No health workforce. No health MDGs. Is this acceptable?
Yesterday, a packed room full of high-level delegates, policymakers and civil society organizations met at the United Nations Headquarters in New York to address the critical question: “No health workforce. No health MDGs. Is that acceptable?”
The UN MDG Summit side-event was organized by the Global Health Workforce Alliance (GHWA) in close partnership with the Health Workforce Advocacy Initiative (HWAI) and HWAI steering committee members, Physicians for Human Rights (HWAI Secretariat), Merlin and AMREF. The panel discussion was moderated by health expert and advocate, Dr Joia Mukherjee, from Partners in Health, with speakers from a range of country governments and bilateral donors. The keynote address was read on behalf of the President of Malawi by his Minister of Health.
Panelists described the alarming human resources challenges they faced in their countries. The audience learned from the Cameroonian Minister of Health (Mr Andre Mama Founda), that Cameroon has just four health workers for every 10,000 people, and that these health workers are paid an average monthly salary of just $331 per year. The difficulties are even greater in fragile states. For example, Carolyn Miller (Chief Executive of Merlin) noted that Liberia had only 23 doctors remaining in the country after peace was declared in 2003, down from the pre-war level of 237.
The message stressed by all panelists was the clear and critical link between the health workforce and health MDGs 4, 5 and 6. Japan’s Vice President of the Japan International Cooperation Agenct (JICA), Mr Kiyoshi Kodera spoke of the strong correlation between the availability of health workers, coverage of health services and health outcomes. Given this relationship, Dr Bjorn-Inge Larsen (Director General of the Norwegian Directorate of Health) argued that it is essential for global leaders to drastically scale up access to motivated and well trained health workers, without which, the international community would be unable to reach new commitments to maternal and child health.
So what can be done?
The audience learned the positive news from the Malawian Minister of Health (Dr Francisco Eduardo de Campos). Since the initiation of Malawi’s six-year Emergency Human Resource Programme in 2004, the country has succeeded in increasing the number of health professionals by 66%. Consequently, Malawi is now on track to achieve MDG 4 on child health, prevention of mother to child transmission services now reach 68% of women, and over 13,000 lives have been saved.
As Michael Anderson (Director of General Policy and Global Affairs at DFID) told us, ‘the exciting thing… is that this experience shows us that we can do this. We have the knowledge now on what can actually work”.
The speakers were clear on what needs to happen. There must be strong, sustained and significant financial and political commitment to the health workforce. This includes the effective scale-up and support of an additional 3.5 million health workers. And leaders are willing to take action. As Mr. Kodera of JICA Japan fervently declared, “We must take this opportunity to take the issue of human resources for health forward… and Japan is ready to ramp up its efforts”.
The event concluded with Merlin’s Hands Up for Health Workers petition. Safaa, a young health worker from Sudan presented the petition with 12,000 signatures to ministers of health from Cameroon and Malawi. She made an impassioned plea for global leaders to act on the health worker crisis and ensure health workers were adequately trained, supported and deployed to meet the needs of individuals and communities.
By the end, all the panelists and the more than 100 member audience raised their hands in support of health workers everywhere.