Health workforce exodus will push health systems to the brink of collapse

What will happen if the Western Pacific's health workforce, seeking better-paying jobs and professional advancement abroad, continue to migrate as the region's population ages, the burden of chronic disease rises and new health threats emerge? Serious effects not only on health, but in the socioeconomic arena as well, are likely to occur unless urgent measures are taken now to keep health workers employed in their home countries.

That was the warning voiced today as senior health officials met here for the World Health Organization's Regional Committee for the Western Pacific. The meeting heard that almost all countries in the Western Pacific Region face health worker shortages, particularly nurses and public health workers. If present trends continue, this worsening shortage will push health systems to the brink of collapse, particularly in poor countries where health needs are greatest.

On the other hand, health workers who stay behind when their colleagues emigrate face increasing workloads and a loss of morale. As a consequence, hard-won gains in health may be reversed as serious workforce shortages leave many countries without the capacity and support needed to mount effective responses to health problems.

According to The World Health Report 2006, the shortage of human resources has replaced funding issues as the most serious obstacle to implementing health interventions and treatment plans. The report urged governments to take the lead in enhancing the effectiveness of their workforces through new strategies and innovative actions, with the support of partners.

With this in mind, WHO's Regional Committee for the Western Pacific, WHO's governing body for the 37 countries and areas that make up the Western Pacific Region, is set to endorse the Regional Strategy on Human Resources for Health 2006-2015. The strategy provides policy options and practical guidelines to WHO Member States for developing and sustaining a robust health workforce that meets population health needs and demands.

"Instead of merely averting immediate crises and current situations, governments must anticipate health needs or new services and technologies," said Dr Richard Nesbit, WHO acting Regional Director for the Western Pacific.

In order to tackle human resource issues, WHO Member States must examine their entire health system, including infrastructure, technology, logistics, supplies and financing. They must attack the health worker shortage in a coordinated manner by working with all sectors of society and by building effective partnerships. Governments will need to fashion country-specific strategies aimed at building, sustaining and retaining sufficient, balanced, competent, productive and responsive health workforces that can promote equitable access to quality health services.

Apart from the overall health worker shortages, the workforce problem is further compounded by minimal or insufficient expertise in epidemiology, infection control, laboratory work, logistics, environmental health and risk communication necessary to meet the challenge of emerging infectious diseases. In addition, aid and technical advice from development partners and donors are mostly fragmented and uncoordinated.

WHO estimates the current global health workforce to be around 59 million people. There are 39.5 million health service providers, and 19.5 million management and support workers. WHO estimates a global health worker shortage of more than 4 million doctors, midwives, nurses, pharmacists, dentists and support workers.

WHO emphasized that training, sustaining and retaining a motivated and supported workforce will require long-term commitment, structural and fiscal changes, and partnership at all levels-country, regional and international.