Health workers, who have saved so many lives and will continue to do so, have accustomed us to so many deeds of valor that they have managed to make their extraordinary contributions commonplace. So much so that we run the risk of not thanking them enough for the work that they do every day.
This year, we are dedicating World Health Day to the recognition of these often anonymous heroes for the sacrifices and contributions they make to public health--something that we are privileged witnesses to, sharing the pride of working alongside them in the Pan American Health Organization
We wish to recognize the least visible among us: the itinerant health workers in Cuzco, Peru; the Cyril Ross home for children with HIV/AIDS; the Family Planning Association of Trinidad and Tobago; the San Esteban municipal health team in Olancho, Honduras; Public Health Nurse Milagros Maldonado; Mary Perez de Marrazini, who has fought for the rehabilitation of people with physical or mental disabilities; the integrated care unit for HIV/AIDS patients in the Dominican Republic; the sensitivity and dedication of the team that delivers care to priority communities in Sarapiquí, Costa Rica; the maternal and child health program of the New River Health Association in Oak Hill, West Virginia; and the program of the Clínica del Pueblo, which serves uninsured immigrants with very limited resources right here in Washington, D.C.
Scarce Resources, Many Needs
Across the Americas, like these and so many other examples that could be cited, health workers--paid and volunteers alike--perform miracles every day and often do so with very limited resources.
We wish to pay homage to them all, from the most noted figures in biomedical research and public policymakers to the women who care for their families and neighbors, helping to relieve pain, prevent disease, and promote health. We salute the young volunteers, children and adolescents who work day by day in solidarity to make their schools and communities healthier and safer; religious and lay groups; and journalists who write about health.
Thus, even though public health receives barely 6% of the Hemisphere’s total budget, over the past two decades we have managed to increase people’s life expectancy by almost 10 years. And this, despite a shortage of human resources formally working in our health systems.
Recent studies indicate that the global shortage of health workers is over 4 million. Our Hemisphere is no stranger to this harsh reality, even though we have other, even more pressing needs. While worldwide, there is an average of 4.2 health workers for every 1,000 people (reaching levels of 10 per 1,000 in Europe and North America), the average in South and Central America is just 2.6.Migration and Imbalances
This shortage is exacerbated by several factors. One of them is migration. The huge nursing shortage projected for countries such as the United States (nearly half a million by the year 2015) and Canada (113,000 by 2011) is serving as a magnet for nurses with a command of English and secondarily affecting other countries in the Region. In the Caribbean, an average of 35% of nursing positions are unfilled, despite the traditional excellence in nursing education; in Jamaica and Trinidad and Tobago, the figure has reached 50%.
Even where there appears to be sufficient numbers of doctors and nurses, the majority of them are concentrated in urban areas, leaving rural and periurban populations without adequate protection. An additional imbalance can be seen in the professional composition of health teams: 19 countries in the Hemisphere have more doctors than nurses, and in Uruguay, 66% of doctors are specialists.A Call to Action
PAHO and the World Health Organization are working to meet these challenges. After three subregional preparatory meetings, the hemispheric meeting that produced the Toronto Call to Action was finally convened in Toronto, sponsored jointly with the Ministry of Health of Canada and the Ministry of Health and Long-term Care of Ontario.
The Call shines a spotlight on the imperative need to strengthen leadership in public health, increase investment in human resources, integrate and coordinate action in all areas connected with these resources, and ensure cooperation among all the countries, agencies, and other actors to foster joint activities that promote, strengthen, and develop the health workforce. A Decade of Human Resources for Health (2006-2015) has been proposed, moreover, to lend continuity to the sustained efforts that will be needed to meet the challenges in this area.
Today, as every day, millions of health workers in the Americas will go forth to safeguard the health of children, women, and men. Let us recognize their work and renew our joint commitment to have many more of them to improve public health throughout the Hemisphere.
Health for all! All for health!
Our thanks to all of you who make health possible!
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