have few ways to share these insights in ways that improve the system.

While evidence shows that having women frontline health workers involved in decision-making and shaping solutions improves life expectancy and patient outcomes, only 25% of leaders in the health