Atiya Mosam, Dale Andrew Fisher, Mehreen B Hunter, Teena Kunjumen, Saqif Mustafa, Tapas Sadasivan Nair, Fatai Ogunlayi, James Campbell, WHO Public Health Roadmap and Emergency Working Group
The COVID-19 pandemic tests the health systems of countries around the world as they seek to respond to rapid and growing needs within their individual socio-political and economic contexts. While pandemic management was rapidly focusing on diagnostic and therapeutic services and supply chains, the need for a well-coordinated, efficient and diverse workforce to perform core public health functions (EPHF), including responding to public health emergencies from international meaning became apparent. At the same time, the lack of preparedness of many health systems to withstand unexpected health shocks and the diversion of human resources to emergency responses has led to widespread disruptions in routine health services, with a consequent effect on morbidity and mortality.
The ability to provide basic clinical and public health services and to respond, if necessary, to emergencies and hazards is a key function of the health system. When this function is properly configured, the sustainability attribute is firmly embedded in its core: with efficient delivery led by a competent workforce, with the appropriate skills assigned a number of functions from emergency response to health system stability. The COVID-19 pandemic and other public health emergencies of international importance in recent years (eg Ebola, Zika and the Middle East Respiratory Syndrome) have highlighted the limitations (or in some cases the complete absence) of public health workforce plans in many countries. With the ongoing pandemic, growing health care backlogs, economic scarring and political recognition of future threats to public health, the need for preventive policies and plans to provide a skilled and easily accessible workforce to provide EPHF is imperative. This includes countries that evaluate and use all available public health staff and professionals, including those outside the health sector.
In this regard, we recognize and welcome the political agreement present in the Rome Declaration, the G20 Italia and a series of World Health Assembly resolutions recognizing the need to build the capacity of the health workforce to provide EPHF, including emergency preparedness and response and the urgency with which action must be taken. They position the concept of “labor readiness” together with the discussion of “country readiness” for the next emergency.
The WHO and its partners have developed a roadmap aimed at standardizing the definition, classification and scope of work for public health and emergency personnel responsible for providing EPHF and responding to future public health emergencies. The roadmap includes recommended actions at national, regional and global levels, together with joint activities to build an integrated, multidisciplinary and multisectoral workforce in public health.
The conceptual approach outlined in the roadmap is based on three separate but interrelated areas of action: defining the functions and services of the public health workforce, developing and enhancing competence-based education for these staff, and mapping and measuring current and future workforce (Figure 1). It is envisaged that these functions will be performed simultaneously, with progressive achievement, based on the context of the individual country.
In order to improve the ability of states to undertake the activities set out in the roadmap, some high-level commitments and activities are essential. The partners urge the leadership of organizations such as the African Union, the European Union, the G7 and the G20 to strengthen the commitments made in the above-mentioned declarations and resolutions through political will and related resource mobilization to achieve their previous consensus, goals and objectives.
In addition, we call on public health associations, institutions, schools and all relevant stakeholders to improve cooperation and coordination within and between regions in order to identify areas of synergy, joint creation of global public goods, joint implementation and subsequent codification. of knowledge and dissemination of best practices. The creation of a unified and standardized set of skills and competencies for managing public health practices around the world will ensure that the well-being of society is always at the forefront of every endeavor and provide communities with a reliable and globally responsible workforce to which they can to address in times of turmoil in the health system, when insecurity and misinformation due to fear and lack of trust threaten the very well-being that this workforce is expected to protect.