Squeaky-clean Iceland, with only 345,000 people, is among the most advanced, prosperous nations in Europe. Crowded Nigeria, with 214 million inhabitants, ranks low in the UN Human Development Index, and despite its oil wealth remains one of the world’s most corrupt countries.

Yet when it comes to women’s health and gender equity, it seems the two share a few things in common.

On March 31, the Meridian International Center hosted a lively discussion on that very topic, featuring both countries’ female ambassadors to the United States: Iceland’s Bergdis Ellertsdóttir and Nigeria’s Uzoma Emenike. The global business briefing was limited to 20 people due to lingering coronavirus concerns, though the one-hour panel is available online here.

Nancy Brinker, US ambassador to Hungary from 2001 to 2003 as well as US chief of protocol during the George W. Bush administration, kicked off the discussion, which was moderated by Jayne O’Donnell, CEO of the Urban Health Media Project.

“For a long time, breast cancer was a dirty word, and was until 1974, when Betty Ford spoke openly about her breast cancer, prompting many women to get checkups,” Brinker said. “But it took years of resistance and step-by-step change to get to where we are today.”

Brinker, who in 1982 founded Susan G. Komen for the Cure, added: “Cancer is deeply personal; I’m a cancer survivor myself, and during my time as ambassador to Hungary, breast cancer was the leading cause of death among Hungarian women. And I saw the same stigma around breast cancer that we saw 40 years earlier in America.”

Yet only 12% of women worldwide said they were tested for cancer in 2020, according to the latest Hologic Global Women’s Health Index—billed as the world’s most comprehensive, globally comparative survey about women’s health, representing the feelings and actions of 2.5 billion women and girls.”

This latest survey, conducted in partnership with Gallup, took place between February 2020 and March 2021 and is based on nearly 120,000 individuals aged 15 or older in 116 countries and territories. Among its key findings:

• The Hologic Global Women’s Health Index global score was just 54 out of 100, and not a single country or territory scored higher than 69.
• Some 40% of those surveyed—equivalent to about one billion women and girls—said they had not talked to a healthcare professional in the last year, while 60%—about 1.5 billion—had not been tested for four common diseases that affect women’s health.
• Only one in three women worldwide had their blood pressure tested in 2020, even though heart disease ranks as the top cause of death globally.
• Diabetes is the sixth leading cause of death for women globally, but only 19% of women reported being screened for the disease. In countries like the US with high obesity rates, only one in three women reported being tested.
• Fewer than one in nine women had been tested for sexually transmitted diseases or infections—all of which are risk factors for HIV, cancer and infertility—in the previous 12 months.

“I’m from a less-developed country,” said Emenike, who came to Washington last year as Nigeria’s first-ever female ambassador to the United States.

“Yes, Nigeria has oil, but that doesn’t negate the fact that we’re still a Third World country. And women in most of these countries make up a greater percentage of the workforce—but not in established small- and medium scale industries,” she said. “I’m talking about women who go to the farm, who have small stores where they sell groceries, women who sell in the marketplace, dressmakers and others who have to provide for their families and make ends meet. Then they come home and do the cooking and chores. Just imagine the impact this has on their health.”

Emenike said it’s the Nigerian government’s policy to boost the number of girls in school, where hygiene and sanitation is taught. At present, only 47% of the country’s girls attend school, meaning more than half of them aren’t even getting a basic education—which is key to helping women make decisions for their own healthcare and be independent in their thinking and earning potential.

“Do we have the facilities to take care of their health? It’s not that it’s nonexistent, but it’s not adequate enough,” she said. “Many of them, by the time they’re of puberty age, they still don’t understand what menstruation is all about. So we need a lot of sensitization. These are some of our challenges. But we still have a long way to go.”

Ellersdóttir, Iceland’s ambassador, said it’s important for women leaders—especially those in the public eye—to speak up.

“We do pride ourselves on being a gender-equal society,” she said. “But recent research in Iceland confirms that, unsurprisingly, there’s a correlation—even in a society like ours—between economic status and access to health. This is something we really need to tackle.”

She conceded that violence against women is still a problem in relatively crime-free Iceland, and that “during the pandemic, it became worse.”

In fact, the Hologic Global Women’s Health Index found two in three women worldwide—or about 1.7 billion women—say domestic violence is a widespread problem in their country, and nearly six in 10 men agree.

“Our defining moment on the path toward equality was when we elected a woman as president in 1980,” she said, recalling Vigdís Finnbogadóttir, who made history in 1980 as the world’s first woman to be democratically elected as president. She served for 16 years first woman to be elected head of state anywhere in the world, and at 92 remains UNESCO’s goodwill ambassador for languages.

“During the campaign before the election, she was always questioned about her gender,” Ellersdóttir said of her Icelandic heroine. “And one of the issues she spoke openly about was being a breast cancer survivor. A reporter asked if she’d be fit to be president without breasts, and she answered, ‘Well, I’m not going to breastfeed the nation.”