Highlights, Next Steps from Fifth Global Forum on Human Resources for Health
Bridget, a midwife from Zambia, on stage at the Fifth Global Forum on Human Resources for Health. She shares her experience mobilizing community health workers during the Covid-19 pandemic. Photo by Goran Abudlla.
Many of the world’s leading experts and decision-makers on the health workforce gathered April 3 - 6, in person and online, at the Fifth Global Forum on Human Resources for Health, sponsored by the World Health Organization (WHO) under the theme Protecting, Safeguarding, and Investing in the Health and Care Workforce. All the proceedings, with the exception of a few closed sessions, were recorded and are available online (you can still go here to register, review the agenda, and access the recordings free of charge).
It was impressive to see the WHO’s leadership and multisectoral convening power in action at this meeting, as well as the dedication and commitment of the WHO Health Workforce Department in pulling off such an ambitious and successful program. As a part of the Forum, the WHO has also published a number of Policy Briefs that are available online here.
Health workers themselves participated and shared experiences and concerns, and this helped make the event far more than just another technical meeting. Representatives of key health worker professional associations took part, as well as a group of health workers from Melbourne, Australia who had formed a choir at the height of the COVID-19 pandemic and sang a moving rendition of “Bridge Over Troubled Water” in the opening and closing sessions. The first day included sessions analyzing the lessons from COVID-19, as well as the unfinished task of ensuring all health workers are fully vaccinated (only one in six in the African region have received the essential COVID booster shot).
Several Frontline Health Workers Coalition member organizations took an active role in the Forum, including leading sessions and high-level roundtables. Civil society representatives presented perspectives in a Roundtable Session on the second day of the Forum, citing several Civil Society Action Briefs. I moderated a practical discussion on how to advocate for investment in the health workforce, which included a nurse from Uganda and a community health worker from Kenya (after registering, watch it here). In another session I urged much greater coordination of advocacy for the health workforce and highlighted the need for a civil society movement to address the needs and rights of health workers.
A highlight of the Forum was the participation of ministers of health and other high-level officials from around the world, including USAID Assistant Administrator Atul Gawande, plus the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus. They engaged in frank dialogue on some sensitive issues, such as how to increase domestic health spending. In one of the roundtables, the Minister of Finance of Egypt used his personal experience to share some invaluable lessons on how to influence ministries of finance, and the Minister of Health of Ghana explained how, despite trying economic circumstances, his country was able to significantly expand the health workforce.
A key moment was when high-level ministers, as well as health worker representatives, expressed alarm at the dramatic increase in health worker migration from low- and middle-income countries to high-income countries. Various speakers emphasized the moral responsibility the main importing countries have to address this crisis, while also alleviating crushing debt levels and loan conditionalities that frustrate efforts to invest in the workforce. I attended a parallel session in which representatives of Ireland and Sudan presented on how their bilateral arrangement has effectively strengthened health care delivery and provided benefits to both countries, and that could point the way forward.
One particularly fascinating session,“Enabling strategic and sustainable investments in the health workforce,” featured Karen Zamboni from the Global Fund, who stated that the Fund is engaging in a deliberate shift to supporting the health workforce in a way that strengthens primary health care delivery and strategic use of health workforce planning tools. This session, led by our FHWC Steering Committee member, Rachel Deussom, included the Minister of Health and Sanitation of Sierra Leone, Austin Demby, plus other high-level speakers.
In his closing speech the Director-General drew attention to the gender pay gap impacting women health workers; the burden of unpaid care work; gender-based violence; and the fact that women account for almost 7 in 10 of all health and care workers, but hold less than 1 in 4 senior positions. There was a strong call for allyship and systems of accountability in a parallel session addressing these issues.
An important outcome of the event was the announcement by the WHO Director-General in his closing speech that he will establish a multisectoral advisory group of experts to provide evidence for action in support of national health policy and workforce priorities, which will report to the WHO’s Global Policy Group, which includes the Director-General and the six Regional Directors. I noted that in a session on April 4, appropriately titled “Overcoming the Crisis,” Dr. Francis Omaswa of the African Center for Global Health and Social Transformation made a strong recommendation that this advisory group have a bold and independent voice.
One lesson from the meeting for me is that a better coordinated civil society movement in solidarity with the health workforce is sorely needed, and I hope that FHWC can contribute to more concerted action. Another missing piece is a clear sense of the funding required for the health workforce; in other areas of health campaigning there are evidence-based estimates of resource needs which advocates can use to make their case, as for instance with the Stop TB Global Plan, but in the complex area of health workforce investment this is lacking (though some have made specific proposals for donor funding).
The Forum started some critically important discussions, but there is much unfinished business as we seek to heed the clear call from health workers to “Invest in Me,” as seen the more than 60 videos submitted by health workers around the world the week of the Forum.