Why would a global corporation reinvest 20 percent of its profits from developing countries back into training health workers? It’s simple. Health workers are the driver of health systems. But according to the World Health Organization, there is an acute shortfall of 7.2 million health workers worldwide. This gap, most keenly felt in low-income countries, will only be plugged if we invest in programs that get more feet on the ground now and in the future.
Front-line health workers are the backbone of healthy, prosperous communities and nations. They provide accessible, essential care in even the most hard-to-reach areas — as the Ebola outbreak so starkly illustrates. But there are simply not enough of them. In Tanzania, for example, only 50 percent of pregnant women are assisted during childbirth by a doctor or other trained health worker. The lifetime risk of death in pregnancy or childbirth is one in 23.
Swelling the ranks of trained health workers requires radical, innovative ideas. That’s why five years ago, health care company GlaxoSmithKline decided to reinvest 20 percent of its profits from least developed countries back into strengthening their health systems — primarily through training health workers. This is implemented with three partner NGOs — Amref Health Africa, CARE International and Save the Children. Thus far, the program operates in 34 countries, has trained more than 25,000 health workers and reached more than 6 million people.
For Amref Health Africa and GSK, this marks the latest evolution in a long-term relationship. More than 25 years ago, we together distributed a raft of bed nets to communities at grave risk of malaria. A quarter of a century later, our relationship has radically evolved from philanthropic beginnings into a partnership that is integral to both our organizations’ business models.
Together we have worked on areas ranging from malaria to HIV and sanitation, like creating the personal hygiene and sanitation education program in Kenya to teach children about the importance of hand-washing, which now reaches 1.5 million children in 16 countries.
Teaming up to train health workers is the latest iteration in a partnership that has had to respond to increasingly complex health challenges, which require organizations to collaborate in innovative ways.
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Investing in health workers makes sense for all of us. Strengthening health systems should — over time — improve access to quality care that helps people stay well. That in turn can bolster these countries’ economic development. Not only does this create a better environment for business, but also for individuals, government and civil society.
Working with a corporate partner who recycles profits with a clear objective in mind gives charities the stability and visibility they need to develop sustainable initiatives. Amref Health Africa and the two other partners receive funds annually based on one-fifth of country profits, enabling them to design and deliver programs. These are typically one to three years long and have capacity to absorb additional funds if these become available in subsequent years.
At GSK, the reinvestment program is part of the developing countries unit, which takes a long-term view on widening access. By taking steps such as capping prices of patented medicines at 25 percent of developed world prices, volumes have increased. This puts the business on a more robust footing and generates more to invest in health worker training. If GSK generates more profit, the NGO partners can do more.
Investing is all very well, but how can you ensure that programs are self-sustaining as well as replicable and scalable? To design programs that are relevant to communities’ needs, we ensure they are aligned with ministry of health strategies on improving access to health care and develop proposals in collaboration with those ministries; with local care providers; civil society organizations; and the communities themselves. This ensures that the right needs are identified.
Already, this approach is delivering results. Amref Health Africa is training health workers in 12 countries across East Africa and southern part of the continent. In Angola, it is working with more than 800 community health workers to improve the health and well-being of the community. Each health worker manages an average of 20 households and advocates for better hygiene practices; proper use of mosquito nets; and antenatal visits, to name but a few. Since the project started in 2011, more than 30,000 latrines have been constructed, helping reduce the prevalence of diarrhea and cholera.
In Tanzania and Uganda — where there are so few midwives — Amref Health Africa has introduced an e-learning program which allows students to access digital learning materials offline. A new approach being piloted by the organization is tapping into mobile technology. This will revolutionize access to information and enable midwives living in remote areas to access training and enhance their skills, meaning they can help more women give birth safely.
Working together is not always straightforward. After all, one of us is for-profit and the other nonprofit — we have different priorities and obligations. But ultimately we share the same aim to help people live healthier, longer and more prosperous lives, wherever they are in the world. With sufficient numbers of skilled and motivated health workers, universal access to health care could become a reality in poorer communities and nations. Recycling one-fifth of profits into training health workers is a mutually beneficial way to help reach that goal.
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Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.
