Lancet Commission Report: Gender Justice & Global Health Equity (2025)
The foundations of global health are shifting. A year after the publication of the report from The Lancet Commission on Gender and Global Health, “Achieving gender justice for global health equity,” the need to fortify the coalition for gender justice feels more urgent than ever. The report, the culmination of a five-year review of the history and politics of gender within the global health system, wasn’t a call for incremental change, but a fundamental re-evaluation of how we approach health equity. It’s a reminder that health isn’t simply a biological matter, but deeply interwoven with power dynamics, social structures, and systemic inequalities.
Beyond Biological Determinism: The Core Argument for Gender Justice
For too long, global health interventions have operated under a framework that often overlooks the profound impact of gender. This isn’t about adding ‘women’s health’ as an afterthought. it’s about recognizing that gender shapes access to healthcare, experiences of illness, and health outcomes across the entire population spectrum. The Lancet Commission’s work underscores that gender injustice isn’t merely a social issue, but a critical determinant of health – for everyone. Which means addressing not only the specific health needs of women and girls, but also harmful gender norms that affect men and boys, and those who identify outside the gender binary.
The Commission identified both progress and significant hurdles. Milestones included increased attention to gender-based violence and reproductive health, but these gains remain fragile and unevenly distributed. The report highlights how gender inequalities exacerbate vulnerabilities to a wide range of health challenges, from infectious diseases like HIV and tuberculosis to non-communicable diseases like cardiovascular disease and cancer. It also points to the critical, yet often overlooked, role of gender in shaping responses to health emergencies, such as pandemics and climate-related disasters.
The Interplay with Sexual and Reproductive Health
A closely related area, and one that frequently intersects with gender justice, is sexual and reproductive health. Recent analysis published in The Lancet emphasizes the challenges and opportunities in developing integrated sexual and reproductive health programmes. These programmes aim to provide comprehensive care, including family planning, maternal health services, and prevention and treatment of sexually transmitted infections. Though, achieving true integration requires addressing the underlying gender inequalities that limit access to these services, particularly for marginalized populations.
For example, restrictive laws and social norms surrounding abortion access disproportionately affect women and girls, particularly those from low-income communities. Similarly, gender-based violence can create barriers to accessing sexual and reproductive health services, and can have long-term consequences for physical and mental health. Integrated programmes must therefore address these broader social determinants of health, alongside the provision of clinical services.
Maternal and Perinatal Health: A Critical Focus
The Lancet Commission’s findings align with a growing recognition of the importance of investing in maternal and perinatal health. A recent WHO global consultation, also reported in The Lancet, highlighted the need for more clinical trials to improve outcomes for mothers and newborns. These trials are essential for identifying effective interventions and ensuring that they are accessible to all who need them. However, it’s crucial that these trials are designed and conducted in a way that is sensitive to gender dynamics and addresses the specific needs of diverse populations.
For instance, trials evaluating novel interventions for preventing postpartum hemorrhage should consider the cultural context and ensure that women have the autonomy to make informed decisions about their care. Research should focus not only on the biological aspects of maternal health, but also on the social and economic factors that contribute to maternal mortality and morbidity.
The Limits of Current Approaches and the Need for Systemic Change
The Commission’s report doesn’t shy away from acknowledging the limitations of current approaches to global health. It points to the persistent power imbalances within the global health system, where funding and decision-making are often dominated by high-income countries and institutions. This can lead to interventions that are not aligned with the priorities and needs of low- and middle-income countries. The report highlights the lack of accountability for gender injustice within the global health system, and the need for stronger monitoring and evaluation mechanisms.
The challenge isn’t simply about adding a ‘gender lens’ to existing programmes; it’s about fundamentally rethinking the way we do global health. This requires a shift from a top-down, technocratic approach to a more participatory and community-led model. It also requires addressing the structural inequalities that perpetuate gender injustice, such as poverty, discrimination, and lack of access to education and economic opportunities.
What Comes Next: Strengthening the Coalition
The report’s call to strengthen the coalition for gender justice isn’t a rhetorical flourish. It’s a recognition that achieving meaningful change requires a broad and diverse alliance of actors, including governments, international organizations, civil society groups, and communities. This coalition must be grounded in a shared commitment to gender equality and social justice, and must be willing to challenge the status quo.
Moving forward, several key steps are needed. First, increased investment in gender-transformative health programmes is essential. These programmes should address the root causes of gender inequality and empower women and girls to take control of their health and lives. Second, stronger accountability mechanisms are needed to ensure that gender justice is integrated into all aspects of global health policy and practice. Third, greater attention must be paid to the intersectional nature of gender inequality, recognizing that gender intersects with other forms of discrimination, such as race, ethnicity, and socioeconomic status. Finally, and perhaps most importantly, we must listen to the voices of those who are most affected by gender injustice and ensure that their perspectives are central to the design and implementation of health interventions. The Lancet Commission’s report provides a roadmap for achieving this vision, but it will require sustained effort and commitment from all stakeholders.
Further research is needed to better understand the complex interplay between gender and health, and to identify effective interventions for addressing gender injustice. Ongoing surveillance of gender-related health indicators is also crucial for monitoring progress and identifying emerging challenges. The global health community must embrace a more holistic and equitable approach to health, one that recognizes that gender justice is not just a moral imperative, but a fundamental prerequisite for achieving global health equity.