On Monday 20 November the first of a series of four Global Health café debates was held at the Royal Tropical Institute (KIT). The series is an initiative of five Dutch development organizations, KNCV Tuberculosis Foundation (KNCV), Amref Flying Doctors, Cordaid, KIT Royal Tropical Institute and Wemos and Dutch development aid publisher Vice Versa. The debates aim to establish a broader strategic approach towards global health and to raise awareness of relevant health system and global health sector issues.
Crisis global health workforce
The first debate focused on the crisis within the global health workforce. The World Health Organization predicts a shortage of 12.9 million health-care workers by 2035; today, that figure stands at a shortage of 7.2 million. Facilitator Petra Stienen led the debate and was joined by a panel of international and national experts.
Not stopped by borders
Amanda Banda, Advocacy Manager in South Africa, Médecins Sans Frontières Belgium raised the issue of migration, a root cause of the shortage in some settings. “The majority of Health Care Workers are present in urban areas because of better living conditions, which leaves rural areas depleted. Given the shortage of Health Care Workers, she wonders “how can we then reach Universal Health Coverage for all by 2030?” At the same time the panel remarked that Health Care Workers shouldn’t be stopped by borders.” Abenet Berhanu, Country director Amref Uganda, felt that a short time solution could be found in increased involvement of community health workers and points at the example of Ethiopia. Andrew Ngugi, Programme Manager Health Projects South Sudan, Cordaid pointed out that if “we start training to have more skilled staff, it will still take 40 years to fill the Health Care Workers shortage gap which is simply too long.”
Present in the panel for KNCV was Mustapha Gidado, Director of Challenge TB, KNCV led program to eliminate TB in 22 countries. Gidado brings the perspective of his years of experience in the public health sector of Nigeria, at the district, state and national levels.
Gidado first of all emphasized the importance of political commitment. Change needs to come from the top down. This approach fits with the KNCV philosophy. KNCV firmly believes that the only way to achieve its goal of ending TB worldwide is to embed TB control into national health programs and involve all relevant parties. Gidado: “When you employ a person, you need to embed this person into the existing national health system and not create trouble.”
Integration at the entry point
Gidado also mentioned the possible disruptive effect of the international donor community. “Despite all good intentions, when we implement vertical pilot programs, we are competing for the same Health Care Workers, for the same people who are scarce. Tuberculosis, HIV; they all have their own programs and all compete for Health Care Workers. We need to find a way to work around this. We need to look for forms of integration at the entry point. A possible way is to sit down with the development parties, with the donors and see how we can cooperate.”
To the question of what consists good health care Gidado answered: “access to quality health care, a patient-centered approach and the continuity of care, so not just one hospital visit.” Interesting in this respect is the important role that digital health already plays and will only grow to play in the coming years.
“Despite all good intentions, when we implement vertical pilot programs, we are competing for the same Health Care Workers” – Mustapha Gidado, Director of Challenge TB, the KNCV led program to eliminate TB in 22 countries “
Picture in header from left to right: Andrew Ngugi (Cordaid), Mustapha Gidado (Challenge TB/KNCV Tuberculosis Foundation), Abenet Berhanu (Amref), Amanda Banda, (Médecins Sans Frontières).