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Minority ethnic status, class, education, and sexuality determine who is represented in unpaid community health-care worker roles 8 The unpaid and low paid labour of women has contributed to profits for private health-care providers and saved the bottom line of health spending in national budgets: capitalism and patriarchy combine to systematically undervalue social reproductive labour—ie, unpaid care roles as women\'s work 9 Governments’ ability to fund health-care services is dictated by their revenue and fiscal policy space Yet the IMF and the World Bank continue to prioritise austerity measures and “private sector first” strategies that systematically undermine the ability of governments to provide public services and achieve UHC 14,15 Neither institution has linked its rhetoric on promotion of gender equality to the development of a systematic approach for evaluating the implications of its austerity policies on gender inequality, health delivery, or outcomes 16,17 The key funders of the IMF and the World Bank, and those that hold the greatest number of Executive Board votes, are G7 and G20 members A feminist economic approach to health requires that all people at all levels of health-care decision making reorient their notion of wellbeing to include gender equality for women in all their diversities 19 Feminist knowledge informs what we count as costs and savings: the national income saved from women\'s low wages or volunteerism as health-care workers;20 the benefit to national budgets and health outcomes when there are gender-based violence health-care prevention programmes;21 and the negative burdens carried by health-care workers exposed to violence, harassment, and exploitation when their work is located in unregulated environments, including homes, non-governmental organisations, and provincial health clinics 22 A WHO economic engagement strategy that does not address the social and political determinants of health delivery, resourcing, and decision making risks perpetuating the falsehood that health is a technical enterprise that can be achieved in a silo
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