Addressing Noncommunicable Diseases – It Takes a Workforce
Health systems with critical health workforce shortages cannot effectively respond to the growing burden of chronic diseases. Addressing the challenges of NCDs requires concerted, comprehensive solutions developed together by all key stakeholders.
Summary of discussions:
New York-Geneva, 19 September 2011 - The two-day UN General Assembly high-level meeting under the theme of noncommunicable diseases (NCDs) opened in New York this week with thirty heads of state and over one hundred senior ministers in attendance.
The Global Health Workforce Alliance (the Alliance) held a side-event: “Addressing Noncommunicable Diseases – It Takes a Workforce” organized together with the Governments of India and Japan, Touch Foundation and the Health Workforce Advocacy Initiative. Panelists and keynote speakers concurred that effectively addressing the challenges posed by NCDs is dependent on the availability of a prepared, motivated, supported and well-functioning health workforce at all levels of care.
The session was opened by Dr. Michael Ebele Omeke (medical doctor, Uganda) who spoke of the realities on the ground in Uganda and other developing nations, where primary care workers deal with one hundred-plus patients a day. “Staffing levels in most public health facilities are generally less than fifty percent of the expected numbers. Furthermore, a large proportion of these health workers were trained before the epidemiological transition towards a mix of communicable and noncommunicable diseases. In this scenario, it is apparent that health workers have little time and knowledge to offer preventive services for NCDs.
Dr Masato Mugitani (Assistant Minister for Global Health, Japan and Chair of the Alliance Board) spoke of the burden and impact of NCDs on societies, and the need for an adequate number of qualified, motivated and supported health workers. The Government of Japan has committed to training 100'000 health workers and policy-oriented professionals.: “It is essential to ensure innovative and sustainable health systems including [the] health workforce […] this cannot be achieved by the Global Health Workforce Alliance alone nor the Government of Japan. It is essential to mobilize available resources from every stakeholder in global health including donors, partner countries, civil society and the private sector.”
Public Health Foundation President Dr Srinath Reddy - moderator - underlined the importance of health workers and urged all stakeholders to work together - “The fact that we have the government, the private sector, and the civil society not sitting across the table, but around the table, is a symbol of hope. […] We have a health worker, the pivotal link - the Global Health Workforce Alliance - and we hope that together they’ll be able to carry this coalition forward into strengthening health systems.”
The panel discussion shed light to the diversity and complexity of issues emerging from the combination of an increased NCDs burden and an insufficient workforce. Panelists included:
- Dr Gustavo Gonzalez-Canali, (Head of the Health and Human Development Department of the Ministry of Foreign and European Affairs, Government of France) spoke of the need of task-shifting and task-sharing:
“We need to have health workers able to integrate beyond a simple one-skill approach. We need to work on the training of health workers to create a multi-skill capacity and so increase the services they are able to provide.”
- Shri. Keshav Desiraju, Additional Secretary, Ministry of Health & Family Welfare, Government of India emphasized the importance of prevention at primary level:
“It’s not that we don’t have the numbers of trained health workers, we don’t have them trained in the areas we want them trained in and we don’t have them in the places we want. One big message which has come out of the NCD summit is that prevention of non communicable disease is best done at the primary level. Treatment may be at the second and tertiary level but prevention is a primary level activity.”
- Scott Ratazan, Vice President, Global Health, Government Affairs & Policy, Johnson & Johnson spoke about the support the corporate sector and more specifically Johnson & Johnson can offer in terms of addressing the growing threat of NCDs challenges, in particular in relation to its health workforce dimension.
“We’re building on what the WHO stated in 2006 a ‘strong human infrastructure’ which is fundamental to closing today’s gap between health promise and health reality and anticipating the health challenges of the 21st century.’ We recognize that shortage of health workers and building healthcare capacity are at the heart of our focused approach.”
- Ben Phillips, Chief Campaign Officer of Save the Children UK reiterated the need for health workers to be part of and engaged in government policies and spoke of the role of civil society in making this happen. He also highlighted the ongoing global health worker campaign aimed at raising profile and securing commitment from government’s and world leaders.
A lively Q&A followed, which included questions on training, task shifting, managerial skills of health workers and migration and retention.
Dr Mubashar Sheikh (Alliance Executive Director) closed the session focusing on the need of an inclusive approach. "We can’t have one sector versus the other: the government versus non government; the private sector versus the non private sector. Both state and non-state leaders need to come together to avoid what we call the “verticalization of NCDs.”
He added: “On behalf of the Global Health Workforce Alliance, we’ll keep urging the policymakers to stay committed to ensure that we have the right kind of health workforce and the right competencies as well as the right support mechanisms. The right tools to provide good quality chronic care must become available."