Discours - Quatrième Forum mondial sur les ressources humaines pour la santé

14 November 2017, Dublin, Ireland

Your excellencies

Honourable Minister for Health of Ireland, Mr Simon Harris

Dean of Health Sciences of Trinity College, Professor Mary McCarron

Ministers, distinguished guests, ladies and gentlemen,

I am honoured to be here today with you and to welcome you all to the Fourth Global Forum on Human Resources for Health. I also welcome you to the WHO European Region and to Ireland, a country with a relatively small population, but with a big heart, a country which has significantly contributed to progressing the global agenda on human resources for health.

I warmly thank the Government of Ireland, the departments of health, foreign affairs and trade and the Health Service Executive of Ireland, and Trinity College, Dublin, for being fantastic hosts and partners of this big undertaking, and for hosting the Fourth Global Forum on Human Resources for Health.

The Fourth Global Forum on Human Resources for Health is the first to be held here in the European Region. Ireland takes the baton from Brazil and the Third Global Forum held in Recife (2013), which clearly articulated the health workforce implications of UHC: workforce availability, accessibility, acceptability and quality. In so doing, it helped lay the foundations for the Global Strategy on Human Resources for Health.

Now, four years from the Recife Forum, we are better equipped to transform health services delivery and to move towards universal health coverage. Taking the 2030 Agenda for Sustainable Development as its frame of reference, and in little more than a year, we have agreed upon the Global Strategy on Human Resources for Health: Workforce 2030. We have also received the report of the UN High-Level Commission on Health Employment and Economic Growth, and we have responded to its key recommendations by agreeing to a joint five-year action plan for WHO, OECD and ILO.

Here in Dublin the theme, and stated objective, for the Forth Global Forum is "Building the health workforce of the future”. We arrive at the Forum at an important time for health workers. Health workforce issues are on the policy agenda as never before, reflecting our shared understanding that we cannot achieve the health-related SDGs, or sustain UHC, without a competent, motivated and well-managed health workforce. UHC – including prevention, promotion, rehabilitation, access to care, palliative care and financial protection – is perhaps the most important policy framework for our discussions here in Dublin.

Excellencies, ladies and gentlemen,

We are living in a rapidly changing world. In the European Region, as elsewhere, we face a number of health challenges: a rapidly ageing population; an increased incidence of chronic conditions and multi-comorbidities; environmental, social and economic pressures; large-scale migration; a changing landscape of information technology; and an assertive population active in social media. Our shared vision for UHC is to maximize health gains, to reduce health inequalities, to guarantee financial protection for populations and individuals, and to ensure an efficient use of societal resources through intersectoral and multisectoral actions consistent with whole-of-society and whole-of-government approaches.

This vision, shared by all of us, can be achieved by transforming services delivery and by working across sectoral and organizational boundaries. Health 2020, the European policy framework for health and well-being, sets out the required strategic changes for health services, using a people-centred approach through the adoption of inclusive models of health care; the reorientation of health systems towards a collaborative primary care approach built on team-based care; and the realization of the potential for technological innovation, such as electronic health services (e-health).

We also recognize that much of the effort must be built on effective primary health care, and next year we will mark the 40th anniversary of the Alma-Ata Declaration with a global conference to be held on 25–26 October 2018 in Almaty, Kazakhstan.

Health workers play a critical role in health systems, by ensuring sustainability, resilience and the delivery of high-quality services. We all understand that without properly educated, skilled, motivated and managed human resources, in the right numbers and in the right places, universal health coverage is not attainable.

Because of this mutual understanding, we now have an unprecedented policy focus on the health workforce at a global level. This gives us great opportunities to make further progress in the next few years.

Member States can only achieve the necessary improvements to health systems and health services delivery with a transformed and sustainable health workforce. We have made great strides in recent years but there is more to do; many challenges in human resources for health must be addressed fully in order to achieve an optimal contribution of the workforce.

These challenges will be familiar to all of us here today. They include supply–demand imbalances, gender inequality and gender imbalances, achieving an appropriate skills mix, geographical maldistribution, gaps in quality, attaining decent working conditions, and improving recruitment and retention. In addition, funding constraints will place increasing pressure on decision-makers in many Member States as they work to address these health workforce challenges.

In turn, this requires effective policy action across various sectors, including health, social care, welfare, education, finance, labour and foreign affairs. Intersectoral processes must engage the public and private sectors, civil society, trade unions, health worker associations, regulatory bodies, and educational and training institutions. This reinforces the fundamental requirement for strong leadership by Member States, and coordinated efforts across national boundaries, underpinned by evidence and labour market analysis.

In the WHO European Region, we have been fully involved in contributing to shaping the direction of these global developments, and to translating them into action that is relevant to the Region and the specific challenges we face.

Health 2020 recognizes that the health workforce is a critical cross-cutting enabler for progress. These key messages will be reinforced in June next year at the WHO high-level meeting on Health Systems for Prosperity and Solidarity – Leaving no one behind; Estonia will generously host this meeting on 13–14 June 2018, on the occasion of the 10th Anniversary of the Tallinn Charter.

In the Region, we have recognized that effective care and improvement in health outcomes can only be fully achieved with a sustainable, resilient health workforce, transformed with the appropriate knowledge, skills and values.

That is why I am pleased to highlight that at the Regional Committee in September, Member States unanimously adopted the framework for action towards a sustainable health workforce in the WHO European Region. The framework was developed to support countries in the Region in moving towards a sustainable workforce by building on the strategic objectives set out in the Global Strategy on Human Resources for Health: Workforce 2030, and by adapting them to the regional context.

We are backing up the European framework for action with a new toolkit of relevant health workforce policies and planning tools. The Regional Office has arranged a lunchtime session to showcase the current version of the toolkit. Please go to the session on Wednesday at 12:30 to hear more!

Ladies and gentlemen, the theme of this Forum is “Building the health workforce of the future”. It is all about people, and we are looking to 2030 and beyond, focusing on what is important for the millions and millions of health workers and those being trained and educated to become health workers, across the world. We are all responsible for ensuring that young health workers and the next generation can remain committed and enabled to make a full contribution across their career span. For them, 2030 is just an early step in what can, and should be, a much longer career journey.

Member States have to adopt a broad approach to transformative change, guided by the overarching aim to better match the supply of health workforce skills with the demands to meet population health needs, by engaging with key stakeholders in this process, and by ensuring that all are clear about their roles and responsibilities. The need for evidence-informed debate among key stakeholders is the rationale for holding this HRH Forum.

This is the global truth: to meet population health challenges, and to sustain UHC, workforces must be transformed in terms of skills mix, competencies, team composition and – in some cases – location, management and regulation.

To achieve this transformation, we must shift the policy focus from regarding the health workforce as a cost (and often a “problem”) to understanding that investment in the workforce will have a positive return in terms of the health, wealth and well-being of the populations of Member States. This theme of investment for change and prosperity will also be on the agenda for our meeting in Tallinn next year.

Achieving this “value add” from the health workforce will require national leadership and strong political commitment, as well as effective partnerships and collaboration among organizations, sectors and countries, if the workforce heart is to keep beating strongly across the globe.

Excellencies, ladies and gentlemen,

I wish all of us a very productive and successful Forum, where we will focus on concrete actions to progress this critical HRH agenda.

Thank you.