Gender issues: do as I say, not as I do?

In this issue of the Journal, Panteli et al. (6) provide insight into the extent to which a gender-sensitive approach is adopted by sixty health technology assessment (HTA) agencies worldwide. Their findings should make all of us involved in the production of HTA take pause: less than a handful of the agency Web sites that were examined by Panteli's team made any mention of gender as an explicit consideration in priority setting processes or in the HTA methods used (6). This is despite the fact that gender is recognized as a social determinant of health (1) and despite best practices that acknowledge the need to account for equity issues—of which gender is one—in the design, conduct, and reporting of HTA (3;4). Assuming we take the findings of Panteli et al. at face value, this does seem to be a case of " do as I say, not as I do. " Admittedly, the work of Panteli's team could be more comprehensive; only the Web sites of HTA agencies were consulted so whether these agencies' Web sites were current and reflective of actual agency practice could be open to debate. A more thorough approach would have been to contact key individuals within each agency to validate the Web site's information or to identify an appropriate sample of HTA reports to determine the extent to which a gender-sensitive approach was applied. This, of course, takes time. In addition, in 2011, there is really no excuse for these agen-cies' Web sites to not accurately reflect current practices and approaches. So, although this reliance on Web sites may have contributed to a degree of uncertainty surrounding the precise prevalence of gender-sensitive approaches among this sample of HTA agencies, I would suggest that Panteli's conclusions are not too far off the mark. So why is this the case? I think I can safely say there is general agreement for what should be examined in an HTA, and an appreciation for why. The fact that HTA studies the clinical, economic, social, ethical, and broader implications of the development, diffusion, and use of a health technology is what makes HTA so inherently valuable to decision makers (5). If we, as HTA producers, didn't believe this to be the case, I doubt we'd be working in this field. On more than one level, a gender-sensitive approach to HTA makes complete sense. Such an approach speaks not only to …