Women and malaria research in the 21st century

Guest blog by Clara Menendez*, Marita Troye-Blomberg, Francine Ntoumi, Esperança EJ Sevene, Azucena Bardaji, Myriam Arevalo and Rose GF Leke [*MENENDEZ@clinic.ub.es]

Since the first mass protest for women’s rights in 1908, there has been a continued increase in the number of women entering universities. However, this has not been accompanied by a similar increase in the number of women in leading university positions. The first female president of Harvard was named in 2007, while in  Spain the first female university director was appointed in 1982, and there are only three female university directors nowadays[1]. In Western Europe as a whole this low level of  female representation in leading positions at Universities is in stark contrast to more than half of university students being women.

From the perspective of malaria research, the following are some of our personal reflections on the roles of women in malaria research. We believe these perspectives might also be relevant to other fields of biomedical research.

The Multilateral Initiative on Malaria (MIM) [2], the most important scientific conference on malaria worldwide, held its last conference November 2009. Given the high burden of malaria worldwide,  research on this disease is representative of research in international health. Since the first MIM conference in 1997 there have been considerable changes in the malaria field.  The economic investment has increased more than five times in the last 6 years; the number of international  organisations that has malaria control as one of their main objectives is greater than ever before;  new initiatives focused on malaria have been created. All of this has occurred in parallel with an increase in the number both in developed, and to a lesser extent, in developing countries, of women working in biomedical research. These changes in the global attention to malaria were reflected in the last MIM conference, in the number of registrations, which had increased; in the higher quality of the communications; in the inclusion of relevant topics such as malaria eradication; and in the renewed interest on the impact of malaria in pregnancy.

However, participation of women in malaria research has not increased in line with the increased focus on this disease. Women registered at MIM 2009 barely numbered 43% of total attendees. But more worrying than this was the small proportion of women presenting  papers (23%), and how few women participated in plenary sessions (4 out of 26) [2]. This last figure is of specific concern,  as it reveals the worryingly small contribution that women apparently make as research leaders in the malaria field.

It is important to understand the reasons for the small numbers of female registrants at the MIM conference and more importantly, what consequences this imbalance between genders in leading positions within the field may have for decision-making of the malaria research agenda. To illustrate this point, it is interesting that malaria papers are increasingly littered with military terminology. For example, “the battle or the war against malaria”, instead of “the race to win malaria”; or “the magic bullet or weapon” instead of “the tool”; or the “generals against malaria”, instead of the “researchers”. This terminology may lead women to feel excluded from malaria research. It also means the research agenda seems to be imbued with a male character, which may influence the way issues that female specific issues are addressed. Another example of the minority role played by female research leaders is in the specialty subject malaria in pregnancy. Again, the main issue is how the lack of female leaders might affect the focus of research on this topic.  Is this research agenda focusing on what is actually relevant for the women who are exposed to malaria, or is it driven by issues that are not priorities for them?

Maternal mortality is another example of a research goal that may have been affected by male dominance at the level of decision-making in international health research. It is the only Millenium Development Goal that has barely changed for the last 20 years [3]. Yet, despite its relevance it is rarely part of the international health research agenda.

Increasing gender diversity can bring clear benefits. For example, the increased participation of women in leading positions in governments has increased attention on solving problems that are specific to, or mainly affect, women. Similarly, the participation of women on the board of directors of businesses has led to a more diverse vision of issues and potential solutions. The lack of diversity at decision-making levels may lead to  a “group-think” [4]. This thinking process is shown by the members of a group which tends to minimize conflicts, and to try to reach consensus without critical analysis, proof or evaluation of the proposed ideas. Research is based on innovation and the emergence of new ideas, which tends to be best-stimulated in diverse environments.

There are some positive signs for research, including the European Union research initiatives, which consider gender aspects in the evaluation of scientific proposals [5]. In some European countries and in the US, public research funding is linked to progress on gender equity issues.

At the individual level a change in attitude is needed. For example, women should be actively sought when it comes to the selection of candidates for leadership posts (women are usually less visible and therefore can tend to be ignored). Women should also change their natural resistance to promote themselves and thus, become more visible. Women need to learn to establish networks of contacts, something which men are usually much more successful at, and which is very important when it comes to being considered for a particular position.

However, all these measures may be insufficient to achieve the goal of gender parity in the medium-term , since time alone is not a solution to  gender differences in research leadership. We think that this will most likely require  quotas, that is, positive gender discrimination [6]. To make a change, we must all be convinced that breaking the gap in research leadership between genders is not only a matter of justice but  will increase the efficiency of  research , and will benefit the progress of science and medicine  in general and society as a whole.

References

1.http://www.abc.es/hemeroteca/historico-06-10-2008/abc/Nacional/rectoras-gotas-en-el-oceano_81419279295.html.
2. 5th MIM conference statistics Nairobi, Kenia. November 2009.
3. World Health Organisation 2007. Maternal mortality in 2005: WHO U, UNFPA, and the World Bank, Geneva: World Health Organisation.
4. Mirella Visser & Annalisa Gigante. Women on boards- Moving mountains. Women @ Work nº8. European Professional Women’s Network. European PWN.
5. http://www.edctp.org/Home.162.0.html.
6. Breaking the glass ceiling. Proposals to adjust the role of women in science. www.irbbarcelona.org. IRB. Institute for Research in Biomedicine Barcelona