Title: IH SECTION RESOLUTIONS INTRODUCED
Author:
Section/SPIG: International Health
Issue Date:
At our strategic planning retreat last June in Washington, D.C., IH Section leaders resolved to submit two resolutions this year on our important IH Section issues for APHA consideration and adoption. Subsequently, when Section members met in November at the Annual Meeting, we identified a list of issues that might be advanced with some APHA attention and advocacy. In January, we narrowed the list to two items: health worker migration from low-income to rich countries, and spending limits imposed by lenders on the health sectors of highly indebted poor countries.
IH Section member Amy Hagopian partnered with Eric Friedman of Physicians for Human Rights on both these issues, and had further assistance from Rick Rowden at Action Aid USA. Section members Karen Solheim and Mary Anne Mercer also provided assistance with the resolutions, along with several others who provided very helpful comments and critiques.
The migration resolution acknowledges that 180,000 (nearly 25 percent) of American’s physicians are trained abroad, 64.4 percent of them in low and lower-middle income nations, and that 90,000 nurses (4 percent of our overall nurse workforce, but 14 percent of recently licensed nurses) are trained abroad. Further, the World Health Assembly (May, 2004; 57.19) has urged member states to “develop strategies to mitigate the adverse effects of migration of health personnel and minimize its negative impact on health systems."
The APHA resolution proposes a very simple code of ethics for U.S. health care employers, based on the U.K. Department of Health’s code. It identifies a list of low-income countries from which it is unethical to actively recruit workers, again based on the U.K. list.
Lincoln Chen, co-author of the recent Joint Learning Initiative (JLI) Human Resources for Health: Overcoming the Crisis report, arguably the most important recent piece of research on the topic of global health work force issues, was impressed with our Section’s effort on the migration resolution. He wrote to us, noting: “This is an interesting and important APHA initiative on medical migration in the US; this belongs as part of the activity report back to WHA2005 (World Health Assembly), and this belongs as illustrative of global initiative/platform solving interdependence issues in human resources for health.” See the full JLI report Lincoln Chen, et al at: <http://www.eldis.org/static/DOC16701.htm> and in The Lancet 2004, 364:9449.
The second resolution, Expenditure Ceilings and the Millennium Development Goals, acknowledges that the levels of increased public spending required for the additional teachers, doctors, nurses and health workers needed to meet the Millennium Development Goals (MDG) by 2015 will not be possible under the current International Monetary Fund (IMF) policies for highly indebted poor countries, and urges the World Bank, IMF and U.S. government to support only those macroeconomic policies and lending conditions that permit and facilitate the significantly increased spending required in poor country health and development sectors to achieve the MDGs. The full text of both resolutions are posted in the APHA Web site:
Ethical Recruitment: <http://www.apha.org/private/2005_Proposed_Policies/d4-2003.pdf>.
Millennium Development Goals: <http://www.apha.org/private/2005_Proposed_Policies/a5-2003.pdf>.