The World Medical Association, Inc.

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Seventy-second World Health Assembly (A72/1)
Agenda Item: 
- Community health workers delivering primary health care: opportunities and challenges

Thank you for the opportunity to speak on behalf of the World Medical Association, which represents 9 million physicians around the world.

WMA welcomes WHO’s message that in order to implement universal health coverage (UHC), more investment into the health workforce is needed. This financial commitment should prioritize closing the predicted 18 million health workforce gap, by increasing the number of students, enhancing education and specialization as well as improving working conditions.

The Global Strategy on Human resources for health: Workforce 2030 recommends that countries should plan for their health workforce as a whole, rather than segmenting planning and related programming and financing efforts into single occupational groups. The current international debate focuses mainly on prompt ways to meet the HP shortage through the replacement of physicians by community health workers (CHW) or nurses. The latest data available shows that 76 countries still have less than one physician per thousand population. It is unacceptable that patients with cancer in some countries cannot access adequate care because there is no oncologist in the country.

In its report, WHO emphasizes that CHW are not a cheap alternative to close the gap of HP and that governments should adopt service delivery models in which CHW are assigned general tasks as part of integrated primary health care teams. For many years, WMA has been advocating for the need of health care teams with various cadres, including community and social workers. Each profession has its own scope of practice and clear responsibilities with one team member having the overarching responsibility. This should be reflected in the WHO Global Competency Framework for Universal Health Coverage.

We know there is still a long way to go, but the aim must be that in the end everybody who needs a physician will be assisted by physician. If you give up that aspiration Universal Health Coverage will not come true.