WMA and ICN Comments G20 G7_ NCD

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WMA and ICN Comments G20&G7 Health& Development Partnership
document on:
NCD condiAons: A threat to Health, A Threat to Wealth
A general comment to health workforce:
• The health workforce is a cornerstone in building responsive health systems yet HRH
planning remains one of the weakest links to health service planning in many
countries.
• WHO es?mates a shortage of 10-18 million health workers globally by 2030
• All countries must take ac?on to protect and safeguard, expand and op?mize their
health and care workforce to ensure the func?onality of health systems in all
countries to respond to ongoing and future health needs and threats
• The slogan WHO is using and which we support: protec?ng, safeguarding and
inves?ng in the health and care workforce
• Strengthen na?onal capaci?es should be done by inves?ng in the training,
development, recruitment and reten?on of a competent, skilled and equipped health
workforce and very importantly enhance the working condi?ons with measure to
protect them from violence.
• Decent working condi?ons include as well fair, equal, consistent and ?mely pay for all
health professionals and the development and use of country-specific career
progression guidelines, supervision, mentoring programs and life-long learning.
• Since Covid 19 the working situa?on of health professional have deteriorated
tremendously. The workload and mental burden is high and many health
professionals end in burnout, consequently many health professionals leave the
profession and it’s difficult to aRack young people to enter the profession.
• Important relevant documents:
• WHPA and WHO report: ‘ What the COVID 19 pandemic has exposed: finding of the 5
Global health workforce professions’.
• WHO Global Health and Care Workers Compact: it provides recommenda?ons on
how to protect health and care workers and safeguard their rights; and to promote
and ensure decent work, free from racial and all other forms of discrimina?on; and to
provide a safe and enabling prac?ce environment.
• Contact at WHO: Dr. Jim Campell, Director health workforce department:
campbellj@who.int
In the document ar?cles 5 address health systems and the health workforce.
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Specific comments
Black : exis?ng text
Bold black: exis;ng headline
Red: new proposed text
Sec?on 3, Ar?cle 5 page 16:
Improved healthcare systems that are accessible, affordable, and responsive to NCD and
mental health are essen;al to mee;ng popula;on needs and reducing preventable
suffering.
Health systems capacity for NCD and mental health management needs to be strengthened
by addressing shortages of necessary health and care personnel and cri?cal medicines, and
enhancing community-based healthcare, referrals, preven?on and care. Countries must take
decisive ac;on to protect, expand, and op;mize the health and care workforce to ensure
resilient systems. This requires sustained investment in educa;on, recruitment, and
reten;on, as well as safeguarding health personnel’s’ physical and mental well-being,
ensuring occupa;onal safety, and providing fair, suppor;ve, and enabling working
condi;ons.
Integrated service delivery models…
Sec?on 4, page 22
Integrated healthcare system strengthening
• Develop integrated service delivery models at the primary care level with clear
referral pathways
• Take decisive ac?on to protect, safeguard, expand and op?mize the health and care workforce
to ensure system functionality and resilience
• Strengthen supply chains for essen?al NCD medicines – recognizing them as cri?cal
life-saving interven?ons
• Investment in the training educa?on, development, recruitment and retention of a
competent, skilled, and adequately equipped health workforce on NCD and mental health
management
• Implement task-shiKing * mul?-disciplinary primary health care teams and
community-based approaches to address health worker shortages
• Establish na?onal standards and implement quality improvement monitoring across
all facility levels
* task shiKing : In 2008 in response to health workforce shortages, par?cularly in regions
where prompt HIV/AIDS care is essen?al, the WHO, UNAIDS, and PEPFAR provided guidelines
and recommenda?ons for task shihing. These models aim to ensure that care can be
provided to all individuals in need. (Treat, Train, Retain). Task shihing was defined as: “Task
shihing involves the ra?onal redistribu?on of tasks among health workforce teams. Specific
tasks are moved, where appropriate, from highly qualified health workers to health workers
with shorter training and fewer qualifica?ons in order to make more efficient use of the
available human resources for health.” In 2021, the WHO published Health Workforce-
related terminology at the request of the WHO Health Workforce Department for use by
member states. It discouraged the use of the word task shihing. It said, “Discouraged from
use, as found inappropriate and typically implying the simple shihing (some?mes dumping)
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of tasks in isola?on, therefore lacking the accompanying support measures.” Instead, it
encouraged the use of task sharing, which the WHO defines as “The ra?onal redistribu?on of
responsibili?es among health workforce teams. Specific tasks or roles are shared, where
appropriate, to less specialised health workers to make more efficient use of the available
personnel. It should be accompanied by appropriate measures in terms of educa?on,
supervision, management support, licensing, regula?on and remunera?on.
On the occasion of UHC Day 2024, World Health Professions Alliance WHPA is released two
statements, calling on WHO member states to invest in health professionals, in the
community and elsewhere, as a priority to deliver safe, high-quality primary health care
(PHC) as a means to achieve universal health coverage (UHC):
1. Invest in health professionals to achieve universal health coverage and safe, quality
care:
Because PHC covers so many facets of health and complex pa?ent needs, it cannot be
implemented by any single type of health worker alone. It requires a mul?disciplinary
collabora?ve approach involving qualified and regulated professionals,
complemented by effec?ve referral pathways to ensure that pa?ents receive the care
they need from the right professional at the right ?me. Community-based health
professionals, such as pharmacists and den?sts, family physicians, nurses and
physiotherapists, are ohen the first point of contact in a PHC model and enjoy high
levels of pa?ent trust. Community health workers can be part of mul?disciplinary
teams, if suitably supervised by health professionals to ensure pa?ent safety.
2. Health professionals call for holis;c primary health care and mul;disciplinary teams
to achieve UHC:
Mul?disciplinary teams are needed to respond to the whole person rather than the
symptoms, and to the various determinants of health considered in a holis?c
approach. Different health care professionals working together to provide a broad
range of services in a coordinated way will op?mize care con?nuity and coordina?on,
align pa?ents’ care pathways, offer comprehensive services, enhance efficiency of
service delivery and improve pa?ent outcomes and sa?sfac?on.
WHPA brings together the global organiza?ons represen?ng the world’s den?sts,
nurses, pharmacists, physical therapists and physicians and speaks for more than 41
million health care professionals in more than 130 countries. WHPA works to improve
global health and the quality of pa?ent care and facilitates collabora?on among the
health professions and major stakeholders. www.whpa.org
both statements relate to the next comment on page 31:
A toolkit of implemen?ng measure (v)
Improving NCD healthcare and health workforce
• Invest in health workforce capacity by training and educa?ng healthcare workers on
NCDs and mental health management, as well as professionalizing community health
workers and develop their capacity to address NCDs and mental health.
• Replace by:
• Invest in health workforce capacity by ensuring decent working condi?ons such as
fair, equal, consistent and ?mely pay for all health professionals and the development
and use of country-specific career progression guidelines, supervision, mentoring
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programs and expand educa?on and training on NCD and mental health care and
management
• Shih towards mul?disciplinary team-based care, which is defined as a partnership
between different cadres of health care workers, inside and outside the health sector
and the community they serve, with the goal of providing con?nuous, comprehensive
and efficient health services carry across the con?nuum of preven?ve, cura?ve and
rehabilita?ve aspects of NCD and mental health care.
Annex 1
On a detailed toolkit of implemen;ng measures for the considera;on of global
legislators
(i) Strengthen health system capacity for NCDs and mental health:
• Implement task-shihing and task-sharing mul?-disciplinary primary health
care teams and community-based approaches to address healthcare worker
shortage and engage all health workers in the preven?on and control of NCDs
and mental health condi?ons
(ii) Enhance health workforce capacity
• Professionalize community health workers and develop their capacity for
NCDs and mental health
• Include community health workers as a part of mul?disciplinary teams, if
suitable with con?nues training and supervised by health professionals to
ensure pa?ent safety and quality.
•
Graph:
A toolkit of implemen;ng measures:
5: Improving NCD healthcare & health workforce
About WMA
TheWorldMedicalAssociation(WMA)istheglobalfederationofNationalMedical
Associations represen?ng the millions of physicians worldwide. Ac?ng on behalf of
pa?ents and physicians, the WMA endeavours to achieve the highest possible
standards of medical care, ethics, educa?on and health-related human rights for all
people.

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About ICN
The Interna?onal Council of Nurses (ICN) is a federa?on of over 130 na?onal nurses
associa?ons (NNAs), represen?ng the over 30 million nurses worldwide. Founded in
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1899, ICN is the world’s first and widest reaching interna?onal organisa?on for health
professionals. Operated by nurses and leading nurses interna?onally, ICN works to
ensure quality nursing care for all, sound health policiesglobally,theadvancement
ofnursingknowledge,andthepresenceworldwideofa respected nursing
profession and a competentand satisfied nursing workforce.
https://www.icn.ch/