The Pan American Health Organization (PAHO) will choose its new director this week at the 30th Pan American Sanitary Conference. Among the candidates is the Mexican Nadine Flora Gasman, a doctor and doctor of public health from Johns Hopkins University.
Gasman has served as representative of UN Women in Brazil, representative of the United Nations Population Fund, in Guatemala; and currently she is the president of the National Institute of Women (Inmujeres) of Mexico.
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Gasman spoke with EL TIEMPO about the axes of his candidacy for the direction of PAHO and the work she has led in Inmujeres, the federal entity in charge of combating violence and discrimination against women in Mexico.
-You are the candidate from Mexico to lead PAHO for the next five years. What are the axes of your proposal to lead this organization?
I am very honored to have been selected as a candidate from Mexico with a focus on multilateralism and the need to strengthen PAHO to not only be better prepared for other emergencies, but also to develop the right to health at the regional level.
My proposal is based on creating a new pact for universal health and has three areas of work. The first is linked to the development in each of the countries of a universal health system based on primary care that truly responds to the needs of the population and that reaches the most vulnerable populations.
The second chapter of my proposal has to do with something that the pandemic revealed to us, and that is the need to have health self-sufficiency. In Latin America and the Caribbean we have the capacities to be a market for supplies, medicines, vaccines, but also the capacity to research, develop and produce so as not to be so vulnerable.
And finally, the third area has to do with making PAHO more effective, more efficient, and more transparent. An organization where the countries are represented and where there is parity, but also an organization that projects globally and carries the voice of our region.
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-What aspects of the Mexican health system do you think can serve as a guide if you reach the direction of PAHO?
I believe that you can learn from each other, but you have to rely on the context to achieve your goals. In other words, we have to see how in each of the countries: in Colombia, in Mexico, in Brazil, we move towards a health system that is really within the reach of the people.
Despite this, I would say that the most important thing about Mexico is this commitment to guarantee free universal health care for everyone. This political proposal to walk towards a universal, free and equitable system is what we can be inspired by.
-What do you think is the greatest lesson that covid-19 left to Latin America and the Caribbean?
That we were not prepared. It is true that we were facing an unknown phenomenon, but the mechanisms that had been developed to deal with pandemics were not put into practice. The big lesson is that we have to be ready and prepared and we have to strengthen multilateralism.
A pandemic cannot be tackled from every country. That is why the interest of being in PAHO: to lead this, to be able to put into practice the lessons we learned, to be better prepared and to promote health self-sufficiency and solidarity.
-In that sense, what do you consider to be the greatest short-term challenge in health matters in the region after the pandemic?
Just develop these capabilities. PAHO is working, for example, on some of the aspects of health self-sufficiency, but that needs to be accelerated.
That is what the pandemic left us. This urgency to strengthen our systems
The most urgent thing, moreover, is to attend to the lag left by the pandemic. We are seeing lags in vaccination, in surgeries, in care. We have to use the next year to catch up, but at the same time to build these systems that, if they are working, allow us to have a broader base of first responders.
I think that’s what the pandemic left us. This urgency to strengthen our systems, bring them even closer to the population, and have this systemic vision of health services. For that, obviously, we need not only the political will, but also the resources.
(You can read: WHO: this is how the international agreement on pandemics would work)
-How do you consider your experience on the issue of gender, at the head of UN Women, in Brazil; of Inmujeres, in Mexico; can you contribute if you assume the position of PAHO management?
I think that’s really one of my greatest strengths. We always say that the gender perspective has to be in everything, and that implies that it has to be very important in the health sector.
Also because working on gender is working every day on the issue of mainstreaming and intersectionality, and that is one of the most important issues in health. That is what I have done all my life; All my life I have spoken with education, with economy, with finance, and that has to be done in health.
-How does the process to elect the director of PAHO work?
The election will be held within the framework of the 30th regional assembly. We are six candidates: there are two candidates, the candidate from Haiti and myself, and four candidates from Brazil, Colombia, Panama and Uruguay.
It is one vote for each of the PAHO member countries, and whoever has 50 plus one, that is, 20 votes, wins. First there will be a round between 00:00 and 06:00. The second round will also be between everyone, and the third round between those with the highest number of votes.
About her work at InMujeres
-Nadine, you currently lead the National Institute for Women in Mexico. How do you see the issue of the gap between men and women in the case of your country?
It is still an important gap, but we have to point out aspects. For example, we have made very important progress on the issue of women’s political participation in Mexico. We have parity in all aspects of the Constitution, as a result of having a parity legislature for the first time in history in 2019.
As far as the economic autonomy gap is concerned, the situation is not so good. We still have a very important gap in terms of participation of women in the formal labor market: 44 percent, compared to 78 percent of men. And this has a significant impact on the autonomy of women, on the informality of employment and is closely linked to an essential issue: the sexual division of labor and the issue of care.
The gaps have been closed, but obviously there is still a lot to do.
(Keep reading: ‘The world has never been so close to the end of the covid-19 pandemic’)
-Unfortunately, Mexico is recognized for being one of the countries with the worst figures for violence against women. Collectives speak of 10 or 11 women murdered a day. What is behind this terrible situation in Mexico?
The causes are directly linked to a patriarchal, sexist, unequal society, where men feel they have rights over women.
People say: ‘ah, well, but the fact is that machismo in Mexico is never going to change’. No, it is going to change and it has to change and we have to do it from education, from work, but also in public transport, in educational content, in books and texts.
This is also interspersed with other phenomena of social and economic violence and with the issue of organized crime. We see that there is a very close correlation between organized crime and violence against women, especially femicide violence.
-What would you respond to criticism from feminist groups that claim that the government has not done enough to prevent violence against women?
I would tell them that we are working every day, that it is a national priority and it is an issue that is dealt with in the security cabinet every day at 6 in the morning with the President and his cabinet. It is also discussed in all peacebuilding and security tables in the states and in the regions.
Prevention, attention, punishment and reparation in the issue of violence against women is a priority.
We are working on the determinants of violence and we are questioning men in relation to their masculinities, because it is this coordinated work, simultaneous in all areas, which can lead us to change this macho and misogynistic culture.
-Mexico has been working for some time on the creation of a care system. How is that going today?
The issue of care and the objective of recognizing, redistributing and rewarding care is an objective of the National Program for Equality between Women and Men.
The Chamber of Deputies approved some modifications to the Constitution to recognize the right to care, to be cared for and to one’s own time, which are waiting to be approved by the Senate. At the same time, the senators developed a bill for the creation of the National Care System.
We have been working closely with them and at the same time we have been doing everything that needs to be done to organize a national care system: we have been coordinating in the Executive all the instances that have services and mapping what is at the local level with a georeferencing study.
With the support of UN Women and ECLAC, we have made a costing of the investment that needs to be made, because really investing in care is an investment that has an economic reward, in addition to being a social issue.
We know that it is going to be a system that is going to be built progressively, but we really have many of the pieces in place.
-How is Mexico advancing in guaranteeing sexual and reproductive rights? Where is there progress and where are the greatest risks?
So far this administration we have made progress in decriminalizing abortion in nine states. For 15 years, only Mexico City had decriminalized abortion, now it has been done in eight other states. The Ministry of Health has invested in having safe abortion services in each place according to what the law dictates, but also in preparing health services to provide a humanized service.
Another area where we have made progress is in the implementation of the national strategy for the prevention of adolescent pregnancy and the eradication of child pregnancy. We have also worked a lot on what has to do with comprehensive sexuality education, both at the state level and at the national level.
ANGIE NATALY RUIZ HURTADO
INTERNATIONAL WRITING
TIME
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