Health workforce crisis has deadly impact in many countries, UN report warns

With at least 10 million people dying each year from largely preventable infectious diseases and complications of pregnancy and delivery, the United Nations today marked World Health Day with an urgent call for more than 4 million additional doctors, nurses, midwives, managers and public health workers for developing countries.

“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,” UN World Health Organization (WHO) Director-General Lee Jong-wook said of the stark statistics detailed in his agency’s World Health Report 2006 - Working Together for Health, issued today.

“Across the developing world, health workers face economic hardship, deteriorating infrastructure and social unrest. In many countries, the HIV/AIDS epidemic has also destroyed the health and lives of health workers,” he added, noting that the report sets out a 10-year plan to address the crisis.

The world community has sufficient financial resources and technology to tackle most of these health challenges, yet today many national health systems are weak, unresponsive, inequitable, even unsafe, the report says in its introduction. What is needed now is political will to implement national plans and international funding to garner resources, harness knowledge and build treatment and preventative systems.

“It is clear that to protect and improve the health of people worldwide, and to achieve the Millennium Development Goals, we need to rapidly bolster the global health workforce,” Secretary-General Kofi Annan said in his message for the Day, referring to the set of UN targets that aim to cure a host of socio-economic ills by 2015.

“Africa alone will require 1 million new health workers to achieve the Goals. Without such a dramatic increase in capacity, paediatric immunizations will not be administered; infectious outbreaks will not be contained; curable diseases will remain untreated, and women will keep dying needlessly in childbirth,” he added.

The health worker shortage is impairing provision of essential, life-saving interventions such as childhood immunization, safe pregnancy and delivery, and access to treatment for HIV/AIDS, malaria and tuberculosis in 57 countries, 36 of them in sub-Saharan Africa. It is a major obstacle in mustering an effective response to chronic diseases, bird flu and other health challenges.

The shortage is exacerbated by brain drain of qualified professionals migrating to better-paid jobs in richer countries.

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 Africa, which has 11 per cent of the world’s population and 24 per cent of the global burden of disease but only 3 per cent of the world’s health workers.

To tackle the crisis, more direct investment in the training and support of health workers is needed now, the report says. Health budgets will have to increase by at least $10 per person per year in the 57 countries to educate and pay the salaries of the 4 million workers needed to fill the gap. To meet that target within 20 years is an ambitious but reasonable goal, the report concludes.

In marking the Day, the head of the UN Population Fund (UNFPA) paid tribute to the global force of midwives. “These skilled health workers play a central role in saving the lives and improving the health of mothers and infants around the world,” Executive Director, Thoraya Ahmed Obaid said.

“Yet, despite their importance, they often face poor working conditions, inadequate supplies and support and, as a female health workforce, are subject to gender discrimination,” she added.

“Concerted efforts are urgently needed to solve the shortage of midwives and other health workers - a shortage that is severe in the poorest countries, putting the lives of millions of people at risk. The brain drain of health workers from the developing world is an urgent issue that deserves a collective response.”