Equity: preach not practise

Published: February 12, 2019
The writer is a Howard Hughes Medical Institute professor of biomedical engineering, international health and medicine at Boston University. 
He tweets @mhzaman

The writer is a Howard Hughes Medical Institute professor of biomedical engineering, international health and medicine at Boston University. He tweets @mhzaman

The last couple of years have opened a window, albeit a very small one, into practices that were long considered acceptable in a world that was defined, driven and executed by insecure men. Movements led by many brave women, and some men, have shed light on the pervasive problems of harassment, sexism, intimidation and misogyny both at the office and in the public sphere. Many of these pioneer women have done so at great personal and professional cost. A discussion is slowly taking shape about who we are and what we ought to do — although so much more needs to be done and not much has changed in the world just yet.

To create a more equitable world, where everyone has a fair chance, not only do we have to quickly and permanently dismantle the structures that enable harassers, but we also have to create opportunities that are truly equal. Academia too often considers itself as the beacon of progression and equity — but there is a gulf between what it preaches and what it practises.

Lancet, the premier journal of global public health, took this topic head on in its latest issue (volume 393; Number 10171) aimed at looking at the systematic barriers that exist for women within public health, and what we ought to do about that. While the content is rich, thought provoking and often sobering, there is one paper that is particularly relevant for us. The study led by Dr Mishal Khan of the London School of Hygiene and Tropical Medicine, with colleagues from the UK, Singapore, Canada and Spain, maps the gap between plan and action — between what is preached and what is practised. What Dr Khan and her team found was that at leading institutions of public health (they looked at a total of 16 top institutions), where the bread and butter is equity, there is a huge disparity. Women often outnumber men in junior faculty ranks but when it comes to senior leadership positions, there are far fewer women than men. The problem is particularly acute for ethnic minority women. There are strategic plans and plans to implement the strategic plans — but when the rubber hits the road women continue to face hurdles reaching top leadership positions.

A broader analysis of the problem would tell us that this is not just the case in public health. In October 2018, when the Nobel Prize in Physics was announced, many of us were thrilled to find Dr Donna Strickland among the awardees. Dr Strickland has had a stellar record by any and all standards, and her list of accolades even before the Nobel Prize was long. Yet at the time of getting the Nobel Prize, she was still not a full professor — something that would be unimaginable for a male scientist of her stature and reputation.

The challenge in Pakistan is no different from the rest of the world — and in many ways perhaps more acute. Girls consistently outperform boys in the national exams, but as they move through the career, few make it to the top leadership positions. Talented women in academia, who start with their male colleagues at the same level, are far more likely to lag behind in promotion. A survey of national university vice-chancellors and deans in Pakistan tells a grim story. Even in disciplines where women outnumber men at the entry point (eg, schools of medicine) the pipeline quickly becomes suffocatingly restrictive for women.

Diversity and inclusion is not just a good buzzword, it is also sound economic policy and a step towards a fairer society that creates value for all its citizens, and does so by valuing every citizen equally. Academia is often the engine of progress, and a driver for positive change, but only when it confronts its own dark side.

Published in The Express Tribune, February 12th, 2019.

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