1. Health workforce: Contributor to the Economy
Professor James Buchan, WHO Europe

2. Health workforce: Contributor to the Economy
Health (Workforce) Challenges, and Solutions
The UN High-Level Commission on Health Employment and Economic Growth
The case for investment…..

3. Health (Workforce) Challenges
Continuing and projected deficits
Insufficient investment and demand, particularly in low-income countries
Inequalities
Outdated education model
Poor data
Resistance to new models of care
Source: Health in 2015 from MDGs to SDGs, WHO 2015

4. Agenda 2030 for Sustainable Development
The Sustainable Development Goals (SDGs) were adopted in September 2015 to end poverty, protect the planet and ensure prosperity for all as part of a new sustainable development agenda.
17 Goals and 169 targets to be achieved over the next 15 years.
The Goals build on what has been achieved with the MDGs but include new areas such as climate change, economic inequality, innovation, sustainable consumption, peace and justice among others.
The SDGS set an ambitious multisectoral agenda and renewed global commitments to health (6 of the 17 SDGs directly address health disparities). The key issue is that that these goals are interconnected - the key to success in one will involve addressing issues more commonly associated with another one.

5. UHC-associated shortage by WHO region, 2030

6. Global Strategy HRH: Workforce 2030
Optimize the existing workforce in pursuit of the Sustainable Development Goals and UHC (e.g. education, employment, retention)
Anticipate future workforce requirements by 2030 and plan the necessary changes (e.g. a fit for purpose, needs-based workforce)
Strengthen individual and institutional capacity to manage HRH policy, planning and implementation (e.g. migration and regulation)
Strengthen the data, evidence and knowledge for cost-effective policy decisions (e.g. National Health Workforce Accounts)

7. Mobility (and remittances
Mobility (and remittances?) % working in OECD countries, (actual numbers in brackets)

8. Country of training of foreign doctors, UK, 2014 (source OECD)

9. Country of training of foreign nurses, UK 2014 (source OECD)

10. The Power of Health Workers video:
Launched on March 2, 2016 by the UN Secretary-General
Co-chaired by the President of France and the President of South Africa
Vice co-chairs: Heads of ILO, OECD, and WHO
19 Commissioners : education, employment, health, labour and foreign affairs sectors of governments and international organizations, health professional associations, trade unions, academia and civil society, geographic and gender parity
Aims to stimulate and guide the creation of 40 million new jobs in the health and social sector, and to reduce the projected shortfall of 18 million health workers, primarily in low- and lower-middle income countries, by 2030.
The Commission seeks to:
Highlight the benefits across the SDGs from investments in the health workforce;
Draw attention to the necessary reforms in health employment, education and service delivery;
Generate political commitment and inter-sectoral action towards more and better investment in the health workforce.
The Power of Health Workers video:

11. Case for investment
1/4 of economic growth 2000 to 2011, in low- and middle-income countries, from improvements in health.
The first 6 recommendations are to transform the health workforce for the SDGs while the 4 last recommendations focus on how to enable the necessary change.
A look at the first set of recommendations:
1. Stimulate investments in creating decent health sector jobs, particularly for women and youth, with the right skills, in the right numbers and in the right places.
2. Maximize women’s economic participation and foster their empowerment through institutionalizing their leadership, addressing gender biases and inequities in education and the health labour market, and
tackling gender concerns in health reform processes.
3. Scale up transformative, high-quality education and lifelong learning so that all health workers have skills that match the health needs of populations and can work to their full potential.
4. Reform service models concentrated on hospital care and focus instead on prevention and on the efficient provision of high-quality, affordable, integrated, community-based, people-centred primary and ambulatory care, paying special attention to underserved areas.
5. Harness the power of cost-effective information and communication technologies to enhance health education, people-centred health services and health information systems.
6. Ensure investment in the International Health Regulations core capacities, including skills development, and ensure the protection and security of all health workers and health facilities in all settings.
The second set of recommendations to enable change are:
7. Raise adequate funding from domestic and international sources (public and private) and consider broad-based health financing reform to invest in the right skills, decent working conditions and an appropriate number of health workers.
8. Promote intersectoral collaboration at national, regional and international levels. Align investments to support the heatlh workforce as part of national health and education strategies and plans.
9. Advance international recognition of health workers' qualifications to optimize skills use and increase the benefits of and reduce the negative effects of health worker migration.
10. Undertake robust research and analysis of health labour markets using harmonized metrics and methodologies to strengthen accountability and action.

12. The Health Economy: Germany
Health: A leading economic and labour sector
The Health Economy: Germany
From 2005 to 2012 the health economy was responsible for
around 11% of gross value added,
around 7% of exports,
around 20% of final consumption and
around 15% of total employment.
Source: Ostwald, D.A., Henke, K.-D., Kim, Z.-G. (2013).

13. Health employment: Women’s economic participation
Source: Magar et al, WHO, based on ILOSTAT (forthcoming 2016)

14. Health employment: Source of future jobs (worldwide)
Human Development Report 2015: Work for Human Development

15. World Health Organization
Health employment and productivity: new evidence
World Health Organization
13 January 2019
Health as a cost disease and a drag on the economy
Health as a multiplier for inclusive economic growth
Arcand et al., World Bank manuscript (2016)
larger dataset; data from low-, middle- and high-income countries
establishes positive and significant growth inducing effect of health sector employment; multiplier effect on other economic sectors
magnitude of effect greater than in other recognized growth sectors
Baumol (1967)
Growth in health sector employment without increase in productivity could constrain economic growth (data from USA)
Hartwig (2008 and 2011)
Confirmation of Baumol hypothesis (data from OECD countries)

16. Commission’s recommendations…
Job creation
Gender equality and women's rights
Education training and competencies
Health service delivery and organization
Technology
Crisis and humanitarian settings
Financing and fiscal space
Partnerships and cooperation
International migration
Data, information and accountability
The first 6 recommendations are to transform the health workforce for the SDGs while the 4 last recommendations focus on how to enable the necessary change.
A look at the first set of recommendations:
1. Stimulate investments in creating decent health sector jobs, particularly for women and youth, with the right skills, in the right numbers and in the right places.
2. Maximize women’s economic participation and foster their empowerment through institutionalizing their leadership, addressing gender biases and inequities in education and the health labour market, and
tackling gender concerns in health reform processes.
3. Scale up transformative, high-quality education and lifelong learning so that all health workers have skills that match the health needs of populations and can work to their full potential.
4. Reform service models concentrated on hospital care and focus instead on prevention and on the efficient provision of high-quality, affordable, integrated, community-based, people-centred primary and ambulatory care, paying special attention to underserved areas.
5. Harness the power of cost-effective information and communication technologies to enhance health education, people-centred health services and health information systems.
6. Ensure investment in the International Health Regulations core capacities, including skills development, and ensure the protection and security of all health workers and health facilities in all settings.
The second set of recommendations to enable change are:
7. Raise adequate funding from domestic and international sources (public and private) and consider broad-based health financing reform to invest in the right skills, decent working conditions and an appropriate number of health workers.
8. Promote intersectoral collaboration at national, regional and international levels. Align investments to support the heatlh workforce as part of national health and education strategies and plans.
9. Advance international recognition of health workers' qualifications to optimize skills use and increase the benefits of and reduce the negative effects of health worker migration.
10. Undertake robust research and analysis of health labour markets using harmonized metrics and methodologies to strengthen accountability and action.

17. UNHLC Five Year Action Plan - Summary
One Vision: Accelerate progress towards UHC and the SDG Agenda by ensuring equitable access to health workers within strengthened health systems .
Two Goals: Invest in both the expansion and transformation of the global health and social workforce.
Three
Organizations: ILO, OECD, and WHO
Four SDGs: Health and well being(SDG 3), Quality education (SDG 4), Equality and empowerment of women and girls (SDG 5), Sustained, inclusive and sustainable economic growth, full and productive employment and decent work (SDG 8).
Five
Workstreams: (1) advocacy, social and policy dialogue; (2) data, evidence and accountability; (3) education, skills and jobs; (4) financing and investments; and (5) international labour mobility.

18. More evidence………….

19. UN High Level Commission: The case for investment
The return on investment in health is 9: 1
One extra year of population life expectancy raises GDP per capita by 4%
“The Commission concludes that, to the extent that resources are wisely spent and the right policies are put in place, investment in education and job creation in the health and social sectors will make a critical positive contribution to inclusive economic growth”.

20. who.int/hrh #workforce2030
THANK YOU.
who.int/hrh
#workforce2030