Programme for Action to combat lack of personnel in the health sector (2007-2013)
This Programme for Action proposes measures at country, regional and global levels to remedy the shortage of human resources in the health sector in developing countries.
Communication from the Commission to the European Parliament and the Council of 21 December 2006 entitled "A European Programme for Action to tackle the critical shortage of health workers in developing countries (2007–2013)" [COM(2006) 870 final – Not published in the Official Journal].
The present Programme for Action provides for actions on three levels – country, regional and global – to respond to the human resources in health (HRH) crisis.
ACTIONS AT COUNTRY LEVEL
The objectives of the Programme for Action are fivefold at country level:
Contribution to the policy and strategic dialogue and planning at country level. In particular, the Commission proposes that the European Union (EU) should:
- underline the barriers to progress towards the Millennium Development Goals (MDG) caused by the shortage of HRH;
- examine the questions relating to more equitable and responsive healthcare provision;
- support the development of a mechanism to link long-term budget support more closely to MDG progress;
- reinforce the management, planning and evaluation of human resources (HR), in particular through dialogue with civil society (for example, the trade unions and research institutions).
HRH capacity-building, through:
- evaluation of the HR skills and the gender balance needed to overcome the shortages;
- expansion of country-level training capacity, including the establishment of link relationships between institutions and the development of south-south and north-south learning communities;
- support for link programmes between professional bodies and regulatory agencies.
- Civil service reform and enhancing terms and conditions of service in the health sector in order to increase access to services for the poor and marginalised and to ensure health worker retention through an improved working environment and increased salaries.
- Addressing HIV/AIDS, TB and malaria, which have exacerbated the HRH crisis and increased the workload of the health systems in developing countries. The Programme for Action envisages the EU supporting the incorporation of the World Health Organisation (WHO) "Treat, Train, Retain" strategy within national health strategies and continuing its support for the Global Fund to Fight AIDS, TB and Malaria.
- Promoting gender equity in health service provision through mechanisms to support the role of women in the health workforce, giving particular attention to gender equality issues in matters of education, recruitment, salary, career development and decision-making positions.
In addition, the EU must:
- support and strengthen local communities by encouraging community and family service provision;
- boost access to European technical expertise in the field of HRH programming, in particular through the development of technical assistance pools managed by the recipient countries;
- support post-conflict or fragile States where governments’ capacity to plan for their HR needs is limited.
ACTIONS AT REGIONAL LEVEL
The Programme for Action provides that the actions at regional and global levels are coordinated by "Platforms for Action", bringing together key stakeholders and informed by Global and Regional Observatories.
Promote political leadership in Africa
In view of the particularly negative impact of the HRH crisis in Africa, the EU must support a strong African voice in the global response to the HRH crisis. In particular, the EU supports boosting the leadership of the African Union (AU) and the New Partnership for Africa's Development (NEPAD) in regional action and building a regional platform for action.
Contribute to developing regional training resources
The EU will support actions to strengthen training capacity through the 7th Research Framework Programme (2007-2013) and its Specific International Cooperation Actions. In addition, it will promote the development of learning networks within and between regions and especially the building of “Networks of Excellence” based on the north-south and south-south links. Finally, the Task Force on eHealth for Africa, established by the Commission, working with the European Space Agency and WHO, will explore the potential of information technologies.
In addition, the EU must:
- promote the conclusion of regional agreements on skill sharing and development in Africa, with a view to strengthening the regional market in HR to avoid brain drain;
- support the creation of an HR regional observatory for Africa as a repository of regional best practice;
- support regional research capacity-building and especially clinical research capacity development through the European and Developing Countries Clinical Trials Partnership (EDCTP) for sub-Saharan Africa.
ACTIONS AT GLOBAL LEVEL
The Programme for Action stresses the need for better coordination of the international response to the HRH crisis. In particular, it proposes action at two levels:
Internal EU action
The Commission provides for measures to strengthen EU HRH planning and promote "brain circulation", i.e.:
- development of principles to guide recruitment of HRH within the EU and from third countries to minimise any negative impact on HRH capacity in third countries;
- concentration on issues such as the transferability of pension rights and recognition of qualifications;
- support for partnerships between medical institutions in the EU and in the developing world.
Action at global level
The EU undertakes to mobilise funding at global level for HRH capacity-building in the developing countries. In particular, in international discussions, the EU will promote the importance of:
- ensuring long-term predictable financing;
- identifying ways of overcoming macroeconomic constraints at country level which can limit health investment;
- ensuring major harmonisation on the national priorities.
The Programme for Action stresses the need to increase predictable long-term aid to allow the beneficiary countries the necessary fiscal space to guarantee long-term investments. In addition, the Commission will develop a framework for identifying and regularly updating Member State and Commission actions on HR and compare EU funding levels with those of other donors. Finally, the Commission has decided to allocate EUR 40.3 million to the budget for the Investing in People Thematic Programme to support catalytic global and regional actions on HRH.
MONITORING AND EVALUATION
The EU will support the development of a country‑level HRH monitoring and evaluation framework and will monitor EU action under the planned reporting to Parliament and Council on the Programme for Action to Confront HIV/AIDS, Malaria and Tuberculosis.
This Programme for Action follows a Commission communication of December 2005 on the crisis in HRH in developing countries, which stressed the importance of a comprehensive response to this problem by the EU. This Programme for Action was approved by the Council on 14 May 2007.