One of the biggest challenges in international development is anticipating when the next pandemic health threat will strike and how we can minimize its damage. Pandemics can be unpredictable, and it is hard to know when and where to focus attention. Having safe, effective drugs ready to use when they are needed saves lives. Clinical trials, which focus on safety and efficacy, are pivotal to the development of these drugs.
The World Health Organization estimates that the current shortage of global health care workers is 7.2 million. Without intervention, this number will soar to 18 million by 2030. Rachel Deussom, an FHI 360 expert on the health workforce and Senior Technical Officer, Human Resources for Health, Health Systems Strengthening, hosted a conversation with other FHI 360 colleagues to examine the shortage, its underlying causes and potential solutions.
The rapid spread of the Ebola virus through human-to-human contact — compelled by the urge to embrace a family member with symptoms of infection, to transport a neighbor to the nearest clinic, to nurse the infected or bury the dead despite the lack of basic protective gear — reminds us of the complex relationship between health and human behavior.
Like Ebola, HIV was once an emergent infectious disease. Although HIV may take years rather than days to kill its victims, similarities exist between HIV and Ebola in the conditions that facilitate their spread and the challenges to containing both diseases. Highly stigmatized, those who fear infection may avoid being tested or disclosing to loved ones; those diagnosed may face limited treatment options provided by harried health care workers within overburdened health care systems.
Now in its fourth decade, the fight against HIV has seen tremendous breakthroughs in medical technology. A spectrum of antiretroviral (ARV) treatment options now exists and is available around the globe. Clinical studies have proven that taking a daily oral ARV-based pill can reduce a healthy person’s chance of getting the infection — and, other types of ARV prevention products (i.e., gels, rings and injections) are on the horizon. Increased testing through provider-initiated strategies has increased access to both treatment and prevention technologies. There is even some thought that we will have a cure for HIV one day.
I am deeply concerned for the wellbeing of people in West Africa confronting the rapid spread of the Ebola virus. We wish to pay our respect to the courageous health workers battling the disease, and who have paid a disproportionate price for their heroism, as well as to the faith-based organizations that have remained on the front lines. We are now faced with a crisis of historic proportions that threatens not just the health of tens of thousands of people, but the economic and social stability of the region. On behalf of FHI 360, I want to express our deepest sympathy for all those affected by this scourge and our solidarity with our staff, counterparts, and colleagues in the affected countries.
This crisis will undoubtedly have broad consequences not only for West Africa, but for the wider world. If World Health Organization (WHO) officials are correct, the epidemic will take thousands more lives and we can expect an even deeper toll on already overwhelmed health systems. This is a crisis that requires the collective efforts of the international community.
The Ebola virus outbreak has exposed the fragility of health systems in poor countries—and shown how vulnerable nations are when basic social systems are unable to respond to critical needs. The world is now witnessing the terrible consequences of the failure to equip health systems, connect patients to direct medical care in rural areas, educate medical staff and the general population to risk factors and prevention methods, provide laboratory testing, and track disease surveillance data to monitor the spread of the virus.
By working to support WHO’s six building blocks of health systems, we can improve availability, use, and quality of health services delivered through both public and private facilities. We need to continue to develop and apply workable strategies to improve the quality of care and the performance of health systems, particularly in resource-constrained environments.