Who Will Coordinate the Global Health Workforce Agenda?

Dear Colleagues,

This is our topic for July and August 2016.

Our last discussion was about the May 2016, World Health Assembly and among the many activities that took place during the WHA was the “celebration” of 10 years of the life of Global Health Workforce Alliance (GHWA) and the transformation of this institution into a Network with a secretariat at the WHO Department of Health Workforce and an independent Management Board. The question that arose was whether this event was a celebration or a funeral for GHWA? I argued that it was both. Why?
A celebration because the founding documents of GHWA are beautiful with very clear objectives, deliverables and methods of work and in a short time we achieved a lot. We raised the visibility of the Health Workforce crisis, we quickly generated new knowledge on country and global work through the work of Task Forces and Working groups and we convened the First ever Global Forum on HRH and have held two other to follow on that. We have succeeded in having HWF at a target in the SDGs and the UNSG has always been supportive as he sent us a personal video message at the first Global Forum in Kampala and now he has appointed a High level Commission on health employment.

We were committed to the vigorous pursuit of our work agenda and in ten years expected to see some illustrative deliverables including:
(a) a significantly increased number of countries with strong national strategic plans and strong indigenous management capacity;
(b) ramped up investments in pre-service education;
(c) stronger workforce policies and regulations;
(d) growing literature and body of knowledge;
(e) global focal point for information and communications, knowledge, and learning;
(f) and solutions to some vexing problems indeed we achieved one feat in having the WHA adopt the WHO code on the International Recruitment of Health Personnel.
In Africa, much as the HWF densities have not changed in 10 years due I believe to rapid population growth, a lot is happening and there has been concrete progress, we now have an African HWF Roadmap adopted by Health Ministers and Heads of State, thirty countries have HWF plans, there are exciting Education Initiatives such as NEPI and MEPI that are now being shared in the region. We have new leadership at the WHO Afro that is repositioning to support HWF work in partnership with the African Platform on HRH and other partners.

However, why is the down grading of GHWA also qualifying as a funeral? Surely the HWF crisis is not yet over; for which the required solutions call for strong and coordinated advocacy, leadership and accountability at all levels, national, regional and global. At global level the situation is getting more complicated, considering the projection in the new Global Health Workforce Strategy of 40 million HWF deficit and the attendant implications for migration. In African countries there are tensions over competing priorities; do we invest in infrastructure or human capital? Between the professions too there are tensions over roles and visibility. Which agency has the resources and mandate to bring all of us together? There is clearly, still work for a strong GHWA and it will not work to leave the leadership of this work to WHO alone.
In Africa, at funerals we also announce and install heirs and whatever mechanism will be selected as the heir to inherit residual GHWA roles, it will be important to ensure that this is well led. Further we were informed that Regional Networks in Africa, Asia, Europe and the Americas will be the mechanisms for coordination. In Africa, we have the African Platform on HRH which we need to rally around and I call upon the WHO Regional Office for Africa, AU Commission Regional Economic blocs to prioritize the HRH agenda by strengthening Professional Associations, Unions, Academic institutions and advocacy groups to ensure the HRH agenda remain visible in the our region. If we do not do this African health professionals will be boarding planes to fill the huge HRH gap in other continents.
How do we increase the visibility of this issue?
Sincerely,
Francis.