Atiia Mosam, Dale Andrew Fisher, Mehreen B Hunter, Teena Kunjumen, Sakif Mustafa, Tapas Sadasivan Nair, Fatai Ogunlaii, James Campbell, WHO Public Health Roadmap and Emergency Working Group
The COVID-19 pandemic tested the health systems of countries around the world as they sought to respond to rapid and growing needs within their individual socio-political and economic contexts. While pandemic management was rapidly emphasizing diagnostic and therapeutic services and supply chains, the need for a well-coordinated, efficient, and diverse workforce to take over core public health functions (EPHF), including responding to public health emergencies of international importance, became prominent. At the same time, the inadequate preparedness of many health systems to withstand unexpected health shocks and the shift of human resources to emergency responses meant widespread disruptions in routine health services with an resulting effect on morbidity and mortality.
The ability to provide basic clinical and public health services and respond, as needed, to emergencies and hazards is a core function of the health system. When this function is properly configured, the resilience attribute is firmly attached to its core: with efficient delivery led by a competent workforce, with appropriate skills, tasked with performing a range of functions from emergency response to health system stability. The COVID-19 pandemic and other public health emergencies of international importance in recent years (e.g., Ebola, Zika, and Middle East Respiratory Syndrome) have highlighted the limitations (or in some cases complete lack) of public health workforce plans in many countries. With the ongoing pandemic, growing backlogs in health services, economic scarring, and political recognition of future public health threats, the need for prevention policies and plans to ensure a skilled and easily accessible workforce to deliver EPHF is imperative. This includes countries that assess and use all available public health personnel and professionals, including those outside the health sector.
In this regard, we recognize and welcome the political agreement present in the Rome Declaration, the G20 Italia and a series of World Health Assembly resolutions recognizing the need to build the capacity of the health workforce to deliver EPHF, including emergency preparedness and response and urgency. actions must be taken. They position the concept of ‘labor readiness’ with a discussion of ‘country readiness’ for the next state of emergency.
The WHO and its partners have developed a roadmap aimed at standardizing the definition, classification and scope of work for public health and emergency personnel in charge of delivering EPHF and responding to future public health emergencies. The roadmap includes recommended actions at national, regional and global levels, together with collaborative activities to build an integrated, multidisciplinary and multisectoral workforce in public health.
The conceptual approach outlined in the roadmap rests on three different but interrelated areas of action: defining the functions and services of the public health workforce, developing and improving competency-based education for these staff, and mapping and measuring current and future workforce (Figure 1). . It is envisaged that these functions take place simultaneously, with progressive achievement, based on the context of the individual country.
In order to improve the ability of countries to undertake the activities highlighted in the roadmap, certain high-level commitments and activities are needed. The partners encourage the leadership of organizations such as the African Union, the European Union, the G7 and the G20 to strengthen the commitments made in the above-mentioned declarations and resolutions through political will and associated resource mobilization to achieve their earlier consensus, goals and objectives.
Moreover, we call on public health associations, institutions, schools and all relevant actors to improve cooperation and coordination within and between regions to identify areas of synergy, joint creation of global public goods, joint implementation and codification of learning and dissemination of best practices. Establishing a unique and standardized set of skills and competencies for managing public health practices around the world will serve to ensure that public welfare is always at the forefront of every effort and provide communities with a reliable and globally responsible workforce to address during health system shocks and uncertainties and misinformation. through fear and lack of trust they endanger the good health that this workforce is expected to protect.