On 11 January 2012, a coalition of 15 major global health organizations—including MCHIP partners Jhpiego, Save the Children, and PSI—was launched to urge “greater and more strategic U. S. investment in frontline health workers in the developing world as the most cost-effective way to save lives and foster a healthier, safer and more prosperous world.”

Every three seconds, a child’s death is prevented in the developing world thanks to a frontline health worker (FHW). FHWs have contributed to the 37% decline in child mortality in the past 20 years, as well as the 34% decline in maternal mortality between 1990 and 2008. Despite this significant progress, UNICEF estimates that nearly 21,000 children still die every day from preventable causes, and 1,000 girls and women die each day in pregnancy and childbirth. According to the WHO, there is a shortage of at least 1 million FHWs—a shortage that, if addressed, could save these lives.

This shortage inspired a panel discussion moderated by Dee Dee Myers (Managing Director, Glover Park Group). The panel included Dr. Ariel Pablos-Mendéz (Assistant Administrator for Global Health, USAID), Anita McBride (Former Chief of Staff, First Lady Laura Bush), Dr. Peter Ngatia (Director of Capacity Building, AMREF), and Duncan Learmouth (SVP, Developing Countries & Market Access, GlaxoSmithKline).

Dr. Pablos-Mendéz began the discussion with a positive description of the recent successes in global health. However, he acknowledged that there is still much work to be done and that investing in global health—and in FHWs in particular—is crucial for further improvements in both health and economic security. As successes in family planning and child survival lead to changes in the demographic pyramid, they also change the workforce structure and thus create economic opportunities. Training FHWs is therefore not only a tool for saving lives, but also for achieving economic growth. Dr. Ngatia supported this view of the role of FHWs by providing examples from Ethiopia and Southern Sudan. As Sub-Saharan Africa bears 24% of the world’s disease burden but only 1.3% of the world’s health force, FHWs are paramount to any progress.

Anita McBride acknowledged that the U.S. cannot solve all the world’s problems, but expressed her belief that it can be the leader in solving some of the problems, including those related to global health. Quoting an FHW from Sierra Leone who claimed that they “don’t allow maternal deaths,” she stressed that a little investment can go a very long way. She then added another dimension to the issue—that of security. Ms. McBride stated that terrorist attacks are often a result of desperation and hopelessness. “There is nothing more hopeless than young children watching their parents die of AIDS and nobody helping,” Ms. McBride concluded.

But how do we convince the American people that investing in FHWs is money well spent? Dr. Ngatia addressed this question with some shocking statistics: there are more Ethiopian doctors in Chicago than there are in Ethiopia, and 50% of Ghanaian doctors practice in the United States. Similar to Ms. McBride, Dr. Ngatia linked desperation and hopelessness to terrorism by citing the lack of FHWs in Ethiopia and the growing influence of an al-Qaeda branch in the country. Investing in FHWs is thus money well spent not only from global health perspective, but also from national security perspective.

Mr. Learmouth turned the focus back to economics and the public-private partnership in global health. “We’re not interested in philanthropy,” he said, “but in sustainable development.” Private companies want to make longer-term strategic investments that would improve health infrastructure in developing countries. Such investments are good not only for a country’s health systems, but also for its economy and, consequently, for the global economy.

After a question and answer session, Pape A. Gaye, President and CEO of IntraHealth International, pushed the audience to take action. “It’s all about leveraging,” he said. “It has a lot to do with resources, but it also has a lot to do with the way we work.” Mr. Gaye stressed that it is no longer about rich countries helping the poor; it is about investment.

Barbora Nemcova
MCHIP Communications Consultant