"Can we achieve MDG6 with the health workforce we have?"
A Panel Discussion
At the UN General Assembly High Level Meeting on AIDS co-organized by the Global Health Workforce Alliance, Commonwealth Secretariat, AMREF & UNAIDS
Please click on the above photo to launch a gallery from the event
June 9th, 2011 - If international aims such as achieving health-related Millennium Development Goals (MDGs) and universal access to HIV services are to be realized, the serious global shortage of health workers must urgently be addressed. This shortage has been severely exacerbated by the AIDS epidemic, significantly increasing the workload of those remaining.
Thirty years into the AIDS epidemic, the world came together to review progress and chart the future course of the global response to the disease at the 2011 UN General Assembly High Level Meeting on AIDS from 8–10 June in New York.
At a side-event, organized by AMREF together with the Global Health Workforce Alliance (the Alliance), the Government of Brazil, the Commonwealth Secretariat, and UNAIDS, the need to recognize human resources as a crucial element in the global AIDS response was explored in depth. The conclusion was that without sufficient human resources, countries efforts to scale up comprehensive AIDS services will not be sustainable, making it impossible to reach the MDGs.
The well-attended meeting, titled Can MDG 6 Be Achieved With the Health Workforce We Have?, included heads of state, senior representatives from donor and international organizations, civil society and the private sector as speakers or panelists. The lively panel discussion examined the interconnectivity of HIV and human resources and also shared best practices.
Joining discussants such as Honorable Mphu Ramatlapeng, both Global Fund Vice-chair and Lesotho’s Health Minister, and Secretary Jarbas Barbosa, Brazil’s Secretary of Health Surveillance, were keynote speakers Honourable Dileita Mohamed Dileita, Prime Minister of Djibouti, and Maxensia Nakibuuka, a Ugandan community health worker living with HIV. The session was moderated by Pulitzer Prize-winning journalist Laurie Garrett, who is also Senior Global Health Fellow at the Council on Foreign Relations research center.
In opening remarks Dr. Mubashar Sheikh, Executive Director of the Global Health Workforce Alliance, maintained, "Key elements of an effective HIV control strategy are clearly health system-related. Every country at every level of socio-economic development can make progress by adopting health workforce development strategies that are evidence-based and tailored to the local context.”
H.E. Dileita Mohamed Dileita highlighted the effects of an insufficient number of health workers, their uneven distribution and limitations in their competencies in his own country, Djibouti. Dr. Barbosa spoke of Brazil’s experience in dealing with HIV challenges which are exacerbated not by a problem of raw numbers of staff but by uneven distribution.
Providing perspective from the frontline, Maxensia Nakibuuka emphasized the difficulties she and her colleagues faced, “We are left to do it alone. Without system strengthening, without budgets, with nothing… We need to be recognized.”
According to Hon. Mphu Ramatlapeng, the Global Fund is helping countries meet their needs with round 11 of Fund proposals that include support for health workforce strengthening. She also stressed the crucial need for all stakeholders to work together.
The role of the private sector was also highlighted. Michael Bzdak, Johnson & Johnson's Director of Contributions and Community Relations, described his firm’s strategic corporate social responsibility plan comprised of three pillars, with building healthcare capacity as the primary pillar. Johnson & Johnson’s efforts in this area, such as the joint training program with AMREF for sub-Saharan health professionals directing HIV/AIDS projects, focus on leadership, management techniques and skills training. “Our approach is … about introducing them [local senior healthcare workers] to management techniques that will help them work better in their clinics”, he said.
Dr. Sigrun Møgedal, former-Ambassador, HIV/AIDS and Global Health Initiatives, Norway, and former Chair of the Alliance board, commented on the need to “do things differently.” She referred to the recently released Alliance taskforce report Will We Achieve Universal Access to HIV/AIDS Services With the Health Workforce We Have? A Snapshot from Five Countries, and stressed actions required by governments and other decision makers. These include:
• Estimating numbers and types of health workers needed to reach international targets;
• Strengthening health workforce management systems;
• Implementing costed plans for increasing and improving the health workforce; and
• Scaling up successful approaches.
Dr. John Palen, HRH Advisor, US Office of the Global AIDS Coordinator, raised another important aspect: the need to focus attention not only on workforce training but on staff retention strategies, looking at motivation and job satisfaction. In their programs, for example, “PEPFAR is incentivizing rural health workers through career tracking, credit disbursement, monetary incentives and regulatory reform.” Dr. Palen further reported on PEPFAR’s commitment to train 140K health workers by 2014, 35k of which have been trained to date.
The answer to the central question posed was a sobering one: if shortage of health workers is not seriously addressed, the human resources crisis will worsen and MDG 6 will become almost impossible to attain. Although progress has been made, many gaps and challenges remain.
