Opinion: Skilled health workers are the foundation of a healthy world

The United Nations General Assembly opened this week with nine days of general debate and discussion focused on creating equitable societies all over the world. As leaders from government, civil society, and the private sector gather for this annual pulse-check on progress toward the Sustainable Development Goals, it’s heartening to see our leaders elevating the cross-cutting role good health plays in creating prosperity and peace across the globe.

This year’s UNGA will feature three high-level meetings on health — one on tuberculosis, one on noncommunicable diseases, and another on access to universal health care. These convenings are encouraging.

TB remains the ninth leading cause of death worldwide, with an estimated 10.4 million new cases of TB in 2016. And according to the World Health Organization, of the 56.9 million deaths in 2016 globally, more than 71 percent were due to NCDs — cardiovascular diseases, cancer, diabetes, and chronic lung diseases. While access to UHC is without a doubt the way make a dent in preventable mortality of all kinds, including TB and NCDs, achieving UHC has been persistently elusive.

So how do we achieve reductions in deaths from preventable, treatable diseases, address the burgeoning NCDs, and increase access to universal coverage for all?

The answer is building a health workforce able to address these challenges. It’s one solution with the potential to address many problems. People are at the heart of the health system in any country. Yet while the evidence shows that we must invest in skilled health workers, not enough has been done to prioritize their funding and support.

Globally, there is a well recognized, critical shortage of health workers, but less addressed is the expected growth in the shortage to 12.9 million by 2035. These missing doctors, nurses, and midwives are the very same workers who are the first line of defense against infectious diseases such as TB, HIV, Zika, and Ebola. They are the ones with the skills and experience to save the lives of women in childbirth, to resuscitate a newborn unable to take his or her first breath of life, or to prevent the millions of diagnoses of cardiovascular or pulmonary disease that will continue to challenge our globe. Without skilled health workers, hospitals are mere buildings, ambulances are just cars, and patients become people left to languish when they could be helped.

The focus on community health workers who can extend the reach of the health system has been laudable and necessary. Their knowledge and reach can be leveraged for disease prevention and early management. But skilled health professionals provide critical support to community health workers and the health system through advanced care and ongoing training. Without them, pregnant women hemorrhage during childbirth or obstruct labor. Malaria becomes cerebral requiring higher level care, or patients become septic, can require surgery, or need advanced diagnosis and treatment plans. In partnership with the community, needed care can be augmented and optimized in the right setting.    

Doctors, nurses, midwives, and other skilled workers are critical to supporting the health system overall, serving not only as care providers but as sources of ongoing training, and even strategy, for solving health system challenges. They can be chief advocates for patients and the bridge between the system’s decision-makers and patients’ needs.

Health professionals act as a critical point of contact and continuing care for patients, helping to ensure treatment is appropriate and adaptive to patients’ needs. Doctors, nurses, and midwives are essential to comprehensive, appropriate, and high-quality primary care delivery where quality primary care can help halt problems before specialty care is needed, saving resources, time, and costs. It can be the difference for a young mother, a patient with heart failure, or a child with pneumonia.

We are three years into the era of the SDGs. The world’s leaders are being held accountable for ensuring the health of the planet and the people who occupy it, and for making sure that no one is left behind in the process. While there is no simple solution to achieve the 169 targets laid out in the 17 SDGs, none of the health targets can be achieved without the health professionals who diagnose and treat disease in all its complexity. Overlook the major role they have in creating strong health systems, or fail to invest in building their capacity — and sustainability will remain a faraway dream.

NCDs. Climate change. Financing. Read more of Devex's coverage from the 73rd U.N. General Assembly here.