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Can We Put Aside Our Differences for Universal Health Coverage?


This post originally appeared on Impatient Optimists.In his remarks on World AIDS Day, President Barack Obama celebrated our progress in the US and abroad, but urged us to double our efforts.The work has only just begun.This and other major current events—including the Fourth Replenishment of the Global Fund, the Third Global Forum on Human Resources for Health, the International Conference on Family Planning, and the upcoming International Conference on AIDS and STIs—are all valuable, yet also indicative of the global health field’s lingering silos.Many of us who have worked across these fields for decades wish we could all be having the same conversation, with one united voice and a common objective.Fortunately, the walls of these silos are not as high as they once were. Countries now use Global Fund resources to help strengthen the health systems and workforces that deliver services for HIV/AIDS, tuberculosis, and malaria. Reproductive health and family planning programs sometimes include strategies such as task-sharing to improve or maximize the health workforce. And we are moving beyond vertical programming, seeing more integrated services and a focus on strengthening health systems and the health workforce.

We’re envisioning a world in which every person has someone to turn to for basic health concerns and illness. And that someone is a health worker.

Though this isn’t happening systematically—or fast enough—it’s exactly what we will need to achieve universal health coverage. Communities around the globe cannot have access to any type of health service without health workers and the health systems that support them.Universal health coverage is within our reach. Simply stated, it means that each of the world’s 7 billion citizens would have access to basic health services. We’re not talking about an ideal scenario where every individual has cutting-edge health care and access to specialists and the latest technologies and procedures. Instead, we’re envisioning a world in which every person has someone to turn to for basic health concerns and illness. And that someone is a health worker.The progress we have made in strengthening health workforces since 2006 has been limited. Universal health coverage calls not only for more health workers, but for more equitable distribution of health workers across vulnerable populations. And we know that to achieve this, political will and commitment to action are essential.We also know that it takes a village—or, more accurately, it takes a lot of networked villages that are willing to learn from and rely on each other. But so far, we have not worked openly and creatively outside of our usual “villages” to identify mutual goals, share what we have learned, work together, and hold each other accountable.It is time to start talking about the health workforce as the key accelerator for strengthening our health systems so we can achieve universal health coverage. But it cannot be the sole responsibility of any one organization or sector. It will take governments, donors, multilateral and civil society organizations, the private sector, and international and local nongovernmental organizations. I believe we need a paradigm shift in partnership, collaboration, and cooperation, and that we must encourage the development of skills in three key areas: adaptation, innovation, and integration.Let’s all challenge our own assumptions, stop the blame game, and promote personal and mutual accountability.Let’s harness the incredible opportunities and potential of technology, never forgetting that these technologies should serve our public health goals and not vice versa.Finally, let’s redouble our effort and fully support the commitments made at the Third Global Forum—always being aware of when we might be tempted to put our own interests first. If we can be transparent, open, and accountable, we can more easily align ourselves with the right partners to achieve greater health for all.IntraHealth has worked in close collaboration with ICS Integrare, CHESTRAD, Public Services International, and many civil-society colleagues to develop an open letter that complements the Recife Political Declaration on Human Resources for Health and states that we must keep health workforce issues at the center of our global development efforts. Many organizations have signed on and I invite you to do the same. Email us at hrhforum2013@intrahealth.org. The letter will remain open until December 14, 2013.