Pay, Protect and Respect Women Health Workers on the Front Lines of Vaccine Distribution

In a new report released today, CARE estimates that for every $1 a country or donor government invests in vaccine doses, they need to invest $5 to deliver the vaccine. Half of that cost must go to funding, training, equipping, and supporting health workers — predominantly women — who administer vaccines, run education campaigns, connect communities to health services, and build the trust required for patients to get vaccines.

Investing in fast and fair global vaccine distribution will save twice as many lives as maximizing vaccine doses for the wealthiest countries in the world. Even better, investing in vaccine equality will speed up economic recoveries in every country in the world. Failing to make this investment could cost wealthy economies $4.5 trillion in economic losses.

Shots in arms are only part of the equation. That overlooks the millions of health volunteers who are holding the vaccine distribution system together. These women are:

• Helping people trust health services enough to believe that they should get a vaccine at all
• Making sure people show up for vaccines at the right time for their appointment
• Providing information about vaccination campaigns, handwashing, and COVID-19 safety
• Running logistics and safety and vaccination points
• Keeping regular health services—like pre-natal visits—running

These systems run on the more than 3.5 million semi-formal and informal health workers around the world who serve patients at the “last mile” of delivery. At least 70% of these health workers are women and they are risking their lives to get vaccines, services, and supplies to the most underserved and at risks populations in the world.

Appallingly, these women are getting little of the protection, recognition, equality, and pay that they deserve. Women health workers contribute $3 trillion to the global economy every year, but half of this work is unpaid and unrecognized. Where they do get paid, they make 28% less than their male counterparts. They aren’t getting access to the vaccines, either. WHO estimates that currently 30 million high-risk people are not included in any government vaccination plans, and many of them are community health workers.

No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.

To benefit globally from vaccines, we must pay, protect and respect women frontline health workers and their rights — a cost that is largely absent from recent WHO estimates on vaccine rollout costs. In fact, current cost estimates pay for per diems, but exclude salary costs or the real cost of running sustainable health systems. No current global conversations or guidance on vaccine costs includes the full cost of community health workers or long-term personnel costs.

As new and dangerous strains of COVID-19 emerge in countries that are struggling to access the vaccine and control the pandemic, every day that we wait for fair global vaccination allows for more contagious strains that spread around the world. The more chances the virus has to mutate in non-vaccinated populations, the higher the risk for everyone. Comprehensive global vaccine delivery plans that make sure the vaccine gets to people who need it — and that those people are ready to get the vaccine when it arrives — are the only way to end this threat. No one is safe until everyone is safe.