Around the Halls: Top Policy Priorities for Human Development and an Inclusive Recovery

2020 was a year of widening inequality around the world. The World Economic Outlook Update published by the International Monetary Fund in January 2021 estimated the global economy contraction at -3.5 percent in 2020. The decade-long gains in eradicating global poverty were reversed, with about 100 million people estimated to be pushed back into extreme poverty. Additionally, the economic burden of the multitudinous health, economic, and climate crises has fallen unevenly across countries, markets, and genders. The United Nations Educational, Scientific and Cultural Organization (UNESCO) estimates more than 1.5 billion learners have been affected by school and university closures, exposing youth to violence, exploitation, and lack of access to safe environments.

With the hindsight of a hard legacy behind us, the Human Capital Initiative (HCI) experts identified the top policy priorities for public health, gender, education, and human development to build an inclusive recovery in the year ahead:

Support Women’s Market Work amid COVID-19

Women around the world have been disproportionally affected by the Covid-19 pandemic. First, women are more likely to work in sectors that were most negatively affected by the pandemic, such as leisure and hospitality, retail and some services. Research by McKinsey and Company shows that 54 percent of global job losses have been suffered by women, although they represent less than 40 percent of workers. Second, in developing countries, women are much more likely than men to work in the informal sector, and thus, less likely to benefit from social protection during the pandemic. Third, women have carried most of the weight of increased childcare responsibilities and other household chores due to school closures and lockdowns. In the US, for example, approximately 2.2 million women dropped out of the workforce between February and October of 2020 to take care of children. In developing countries, more household responsibilities mean women will struggle to keep working in their small businesses.

Globally, women-owned enterprises are about 6 percentage points more likely to have closed their business than male-owned businesses due to the pandemic. This gender gap is explained both by women’s businesses operating in more affected sectors and by women facing higher difficulty balancing family and work.

The setback of women in the labor force does not only harm women and their families – it has a high cost in terms of economic growth and productivity. Bringing women back into the workforce should be a priority of governments all around the world. The specific policies will depend on the country. The US, for example, needs to avoid a permanent and dramatic contraction of the childcare sector by providing economic support, while countries where women’s main source of work and income is their own small business need to provide financial support to women-led enterprises.

Prioritize Maternal and Child Health 

With the development of the COVID-19 vaccine, much of the global focus will now be centered on vaccine production, vaccine distribution across countries and populations, and complementary preventative measures such as social distancing, contact tracing, mask wearing, etc.

Such efforts play a critical role in the pandemic response; however, they also bear significant costs to health systems by diverting resources and support for other essential health services. Indeed, an accompanying feature of the pandemic has been the reduction and suspension of health programs, particularly in maternal and child health, the consequences of which will be observed for years to come. Recent evidence from the Ebola outbreak in West Africa has shown how health emergences can be a significant threat to the lives of mothers and children not only through the direct effects of the outbreak (higher mortality, infection, etc.), but also through the diversion of scarce resources from essential health services, such as emergency obstetric care, antenatal coverage, facility delivery coverage, and child immunization programs.

In applying the lessons learned from Ebola to the COVID-19 case, we can expect that the reductions and stagnations in service provision over the last year will likely contribute to adverse health and mortality outcomes for women and children, particularly in settings where service provision was already constrained. With this in mind, policymakers must continue to monitor the impact of the pandemic, and the global responses to the pandemic, on these vulnerable groups. Moreover, investments that are targeted directly to women and children must be made to re-establish essential services and recover all of the progress that has been made in recent decades.

Build Gender-Inclusive Institutions

The impacts of COVID-19 are blindingly clear for gender inequality. Globally, women comprise over 70 percent of healthcare workers – and even more in COVID-19 epicenters (90 percent in China’s Hubei Province and 78 percent in the US), according to UN estimates. In the world’s largest democracy, India, the face of frontline health workers is almost exclusively female, and plans for mass vaccination rely on women. Yet, women are less likely than men to have access to formal wages, wealth, healthcare, and, as health workers have less effective personal protective equipment (PPE).

At the very moment when women’s work serves a vital function for our survival, we see women leaving the workforce in disproportionately high numbers: McKinsey estimates women’s jobs are 1.8 times more vulnerable to the global pandemic than men’s jobs, accounting for 54 percent of overall job losses while women represent only 39 percent of global employment. This is mainly a response to the increasing burden of care as schools and daycare centers shut down.

Pre-pandemic, women performed at least three times as much care work as men, according to the International Labour Organization. While some studies predict that gender norms may shift as men increase their engagement by working from home, there is a clear cost of our failure to build institutional support for “care” that has locked many women out of the labor force during the pandemic, amounting to a loss of $64 billion in the US and up to $13 trillion in potential global GDP by 2030.

What can we do? Alongside making healthcare coverage universal, we should make access to childcare and education universal and safe for all concerned. To do so, governments should make substantial investments to guarantee and improve the pay, job security, and benefits of daycare providers and teachers at all levels; upgrade the physical infrastructure of schools so they are safe to attend; direct significant additional learning, career, and financial resources to the most vulnerable students and families; and provide significant investments in our mental health infrastructure to support necessary healing of individuals, families, and communities during this collective trauma. These investments are costly, but their price pales in comparison to what they will enable us to achieve.

Now is the time to tackle inequality head on, for a resilient future where we not only survive, but expand our capacity to flourish.

End Decades of Neglect for Public Health in the United States  

The year 2020 was an epic failure of disease management and social policy in the United States. About 450,000 more Americans died in 2020 than in a typical year, a 15 percent increase in total mortality. COVID-19 was the bullet, but long-standing failures of economic, social, and health policy were the gun.

COVID-19 exposed the underbelly of American exceptionalism: anemic worker protections and enforcement; a health care system that ties people to their employers and leaves millions uninsured when they most need care; decades of divestment in public health infrastructure; poverty wages for service sector and frontline workers; an uneven and capricious system of unemployment insurance; crowded housing and segregated communities; no universal paid sick leave; mass incarceration that put millions at risk of infection; and immigration policy that criminalizes migrants and discourages use of public services. These factors led to dramatic differences in exposure to COVID-19 by race and class.

These specific policy failures are rooted in systemic racism, rising income inequality, and neglect of the basic obligations of government to solve collective problems and improve people’s lives over the past 40 years. As illustrated in a new Lancet report, decades of neglect have left the US with health outcomes that lag far behind other wealthy nations. Before COVID-19, if the US had mortality rates equivalent to other G7 nations, 461,000 deaths would be averted each year, a number that has increased steadily since 1980. Even if the Biden Administration can effectively bring COVID-19 to heel through mass vaccination, the US will still be losing half a million Americans each year to premature death.

As we look to 2021 and beyond, we need to learn the right lessons from COVID-19, focusing on policies that reduce economic precarity and protect public health. For example, expanded income transfers through the federal unemployment insurance subsidy led to marked reductions in food insecurity. More than a return to normal, the US needs large scale reinvestment in the health of all Americans.

Subsidize Vocational Education Programs  

Even before the pandemic, many developing countries faced a serious challenge of youth unemployment. Over the past 20 years, most developing countries have experienced tremendous growth in school enrollment and rates of primary school completion. But education systems have often struggled to adapt to the pedagogical challenges of teaching millions of first-generation learners.  Despite the tremendous heterogeneity of preparation levels within the classroom, curricula are often tailored to the top of the class, and many students fall so behind their grade in the first few years of school that their learning stagnates.    

As a result, a size-able share of new cohorts entering the labor force have decent educational qualifications, but lack foundational skills. These skill gaps mean that employers have additional challenges in screening candidates (as qualifications aren’t a great indication of skills) and in training new hires. Moreover, if turnover is high, firms may have weak incentives to train workers.  

There is thus a strong case for governments to subsidize vocational education programs. These programs could build foundational literacy and numeracy skills, as well as coordinate with the private sector to ensure they cover relevant sector-specific skills. Ensuring demand for these programs will also require a change in social norms. Many societies stigmatize blue-collar work and give little prestige to vocational qualifications, even though they prepare one well for a specific career.  

In many countries, the pandemic has aggravated and made the employment crisis salient, but if the pandemic experience increases the political returns to act now on this chronic problem, it would be a (small) silver lining.