Wednesday, 4 December 2013

Taking action on the global health worker crisis

A couple of weeks ago I covered the importance of a well-trained, well-paid and well-respected human resources system in providing free universal healthcare globally. I analysed the challenges of doing so and examined some of the factors which can enable or inhibit good practice. Since then I’ve become aware of a new drive, flagged up by Health Poverty Action, which highlights the UK’s responsibility when it comes to global human resources in the field of health. It emphasises a developmental imbalance - with serious consequences for developing countries - created by the Western exploitation of global health worker labour.

Health Poverty Action has identified more than fifty countries, mainly in Africa and South Asia, which suffer from a “critical shortage of health personnel” while simultaneously carrying “a large part of the global burden of disease.” At the same time the increased necessity of long term care for ageing populations in European countries is creating strong demand for health workers, fuelling the migration of health workers to Europe from developing countries in today’s heavily globalised labour market.

Image of health worker in clinic in Tsumkwe in Namibia (c) Health Poverty Action

Health Poverty Action has been calling for the UK to “compensate developing countries for its role in the global health worker crisis.” There is a cached copy of the call here; I'm not sure what has happened to the plan to get supporters to write to UK MPs. The charity points to the shortage of health workers in developing countries and the UK's strong record of employing health workers who are originally from developing countries and migrate to the UK to work. HPA is not challenging people’s entitlement to move for work, to earn, to study and to create better lives, but instead seek simply to raise awareness of the consequences of the health worker shortage in developing countries. The responsibility for this must be on world governments engaged in large scale health infrastructure and planning. The shortage of health workers in developing countries results not only in poorer treatment there but in a variety of deficits which weaken the entire health system in the long term, from the under-staffing and under-maintenance of hospitals, clinics and rural health stations to poorer quality and less up to date training and education, the under-provision of medical equipment, the reduced chance of future investment when a future workforce cannot be relied upon and much more.

The charity adds,
It is estimated that 1 billion people [virtually all in developing countries] will never see a health worker, putting them at risk of dying from easily preventable diseases, from childbirth and basic health conditions.
The report Aid in Reverse challenges the UK government to play a conscientious and responsible role in ending the global health worker crisis, which Health Poverty Action labels a developing world “brain drain.” They suggest that in the UK the Departments of Health and International Development could work together on two complementary issues: first, treating the roots of the UK’s own shortage of health workers through better planning, training and education; second, giving something back to the developing countries whose health infrastructures are being weakened through lack – with severe ramifications for those nations’ own long term development – while they contribute so much to developed nations’ healthcare systems.

The challenge to developed nations who use the labour of talented health workers from developing countries to ensure their own citizens’ wellbeing is part of a pan-European initiative aiming to create a sustainable global health workforce. One of the main directives of the project is the implementation of a World Health Organisation Global Code of Practice on the International Recruitment of Health Personnel. The project’s tagline runs,

Bidisha is a Fellow of the 2013 International Reporting Project, covering global health and development.