The United States is the world leader in supporting global health and humanitarian response, making it uniquely placed to elevate the critical health and safety needs faced by women and girls in emergencies and fragile settings around the world. While addressing these needs is an important goal on its own, it also forms a pillar of global health security, as the preven­tion of health crises and conflict, and recovery after they occur, are greatly enhanced when these needs are met.

The United States has unrivaled financial and pro­grammatic capacities in maternal health, reproductive health, family planning, and gender-based violence (GBV) prevention and response. However, it seldom marshals these extensive capacities in emergency settings, where the needs and vulnerabilities of women and girls are most severe. In emergencies around the world—from the Ebola outbreak in the Democratic Republic of the Congo (DRC) to the simmering conflict in Venezuela to the protracted crises in Yemen and Syria—the United States has not channeled its exten­sive capacities to address glaring operational gaps in these critical areas. The alarmingly high risks of GBV and severely limited access to maternal health, family planning, and reproductive health services are too often overlooked in these and other crisis settings.

A categorical shift is required for the United States to prioritize women’s and girls’ health and protection in emergency settings to advance resiliency and health security. There is growing recognition among both practitioners and policymakers that failure to address these gaps significantly worsens the impact and trauma of crises and significantly undermines global health security. Conversely, the engagement of wom­en, girls, and communities in decision-making and program design can help build public trust and confidence, which is sorely lacking in many health security crises around the world.

This report proposes an approach to ensure that the extensive capacities of the U.S. government in the areas of maternal health, reproductive health, family plan­ning, and GBV prevention and response are no longer left on the sidelines in crisis response and recovery. The overarching goal of this approach is to correct this persistent problem and bring existing resources and programs to bear to ensure the health and safety of women and girls in crises and disordered settings.