By Insight Post –Uganda
Kigali-Rwanda
Ahead of the Africa Health Agenda International Conference (AHAIC) 2023 in Kigali, Rwanda, several big questions have been answered by Dr. Vanessa Kerry, the Chief Executive Officer- Seed Global Health and Dr. Bonaventure Ahaisibwe, the Managing Director-Impact, Innovation and Seed Global Health.
With overstretched health systems and unstable health financing presenting formidable barriers to addressing the continent’s shortage of well-trained, fairly paid, highly motivated health workers, can Africa bridge the existing gaps between what we need and what we have before the situation worsens?
In the newsletter received by The Insight Post-Uganda, the two reputable experts at Seed Global Health expound on how cross-sectoral partnerships could improve health delivery through more effective recruitment and retention of health workers.
Question: The global shortage of health workers was spotlighted during the COVID-19 pandemic. However, this is an issue that many countries have been grappling with. What are the implications of failing to urgently invest in boosting Africa’s health workforce?
Dr. Vanessa Kerry: There is a huge shortage of health workers globally. The World Health Organization (WHO) is projecting a shortfall of 10 million by 2030, with a third of those in Africa.
Failure to invest in the health workforce means weakened health systems, poor care and the inability to meet today’s burdens of disease. Many health workers are overworked, under-resourced or unprotected against disease and this has huge implications for the availability and quality of care, particularly in Sub-Saharan Africa. Without well-trained, well-supported health workers, we face the reality that millions will continue to die of entirely preventable causes.
Health workers are the foundation of every strong health system and investments in the health workforce are a positive return on investment – it is more expensive not to invest. Not only will outcomes for patients improve, leading to healthier populations and societies, it also means job creation – so important for Africa where half of the population is under 25 – and drives equity with over 70% of health workers being women.
Question: What barriers would you say the continent faces in building its health workforce, and at the same time what opportunities are present for investment in the health workforce?
Dr. Bonaventure Ahaisibwe: There is no lack of will among leaders in Africa to improve their countries’ futures by building stronger health systems and investing in health workers, but many are lacking the necessary funding and global support to make these long-term, large scale and transformative investments.
At Seed Global Health, we recognize that one of the most glaring opportunities for investment lies at the end of the continuum of care: to see true advances in quality health care, we must invest in the physicians, nurses, and midwives who provide advanced care and compose the critical, but often overlooked referral system for a growing network of community health workers.
We are beginning to see real change on this issue, in part driven by the leadership of the African Union and Africa CDC who have rightly understood the importance of investing in the health workforce.
With Amref, Seed is advancing a new strategy for the continent to support the scaling up and strengthening of the health workforce, in partnership with Africa CDC to transform the education and training of health professionals. It is essential this work continues to be prioritized.
Question: How can African countries work with development partners and other institutions to address these challenges and adequately train, equip, and retain a fit-for-purpose health workforce, especially as the demands on health workers intensify as a result of climate change, disease outbreaks, poverty and conflict?
Bonaventure: The lack of investment in the health workforce across developing economies is stunning: just 7% of global health aid over the past 10 years has been invested in the workforce itself. When funding does arrive, it is too often narrowly focused on specific disease verticals rather than taking a holistic approach.
While a majority of African countries have developed early-stage national human resources for health strategies there has been a dearth of funding and technical support to implement them.
There is an urgent need for clear, ambitious, and importantly, African-led roadmaps to catalyze investment and action toward growing and strengthening Africa’s health workforce, and to prioritize our healthcare workers as a long-term investment.
Question: As a trained physician yourself, you know first-hand the demands of a career in health. These demands are often even more for women, who make up 70% of the global health workforce, yet whose contributions are often undervalued. How best do you think health workers can be supported to safeguard their physical, mental and economic well-being?
Vanessa: Health workers are the frontline of our pandemic response, essential for the prevention of communicable and non-communicable diseases and critical to the health, resilience, and responsiveness of any health system. They are there when we are sick, when we are welcoming a new life into this world or when we are passing on the next. They are a critically important asset that must be better supported, protected and valued.
I speak personally when I highlight that during the pandemic health workers were at the frontline against COVID and without their sheer hard work – often confronting the many associated unknown challenges – many more people would have died. Yet at least 180,000 health workers themselves died, and instead of action, they got applause.
For women, these challenges can be even greater. Women are consistently at the frontlines, making up over 70% of the health workforce in total and 90% of the health workers in patient-facing positions. Yet, women are often left out of leadership positions, are undervalued or go unpaid with half of the $3 trillion contribution of women’s work to the global economy being unpaid work.
Enough is enough – we urgently need more recognition of the vital role health workers play and this starts with investing more in the workforce.
Question: Climate change is an increasingly understood driver of morbidity and mortality globally with those countries who are least contributing to the acceleration of climate change most vulnerable to its impacts. How do we better highlight the profound impacts of climate change on human health?
Vanessa: Climate change has wide-ranging impacts on human health, from increasing infectious disease outbreaks to accelerating non-communicable disease burdens to rising burdens of pre-term birth and stillbirths. Today, 23% of all global deaths are secondary to avoidable environmental causes.
These deaths are slated to increase by a quarter million annually at our current rate; moving us farther away from our 2030 goals, not closer. Beyond direct health impacts, there are indirect ones on conflict, migration and the refugee crisis, with 216 million climate migrants expected by 2050.
Local health system strengthening in these vulnerable countries including a healthcare workforce is essential to confronting outbreaks, preventing premature deaths and saving lives.
A health-centred response to climate change would decrease the likelihood of the most catastrophic climate impacts, improving human security, creating opportunities for economic protection and recovery, and immediate and future health benefits. For example, investments in health improvements would lead to a USD2-4 return on investment for every USD1 invested – USD4.4 trillion in GDP growth across all developing countries.
COP28 provides a critical opportunity for real leadership on the intersection of climate and health. The UAE Government and COP28 organizers can help set bold and necessary commitments and tangible targets for this health-centred response and the pathway to measuring its multi-sector impact, furthering the support and case for investment for the public and private sectors alike.
Question: Lastly, what key resolutions and actions are you looking forward to from AHAIC 2023 to safeguard and grow Africa’s health workforce through investment, partnerships, and diplomacy?
Bonaventure: This is a crucial year for Seed Global Health and Amref as we continue to drive forward our work with the Africa CDC to create a fit-for-purpose health workforce for the continent.
At AHAIC, the team will be relentlessly highlighting the powerful ripple effect investing in the health workforce has – not only on improving health outcomes but on economic opportunity, job creation and closing the equity gap. We will also be urging partners to be in it for the long haul.
Challenging the status quo does not happen overnight. To truly address the failings of health systems there is no shortcut – we must invest in the people who care for us if we want to see our populations healthier.
We will also be discussing the huge impact climate change is already having on health – whether that’s the worst outbreak of cholera ever in Malawi or more infectious diseases across the continent – and the need to invest now in climate adaptation.
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