Back 15 January 2015

Strengthening Health workforce in the SDGs

The Health Workforce Advocacy Initiative (HWAI), is an international civil society network addressing the global health workforce crisis, working toward a shared strategic vision of a health worker for everyone, everywhere. ICM has signed onto a letter that HWAI is sending to the Ambassadors to the United Nations from Kenya and Ireland, who are co-facilitating the post-2015 negotiations on the Sustainable Development Goals. This letter contains three main requests:

1. That the health workforce sub-target contained in the Sustainable Development Goals zero draft is maintained and strengthened
2. That the Universal Health Coverage sub-target include access to a health worker
3. That the indicators developed for the health target include strong, measurable indicators for the health workforce

A robust, empowered health workforce—which includes community health workers, midwives, nurses, pharmacists, doctors and other health workers—is the backbone of effective health systems, ensuring universal health coverage and healthy lives for all people. The World Health Organization (WHO) in 2013 estimated the at least 7.2 million more doctors, nurses and midwives are currently needed to provide essential services to everyone, a devastating gap that will keep growing if it continues to be neglected.

The Sustainable Development Goals can provide an excellent platform to drive progress in filling these health workforce gaps. It can inspire governments worldwide to commit to working towards healthier communities serviced by a robust, well-trained, and well-equipped national health workforce at its core. As made evident by the recent devastating spread of Ebola, a sustainable and resilient health workforce is essential for safeguarding the health of people everywhere.

The SDG “zero draft” submitted by the Open Working Group to the United Nations General Assembly includes the following health workforce sub-goal under Goal 3, which aims to “ensure healthy lives and promote well-being for all at all ages”: “Sub-Goal 3c: Increase substantially health financing and recruitment, development and training, and retention of the health workforce in developing countries, especially LCDs and SIDS.” We strongly support inclusion of a sub-goal specific to strengthening the health workforce in the SDGs, and commend the Open Working Group for recognizing health workforce needs in Sub-Goal 3c to meet the “health for all” goal.

We encourage this sub-goal be modified with a measureable the target to increase financing for and numbers of health workers, and that this sub-goal be inclusive of all countries – not just LCDs and SIDS. Given diverse interpretations of what qualifies as reasonable access to a trained health worker, a measurable target (ie. minimum X skilled health workers per 10,000 population) can clarify how many health workers need to be recruited, trained, supported and retained to achieve reasonable access. We also strongly support the development of robust and measurable indicators for health workforce development to track progress of all aspects of the proposed SDG 3 on health.
The SDGs also must explicitly recognize how improving access to health workers is a crucial and indispensable requisite to achieving universal health coverage (UHC). UHC has been identified as a critical global health priority in the post-2015 development agenda, but inadequate numbers of health workers will be one of the biggest barriers to achieving this goal.

In this light, HWAI recommends that access to trained and supported health workers for all be included in the UHC sub-target in the SDGs, and proposes the following language:

3.8: Achieve universal health coverage (UHC), including financial risk protection, access to quality health care services, access to trained and supported health workers for all, and access to safe, effective, quality and affordable essential medicines and vaccines for all. 

The letter requests that the two Ambassadors as leaders in the SDG negotiations, articulate and support this stronger health workforce language in the final version of the SDGs. 

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