The COVID-19 pandemic has exposed the weaknesses in the health systems of countries across the world. It has provided fresh impetus to strengthen health systems, revitalize the essential public health functions (EPHFs) and enhance emergency preparedness and response (EPR) capacities (1). Attaining universal health coverage (UHC) with investment in the EPHFs and ensuring health security through the implementation of the International Health Regulations (IHR 2005) are complementary goals; however, the essential role and impact of the workforce involved in these activities is often overlooked.
Many countries do not have a dedicated public health workforce policy or plan, or their plans have limited linkage to national health sector strategic plans, national action plans for health security and other disease-specific plans. In order to strengthen public health and emergency capability, it is important to understand the centrality of the public health workforce to their delivery. Monitoring the composition of the workforce which delivers the EPHFs (which includes a specific function and focus on EPR) is a key element of public health workforce planning to ensure the development of national capacity. It is important to avoid fragmented investments and efforts in building workforce capacity and instead utilize a system approach to ensure that the workforce is adaptive, agile and fit for purpose to meet diverse, ongoing and future public health challenges.
The Rome Declaration of 2021 (2), the G20 Italia Declaration of the G20 Health Ministers (3) and a series of World Health Assembly resolutions (4–7) call for investments in building workforce capacity and “readiness” to protect populations and accelerate progress towards UHC. This political consensus is welcomed. However, implementation must be grounded in:
A shared understanding of the skills and competencies needed to deliver the EPHFs.
A shared understanding of the composition of the workforce which delivers the EPHFs.
Alignment with broader health workforce policy, planning and investment, including international standards of classification.
Alignment and integration with broader health sector reforms, policies, plans and ongoing health system strengthening efforts.
The chronic underinvestment and lack of attention to public health has resulted in depleted country capacity to deliver the EPHFs and take integrated action within and outside the health sector. This includes, for example, using a One Health approach, which aims to design and implement research, programmes, policies and legislation in which multiple sectors (such as public health, veterinary, agriculture, environment, climate and planetary health) communicate and work together to achieve better public health outcomes. Building an integrated, multidisciplinary and multisectoral workforce which can perform part or all of the EPHFs (including EPR) through health system strengthening is a sound return on investment. This can help meet the challenges brought about by COVID-19 as well as better prepare the world to prevent future pandemics, and other public health threats that could have significant impact on economies and social development (e.g. climate-related events, zoonotic spillover, noncommunicable diseases [NCDs], antimicrobial resistance [AMR]).
A strengthened workforce in every country; delivering all the essential public health functions including emergency preparedness and response for UHC, health security and improved health and well-being.
Purpose of the roadmap
Outline the actions to identify the skills and competencies needed to deliver the essential public health functions, including a specific focus on emergency preparedness and response.
Develop a shared understanding on the definition, classification and scope of practice of the workforce engaged in delivering these functions.
Provide high-level guidance and develop global public goods in public health workforce policy and planning, the measurement and assessment of workforce capacity, and competency-based education to help countries bolster their national workforce capacity and readiness.
Mobilize global political leadership, stakeholder partnerships and collaboration around an integrated approach to strengthening the public health workforce for the achievement of UHC and global health security.
Policy-makers, health workers and key stakeholders within and outside the health sector involved in public health and emergency preparedness and response.