2018-10-24 WHPA response to Astana Declaration

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World Health Professions Alliance (WHPA)
C/o FDI World Dental Federation, Avenue Louis-Casaï, 51, 1216 Geneva, Switzerland
info@whpa.org – http://www.whpa.org/
Involvement of Regulated Health Professionals key to meeting
commitments made in the Astana Declaration
WHPA acknowledges the Astana Declaration on Primary Health Care: From Alma-Ata
towards Universal Health Coverage and the Sustainable Development Goals and welcomes
the strong emphasis on health care system strengthening and the importance of supporting
the health workforce.
The World Health Professions Alliance (WHPA) speaks for more than 31 million health
professionals across 130 countries and brings together the International Council of Nurses,
International Pharmaceutical Federation, World Confederation for Physical Therapy, FDI
World Dental Federation and the World Medical Association. WHPA works to improve global
health and the quality of health services and facilitates collaboration among the health
professions and other major stakeholders.
On 25 and 26 October 2018 the world will come together for the second Global Conference
on Primary Health Care, in Astana, Kazakhstan to reaffirm the principles of the Declaration of
Alma-Ata which was signed 40 years ago. The importance of Primary Health Care (PHC) for
the 21st century will be highlighted and states will renew their commitment to strengthening
PHC to achieve Universal Health Coverage (UHC) and the Sustainable Development Goals
(SDGs). The outcome of the event is the Astana Declaration on Primary Health Care. WHPA
believes this declaration provides an opportunity for states to increase their efforts in
developing health systems while ensuring there is adequate support for health care
The alliance would like to highlight the continued critical role that regulated health
professionals play in achieving UHC. The global economy is projected to create around 40
million new health sector jobs by 2030; mostly in middle- and high- income countries. Despite
the anticipated growth in jobs there will be a projected shortage of 18 million health workers
to achieve and sustain the SDGs primarily in low and lower-middle income countries.
To respond to this need, unregulated workforce programmes, for example with Community-
Based Workers (CBW), will be implemented. These programmes will engage workers with
varying competencies and remits. WHPA recognises the need for additional staffing and the
role that unregulated workers play. Further WHPA emphasises the importance of the health
care team consisting of different disciplines and specialities in delivering good quality health
care. WHPA stresses that patient safety remains of paramount importance and should not be
neglected in efforts to bridge the gaps in the workforce. Regulated health professionals are
bound by ethical frameworks and have a scope of practice designed around the complex care
needs of patients. Unregulated workers should not be utilised as a cheaper replacement for
regulated health professionals, as they lack the breadth and depth of knowledge needed to
adequately respond to and support the health needs presented.
WHPA stresses the need for adequate planning and monitoring to avoid generating a
fragmented and disjointed system that fails to meet the total health needs of the patient. WHO
defines that primary health care is about caring for people, rather than simply treating specific
diseases or conditions. This requires a wholistic, people-centre approach with adequately
trained staff who can respond to the complex needs of the patient, rather than solely
performing limited, defined tasks.
Programmes need to be implemented in such a way that does not lead to a series of
disconnected and parallel services that are both inefficient and confusing. Such services are
not only detrimental to the care of the patient and the health system, but they may also lead
to de-motivation and high attrition rates of both regulated health professionals and unregulated
WHPA offers its expertise and assistance to the WHO and states for the development of
recommendations and guidelines to effectively incorporate unregulated health workers into
health systems.
In addition, WHPA insists that health promotion efforts are conducted within an ethical
framework. Involving regulated health care professionals in this work can help to ensure that
stigmatising images and coercion are avoided. In this way effective and sensitive promotion
will reach the target individuals and have tangible impact on their lifestyles, enabling them to
have real ownership of their health and health care.
WHPA looks forward to the impact resulting from the renewed energy and commitments made
in October 2018 and stands ready to support WHO and states in achieving UHC and SDGs.
October 2018
About the World Health Professions Alliance (WHPA)
The World Health Professions Alliance (WHPA) speaks for more than 31 million health care
professionals worldwide, assembling essential knowledge and experience from the key health
care professions in more than 130 countries.
The WHPA was formed in 1999 and now brings together the global organizations representing
the world’s dentists, nurses, pharmacists, physical therapists and physicians. We work to
facilitate collaboration among the health professions and major stakeholders such as
governments and international organizations, including the World Health Organization. By
working in collaboration, instead of along parallel tracks, patients and health care systems
Together, the partners of the WHPA include more than 600 national member organizations,
making us the key point of global access to health care professionals within the five disciplines.
The International Council of Nurses (ICN) is a federation of more than 130 national nurses
associations (NNAs), representing the more than 20 million nurses worldwide. Founded in
1899, ICN is the world’s first and widest reaching international organisation for health
professionals. Operated by nurses and leading nurses internationally, ICN works to ensure
quality nursing care for all, sound health policies globally, the advancement of nursing
knowledge, and the presence worldwide of a respected nursing profession and a competent
and satisfied nursing workforce. www.icn.ch
International Pharmaceutical Federation (FIP) is the global federation of national
associations of pharmacists and pharmaceutical scientists representing more than three
million pharmacists around the world. www.fip.org
FDI World Dental Federation (FDI) is a federation of approximately 200 national dental
associations and specialist groups from over 130 countries representing more than one million
dentists worldwide. www.fdiworldental.org
World Medical Association (WMA) is the global federation of national medical associations
from around the world, directly and indirectly representing the views of more
than nine million physicians in over 106 countries. www.wma.net
World Confederation for Physical Therapy (WCPT), the global voice for physical
therapists/physiotherapists, has 106 national member organisations representing over
350,000 members of the profession. www.wcpt.org