Non-Communicable Diseases and COVID-19: A Conversation With Dr. Belén Garijo and Dr. Felicia Knaul

Summary: “NCDs have raised the risk of and the severity of the COVID-19 infection,” says Dr. Belén Garijo, Executive Board Member and CEO of Healthcare at Merck KGaA Darmstadt, Germany, in this week’s Friday Podcast. Women living with NCDs like cardiovascular disease, hypertension, cancer, mental health disorders, multiple sclerosis, and diabetes, have an increased risk of severe complications and death from COVID-19. “When you take a look at the mortality rate for one million inhabitants, you see a lot of diversity, and what has been consistent amongst all the countries is the association between severity of the infection and underlying diseases,” says Garijo. “We know that this pandemic is affecting women in a number of ways that are very harsh compared to men,” says Dr. Felicia Knaul, an international health economist and founder of Tómatelo a Pecho. Since the onset of the COVID-19 pandemic, women have experienced “more unemployment, more lack of access to jobs in all but the health sector, more issues of caregiving and less ability to earn income, more exposure to domestic violence.” “In the U.S., women accounted for up to 55 percent of the 20.5 million jobs that have been lost in April. In February, the unemployment rate for adult women was 3.1 [percent], in April this has gone up to 15 percent. In the same period, the unemployment rate for adult men was of 3.6 percent. And in April, this rate, 13 percent,” says Garijo. “The risk that we're facing is that we will see the gains of decades—which were not enough, but were still gains—in gender equality being eroded if we're not careful,” says Knaul. “This pandemic has really changed the way we are looking at our research focus,” says Garijo. “I can tell you that we have, right now, almost completely focused our efforts in finding solutions for pandemics. I am hoping that we will never forget this, and that our pandemic preparedness will stay strong for the future in any and every continent. As an industry, we can never do that alone. We need to collaborate with others. We need to collaborate with governments. We need to collaborate with academic institutions, with healthcare professionals, with patient associations.” “You cannot have strong health systems if you don't include women, not least which, because they are the majority of providers today.” says Knaul. “We've been working on some ideas around how to strengthen health systems in the face of COVID-19 and the first and key lesson is that this cannot be done without a gender transformative response.” A gender transformative response requires the inclusion of all genders, “otherwise we would never be strong enough, not only to respond to the COVID-19 onslaught, but what we're talking about today, which is the incredible onslaught of NCDs that face low- and middle-income populations and countries, as well as, high-income countries.” “I am absolutely sure that you are aware of the articles highlighting that countries that have performed better against COVID-19 are led by women. I have to say that I don't believe this is by chance,” says Garijo. “Female leaders promote the more inclusive leadership model and they are willing to listen. They are willing to listen to diverse opinions and voices. They don't believe they know it all.” This podcast is part of the Maternal Health Initiative’s CODE BLUE series, developed in partnership with EMD Serono, a business of Merck KGaA, Darmstadt, Germany.