#SpeakerSpotlight: Loune Viaud

Women are the metaphorical backbone of the health sector, they enrich the sector at all levels, and yet their representation around the decision-making table is plaintive. 75% of global health positions are occupied by women, and yet 25% make up global positions of leadership. Across nearly every profession in the sector, women encounter hurdles to their progression; from hostile working environments unconducive to leadership, to the double-standards that belittle their capabilities. To reach positions of leadership, they often have a more labyrinthine journey to the top, unable to progress up a linear career trajectory in the same way as men.

I spoke to Loune Viaud, Executive Director of Zanmi Lasante, as Partners in Health is known in Haiti, who shared the challenges of working with government and policymakers globally to ensure health is a top priority. Her solution? Visible advocacy from a variety of networks, strong channels of communication, ensuring there is always a clear path to outcome when fundraising and, most critically, representation at the top. Health systems cannot improve if the people making the decisions are not reflective of the people they are serving. The decisions around ‘Universal’ healthcare should not mean ten men and one woman in the boardroom. Nor should it mean the same ten taking up executive offices in the western world.

Loune herself knows first-hand the importance of women’s voices at the table, as the first Haitian woman ever to represent Haitian civil society at the UN Security Council. ‘When women speak, we speak of social adversities and equity’ she explains. ‘It’s necessary to have women’s voices at the table to look at the whole person, to speak on human capacity, whilst focusing on vulnerable populations, equity for women and girls.’ By committing to intersectionality and diversity in policymaking you create an environment where more voices are represented, and move the dial closer to more inclusive, fairer health access for all.


But it’s a downstream dialogue also. The importance of communication extends beyond the decision-making table to the valuable resource at the community level. If you look around the world, the majority of healthcare providers are women, and yet their unique insights at field-level are often left unvoiced. Too often health programmes are developed without consulting those who will actually implement the programs, those who have primary contact with the patients the program is designed for. ‘CHW’s live in the community so they are the experts.’ says Loune, ’the challenge is lack of visibility … their voices are often offset at the discussion table’. After all, PIH started as a community health worker organization, and has continued to be the cornerstone to the organization’s success over the years. CHW’s are the experts in what is right for the patient, not just in terms of the physical treatment, but in terms of how you personalize it to different cultural and environmental contexts. ‘As representatives of the communities, they want what is best for their neighbors and how to support them.’ In certain countries, they are the only source women seek treatment or advice from, especially in sexual and reproductive matters. To ignore this is to see a very small section of the issue, and consequently to act upon it in an unrefined, un-localized way.

Whilst these inequities still exist, I ask Loune about her advice to the next generation of women eager to become leaders of the future. ‘Aim high ‘says Loune, ‘The next generation have more access to services and tools at their disposable and should make use of them to accelerate their progression.’ Diseases such as HIV/ TB are today no longer a death sentence due to vastly improved treatments, and vaccines such as HPV can eradicate cervical cancer. And although this is clearly progress, unless these vaccines and treatments are widely available and affordable in all parts of the world, a major problem still exists – that of health inequity. ‘We as leaders have made a path for the next generation, to learn from our lessons’, says Loune, ‘But they need to improve it, they need to do better than us’.

Laura Wotton