WHO's "World Health Report" warns that workforce crisis is en-
dangering the fight against disease
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WHO Press Release - World Health Day
7 April 2006
Manila, 7 April 2006 A serious shortage of health workers in
many countries is impairing the provision of essential life-
savings interventions such as childhood immunization, safe preg-
nancy, and access to treatment for HIV/AIDS, malaria and tuber-
culosis. This shortage, combined with a lack of training and
knowledge, is also a major obstacle for health systems as they
attempt to respond effectively to chronic diseases, avian influ-
enza and other health challenges, according to The World Health
Report 2006 - Working together for health, published today by
the World Health Organization (WHO).
More than four million additional doctors, nurses, midwives,
managers and public health workers are urgently needed to fill
the gap in 57 countries, 36 of which are in sub-Saharan Africa,
says the report, which is highlighted by events in many cities
around the world to mark World Health Day. Every country needs
to improve the way it plans for, educates and employs the doc-
tors, nurses and support staff who make up the health workforce
and provide them with better working conditions, the report con-
cludes.
At least 1.3 billion people worldwide lack access to the most
basic healthcare, often because there is no health worker. The
shortage is global, but the burden is greatest in countries
overwhelmed by poverty and disease where these health workers
are needed most. Shortages are most severe in sub-Saharan Af-
rica, which has 11% of the world's population and 24% of the
global burden of disease but only 3% of the world's health work-
ers.
"The global population is growing, but the number of health
workers is stagnating or even falling in many of the places
where they are needed most," said WHO Director-General Dr LEE
Jong-wook. "Across the developing world, health workers face
economic hardship, deteriorating infrastructure and social un-
rest. In many countries, the HIV/AIDS epidemic has also de-
stroyed the health and lives of health workers."
"Not enough health workers are being trained or recruited where
they are most needed, and increasing numbers are joining a brain
drain of qualified professionals who are migrating to better-
paid jobs in richer countries, whether those countries are near
neighbours or wealthy industrialized nations," said WHO Assis-
tant Director-General Dr Timothy Evans.
The World Health Report sets out a 10-year plan to address the
crisis. It calls for national leaderships to urgently formulate
and implement country strategies for the health workforce. These
need to be backed by international donor assistance.
More direct investment in the training and support of health
workers is needed now. Then, as these people graduate and enter
the workforce, funds will be needed to pay their salaries.
Health budgets will have to increase by at least US$10 per per-
son per year in the 57 countries with severe shortages to edu-
cate and pay the salaries of the four million health workers
needed to fill the gap. To meet that target within 20 years is
an ambitious but reasonable goal, the report concludes.
Financing this gap will require significant dedicated and pre-
dictable funding from national sources, as well as from interna-
tional development partners. The report recommends that of all
new donor funds for health, 50% should be dedicated to strength-
ening health systems, of which 50% should be dedicated specifi-
cally to training, retaining and sustaining the health work-
force.
The report calls for prompt and innovative initiatives to im-
prove efficiency. For example, HIV/AIDS, TB and other priority
disease programmes have implemented ways for health workers with
limited formal training to successfully carry out specific
health tasks. These experiences should be drawn upon to develop
national health workforce strategies.
The World Health Report recommends that in order to achieve the
goal of getting "the right workers with the right skills in the
right place doing the right things," countries should develop
plans that include the following:
- Acting now for workforce productivity: better working condi-
tions for health workers, improved safety, better access to
treatment and care;
- Anticipating what lies ahead: a well-developed plan to train
the health workforce of the future;
- Acquiring critical capacity: workforce planning; development
of leadership and management; standard setting, accreditation
and licensing as drivers for quality improvement.
Beyond the national strategies the report urges global coopera-
tion:
- Joint investment in research and information systems;
- Agreements on ethical recruitment of and working conditions
for migrant health workers and international planning on the
health workforce for humanitarian emergencies or global health
threats such as an influenza pandemic;
- Commitment from donor countries to assist crisis countries
with their efforts to improve and support the health workforce.
For more information, please contact:
Thomson Prentice, Editor
WHO, Geneva
Tel: +41-22-791-4224
mailto:prenticet@who.int