1,561 injuries. Over half of attacks were against health-care facilities and another quarter against health-care workers. 62% of attacks intentionally targeted health-care services. These are the figures disclosed in a recently published World Health Organization (WHO) report, which looked at 19 countries experiencing emergencies between January 2014 and December 2015.
With those figures in mind, and health-care services continuously coming under attack, there is no denying that objectives like universal health coverage and the Sustainable Development Goals (SDGs) are a real challenge. But important decisions taken during the 69th World Health Assembly (WHA) in May could make this challenge less daunting.
Erin Kenney: On 27 May the member States of the WHA adopted this landmark strategy which sets out a vision to accelerate progress towards universal health coverage and the SDGs by ensuring equitable access to health workers within strengthened health systems. This issue is capital: we are seeing a rising global health workforce deficit and a mismatch between the supply, demand and population needs for health workers. Our models indicate that by 2030 the health workforce will be 18 million people short of the numbers needed to meet the SDGs and universal health coverage targets. The gap will be concentrated in low- and lower-middle-income countries.
If we want to achieve universal health coverage and the SDGs we have to break down barriers to the development of the health workforce, which are greatest in countries experiencing conflicts or other emergencies. There, challenges such as recruiting and retaining staff may be amplified by attacks against health care. Without a strong and resilient global health workforce we cannot meet our public health goals. And to achieve this we must first and foremost protect health-care workers from violence and create a safe working environment even – or especially – during conflicts and other emergencies. The WHA’s decision provides additional momentum and practical ways for States and the WHO to do just that, setting out four important policy areas and responsibilities:
The role of States
1. Reflecting United Nations General Assembly (UNGA) Resolution 69/132 on Global health and foreign policy, the Global Strategy tasks member States with enhancing and promoting the safety and protection of health personnel and facilities and respect for professional codes of ethics. This includes universally recognized marking of health personnel, their means of transport and installations; education for health personnel, State employees and the general population; appropriate measures for the physical protection of health personnel, their means of transport and installations; and national legal frameworks (where warranted) to effectively address violence against them.
2. Member States are tasked with gaining a comprehensive overview of the health workforce, including by collecting data on obstruction, threats and physical attacks on health workers, and to set up national registries to this end.
The role of the WHO
3. The WHO should develop normative guidance, support research to identify evidence-based policy options, and facilitate technical cooperation when requested by member States and relevant stakeholders, including on preventive measures for the safety and protection of health workers.
4. The WHO is also responsible for adapting, integrating and linking the monitoring of Global Strategy targets to the emerging accountability framework of the SDGs and other UNGA resolutions. The WHO should assist States with the collection of data and submit a report on the protection of health workers, based on the experiences of Member States and presenting recommendations for action to be taken by relevant stakeholders, including appropriate preventive measures, as called for by UNGA Resolution 69/132.