Biden’s new global health care push should look to Pepfar as a role model

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About the authors: Vanessa Kerry is a critical care physician, associate professor at Harvard Medical School, and CEO of Seed Global Health. Polly Dunford is the President and CEO of IntraHealth International.

The Biden administration will soon launch an initiative to meet the needs of the global health workforce. This investment is absolutely necessary. Providing increased protection and support for health workers, while increasing their numbers, especially in countries with limited resources, is essential to ending Covid-19 and preparing for future health emergencies.

Health workers have faced immense challenges over the past two years. At least 115,000 have died on the front lines in the fight against Covid-19, and that’s a conservative estimate. Poor working conditions lead many of them to go on strike or to consider leaving their profession.

So far, we haven’t done enough to protect them. While more than 80% of health workers in rich countries are vaccinated against Covid-19, less than 30% in Africa are.

As the main challenge for global immunization efforts shifts from the availability of supply to the equitable delivery of the more than one billion vaccines that are currently manufactured each month, the obstacles to the rapid distribution of vaccines are enormous, thus putting jeopardize the entire effort to end the pandemic.

At the heart of these challenges is the insufficient number of well-trained health workers to respond to Covid-19 while maintaining other vital health services, such as child and adolescent health and nutrition. Health systems weakened by years of insufficient and fragmented investment simply cannot meet the overwhelming demands.

When it comes to strengthening health systems and the health workforce in these low- and middle-income countries, the challenge is often described as too large, too amorphous or too complex to address.

But this is not the case, and history proves it.

The global community, spurred on by American leadership, has risen to meet global health challenges in the past. We can do it again. Twenty years ago, the world was at a turning point in the HIV/AIDS crisis. Targeted interventions started slowly, but the early 2000s finally delivered the watershed moment – ​​leading to the launch of Pepfar – that the epidemic demanded.

Founded in 2003, the United States President’s Emergency Plan for AIDS Relief has proven to be one of the most successful global health programs in history. It provides us with a roadmap for bold investments. It has invested over $100 billion in antiretroviral treatment for over 18 million people and prevented nearly 3 million babies from being born with HIV.

Faced with a new pandemic, we can learn from the past to respond more effectively and prepare for future crises. More than 60 international organizations, including those we lead, recently sent a letter to U.S. Agency for International Development Administrator Samantha Power recommending how to ensure the success of the health workforce initiative of Biden.

For starters, the administration could invest at least $500 million in new funding over the next five years through a new USAID Global Health Programs line item to support health workforce development. and strengthening health systems, prioritizing countries that already show a strong commitment to progress.

Second, it can develop programs to improve community-based primary health care that integrates all diseases and supports all health workers at all levels.

Third, the United States can redefine the timing and scale of investments. Investments in the health system and human resources require time and sustained funding. We need long-term horizons, with strict reporting requirements and interim metrics to measure progress.

Finally, the United States can improve working conditions, ensuring that all frontline health workers are well-equipped, protected, and compensated, while addressing the specific needs of women, who make up 70 percent of health workers. health.

The model for a large-scale international effort already exists and is working. In 2000, more than 36 million people in the world were living with HIV/AIDS, more than two thirds of them in sub-Saharan Africa, and nearly 22 million deaths had already been recorded. The global community realized that the status quo was unacceptable and took decisive action.

Today, the United States has an unprecedented opportunity to catalyze much larger, long-term investments in the health workforce. We believe that a US initiative for global health workers could lay the foundation for resilient health systems that can deliver health for all. We have the tools and the know-how, now we just need the political will.

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