World Health Day, 7 April 2006: Message from Commonwealth Secretary-General Don McKinnon
5 April 2006
World Health Day addresses facts and challenges: the fact that the Commonwealth is home to 30% of the world's population yet 60% of its maternal deaths and HIV/AIDS cases is as great a challenge as it faces. Some of the Commonwealth's 53 members, particularly in sub-Saharan Africa, have health indicators which are standing still or even going backwards. It is no coincidence that these countries also have health systems that are seriously under-resourced and under-staffed - a problem increasingly compounded by a workforce cut down by HIV/AIDS, and by doctors and nurses leaving to seek a better life abroad.
All over the world, there can be no health services without trained and motivated staff to deliver them. That's why the theme of this World Health Day and of the 2006 World Health Report - 'Human Resources for Health' - is so critical and so timely.
Health is labour intensive. At 60% to 80%, the proportion of expenditure spent on staff is much higher in health than in most manufacturing industries, and in many service industries. The workforce is the most important but also the least predictable aspect of planning and managing health systems.
In 2003, Commonwealth Health Ministers adopted a voluntary Commonwealth Code of Practice for the International Recruitment of Health Workers. The Code is designed to protect the most vulnerable states from unmanaged migration, while also protecting the rights of the migrating health workers themselves. In turn, it has led to a number of bilateral agreements between Commonwealth countries - such as the UK with South Africa, and Canada with Jamaica - on health worker recruitment.
Commonwealth countries have also developed measures - like housing allowances for doctors in Ghana, and top-ups to doctors' salaries in Malawi - to retain health professionals and to attract back those who have left.
So 'disaster' is avoidable. The ideas are in place to preserve and to improve health services in developing countries. And as we strive to improve them, we pay particular tribute to the millions of dedicated health professionals, the women and men who struggle against overwhelming odds to make the right to health care a reality. In Mozambique, for example, there is one doctor for every 30,000 people; in the UK, one for every 600. Health professionals everywhere don't only confront impossible workloads: they also risk their own health. Meanwhile, health professionals are front line workers in wars and natural disasters. Last year saw incredible responses from Commonwealth doctors and medical staff volunteering to help those afflicted by the Indian Ocean tsunami and the Pakistan earthquake.
There are scores of happier health stories: of polio, for instance, now almost extinct in India and Pakistan, leaving Nigeria as the last country in the Commonwealth with the disease, and hoping to be free of it by 2007. Or look at Zambia, where 65% of people subsist on a dollar a day, while the average trip to a clinic costs at least US$3. So it is extraordinarily good news that the US$4 billion of debt relief that the country gained at the G8 Summit last July is now being used to offer free health care for people in rural areas.
For millions of people on this World Health Day, the right to health care remains only a possibility. Our challenge is to make global healthcare a reality, even a safe assumption. We must make sure it happens.
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- Commonwealth ICT SummitBetty Mould Iddrisu, Director, Legal and Constitutional Affairs
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