The World Health Organization (WHO) released today an updated WHO health workforce support and safeguards list 2023, identifying 55 countries as vulnerable for availability of health workers required to achieve the UN Sustainable Development Goal target for universal health coverage (UHC) by 2030.
The impact of COVID-19 and widespread disruptions to health services has resulted in a rapid acceleration in the international recruitment of health workers. For countries losing health personnel to international migration, this could negatively impact on health systems and hinder their progress towards achieving UHC and health security.
Of the 55 countries, 37 are in the WHO African region, eight in the Western Pacific region, six in the Eastern Mediterranean region, three in the South-East Asia region and one is in the Americas. Eight countries have been newly added to the WHO health workforce support and safeguards list 2023 since its original publication in 2020.
“Health workers are the backbone of every health system, and yet 55 countries with some of the world’s most fragile health systems do not have enough and many are losing their health workers to international migration,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO is working with these countries to support them to strengthen their health workforce, and we call on all countries to respect the provisions in the WHO health workforce support and safeguards list.” The list should be used to inform advocacy, policy dialogue at all levels and financing efforts in support of health workforce education and employment in these countries.
The countries included in the WHO health workforce support and safeguards list 2023 have a UHC service coverage index below 55 and health workforce density below the global median: 49 medical doctors, nursing and midwifery personnel per 10 000 people. These countries require priority support for health workforce development and health system strengthening, along with additional safeguards that limit active international recruitment.
The WHO health workforce support and safeguard list 2023 does not prohibit international recruitment, but recommends that government-to-government health worker migration agreements:
WHO also recommends that these safeguards be extended to all low- and middle-income countries.
Implementation of the WHO Global code of practice on the international recruitment of health personnel (WHO Global Code) can ensure that international movement of health workers is ethically managed, supports the rights and welfare of migrant health workers and maintains health service delivery objectives.
The 2023 update is informed by the report of the WHO Expert Advisory Group on the Relevance and Effectiveness of the WHO Global Code. WHO will update the list every three years, with the next update scheduled for publication in 2026.
This issue will be discussed at the upcoming Fifth Global Forum on Human Resources for Health, which will examine the required policy solutions, investments, and multi-sectoral partnerships to address health and care workforce challenges to advance health systems towards the attainment of UHC and health security. The outcomes of the Forum will inform the United Nations General Assembly’s High-Level Meeting on UHC in September 2023.
Countries of the World Health Organization have begun negotiations on a global accord on pandemic prevention, preparedness and response, using the “zero draft” as a basis for negotiating an agreement to protect nations and communities from future pandemic emergencies.
Ending Friday, discussions on the draft pandemic accord took place during the weeklong fourth meeting of the Intergovernmental Negotiating Body (INB), which includes WHO’s 194 countries. Negotiations on the draft will continue over the next year according to a timetable laid out by the World Health Assembly.
Mr Roland Driece, Co-Chair of the INB Bureau, from the Netherlands, said: “The start of discussions of concrete language for the WHO pandemic accord sends a clear signal that countries of the world want to work together for a safer, healthier future where we are better prepared for, and able to prevent future pandemic threats, and respond to them effectively and equitably.”
Fellow INB Bureau Co-Chair, Ms Precious Matsoso of South Africa, said: “The efforts this week, by countries from around the world, was a critical step in ensuring we do not repeat the mistakes of the COVID-19 pandemic response, including in sharing life-saving vaccines, provision of information and development of local capacities.”
Ms Matsoso added: “That we have been able to move forward so decisively is testimony to the global consensus that exists on the need to work together and to strengthen WHO’s and the international community’s ability to protect the world from pandemic threats.”
WHO Member States will continue negotiations of the zero draft of the pandemic accord at the INB’s next meeting, to be held over 3-6 April, with a view to collecting all inputs necessary to develop the first draft.
According to the process agreed by governments at a special session of the World Health Assembly in late 2021, negotiations on the draft pandemic accord will aim to produce a final draft for consideration by the 77th World Health Assembly in 2024.
During the week, the senior diplomats from Israel and Morocco, who are serving as co-facilitators of the United Nations General Assembly High-Level Meeting on Pandemic Prevention, Preparedness, and Response, briefed the INB on their preparations for the 20 September meeting, in order to ensure collaboration between the processes.
In parallel with the pandemic accord negotiations, governments are also discussing more than 300 amendments to the International Health Regulations (2005) in an effort to make the world safer from communicable diseases and ensuring greater equity in the global response to public health emergencies.
Governments have been working to ensure consistency and alignment across the INB and IHR processes. The proposed IHR amendments will also be presented to the World Health Assembly in 2024, and would together, with a future pandemic accord, provide a comprehensive, complementary, and synergistic set of global health agreements.
WHO Director-General Dr Tedros Adhanom Ghebreyesus today visited north-west Syria following the devastating earthquakes that hit northern Syria and southern Türkiye on 6 February 2023. Dr Tedros is the first UN principal to enter north-west Syria since the beginning of the conflict, 12 years ago.
Dr Tedros met with the partners WHO works with in north-west Syria to deliver essential health care, including specialised orthopaedic care and paediatric care.
Also today, WHO distributed additional life-saving medicines, supplies and equipment to three hospitals in north-west Syria. These are sufficient for over 280,000 treatments, including for the management of trauma, diabetes, and pneumonia, as well as vitally needed anaesthesia drugs and surgical supplies. WHO has sent over 140 tonnes of supplies to north-west Syria, from across the border in Türkiye and across lines within Syria. In the first hours after the earthquakes, WHO distributed 183 metric tonnes of supplies prepositioned inside north-west Syria from warehouses in Azaz and Idlib to more than 200 health facilities.
Dr Tedros spoke at a media briefing following the visits, saying:
"WHO is playing our role in supporting the Syrian people, who have responded incredibly with the little that they have. WHO has been delivering essential medicines, supplies, and equipment for years, as well as on the day the earthquakes struck. And we will do more. But the people of northwest Syria need the assistance of the international community to recover and rebuild. Even before the earthquake, more than 90% of the Syrian people were living below the poverty line...I call on the international community – governments, philanthropies and individuals – to dig deep to lift up those who are enduring unimaginable loss, poverty and deprivation. At the same time, I call on the leaders of both sides of the Syrian conflict to use the shared suffering of this crisis as a platform for peace."
On 28 February, Dr Tedros met with Turkiye's Minister of Health, health workers and others affected by the earthquake. Earlier in the month, he visited Aleppo, Syria to meet with affected people and officials.
The Fifth Global Ministerial Summit on Patient Safety was held in Montreux, Switzerland on 23 and 24 February with the slogan “Less Harm, Better Care – from Resolution to Implementation”
The Fifth Global Ministerial Summit on Patient Safety closed in Montreux, Switzerland on 24 February, after endorsing the Montreux Charter on Patient Safety with recommended actions to address avoidable harm in health care. This was the first Global Ministerial Patient Safety Summit to take place after the COVID-19 pandemic, which has exposed the high risk of unsafe care to patients, health workers and the general public, and made visible a range of safety gaps across all core components of health systems. The Summit was hosted by the Swiss government.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, participated in the Summit with the host, the Swiss President Alain Berset. In his address to the ministerial segment, Dr Tedros urged health ministers to invest in patient safety as part of their commitment to universal health coverage and health security; to build a culture of safety and strengthen reporting and learning systems; to support health workforce and strengthen their capacity; to strengthen data systems; and to engage patients and families in their own care. Dr Tedros announced that the theme for World Patient Safety Day 2023 will be “Engaging patients for patient safety”.
In Montreux, delegations from more than 80 countries discussed the gaps and key challenges for the implementation of the World Health Assembly resolution (WHA72.6) "Global Action on Patient Safety" and the global roadmap for patient safety, the Global Patient Safety Action Plan 2021–2030: Towards eliminating avoidable harm in health care.
Despite progress to address patient safety challenges worldwide, concerted efforts are needed to ensure safety of patients and health and care workers, noted the delegations and stressed that lessons learned from the COVID-19 crisis hold huge potential to build safer and more resilient health systems.
The Montreux Charter on Patient Safety, endorsed at the Summit, reaffirms that patient harm in health care is an urgent public health issue, pertinent to countries of all income settings and geographies and therefore a shared global challenge. It identifies actions for countries to narrow implementation gaps in patient safety, including by treating patient safety as a global public health priority, building upon lessons learned from the COVID-19 pandemic, deepening partnerships, collaboration and mutual learning, and engaging patients and their families. The Charter also urged setting priorities for patient safety, including medication safety, safe surgery, infection prevention and control, and antimicrobial resistance.
Unsafe care is among the leading causes of death and disability in the world. It is particularly acute in resource-constrained settings. In the years preceding the COVID-19 pandemic, 2.6 million people died every year due to safety lapses in hospitals in lower-income countries. Rich countries are not immune: nearly 15 per cent of hospital expenditure and activity in countries of the Organization for Economic Co-operation and Development could be attributed to treating safety failures.
It is estimated that more than half of cases of patient harm are preventable, by working together to create a safer healthcare system for all and to build a culture of safety that emphasizes continuous improvement, learning, and innovation.
The Summit in Montreux builds on the preceding Global Ministerial Summits on Patient Safety which have raised awareness about burden of avoidable patient harm in health care and fostered strategic approaches to strengthening Patient Safety, from London (2016), to Bonn (2017), to Tokyo (2018) and to Jeddah (2019).
The Sixth Summit will be held in Chile in 2024.