This guest post was written by Arush Lal, Global Health Corps Fellow at Frontline Health Workers Coalition (FHWC) c/o IntraHealth International. The post was originally published on the FHWC website. The Frontline Health Workers Coalition (FHWC) is an alliance of United States-based organizations working together to urge greater and more strategic U.S. investment in frontline health workers in developing countries as a cost-effective way to save lives and foster a healthier, safer and more prosperous world. FHWC is a 2017 Global Health Council member.
It’s no accident that Universal Health Coverage Day — December 12 — falls on the heels of Human Rights Day. Universal health coverage (UHC), the goal of ensuring that all people can access essential health services without exposure to financial hardship, is a dignity and a right not afforded to many around the world.
Today, I remember Gabriel, a Panamanian boy half my age who first taught me how a fractured health system fails people. I met Gabriel in the waning hours of our fourth clinic day, where our team of passionate doctors and volunteers was visibly exhausted after treating hundreds of patients in the remote islands along Panama’s rugged coastline. I vividly recall watching him bear the sweltering heat as he waited to be examined, and felt proud when I saw him leave with a much-needed bottle of Albendazole and a bag of nutritional supplements for his sister back home. As I instructed the team to wrap up for the day, I suddenly noticed Gabriel running the winding path back to the clinic, stopping in front of me wide-eyed and out of breath. He urgently explained that his disabled grandmother needed medications to control her diabetes, but no health workers reached their part of the island. I asked him if he could bring her to the clinic before we left, but he informed me she was too weak to make the hour-long journey to meet us. I desperately wanted to help, but we were short-staffed, facing a surge of patients and a setting sun. As the leader of the group, I was faced with an impossible decision: provide the medication without an examination or send the boy home empty-handed. I was forced to choose the latter.
Gabriel is one of 400 million people who lack access to health workers, and that number grows every day. In fact, it’s estimated that the world will face a shortage of 18 million health workers by 2030, meaning a shameful rise in stories like Gabriel’s.
Where someone lives should never determine if they live, but although illness is universal, healthcare isn’t. As a vocal advocate for UHC, I now focus on health workers, because without them, health doesn’t happen. Frontline health workers are the first and only point of contact for many marginalized populations, often facing unsafe conditions with limited training, equipment, and resources needed to perform their lifesaving duties.
Investing in health workers isn’t just a cost-effective solution (the UN Secretary-General’s Commission on Health Employment and Economic Growth estimates a 9 to 1 return on investment), it’s essential to achieving the Sustainable Development Goals (SDGs) — eliminating poverty, fueling economic growth, reducing gender inequalities, and saving millions from preventable diseases.
In many ways, Gabriel reminded me of myself. Just as I, one of the youngest team leads in VAW, was busy overseeing our clinic operations to ensure rural populations had access to lifesaving care, so was he, a compassionate nine-year-old, spending his day scouting medications for his family rather than, well, being a kid. But where healthcare is scarce, everyone, including our youngest, must step up to the plate.
Arush Lal asks a question during a plenary at the Fourth Global Forum on Human Resources for Health in Dublin, Ireland, Nov. 13–17, 2017. Image Credit: Frontline Health Workers Coalition
With the support of Global Health Corps and IntraHealth International, I recently attended the Fourth Global Forum on Human Resources for Health, convened by the World Health Organization and several partners in Dublin, as a youth delegate and panelist. Along with 1,000 policymakers and advocates, we discussed possible solutions to the health workforce crisis and the pivotal role young people play.
Over half the world’s population is under 30, and young people have woefully untapped potential as crucial advocates and partners in achieving UHC. Youth aren’t just the leaders of tomorrow; they’re leaders today, as young doctors, policymakers, and researchers. Bold, innovative, and visionary, my peers are making noteworthy advances in the way we pursue global public health. Youth must be empowered to push for greater accountability, stronger policies, and sounder investments to improve access to frontline health workers and resilient health systems. Without over three billion of us at the table, world leaders will continue to struggle achieving their global health targets.
As the next health workforce, young people must be actively involved in planning their future, and we should push for academic programs that cultivate students who are well-versed in the SDGs and UHC. This includes expanding models like the UN Regional Centers of Expertise, one of which I recently helped create in Atlanta, to bring the global goals onto college campuses. Similarly, there is a need to create effective education programs, like an undergraduate degree in global health systems and technology I proposed at Georgia Tech, aligning interdisciplinary curriculum with the goal of achieving UHC.
Young people should work with local governments and NGOs as implementers in the fight for UHC, because youth are effective at reaching vulnerable populations. IntraHealth is a shining example of how to mobilize young people as frontline health workers. Through its CS4FP Plus program, IntraHealth has trained 92 youth ambassadors to lead family planning campaigns, featuring advocates like 16-year-old Nina Kone of Burkina Faso, who pushes for gender equality while de-stigmatizing sexual education, and Abou Diallo, who ensures that young people have access to contraceptives and reproductive health services in Guinea.
A Voice For Change
Few things are more effective than a passionate young person with a platform and a voice to cut through cynicism and question the status quo. Youth can and should advocate globally, ensuring governments commit to the policies they enact.
The Dublin Declaration and an accompanying Youth Call to Action are promising examples of youth engagement in UHC done right. For the first time, “youth” appears as a key stakeholder in the Dublin Declaration — and for good reason too. Youth perspectives are catalytic in achieving the SDGs, and our fluency in social media to push our messages far and wide make us an asset to governments trying to drive change. The first generation faced with climate change and an innately powerful imagination for new technology, we apply innovative solutions to health systems gaps, creating database and information systems, training health workers online, and improving telemedicine.
Young people: Be proactive and vocal advocates for change in achieving UHC, building relationships with diverse stakeholders and holding leaders accountable when they fail to deliver.
Established leaders: Engage youth more meaningfully, as key partners and not as an afterthought or disconnected silos. Mentor us, empower us, give us a platform.
For me, the story of Gabriel regularly reminds me of two truths we simply can’t ignore:
Emboldened youth today are our future — it’s time we start recognizing it.
Our world needs more health workers — it’s time we start showing it.