Addressing the Global Health Workforce Crisis

After I went to Uganda for the Global Forum on Human Resources for Health, I spent a week in Kenya, meeting with our partner group, the Kenya Health Rights Advocacy Forum. As many of you know, Kenya was just coming out of a tragic post election period during which violence killed over 1200 people and displaced almost 300,000. While a peace agreement has been signed, there remain deep divides and challenges to be met in Kenya—especially around health and health workers. During the turmoil in January and February, health workers were displaced, and some faced violence and ethnic discrimination, weakening the health system and scattering doctors and nurses across the country—including to IDP camps. HERAF is deeply concerned about the effect of post-election violence on health workers, and therefore, on the entire health system. During the crisis, HERAF stood with civil society to urge an end to violence and attention to health rights, especially for those with HIV/AIDS. In the coming months, they will document the effects of the violence on health workers while advocating for health and human rights for all during this difficult recovery period in Kenya’s history.

Indeed, while challenges remain in Kenya and across the continent, the Forum gave the world renewed energy to fight for health systems that work—and renewed anger at the promises made and not kept by policy makers world wide.

Please find attached HWAI’s new Platform on Adequate and Sustained Health Workforce Financing, one way PHR will continue to fight to health systems and human rights around the world. We’ve heard plenty of rhetoric about the need for improved health workforce worldwide—but have yet to see anything near the estimated $70 billion needed to make this happen. Donors, national governments and international financial institutions all have obligations–and HWAI demands they meet them in order to ensure health rights for all. Read our platform and stay tuned for what you can do to help build health systems in Africa.

HWAI Platform on Adequate and Sustained Health Workforce Financing (PDF)

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The Health Workforce Advocacy Initiative (HWAI) held our second strategy meeting during the opening two days of the Forum. PHR chairs and helped to found this international advocacy coalition affiliated with the Global Health Workforce Alliance. We’re a coalition of 14 institutions from Africa, the United States, Europe and Asia, with a loosely affiliated network. Building on plans from our first strategy discussion, we have decided to launch a Campaign on Sustained Health Workforce Financing.

The choice seemed fairly self-evident. So many of the things we’re talking about in the health workforce arena—retaining health workers, training new ones, improving their working conditions, ensuring that they receive health care, providing health workers to serve in rural areas—cost money. That money simply hasn’t been forthcoming. Since health workforce came onto the international agenda three, four years ago, we have all had one example of significant donor investments in health workforce—the United Kingdom (along with the Global Fund) in Malawi. The attention is now there, but not the money. Moreover, if there was one area where civil society had to be speaking out, it would be evident that governments—even those genuinely interested in strengthening the health workforce—and I think many are—weren’t going to be doing it on their own.

Well, this isn’t exactly our first launch. We decided upon this campaign back in July. But our work quickly moved elsewhere—rights-based national guidelines on developing health workforce plans, an advocacy toolkit for health workers, preparing for this Forum and more.

But that’s going to change. Over the past days, we strategized on how to re-energize the campaign, and I think we’re off to a good start. We still have to finalize our plans, but the opportunities are there, including bringing more international voices to PEPFAR reauthorization and doing what we can to encourage countries to apply for funds for health system strengthening from the Global Fund. And we will push on the International Health Partnership—a new effort by most donors other than the United States to focus their aid on national health strategies. This effort misses the important element of new money to fund these strategies. We’ve developed a platform, and are holding a press conference tomorrow about the launch of the campaign.

So be on the lookout for this exciting effort to start to turn the tide of funding! I hope through our growing coalition, and by taking advantage of our potential for reaching deep into the health workforce in Africa—our coalition members includes the International Council of Nurses, which has member organizations in 130 countries—we can make a difference, can help governments respond to the fact that there simply is no excuse for not making life-saving investments in the health workforce.

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Next week, a team of Physicians for Human Rights staff members, including Frank Donaghue, Pat Daoust, Sarah Kalloch, Eric Friedman and I, will travel to Uganda for the First Global Forum on Human Resources for Health in Kampala. We will also be joined by our colleagues in Uganda, including Emily Bancroft, Winnie Ngabiirwe, Pam Babirukamu Kamujuni, from the Action Group for Health, Human Rights and HIV/AIDS (AGHA). The Forum is being convened by the Global Health Workforce Alliance (a global partnership hosted by World Health Organization) and will bring together up to 1000 participants, including ministers of health, civic leaders, civil society members, health workers, academics and health professional leaders from around the world.

The Forum will provide an extraordinary opportunity for PHR to share and explore solutions with the global movement that is emerging to respond to the critical lack of human resources in health systems. In partnership with our colleagues, including Action Group for Health, Human Rights and HIV/AIDS (AGHA), we will run two workshops on human rights and advocacy training and also attend strategy meetings for the Health Workforce Advocacy Initiative (HWAI). As some of you may know, HWAI is the civil society-led network of the Global Health Workforce Alliance, which PHR currently chairs. HWAI advocates for the needed financing, a rights-based approach and other actions to enable countries to develop the health workforces they need to achieve universal access to essential health services.

As this year marks the 60th anniversary of the Universal Declaration of Human Rights, the Kampala Forum can direct international attention towards a rights-based approach to the crisis in human resources for healthcare. As members of the global come together for the forum, the wider global community can unite to achieve global goals and to secure the highest available standard of health for all. Please stay close by as we bring you updates from the exciting developments in Kampala throughout the coming week.

Jirair Ratevosian, MPH, is the National Field Organizer for PHR’s Health Action AIDS Campaign. 

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