Every year, UNGA brings together governments, civil society, multilateral institutions, philanthropy, and others for a dizzying number of conversations about the issues shaping our world. This year, artificial intelligence, growing geopolitical divisions, and the future of multilateral cooperation were impossible to miss. And for those of us working in global health, the High-Level Meeting on Pandemic Prevention, Preparedness and Response was an important focus, bringing renewed attention to how the world prepares for the next pandemic.
These are important conversations, and I spent plenty of time engaged in them. But, last week, as I moved from event to event across New York, I found myself increasingly distracted by something that wasn't getting nearly as much attention: the remarkable number of men on the stages. “Manels,” (a panel of speakers composed entirely or almost entirely of men) it seemed, were everywhere.
This was particularly noticeable when government officials were involved. I sat through panel after panel that were overwhelmingly male. Manels are not a new phenomenon and there has been plenty written about why event organizers should do better. But after a few days, I started wondering whether what I was seeing was really a problem with the panels, or whether the panels were simply reflecting a much larger imbalance.
When I got home, I started looking at the numbers.
Across 194 countries, only about 27% of Ministers of Health are women, based on the most recent information I could identify. For Ministers of Finance, the figure is approximately 13%. About 21% of Foreign Ministers are women.* And in March of this year, the President of the UN General Assembly noted that just 40 of the 193 Permanent Representatives to the United Nations in New York were women.
Those numbers helped explain what I had seen during UNGA. By the time an event organizer starts assembling a panel of senior government officials, much of the gender imbalance has already happened. But the more I thought about it, the less concerned I became about the panels themselves. This is not fundamentally about who gets a speaking slot at an event but about who gets to make decisions.
Health ministers make decisions about health systems, maternal health, sexual and reproductive health, infectious diseases, health workforces, and access to essential services. Finance ministers make decisions about whether those priorities receive resources. Foreign ministers and ambassadors negotiate agreements and shape decisions about development, conflict, humanitarian response, security, and international cooperation. These decisions affect everyone, but many of them have profound and distinct consequences for the health, rights, safety, and economic security of women and girls. Yet women remain dramatically underrepresented among the people making them.
I lead a civil society organization, not a government ministry. But I have spent much of my career working alongside advocates and communities trying to ensure that the people affected by policy decisions have a meaningful voice in shaping them. It is a principle we talk about constantly in global health: who participates matters. We believe that when we talk about communities and when we talk about civil society. We should believe it when we talk about government leadership, too.
There is another dimension to these numbers that I find particularly troubling. Women are not simply underrepresented in cabinets overall. They are also less likely to hold some of the portfolios with significant control over money, diplomacy, and security. UN Women has documented this pattern, with women more heavily represented in portfolios related to gender equality, family, children, and social affairs, while men continue to dominate areas including finance, defense, and foreign affairs.
That means counting the number of women around a cabinet table only tells us part of the story. We also have to ask which seats women occupy and where decision-making power sits. My quick look at health and finance illustrates the point: women make up roughly 27%of health ministers but only about 13% of finance ministers.
For those of us working in global health, that distinction matters. We spend a great deal of time talking about sustainable financing, domestic resource mobilization, and the need to make health a political and economic priority. Those decisions do not sit solely with ministries of health. They are shaped by finance ministries, heads of government, and other political leaders. Who holds those positions matters.
Perhaps what has stayed with me most since I started looking at these numbers is how accustomed we seem to have become to the imbalance. If I walked into an event with 10 speakers and nine of them were men, I would notice immediately. Many of us would. But a world in which nearly nine out of 10 finance ministers are men generates considerably less surprise. A world in which roughly four out of five countries are represented at the United Nations by a man has somehow become normal.
There has been real progress in women's political representation, and that’s encouraging. But progress and parity are not the same thing. I worry that we have become so accustomed to incremental gains that we no longer react strongly enough to the scale of the imbalance that remains. Cabinet appointments, diplomatic appointments, decisions about who will control a country's finances, represent it internationally, or lead its health system are all choices. There is no shortage of qualified women capable of doing these jobs.
Event organizers should absolutely continue paying attention to who is on their stages. Representation matters, and there are almost always opportunities to broaden whose expertise and leadership are included. But we cannot panel-design our way out of a leadership problem.
I started asking these questions because I was struck by how many stages at UNGA were filled with men. I came home realizing that those stages were telling us something much bigger. The question isn't only who gets the microphone but who has the authority to make the decisions in the first place.
In global health, we talk constantly about participation, equity, and the importance of ensuring that people have a meaningful voice in the decisions that affect their lives. But meaningful participation is not only about who is consulted or invited into the room. It is also about who holds power once they get there. Women are dramatically underrepresented in the positions that determine how resources are spent, which priorities are pursued, and how countries engage with the world. We should be asking harder questions about whose perspectives are shaping those decisions.
This is about more than representation. It is about whose experiences inform policy, whose priorities carry weight, and who has the authority to decide. For a field committed to improving health and well-being for everyone, that makes gender parity in political leadership more than a leadership issue. It is a global health imperative.
*Sources include: https://www.cia.gov/resources/world-leaders/foreign-governments/; WHO Gov Dataset (https://politicscentre.nuffield.ox.ac.uk/whogov-dataset/); and https://www.ipu.org/resources/publications/infographics/2025-03/women-in-politics-2025