Key messages from Public Services International (PSI) on the WHO Code of Practice in the context of COVID-19
In its report, the Expert Advisory Group reaffirms the vital role of the WHO Code as the global framework in achieving universal health care through strong health systems equipped with a sustainable and healthy workforce. In the COVID-19 pandemic, the Code becomes even more relevant as nations are in a race to fill-in the needed health workforce to fight the virus. We all know that even before the outbreak, the world was already facing a shortage of 18 million health workers by 2030, with the biggest shortages expected in Southeast Asia and Africa. The EAG highlights how migrant workers, moving permanently or temporarily for employment, are taking an increasing role in delivering UHC, more so in this pandemic time. Migrant workers represent a highly significant proportion of the health workers at the frontlines. Sadly, many of them were among those over 3,000 health workers who have died from the infection. The tragic and massive loss of health workers’ lives is unacceptable and could have been avoided.
And yet, despite these deaths and them being sung as heroes, our health workers continue to work in dangerous and difficult conditions. They are undervalued, uncompensated and unprotected. Across the world, health workers are on strike demanding for their rights and safety at work, for just compensation, for social protections, for their inclusion in decision-making and for sustainable funding of public health services.
The COVID-19 pandemic has shown evidence to the urgent need for better investments in public health care and in the health workforce in all countries. Strict lockdown measures were a direct response to the lack of capacity of health systems to deal with the large numbers of patients. The pandemic has also put on spotlight the high number of migrant workers risking their lives on the frontlines. It has highlighted the need for international cooperation to address the global health workforce shortage. It underscored the imperative for an effective governance of health labour migration and mobility, so that fragile health systems particularly in the developing countries are not stripped of their health workforce that is crucial in fighting the outbreak.
In view thereof, Public Services International (PSI) brings these key messages:
In light of the projected global shortage, priority needs to be placed in strengthening public health care services as the foundation for the creation of at least 40 million new jobs in the health and social care sectors and reducing the shortfall of 18 million health workers, primarily in low- and lower-middle-income countries by 2030.
Ensuring adequate numbers of health workers to prepare for UHC and health emergencies, such as the COVID-19 pandemic, will require sustained public investment in staffing and equipment, planning and health systems restructuring that prioritizes people over profit.
Building resilience to future health emergencies by investing in public services for both rich and poor countries alike. Rich countries must strive more to assist developing countries in the pandemic crisis response and recovery efforts, including debt cancellation for the poorest countries.
Calling on the World Bank and the International Finance Corporation to end health privatisation and the flawed model of Public Private Partnerships, and for the International Monetary Fund to end its policy of directing governments to cut public spending and public sector wages that lead to more poverty and driving forced migration.
The need for international cooperation and global governance strategies that prioritize investment in the local health workforce in all countries in order to reduce the dependence on international migration to fill essential health care staffing needs.
The need for safeguards, including the better implementation and enforcement of the WHO Code. We want to see the WHO Code becoming a binding instrument and for it to develop stronger lateral links to other international policies on equality and public health.
With the increasing use of bilateral labour agreements in facilitating health worker migration and mobility, the WHO Code, along with human rights norms and labour standards, should serve as a pre-requisite in the negotiation and implementation of any bilateral or multilateral labour migration agreement. Only then can we ensure that international health and labour standards, as well as fair and ethical recruitment, are upheld and reciprocity is adhered to.
Finally, the role of trade unions and civil society as partners of member states in the promotion and application of the WHO Code is crucial. Social dialogue on the governance of health labour migration can benefit from the guidance of the WHO Code, along with international human rights norms and labour standards.