4 million extra health workers needed worldwide

Nov 29 2004

Authors of a public-health article in this week’s issue of THE LANCET are calling for urgent international action to address the chronic lack of investment in human resources which is limiting the chance of tackling diseases such as HIV/AIDS, malaria, and TB.

The Lancet article is an executive summary of a fuller report about human resources investment and global health being published by Harvard University Press. The key premise of the article and full report is that no amount of improvements in the development of new treatments and relative reduction in financial costs of health services can make the required impact unless there is a renewed investment in human resources—health-care workers—to deliver health services in the areas where they are most needed, especially in sub-Saharan Africa.

The Joint Learning Initiative—a consortium of more than 100 health leaders—proposes that mobilisation and strengthening of human resources for health, neglected yet critical, is central to combating health crises in some of the world’s poorest countries and for building sustainable health systems in all countries.

Co-author of the study Lincoln Chen (Harvard University, USA) explains: “Nearly all countries are challenged by worker shortage, skill mix imbalance, maldistribution, negative work environment, and weak knowledge base. Especially in the poorest countries, the workforce is under assault by HIV/AIDS, out-migration, and inadequate investment. Effective country strategies should be backed by international reinforcement. Ultimately, the crisis in human resources is a shared problem requiring shared responsibility for cooperative action.”

The authors highlight how 4 million extra health workers worldwide are needed if the required health improvements and millennium goals are to be met by 2015. Human resources in sub-Saharan Africa are singled out as a top priority: the authors estimate that this region needs to triple its current human resources infrastructure by creating one million extra workers to deliver health services, most of them at the community level.

Dr. Chen comments: “It is impossible to underestimate the importance of a response to this call for action. At stake is nothing less than completing the unfinished agenda in health of the past century while addressing the historically unprecedented health challenges of this new century. Millions of people around the world are trapped in a vicious spiral of sickness and death. For them there is no tomorrow without action today. Yet, much can be done through the rapid mobilisation of the workforce, and wise investments today can build a stronger human infrastructure for sustainable health systems. What we do—or what we fail to do—will shape the course of global health for the entire 21st century.”