International initiatives

During the last two years, there has been an increase in the development of new initiatives concentrated in health workforce issues. More than 75 health funds and partnership have been created. See Mapping Global Health Partnerships.

The Global Health Workforce Alliance (GHWA) is a new international partnership that is dedicated to identifying and implementing solutions to the health workforce crisis. It brings together a variety of actors, including national governments, civil society, finance institutions, workers, international agencies, academic institutions and professional associations. The GHWA draws together and mobilises key stakeholders engaged in global health to help countries improve the way they plan for, educate and employ health workers. The World Health Organization (WHO) will host its secretariat.

The Joint Learning Initiative on Human Resources for Health and Development (JLI) was launched in November 2002 by the Global Health Trust in recognition of the centrality of the workforce for global health. The JLI was a consultative process that was intended to increase creativity, innovation and dialogue. The process resulted in the JLI Strategy Report Overcoming the Crisis. The report suggests that action based in the community, with leadership at country level and globally supported is the best approach. The report calls for strengthening health systems, mobilising to combat health emergencies in crisis countries and building a knowledge base.

A central theme that runs through many recent initiatives is the importance of leadership at country level.

EU strategy for action on the crisis in human resources for health in developing countries sets out the action that the European Union intends to take to help developing countries solve their worsening human resources problems. In May 2006 the EU Council adopted a package of action oriented decisions derived from the strategy for action on the crisis in human resources for health in developing countries. This includes incorporating human resources issues into Poverty Reduction Strategies and health policy discussions, and supporting and financing national human resources plans.

A central theme that runs through many recent initiatives is the importance of leadership at country level. This creates both challenges and opportunities for country HRH policy leaders and advocates. Country leadership:

• reduces dependence on external decision-makers but it increases accountability for action
• provides frameworks for action but it increases the number of stakeholders
• raises visibility and political attention to health but implies greater involvement with actors outside the health sector
• It means that action on HRH will necessitate building new coalitions for analysis and decision-making among the multiple actors who need to be engaged for effective change on HRH matters

For the first time the G-8 ( Group of Eight major industrial countries) summit in April 2006 included a Health Ministers’ meeting with participation of the EU, China, Brazil, Mexico, South Africa and representatives from UN agencies for Health. Human resources for health was recognised as one of the main areas in need of support.

By 2002, the secretariat of the Global Fund to Fight AIDS, TB, and Malaria (GFATM) was established, reflecting a growing political commitment to health improvement in developing countries. The Fund has already delivered 2 billion USD in the fight against these three major diseases. It now provides some funding for HRH through health systems strengthening interventions. However, few countries have taken advantage of this opportunity as of yet. The authors of Health workforce issues and the Global Fund to Fight AIDS, Tuberculosis and Malaria: an analytical review argue that countries should go beyond short-term objectives and link their Global Fund activities to a long-term development of their human resources for health.

Developing country initiatives

The number of initiatives among developing countries has increased in the past few years. TOUCH is a charity that was created in January 2005 to help train more doctors, nurses, pharmacists, dentists, and other health care workers in developing countries.

The health strategy of the New Partnership for Africa's Economic Development (NEPAD) manifests a political commitment similar to the GFATM concerning African countries. In 2002 the Council of the African Union (AU) called upon its members to develop realistic plans for Human Resources for Health (HRH) and requested the establishment of an international partnership for HRH.

Private sector involvement

Within the World Trade Organization, the 2001 Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health addresses public health issues, especially pharmaceutical policy issues, in connection with the ongoing effort for trade liberalisation. The commitment of many major multinational enterprises to address HIV/AIDS, TB, and malaria is reflected in Global Health Initiative of the World Economic Forum.

Actions

The commitment of the international community is also reflected in a wide range of initiatives for policy change, new instruments for providing development assistance, and new tools, all with potential for impact of human resources for health. The list below includes selected actions on individual health-specific conditions and diseases (often known as 'vertical programmes'), and examples of bilateral assistance.