Last month marked a transition from one era of global health and development to the next.
Seventeen Sustainable Development Goals were agreed by 193 heads of state and government at the United Nations General Assembly in New York. As with the Millennium Development Goals, health is rightly recognized as a fundamental human right and driver of development.
Closing the gaps
Since 1990 we have seen unprecedented progress in improving global health outcomes, thanks in part to the priority given to health in the MDGs (3 out of 8 MDGs are focused on health). A 47 percent reduction in maternal mortality, and a 49 percent reduction in child mortality are just two of the extraordinary achievements of the past generation.
As we move now into the post-2015 era, we know that to sustain and build upon on these past successes, we must do more to address inequities in access to quality health care. Progress in achieving the MDGs has been uneven, with the poorest and most marginalized people still being denied the most basic health services. That is why SDG 3 — as with all the goals — moves away from targets that can be met while leaving the poorest behind, and instead calls on governments and other partners to ensure healthy lives and promote well-being for all.
Renewed focus on health systems
The quantity, skills and geographic distribution of the health workforce have long been recognized as factors that have held back even greater and more equitable progress on the health-related MDGs. A strong and motivated health workforce is key to a resilient, integrated and people-centered health system. Without a fit for purpose workforce, the world puts itself at risk of not only failing to meet the ambitious targets of the SDGs, but of even reversing progress in the face of population growth and unexpected challenges, such as the Ebola outbreak.
The need for greater priority to be given to health systems and human resources for health is recognized in the new SDG targets. For example, there are new targets to “achieve universal health coverage” and to “substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries.”
A number of new strategies were launched in New York that will help translate the SDG goals into action. Two in particular have a focus on human resources for health:
First, “Roadmap: Healthy Systems — Healthy Lives,” a global initiative to strengthen health systems, was initiated at a high-level side event on Sept. 26, hosted by the governments of Germany, Ghana and Norway. The road map will be developed through a multistakeholder process that intends to facilitate a comprehensive understanding of health systems strengthening and agree on principles and approaches that will help countries build strong and resilient health systems. This process will be facilitated by Germany and the World Health Organization, with a target completion date set for mid-2016.
Secondly, a new “Global Strategy for Women’s, Children’s and Adolescents’ Health,” also launched on Sept. 26, calls for an even more ambitious agenda of ending all preventable deaths within a generation, by expanding equitable coverage of a broader range of reproductive, maternal, newborn child, and adolescent health services.
As a recent paper, “Improving the resilience and workforce of health systems for women’s, children’s, and adolescents’ health,” published in the British Medical Journal highlighted, the updated “Every Woman, Every Child” strategy must place health systems — and health workforces — at its heart. Their performance will decide success or failure for reproductive, maternal, newborn, child, and adolescent health in the next 15 years. Clear guidance should be developed for countries so that they can build integrated and resilient health care delivery systems that meet the needs and expectations of all women and children.
Building health workforces fit to deliver the SDGs
An extensive, global consultation on HRH has just been completed and the results are currently being translated into an updated draft of WHO’s “Global Strategy on Human Resources for Health: Workforce 2030.” This strategy will provide essential guidance for all partners looking to improve health outcomes related to the SDGs.
The strategy highlights the increasing evidence that HRH offers a triple return on investment:
1. It drives improvement in population health outcomes;
2. It triggers broader socio-economic development, with positive spillover effects on the attainment of the SDGs, including education, gender equality and on the creation of decent employment opportunities and sustainable economic growth; and
3. It serves as a first line of defense for individual countries to meet the International Health Regulations (2005) and promote global health security.
We all have an opportunity to set off on the right path towards the achievement of the SDGs in 2030. Ensuring that we create the conditions for employment in the health and social sectors, addressing global deficits and improving access to care is surely the smartest place to start the journey.
Jim Campbell is director of health workforce at the World Health Organization (WHO) and executive director at the Global Health Workforce Alliance (GHWA). Prior to joining WHO/GHWA, he was the director of the Instituto de Cooperación Social Integrare (ICS Integrare), a not-for-profit research institute in Barcelona, Spain where he worked for 8 years. He has worked as a researcher/advisor on human resources for health for governments, UN agencies and philanthropic foundations, including WHO, GHWA, UNFPA, World Bank, UK DFID, Norad and the Bill and Melinda Gates Foundation.
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