‘Any advice for everyone?’ World health organizations aren’t even close

Jhe diversity of age, gender and ethnicity on the board of directors of a company or organization is essential to its financial and operational success, helping it to perform better, make more effective and emerge stronger from adversity.

This critical link between board diversity and performance is something organizations, including global health organizations, have long failed to recognize – and continue to ignore, as the findings of the new report show. Global Health 50/50, “Boards for All? An examination of the power, politics and board membership of organizations active in global health,” published by Global Health 50/50.

Measuring, for the first time, the gender and geographic diversity on the boards of the world’s most influential global health organizations, the report found that the overwhelming majority of board seats are held by men from high-income countries. Of more than 2,000 seats on the boards of 146 organizations assessed, less than 1% (only 17 seats) are held by women from low-income countries. The analysis did not include race or ethnicity, as these are very difficult to measure using publicly available data. Private sector companies, a subset of organizations assessed by Global Health 50/50, were even less diverse, with no women from low-income countries serving on their boards.


This stands in stark contrast to the 51% of board seats held by people – mostly men – from the US and UK.

These alarming statistics show how unequally power is distributed within the governing bodies of some of the most powerful organizations in the world. This lack of diversity is not only unfair, but also lends itself to poor performance. The lack of representation of the communities they serve on boards reveals a critical flaw in their business models at a time when it is critically important for them to make effective decisions and successfully manage risk to lead the world. through the Covid-19 pandemic.


The pandemic has had severe economic consequences around the world, illustrating in detail how interconnected global health and economic performance are. As a result of the pandemic, unemployment soared around the world, a majority of countries entered recession and global trade fell by 8.9% in 2020, the biggest drop since the financial crisis.

As the world continues to recover from these economic shocks, it is more important than ever that the organizations tasked with ensuring equitable health outcomes for all are resilient and effective. To do this, they must commit to improving the gender and geographic diversity of their boards and governing bodies.

By taking positive steps to drive change at the board level, global health organizations will be better equipped to make decisions that reflect the needs and priorities of the populations they claim to serve. The same is true for companies in the private sector: better diversity on the board of directors is likely to improve their revenue growth and generate shareholder value.

A recent report by Board Ready, an American non-profit organization, found that companies with more than 30% of board seats held by women consistently outperformed their less diverse counterparts in terms of revenue growth. one year to the next. A separate report from McKinsey and Company showed that companies whose leaders represent multiple perspectives were more likely to emerge stronger from the Covid-19 pandemic.

As co-founder and CEO of Women on Boards UK, I regularly meet smart, ambitious women looking to take the next step in their career. It often takes convincing before they believe that serving on a board of directors might be a viable option for them. These women already have the skills to become valuable contributors to an organization’s governance. Yet they are put off by the fact that they simply don’t see many people at the highest levels of leadership who look like them or come from similar backgrounds. The continuing shortage of women in leadership positions is inexcusable. Women on Boards believes that companies should aim for a 40:40:20 gender split, where 40% of the board is made up of men, 40% women, and the rest is the result of a natural fluctuation in recruitment by sex. This is what we must aim for, and we still have a long way to go.

There are several strategies that organizations can adopt to dismantle the structures that have traditionally held back women in low-income countries. These include transparent and open advertising of board positions, deliberately seeking candidates outside of existing networks when recruiting for these positions, and adding a new seat to the board so that there is no need to wait for a director to retire or reach term limit. Some people in the so-called Global South, especially those from disadvantaged communities, need additional support, such as funds to attend meetings and on-the-ground support networks to offer information, encouragement and advice.

To ensure greater youth representation, board members should lower their criteria, such as 20 years of global health experience or CEO experience. A support structure specific to global health is also needed to enable greater participation, as support is truly valuable for board members as well as the organizations themselves. These strategies must also be accompanied by advocacy and activism by global health professionals to demand these changes.

An evolution of governance is underway today. As the world and the global economy become increasingly turbulent, more and more organizations are recognizing that without diverse perspectives at the highest levels of leadership, they simply cannot keep up. While major industry regulators, such as the Financial Conduct Authority in the UK, are already recognizing this and introducing policies to ensure board diversity in the financial services industry, the global healthcare sector is clearly behind.

Instead of evolution, revolution is needed: global health organizations are publicly committing to creating “advice for all” if they are to fulfill their core mission of achieving health for all.

Fiona Hathorn is co-founder and CEO of Women on Boards UK

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