Ebola and health care’s ‘Achilles’ heel’

Editor’s note: Ashley Judd is an actor, author, advocate and global ambassador for Population Services International, a global health organization, http://www.psi.org/ and Karl Hofmann is the president and CEO of PSI. Follow Ashley Judd on Twitter at @AshleyJudd and Karl Hofmann at @KarlHofmannPSI

(CNN) — The first case of Ebola in the United States was diagnosed in Texas. Officials from the Centers for Disease Control and Prevention took to the airwaves to assure the public that there is no risk of widespread infection.

The reason: The United States has a strong health system and trained health workers who can efficiently and effectively contain Ebola.

This is good news for America, but what about the rest of the world? In fact, the devastation of Ebola highlights an urgent global crisis that, as we now see, can reach into the United States: Across the world, there is a shortage of 7.2 million health workers.

The United States is sending thousands of troops to West Africa to fight Ebola. In Liberia, Sierra Leone, Nigeria and Senegal people suffer because Ebola death stalks faster than local governments and international relief agencies can respond. Our moral imperative to respond swiftly is obvious.

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This is made very difficult because at least 1 billion people have little to no access to a health worker, according to the World Health Organization.

The Ebola epidemic has exposed global health’s Achilles’ heel.

A big part of the reason is that the global health community has unwittingly built a system in which health advocates compete for funding allocated to specific diseases: HIV, malaria, tuberculosis — the list goes on.

Countless powerful advocacy coalitions lobby lawmakers, at conferences and in the media, but too often they don’t focus their efforts and investments to address the conditions that make long-term improvements impossible to achieve: too few health workers and weak public and private health systems.

Until governments, funders and global health organizations address this need, efforts to fight specific diseases –like Ebola–may succeed, but those results may be short-lived and inefficiently achieved.

 

The attraction to funding specific diseases and not a whole system in need of support is understandable. It’s easier to measure the results of, say, providing millions of vaccines to children and touting that to lawmakers, than it is to sell them on long-term investments in more esoteric concepts such as recruitment, training and retention of a health workforce.

And as a result of those more acute efforts, the world has indeed made astounding progress in reducing maternal and child deaths, we are close to eradicating polio and for the first time in history we are talking about an AIDS-free generation.

But are we missing an opportunity for greater, more lasting impact?

The global response to Ebola presents an important moment to talk about what it will take to recruit, train and retain qualified health workers for the regions that need them most. Recently, the United Nations General Assembly set the global health agenda through 2030. The goals are ambitious and we have the chance to incorporate these pressing issues into a larger world view.

Recruitment, training and retention of health workers doesn’t fit neatly into sound bites and it doesn’t grab headlines, but a shift in thinking has the potential to be far more effective at saving lives. According to the Frontline Health Workers Coalition, 7.6 million children dying annually from pneumonia and diarrheal disease could be saved by already proven interventions that simply need health workers to deliver them. The same can be said of the 358,000 women still dying in childbirth and the 1.3 million people losing their lives to tuberculosis.

This evolution requires a paradigm shift that looks like a play from the corporate playbook: mergers of nonprofit organizations, a consolidation of splintered initiatives and a unified message from the many health coalitions about the need to build stronger health systems and invest in health workers. We’ll also need strong leadership from health ministries and streamlined funding among foundations, corporations and donor governments.

And what is the potential of such an improved health work force beyond this latest crisis? Each isolated response, one disease at a time, creates myriad inefficiencies. With a health workforce at capacity, we could expand our efforts to address the economic inequities that allow these diseases to take root.