Speech by Minister Coveney at Global Health Forum Closing Ceremony

Speech for Minister Simon Coveney at the Closing Session of the 4^th Forum for Global on Human Resources for Health, at the Concert Hall, Royal Dublin Society, on the 17^th November, 2017.

Ladies and gentlemen, fellow Ministers and delegates

It is my great pleasure to address the closing plenary of this Fourth Global Forum on Human Resources for Health.

Can I thank those who worked so hard to organise this Global Forum, in particular our colleagues in the World Health Organisation.  I would also like to pay tribute to those who negotiated the Dublin Declaration, affirmed today, and which maps a path to Fifth Global Forum on Human Resources for Health.

This is the first Forum since the launch of the 2030 Agenda for Sustainable Development. Your discussions this week have addressed one of the fundamental challenges facing all nations, namely how to translate those global goals into actions.

The 2030 Agenda for Sustainable Development is a stand-out achievement. The 17 goals have the power and potential to transform our world, addressing the root causes of poverty, inequality and instability.

Fundamental to the 2030 Agenda is goal 3, to ‘ensure healthy lives and promote wellbeing for all at all ages’. This is something we all want, for ourselves, for our families and friends, for our communities and our societies.

We cannot achieve healthy lives and promote wellbeing without strong health systems: a strong and effective health workforce is at the heart of any effective health system.

The report and consensus arising from the Third Global Forum in Recife, Brazil, held in 2013, remains of utmost importance: we all acknowledge that there is ‘A universal truth – no health without a workforce’.

The health workforce is the back bone upon which SDG Goal 3 will be delivered.

Investment in our health workforces will also guarantee additional dividends for other Sustainable Development Goals, Goal 4 on education, Goal 5 on gender and Goal 8 on inclusive economic growth. Investing in health workers is an investment in our individual and collective sustainable development.

I am conscious, though, that demands on our health systems have never been greater, wherever on this planet we reside. These demands can manifest themselves in challenges to service delivery, challenges to access and to fairness.

This can be seen in the movement of health workers from Africa, where they are much needed, to other, wealthier countries, an example of unfairness of the current global health system.  And while each individual decision is rational and aimed at addressing a gap, whether of income, expectation or clinical need, such decisions taken together debilitate national health systems in places that most need strengthening.

The World Health Organisation reminds us that Africa experiences the highest burden of disease of any continent, yet it has less than 4.3% of the world's skilled health professionals, and less than 2% of the expenditure on health. While the continent continues to grapple with infectious diseases, such as HIV, malaria, cholera, tuberculosis and child pneumonia, as well as challenges to improving maternal health, there has also been a rise in non-communicable diseases. This is in a context where the availability, skill-mix and geographical distribution of health workers to respond to these challenges is drastically inadequate.

Shortcomings in the health workforce stretch well beyond Africa and current disease outbreaks. We know the challenges only too well here in Ireland. I work closely with my other Cabinet colleagues in Government to address the health workforce challenges we face domestically and I am particularly pleased to see the launch this week of Ireland’s workforce planning framework. This sets out the approach for how Ireland will domestically address our health workforce requirements. However, I am also acutely aware that other countries in the global north, those of who may be considered as ‘high-income’ and ‘developed’ countries are faced with similar challenges in how to educate, develop, and maintain a workforce that is responsive to population needs and can maintain and expand access to quality health and social services. Indeed the Open Working Group on the Sustainable Development Goals proposed a broad health agenda – the ambitions of which are yet to be matched by investment in the health workforce.

However, investments in the models of human resources for health needs an urgent upgrade. Yes, we need more health workers, but not always and not necessarily more of the same. In country after country, we are seeing that top-down, facility-based, doctor-dependent, disease-focused models of health care are neither ideal nor sustainable. Education, training and incentives should be focused on creating an efficient workforce that is centred on people, rather than diseases.

Now two years on from agreeing the Sustainable Development Goals we can see how the international health community has done its part in putting together a coherent framework on the health workforce. These steps include:

• The unanimous and adoption by the World Health Assembly of the Global Strategy on Human Resources for Health: Workforce 2030. This outlines the policy options and recommendations for Member States on matters ranging from institutional capacity development to strengthening data on human resources for health for monitoring;
• The UN Secretary General’s High Level Commission on Health Employment and Economic Growth which so clearly highlights the benefits across the Sustainable Development Goals from increased investments in the health and social workforce. This report shows that the health sector is a key economic sector, drives inclusive economic growth, promotes human security and sustainable development and is also a driver of job creation;
• The adoption of the ILO, OECD and WHO five-year action plan: ‘Working for Health’.  This represents an unique approach in the SDG era, demonstrating how Goal 17 on partnerships can leverage impact across the Sustainable Development Goals. 

We have clear guidance on how to plan and develop our future workforce needs. Investment in our health workforces is an investment that has clear economic returns.  Addressing health and social needs helps create decent job, enables inclusive economic growth and helps address inequality. 

I am conscious, though, in arguing for investment in human resources for health that all of us in Government must make difficult resource choices, balancing competing demands.  It will be important to keep the momentum, which your work at this Forum has helped build, going. 

The Dublin Declaration, which we have just acclaimed, identifies a number of clear actions which will help take things further.

This Dublin Declaration is an expression of intent by the international community and its many constituencies as represented here at this Fourth Global Forum.  It identifies nine key actions, which if implemented can improve the lives of our citizens.

National governments have an important role in prioritising health system strengthening, including ensuring an adequately skilled and compensated health workforce.

The WHO has a particular and special role, in providing leadership and in its governance activities. 

The measurement of, and reporting on, improvements in human resources for health at both national and international levels will be an important demonstration of progress.

We need to work to maximize the benefits and address the challenges of the increasing rate and complexity of health labour mobility.  The International Platform on Health Worker Mobility will assist us in that task.

Ladies and Gentlemen,

Ireland was proud, together with Kenya, to have helped facilitate agreement on the Sustainable Development Goals at the United Nations.

The challenge now is that of implementation, of helping achieve the ambition which our shared Agenda 2030 sets out. 

Each of us has much to do at home to ensure delivery.

We can also help each other.

I pleased to re-affirm that Ireland’s international cooperation programme will:

• continue to invest a large portion of our overseas development assistance on addressing health and HIV and AIDS. In 2016 this amounted to over €80m;
• prioritise improving access to quality, basic health services for poor and marginalised citizens, reaching those most in need;
• continue to support investment in human resources for health. This will include the training and retention of health workers in low income countries;

Ireland will continue our support for collaborations which build workforce capacity in partner countries, such as the RCSI-COSECSA Collaboration Programme.  I attach importance to the continued development of bilateral agreements to share good practice and experience in health workforce strengthening.  Building on an existing agreement with the Ministry of Health in Mozambique, just this week Ireland’s Health Service Executive signed a partnership agreement with the Ministry of Health in Sudan. We can also seek to leverage expertise in innovation and technology to inform solutions to the challenges faced by many of the countries we work with

I look forward to our continued partnership with the Global Health Workforce Network, which supports the advancement of health workforce policies and the development and adoption of the Global Strategy on Human Resources for Health: Workforce 2030.

Taking these priorities forward will of course form part of Ireland’s wider advocacy.

I hope that you too will have similar priorities in your advocacy, in your domestic and your foreign policy. 

Ladies and gentlemen,

The quality of the discussion and the commitment of delegates to improved human resources for health was very much in evidence this week.  Your enthusiasm, your commitment, your knowledge is the key to delivery on the ambition for a better global health workforce.  Your continued engagement will help realise that ambition.

Thank you for all your work and contributions this week and I wish you a safe journey home.