Best Investment for a Healthier World


Prioritize Health Workers at the US-Africa Leaders Summit

Community health supervisor Karana Weefar coaches community health workers Laura Gbee and Peter Zeo on how to count a young girl's respiration rate. Photo by Rachel Larson for Last Mile Health.

Community health supervisor Karana Weefar coaches community health workers Laura Gbee and Peter Zeo on how to count a young girl's respiration rate. Photo by Rachel Larson for Last Mile Health.

The US-Africa Leaders Summit taking place next week presents a momentous opportunity for the Biden-Harris Administration to move from vision to action on its ambitious and long-overdue Global Health Workforce Initiative while simultaneously bolstering Africa-led workforce initiatives.

The Summit will include high-level dialogue with African Ministers of Health on the health workforce, but any ongoing US-Africa dialogue should be expanded to include health workers themselves and their representatives, based on the principle of “nothing about us without us,” to ensure their needs are fully addressed.

A strong, well-supported health workforce is the backbone of well-functioning primary health care systems, and critical for global health security. But it is not yet in place. Even prior to the pandemic the world faced a shortage of nearly 15 million health workers, mostly in low- and middle-income countries, with the shortage growing in Africa. The Institute for Health Metrics and Evaluation (IHME) reported an even greater shortage, estimating that over 43 million additional health workers are needed to meet targets for universal health coverage around the world, with the largest gaps in Sub-Saharan Africa.

For the already too few health workers that are active today, severe inequities and precarious working conditions prevail. The vast majority of health workers are female. Six million of them are unpaid or grossly underpaid. Just 14% of community health workers on the African continent are salaried. Shocking statistics like this explain high attrition rates among health workers and hint at why, tragically, half the world lacks access to essential health services.

It's time for us to support and respond with what the evidence has proven works. Professional, paid community health workers embedded in strong health systems can slow the spread of outbreaks, and they can also maintain access to essential services during periods of disruption. The absence of a strong health workforce has the opposite effect, creating conditions in which outbreaks can spread and patients are left at risk. Putting global health workforce strengthening on the agenda at the US-Africa Leaders Summit and taking advantage of the Summit to announce concrete commitments to operationalize the Global Health Workforce Initiative would be important steps in addressing this issue.

The Biden-Harris Administration has already cast its vision for the Global Health Workforce Initiative which would accelerate US contributions to the Sustainable Development Agenda and increase investments in health and care workers through four pillars: protecting health workers, expanding the global health workforce and accelerating economic development, advancing equity and inclusion, and driving and investing in technological advancements and innovation. Now, it’s time to take this initiative to action. The Summit provides an opportunity for leaders like USAID Ambassador Samantha Power to champion the initiative, not only to African leaders but also members of US Congress who may be watching and who will ultimately determine whether or not to fund the Initiative.

At the Summit of the Americas earlier this year, the Biden-Harris Administration announced the Americas Health Corps, which will provide basic and specialized training to 500,000 public health, health science, and medical professionals throughout the region within five years. Issuing a similar commitment at the US-Africa Leaders Summit would demonstrate to visiting African Heads of State and Ministerial leaders that the US is serious about the Global Health Workforce Initiative and can be counted on as a partner in regional- and continental efforts.

Meanwhile, the Summit gives African delegations ample opportunity to highlight continental leadership on health workforce, which has been on full display as COVID-19 upended health systems the world over. Earlier this year, the African Union set up a dedicated task team for the health workforce; member states can use the Summit as an opportunity to showcase the task team’s progress in countries across the continent and offer recommendations on how a US-championed Global Health Workforce Initiative can accelerate such progress. Africa CDC, meanwhile, has announced its vision for a new public health order, which includes the strengthening of desperately-needed and under-funded professional community health worker programs across the continent. This vision is bolstered by exciting private sector-led initiatives such as Africa Frontline First, which aims to deploy 200,000 professional CHWs across ten African countries by 2030. These types of investments, accelerated as part of the Global Health Workforce Initiative, would enable countries to provide thousands of new paid health workers with the salaries, skills, supplies, and supervision they need to provide hours of boots-on-the-ground public health support, working to identify COVID-19 cases, support effective isolation, and get people the care they need so that a lower mortality can build trust in the health system.

The Summit provides an opportunity for US and African Leaders to prioritize coordination and cooperation on these various initiatives as part of an ambitious and overdue effort to address the health worker shortage. Leadership from both sides of the Atlantic is critical and will be the difference between a world that is prepared for the next pandemic and one that is not. It’s time for the health workforce to be on the agenda once and for all, so that patients can get the care they need, outbreaks can be contained, and health for all can become a reality.

Community Health Impact Coalition would like to thank Carey Carpenter Westgate (Community Health Impact Coalition), Dan Palazuelos (Partners in Health), Carol Bales (IntraHealth International), Beth Geoffroy (GAIA), Mandy Folse (Living Goods), Matthew French (Nama Wellness), Niloo Ganjian (Last Mile Health), Stephanie Rapp (Muso), Kim Lipman-White (Possible), Pauline Keronyai (Nama), Rachel Hofmann (D-Tree), and David Bryden (Frontline Health Workers Coalition and IntraHealth) for their contributions to this post. Community Health Impact Coalition is a member of the Frontline Health Workers Coalition.