Dear G8, 1 billion people who never see a health worker is far too many
On the one hand, the G8’s latest accountability report, monitoring progress on the 60 development commitments that have been made over the past 11 years, makes impressive reading. According to their self-assessment, good progress has been made on health – the subject of almost one-third of the commitments monitored in the report. On the other hand, despite big reductions in maternal and child mortality and deaths from infectious diseases, the G8 has recognised that progress on increasing access to skilled health workers is falling “below expectations”.
Five years on, little progress
Under the 2008 Japanese presidency, the G8 committed “to work towards increasing health workforce coverage to meet the World Health Organisation (WHO) recommended target of 2.3 midwives, nurses & doctors per 1,000 people”. Countries falling below this are considered unlikely to be able to meet the health-related Millennium Development Goals (MDGs).
Five years on, of the 57 countries identified as falling below the WHO target, Indonesia is the only country said to have exceeded the threshold. Only 19 countries have seen an improvement in their average health-worker density and worryingly, 18 countries have actually seen a reduction. The remaining 20 countries lack enough data to make an assessment.
The G8 says it will continue to monitor progress against their commitment but according to the Health Workforce Advocacy Initiative (HWAI), which I chair, this is not enough. It takes time to train health workers and to build the systems that enable them to work effectively in the places of greatest need. Urgent investment is required now.
Where G8 investment can make a difference
The G8 can invest in training institutions to increase the number of qualified health workers. It can also provide resources and advice to to help countries ensure that existing health workers stay in the job and are supported and motivated to provide the best quality of care.
The G8 can also help countries to build strong information systems so that governments and donors can make informed policy decisions. The truth is that we don’t really know how many health workers there are or where they are located. We also don’t know whether the WHO’s target is still a helpful one for countries to aim towards.
The WHO and Global Health Workforce Alliance have a critical role in providing countries with guidance and technical assistance. But instead of building up their capacity to deal with the global health-worker crisis, the G8 and other rich countries have reduced their funding, resulting in staffing cuts and weakened global leadership for health workforce issues.
Third Global Forum: an opportunity to seize
Around 1 billion people never see a health worker in their lives. This situation is unacceptable and can be changed if there is sufficient political will to work towards universal health coverage and ensure that every person has access to a skilled health worker.
This is the theme of the upcoming Third Global Forum on Human Resources for Health in Recife, Brazil, in November. Leaders from the G8 and other nations can demonstrate their commitment to help countries build towards universal health coverage.
This will be a crucial moment for testing countries’ commitment to making the long-term investments needed to improve health for all people. The G8 should seize this opportunity: doing so would mean, among other things, a better mark in next year’s Accountability Report.