By Flavia Bustreo, Global leader for health & rights of women, children, adolescents & elderly & Former Assistant Director-General at WHO, Gabriela Ramos, Assistant Director-General for Social and Human Sciences, UNESCO and Felicia Knaul, Director, Institute for Advanced Study of the Americas, Professor, Department of Public Health Sciences at the Miller School of Medicine
Last year, in early February, we joined global leaders and Ministers from a number of countries at a landmark conference organised by the OECD on ending violence against women. The first of its kind, it reflected the rising recognition among OECD countries that violence against women is both a grave violation of human rights as well as an economic sinkhole. The COVID-19 crisis has magnified the existing ‘pandemic within a pandemic’ of violence, with devastating consequences for individuals, and for our societies and economies at large.
Even in non-pandemic times, the economic impact of gender-based violence is staggering and has traditionally been vastly underestimated. Considering only direct costs, gender-based violence reduces global gross domestic product (GDP) by 2% per year, equivalent to an annual loss of more than US$1.6 trillion. In some countries, the annual costs of gender-based violence have been estimated at more than 3.5% of GDP, nearly half of what OECD countries spend on average on all healthcare. These figures, however, are but the tip of the iceberg, accounting only for direct medical costs and immediate productivity losses. A broader model – taking account of the lost capabilities of survivors and caregivers, and how these traumas and hardships are transmitted across generations – would reveal a far higher figure of the cost of inaction.
During the current pandemic, red flags of rising violence emerged just days and weeks into the first ‘lockdowns.’ In many countries, these early indications came in through police reports, administrative data, and domestic violence hotlines unable to keep up with soaring demand. Building on this initial data, the Centre for Global Development summarised the findings from nearly 50 rigorous studies carried out since the beginning of the pandemic. This growing body of evidence confirms our fears: COVID-19, and policy measures to contain it, have increased violence against women and children across many contexts. Moreover, data can sometimes be misleading – which is in itself a concern. Seemingly declining rates of violence are often an artefact, stemming from the closure of shelters, health and legal services during lockdowns, or the greater barriers that women face in accessing them.
“Just as a gender lens is critical in emergency preparedness plans, so too must gender be a central consideration in economic mitigation measures.” #DevMattersTweet
The frequent absence of a gender lens in emergency preparedness plans meant that increased rates of gender-based violence came as a surprise for many, evidenced by reactive policy measures implemented after lockdowns were imposed. However, the rise in domestic violence was as predictable as it is tragic, and consistent with our knowledge from past pandemics and other crises. Multiple sources reported an increase in gender-based violence during the Ebola epidemic in West Africa in 2014-2015; the ‘unintended consequences’ of public health measures now very familiar to us, like quarantines, curfews and school closures. Many post-crisis assessments found that these measures were largely adopted without consideration of how they increased risks for women and girls.
As we advance the work of the Lancet Commission on Gender-Based Violence and Maltreatment of Young People, we are deeply disturbed by these trends. But we also know that there are measures that governments can take, both short-term and long-term, to prevent violence against women and children and to mitigate its human and economic consequences. Cash transfer programmes, both conditional and unconditional, are operational around the world, and backed by an impressive body of evidence demonstrating their effectiveness in reducing poverty and improving other important human development outcomes. Perhaps less widely known is another positive externality of many of these programmes – their contribution to reducing intimate partner violence. In a recent review of cash transfer programmes, nearly three-quarters (73%) of studies found that these programmes meaningfully reduced physical and/or sexual intimate partner violence.
To mitigate the pandemic’s economic devastation, over 1,100 social protection measures have been introduced by more than 200 countries, including 340 cash transfers (conditional and unconditional) in 156 countries. Many of these are new and short-term programmes, but others are expansions of existing schemes. In Latin America, the bastion of some of the world’s most well-known and pioneering cash transfer programmes, OECD members Chile and Colombia are two of several countries that both increased cash transfers and removed conditionality in existing programmes that largely target mothers as recipients. Moreover, they developed new demand-driven programmes focused on individuals who are usually dependent on informal sources of income. Elsewhere in the world, Italy is one example where existing conditionalities have been at least temporarily lifted from a guaranteed minimum income programme.
“Gender-based violence reduces global GDP by 2% per year, equivalent to an annual loss of more than US$1.6 trillion.” #DevMattersTweet
Just as a gender lens is critical in emergency preparedness plans, so too must gender be a central consideration in economic mitigation measures. The past success of many cash transfer programmes – in terms of poverty reduction, improved maternal and child health outcomes, as well as the reduction of intimate partner violence – has rested upon targeting women as recipients. To date, it seems that this lesson has not universally been applied, with many new cash transfer programmes focused on loss of employment, and thus privileging men. There are also concerning signs that a majority of countries are not publically reporting sex-disaggregated data on cash transfer beneficiaries, making it more difficult to track and evaluate.
There are also more long-term measures that countries can and should take to address the human and economic consequences of gender-based violence. While stressing the importance of supporting survivors in their recovery and in the full realisation of their rights, countries must also significantly scale up investments in prevention. The international body charged with pandemic preparedness has estimated that it would take 500 years to spend as much on pandemic preparedness as the world is losing due to COVID-19, and we must apply the same logic to the prevention of violence. Though still expanding, the field of violence prevention highlights that there is no ‘silver bullet,’ and that successful programmes engage multiple stakeholders with many approaches, aiming to address the underlying drivers of violence, including harmful gender norms that condone violence.
We are heartened that the OECD – a leader in social and economic policy – has both recognised the importance of tackling violence against women and children, and committed to expanding its expertise and engagement in this area. At the beginning of another turbulent year and amidst the continuing ‘pandemic within a pandemic,’ it is more urgent than ever that the OECD and its member countries take heed of specific policy measures – including cash transfers and longer-term preventative measures – that can help us all mitigate the human and economic calamity of violence.