Two of the great global health issues of the 21st century are the climate emergency and gender inequality. The first is an incipient mass extinction event facing the biosphere. The second is a disfiguring moral injustice that, unless addressed, will severely limit possibilities for advancing the health and wellbeing of all peoples. But while the climate crisis has recently achieved wider awareness, triggering public concern and even (admittedly inadequate) political action, gender inequality remains marginal to the central discourse of society. Several attempts have been made to catapult gender into the mainstream of national politics and international affairs. The most important was the 1995 Beijing Declaration and Platform for Action, celebrating its 25th anniversary next year. The Declaration called for “the advancement and empowerment of women all over the world”. This proposition was grounded on the principles of sustainable development—economic growth, social development, environmental protection, and social justice. Sustained economic growth would provide the basis for investments in primary health care. And those principles would also mean that women must have “equal access to economic resources”, including access to markets. In 2020, there will be a major review of progress towards these commitments—Beijing+25. Next year will be the most important opportunity for a generation to accelerate action to improve the health of women and girls. But that opportunity cannot be seized by taking a business-as-usual approach to gender inequality, an approach unfortunately endorsed and institutionalised by the Beijing Declaration's advocacy for economic development through market capitalism. As currently conceived, Beijing+25 will fail. A more fundamental question must be asked: what is the point of gender equality? SDG-5 defines gender equality as ending all forms of discrimination and violence against women and girls; eliminating harmful practices (such as early marriage and female genital mutilation); recognising and valuing unpaid care and domestic work; ensuring women's full and effective participation in political, economic, and public life; and ensuring universal access to sexual and reproductive health and rights. These objectives deserve the global health community's full support. But the political and economic frameworks within which these targets exist mean they can never be fully achieved. As Cinzia Arruzza, Tithi Bhattacharya, and Nancy Fraser argue in Feminism for the 99%: A Manifesto (Verso, 2019), “capitalist societies are also by definition wellsprings of gender oppression”. The liberal “lean-in” feminism prevalent today is the “handmaiden of capitalism”. In its “bankruptcy”, liberal feminism offers nothing more than “equal opportunity domination”. Arruzza, Bhattacharya, and Fraser offer 11 theses that draw the contours of an entirely different vision for gender equality. Put simply, capitalism is the problem, not the solution. Capitalist society inherently undervalues women's work, paid and unpaid—“it propounds a market-centred view of equality that dovetails perfectly with the prevailing corporate enthusiasm for ‘diversity’…liberal feminism steadfastly refuses to address the socioeconomic constraints that make freedom and empowerment impossible for the large majority of women”. Instead, liberal feminism “outsources oppression” and envisions a world where “a few privileged souls can attain positions and pay on a par with the men of their own class”. Feminism risks being “a vehicle of self-promotion, deployed less to liberate the many than to elevate the few”. The crucial step that capitalism made to reinvent women's oppression “was to separate the making of people from the making of profit”. The making of people—social reproduction—“relies on gender roles and entrenches gender oppression”. What Arruzza, Bhattacharya, and Fraser propose is “gender justice in an anticapitalist form”. They reject liberal feminism. They embrace “an anticapitalist feminism—a feminism for the 99%”. They also emphasise “the enormous political potential of women's power: the power of those whose paid and unpaid work sustains the world”. Free, universal, not-for-profit health care is foundational to this vision. But it cannot be realised unless capitalism itself becomes a target. And this truth is one that the conveners of Beijing+25 choose to ignore, with fatal consequences for the health of women and girls worldwide.
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