IHME Women in Health Metrics Spotlight: Prof Deborah Malta, Federal University of Minas Gerais, Brazil

Can you share any challenges you have faced as a woman in this field and how you overcame them?

It is not easy to be a woman and a researcher, especially at the beginning of your career, when women face this double shift even more and, often, women spend long periods away from research during periods of maternity leave. This results in fewer women publishing, fewer women receiving funding, fewer women leading research groups. This is the result of this process of structural machismo – we still have a long way to go, and a lot of change needs to be made. It was no different for me at the beginning of my career: it was difficult to balance work, my master’s and doctoral studies, and motherhood.

How do you think gender diversity impacts the field of health metrics science?

Choosing a career in science is especially challenging for women. Prejudices, gender stereotypes, and lack of support make it difficult to continue and, consequently, to succeed in careers in all countries, especially in low- and middle-income countries. According to the UNESCO Institute for Statistics, in a survey conducted in 107 countries between 2015 and 2018, women represent 33.3% of researchers worldwide. They are also less credited in articles and receive less funding. This is no different in Brazil. Reversing this situation is essential. However, female sensitivity definitely impacts the perspective of research. Women stand out for their choice of topics such as social inequality, studies among vulnerable populations, and domestic violence. Thus, women in science add new questions and new perspectives. Topics such as diversity, equity, and ethics gain prominence and centrality with women. In addition, women are very determined in their objectives and goals, and at the same time supportive, seeking to add new perspectives and new applied topics that can improve people’s lives, which have consequences for improving public policies.

What advice would you give to young women interested in entering this field?

Take your place! Science needs you – it needs the female perspective! Women’s sensitivity makes all the difference in research questions. The research questions that women bring to the table are extremely relevant and include topics such as care, looking at vulnerabilities and inequalities; these are of great relevance. Be bold and fight for your space! We have to expand the space for women in science. When one woman opens a door, others will follow.

How did you get involved with GBD/IHME and how has it impacted the way you do your work?

My partnership with GBD began 10 years ago, in 2014. I was the Director of Surveillance in Non-communicable Disease and Prevention of Violence at the Brazilian Ministry of Health when we invited Professors Chris Murray and Mohsen Naghavi, and other colleagues of the IHME team to come to Brazil to present GBD at Expoepi Conference. That’s when the GBD Brazil network was born, and we began a partnership that has been so important for Brazilian research. We have had a lot of collaboration with IHME, which is a two-way relationship. Brazilian researchers have contributed a lot to national databases, supporting corrections to GBD estimates, adjusting methods and national analyses. Brazil has hundreds of databases and historical series on mortality, hospital admissions, live births, disease notifications, violence notifications, and epidemiological surveys, all of which are widely accessible and free of charge, making a major contribution to global estimates. As a partnership, we have also learned a lot from the IHME team. We have made progress in understanding the methods and metrics for calculating the burden of disease. In recent years, we have published more than 100 articles analyzing data from GBD Brazil, which has contributed greatly to understanding the health situation of the Brazilian population.

Can you share any ongoing projects or research projects that you are involved in and that you are very proud of?

One of the most far-reaching studies has been the analysis of gender-based violence measures, a sad reality that affects almost one-fifth of Brazilian women and girls. We have established many national and international partnerships, including partnerships with Professor Emmanuela Gakidou’s team (IHME) and support from the Gates Foundation to analyze these data. We have published numerous articles in scientific journals and disseminated results in the mainstream media. We have carried out advocacy work and denounced the conditions of daily violence against children, adolescents, and women. We have also made progress in training health professionals and students; we created an application that trains and encourages health professionals to report violence. Thus, we understand the meaning of research articulated with public policies for the protection, prevention, and promotion of health, aiming to achieve SDG 5.4: “End violence against women and girls.”

How do you see the future of health metrics science evolving with more women in leadership positions?

Although we are evolving, there are still few women in leadership positions. In Brazil, we had only one woman president, who was impeached due to misogyny and structural machismo. In Brazil, the number of women in congress is only 18%, and there are few female governors and mayors. In science, it is no different: less than 30% of articles have women in leadership. It is essential to monitor these metrics and seek policies that value women, provide ongoing training, and seek gender equity. For policymakers, understanding the global and national scenarios can help inform decisions, such as allocating research funding and incentives for female researchers, and defining strategies to stimulate investment in gender equity policies.

What policies or initiatives do you think are necessary to support women in health metrics science?

I think it is essential to allocate more funding for science, launching public calls that value women in science more. Opening specific calls for proposals for women, practicing gender equity, valuing quality basic education and free public universities, supporting the training and qualification of young female scientists, and allocating more funding for research are essential to changing this situation.

Can you share any success stories of significant impact on policies due to your research/policy work?

I worked for many years at the Ministry of Health on epidemiological surveys on NCDs and violence that showed the magnitude of NCDs and their risk factors. With this, we were able to influence many policies in Brazil, such as the launch of the National Plan for Chronic Non-communicable Diseases in 2011, which I coordinated, in which we launched the “Health Academy Program,” transferring federal government resources to municipalities to invest in community programs to encourage physical activity and promote health. The NCD Plan also included policies to combat tobacco, based on the research I coordinated. Thus, we were able to influence and launch new ordinances from the Ministry of Health and support new laws such as the creation of tobacco-free environments (2011), expanding the warnings on cigarette packaging, increasing taxes on tobacco products, and banning the sale and marketing of electronic cigarettes in the country (2009). Based on research evidence, we were able to support the enactment of healthy public policies. I would also like to highlight the 2011 publication of the mandatory notification rule for all cases of domestic violence treated in health units. This initiative resulted in the prioritization of the issue of gender-based violence in the Unified Health System. Currently, more than 400,000 cases of domestic violence are reported in health units every year. What was once invisible has become a public health concern, and there is still a huge under-reporting of cases, requiring close attention and training of health professionals, a step that we are also working on. In other words, health research can influence healthy public policies that defend life.