This post originally appeared on the USGLC blog on July 8, 2020.
Despite the multiple mechanisms that exist to respond to infectious disease threats, including the World Health Organization’s International Health Regulations and the Global Health Security Agenda (GHSA), only 11 percent of countries have plans to dispense medical countermeasures during health emergencies and 27 percent have an updated health workforce strategy. Since the inception of GHSA in 2014, more than 100 countries completed their Joint External Evaluations to identify gaps within their health systems and prioritized opportunities for enhanced preparedness and response in their National Action Plans for Health Security. Although these extensive efforts reflect country commitment and international coordination, the October 2019 Global Health Security Index (GHI) showed that national health security remains fundamentally weak around the world. GHI findings revealed health systems as the lowest-scoring category, regardless of a country’s income level, with 131 countries in the bottom tier.
These disturbing numbers are exacerbated by reports of a looming crisis in many low- and middle-income countries where there are already too few doctors and essential medical commodities to adequately meet the basic health needs of their populations, let alone respond to the potential exponential number of COVID-19 cases. Further, the lack of infrastructure and population density in some communities, for instance urban slums and refugee camps, hinder the practice of social distancing and consistent handwashing.
The global community – including governments, donors, NGOs, and the private sector – must focus on three critical areas to mitigate the impacts of COVID-19 and better prepare for future global health threats: health workforce expansion, supply chain preparedness, and private sector engagement.
1. Integrate, Expand, and Optimize the Health Workforce
The backbone of any health system is its workforce. Frontline workers are the first line of defense against emerging diseases. COVID-19 has highlighted the importance of expanding the pool of frontline workers to ensure adequate response in times of crisis.
Workforce crisis expansion means:
- tapping into cadres beyond the traditional workforce to include dentists, veterinarians, and other country-specific health professionals who can be rapidly trained on basic service delivery tasks (vital signs, triage, etc.);
- implementing policies that enable senior year medical, nursing, and laboratory students to actively contribute to the response by allowing benefits like early graduation in exchange for interning with hospitals to support pandemic response; and
- leveraging community networks to provide health services and support social behavior change among populations or community interventions like contact tracing.
Beyond expansion, when countries face workforce shortages, our experience shows that optimizing service delivery tasks through task sharing and alternative service delivery modalities are also effective in ensuring continued quality health services reach those in need.