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World Health Day - April 7, 2006:

Keeping the world healthy

by Dr. Tim Evans

Health workers - the people who provide health care to those who need it - are the heart of health systems. But around the world, the health workforce is in crisis - a crisis to which no country is entirely immune. The results are evident: clinics with no health workers, hospitals that cannot recruit or keep key staff.

There is a chronic global shortage of health workers, as a result of decades of underinvestment in their education, training, salaries, working environment and management. This has led to a severe lack of key skills, rising levels of career switching and early retirement, as well as national and international migration.

In sub-Saharan Africa, where all the issues mentioned above are combined with the HIV/AIDS pandemic, there are an estimated 750 000 health workers in a region that is home to 682 million people. By comparison, the ratio is ten to 15 times higher in OECD countries, whose ageing population is putting a growing strain on an over-stretched workforce.

Solutions to this crisis must be worked out at local, national and international levels, and must involve governments, the United Nations, health professionals, non-governmental organizations and community leaders. There is no single solution to such a complex problem, but ways forward do exist and must now be implemented.

For example, some developed countries have put policies in place to stop active recruitment of health workers from severely understaffed countries. Some developing countries have revised their pay scales and introduced non-monetary incentives to retain their workforce and deploy them in rural areas.

Education and training procedures have been tailored to countries' specific needs. Community health workers are helping their communities to prevent and treat key diseases. Action must be taken now for results to show in the coming years. In 2006, World Health Day (celebrated annually on 7 April), will be devoted to the health workforce crisis.

On this day around the globe, hundreds of organizations will host events to draw attention to the global health workforce crisis and celebrate the dignity and value of working for health. We invite you to join with WHO and other organizations to celebrate World Health Day 2006. Together, we can make a difference.

Dr Tim Evans is the Assistant Director-General Evidence and Information for Policy of the World Health Organization.


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