Sharing knowhow and joining forces towards Health for All

MMI Network News, June 2013

MMI Network News, June 2013

Editorial: WHO Global Code of Practice - lost in translation?

Dear reader,

The “WHO Global Code of Practice on the International Recruitment of Health Personnel” was adopted by the World Health Assembly, in May 2010. Three years later, back in Geneva at the World Health Assembly, it looked as if the Code has gone lost somehow in its translation from paper to practice.

“We still require at least an additional 4.3 million health workers. Still, one billion people world-wide will never see a health worker in their life.” This is how Anke Tijtsma, Wemos, introduced a civil society side event to the World Health Assembly organized by the Medicus Mundi International Network for a great number of civil society partners and co-promoters such as the delegations of the EU, USA, Switzerland and Malawi to the WHA. The event was attended by over 80 WHO Member States delegates, WHO staff and civil society delegates. Starting with case stories of Code implementation, country leadership and civil society involvement from source and destination countries and regions, the event led to a general discussion and overall conclusions on the state of Code implementation and the management of health personnel migration.

As Marie-Paule Kieny, Assistant Director General of the WHO, admitted, progress in Code implementation is “painfully slow”. But what are the reasons that “stoking up the fire for Code implementation” has become such a challenge? Some possible explanations:

International recruitment or overall roadmap? The “WHO Global Code of Practice on the International Recruitment of Health Personnel”, despite its name and besides more specific sections dealing with international migration and recruitment, provides an overall roadmap for health workforce development. In the words of Amani Siyam from the WHO Secretariat: “The Code is a planting bed for many good seeds of change. Just read it again!” And, more important, this roadmap was agreed and unanimously endorsed by all WHO member states in 2010. So one of the biggest problems with the Code is its title. A simple solution would be to just informally re-label and promote it as “WHO Code of Practice on addressing the health workforce crisis”.

What cannot be counted does not count...: Dealing with the global health workforce crisis in a systemic and comprehensive way, as proposed by the Code, and promoting good practice in various fields related to developing and retaining a sustainable health workforce has its risks. Health systems are something “complex”, not easy to deal with. But national policy makers and international agencies and donors prefer more simple proposals: simple, easy to implement and internationally funded programs with clear, measurable and time-bound targets. So why not link the promotion of the Code with the efforts for scaling up and transforming health workers education and with the current global push for achieving universal health coverage. If we focus too much on a particular aspect of the health workforce crisis (migration and recruitment OR education) and the related policies and strategies, we get lost in fragmentation. So rather let us admit, that, in its core, it is all about the same. Let us leave our silos and realize that are stronger walking together.

Code adopted - everything (nothing) achieved? At the civil society side event to the World Health Assembly various speakers stated that, after the tough negotiations before and during the 2010 WHA, the adoption of the Code was for many the end of something instead of its beginning: At that moment, there was great enthusiasm, but no preparedness to work with the Code, and no proper mechanisms in place for its implementation. And it also rather looked then as if those who promoted the Code considered the mission as accomplished and dropped or downgraded the issue afterwards. This was at least how the drastic staff cuts at the HRH unit of the WHO Secretariat in 2011 were seen from the outside.

You can also see this point differently: During the elaboration of the Code in 2010 the language was diluted in that the mention of compensation to source countries for the costs incurred in the formation of emigrated health workforce was removed. So, when the Code was adopted, it might be that those countries that expected cash were not happy just to get just kind (words). It is time to re-politicise the discussion on the devastating effects of lacking health personnel in poor countries and regions and on the global dimensions of the national health workforce crises. It is time to denounce and address the economic and political determinants of poor health and poor social protection, such as tax evasion and capital flight.

Everybody’s business? When Marie-Paule Kieny, Assistant Director General of the WHO, expressed the greetings of the WHO Director General to the participants of the civil society side event, she said that civil society involvement in the follow-up of the implementation of the Code was well acknowledged by WHO and concluded: “It is everybody’s business to move ahead with it.” But what sounds encouraging can also be a problem: If everybody is responsible, nobody takes responsibility. So even if it is “everybody’s business” to move ahead with the Code, the main responsible are the WHO and its member states. It is up to them to show commitment, ownership and leadership. There is much at stake. The success or failure of the implementation of the Code will be seen as a case study for the capacity of WHO – and its members – in the field of global standard setting and regulation. This links the technical issue of Code implementation with the overall issue of WHO reform and the role of WHO in global health governance.

Conclusion of the WHO Secretariat’s report to the WHA: “The health workforce crisis is a global, multidimensional challenge. It requires a comprehensive global strategy to transform the production of health workers, encompassing labour market analysis as well as the transformation of education and training of the health workforce, at national and transnational levels. It is essential that countries wanting to improve access to health care meet the challenge posed by shortages in the health workforce. Renewed approaches to the health workforce crisis will therefore be critical for moving towards universal health coverage.” - There is nothing to add to that one.

Thomas Schwarz, Executive Secretary
Medicus Mundi International Network

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Extract from an article published earlier in the MMI blog
“Get involved in global health” (12 June 2013)
www.bit.ly/whocode-2013 with full references

The MMI Network is a member of the European project
“Health Workers for all and all for health workers”
www.healthworkers4all.eu/home/

WHO Global Code of Practice on the International Recruitment
of Health Personnel: Stoking up the fire for Code implementation
WHA side event documentation: www.bit.ly/wha66-code 


MMI Network: News and resources

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MMI Jubilee Assembly in Barcelona, 7-8 June 2013
Primary Health Care and cooperation: A utopia? 

The Jubilee events of the Federation of Medicus Mundi Spain (MM Spain) started with a scientific conference on “Primary Health Care and Cooperation: A utopia?”. The Assembly of MMI on Saturday morning was held in parallel with the MM Spain Jubilee Assembly . Further jubilee side events took plaace from Friday to Sunday. Many thanks to MM Spain and to Medicus Mundi Catalunya for having invited MMI to Barcelona!

> Event and Assembly documentation: www.bit.ly/mmi50

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Annual Report 2012 of the MMI Network
Jubilee Report: 50 years of MMI - Looking back and ahead

Contents: Message from the President; Implementing the Network strategy: From initial Network programs to systematic work plans; Network meetings; Welcome to new Network members; “Short stories” by Network members; Financial facts and figures; Network members.

As an annex to the Annual report 2012, the MMI Network published the report “50 years of MMI - Looking back and ahead” with memories and insights by the current and former MMI presidents (PDF, 2 MB)

> Report: www.medicusmundi.org/en/contributions/reporting/2013/annual-report-2012-of-the-mmi-network

> Jubilee annex: www.medicusmundi.org/en/contributions/events/2012/1963-2013-50-years-of-mmi/mmi-jubilee-2013.pdf

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Members of the MMI Network: “short story” by Medicus Mundi Navarra
A new Healthcare Model for Latin America

Medicus Mundi (medicusmundi) Navarra is promoting an intercultural, comprehensive and inclusive healthcare model in Guatemala, Bolivia and Peru which aims to transform the continent’s healthcare systems in order to guarantee universal coverage for communities that are traditionally excluded. (contribution to MMI Annual Report)

> www.medicusmundi.org/en/contributions/reports/2013/a-new-healthcare-model-for-latin-america

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Members of the MMI Network: “short story” by Medicus Mundi Poland
Celebrating the 20th Anniversary

Medicus Mundi Poland was created on the basis of “Redemptoris Missio” Foundation in Poznań, Poland. The Foundation started at the Clinic of Tropical and Parasitic Diseases, University of Medical Sciences in Poznań, Poland in the year 1992, and in 2012 has celebrated its 20-years anniversary. (contribution to MMI Annual Report)

> www.medicusmundi.org/en/contributions/reports/2013/celebrating-the-20th-anniversary

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Members of the MMI Network: “short story” by HealthNet TPO
Community Systems Strengthening: Addressing the Social Determinants of Health

HealthNet TPO is a health organization that works with violence-affected communities in fragile states to enable them to take control of their own health and wellbeing. We have been developing and piloting the Community Systems Strengthening (CSS) approach over the last 2 years in order to operationalize this principle of empowerment. We are now preparing to use it as a core component for complex and scaled-up health interventions in several of our project countries. (contribution to MMI Annual Report)

> www.medicusmundi.org/en/contributions/reports/2013/community-systems-strengthening-addressing-the-social-determinants-of-health

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Members of the MMI Network: “short story” by Emergenza Sorrisi
The Sweet Smile of Alexandra

In October 2012 Emergenza Sorrisi – Doctors for Smiling Children N.G.O. and N.P.O. (formerly Smile Train Italia) has completed a humanitarian project to give joy to smile to a 3 years old Ukrainian child called Alexandra. (contribution to MMI Annual Report)

> www.medicusmundi.org/en/contributions/reports/2013/the-sweet-smile-of-alexandra

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Members of the MMI Network: “short story” by Health Poverty Action
Bridging the gap between communities and formal health services

Despite the indicator of 90% of births attended by skilled health personnel under Millennium Development Goal 5 (to reduce maternal mortality by ¾), 52 million births still take place without a skilled birth attendant every year. (contribution to MMI Annual Report)

> www.medicusmundi.org/en/contributions/reports/2013/bridging-the-gap-between-communities-and-formal-health-services

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Members of the MMI Network: “short story” by Doctors with Africa CUAMM
The doctor is waiting for a smile

A smile is one of the first signs that a malnourished child is regaining strength and recovering. A smile is what many doctors await as confirmation of effective treatment. The wait is particularly intense among young doctors at their first experience of the harsh reality of Africa where malnutrition is often, too often, a fact of life for many families. (contribution to MMI Annual Report)

> www.medicusmundi.org/en/network-resources/network-reporting/the-doctor-is-waiting-for-a-smile

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Members of the MMI Network: “short story” by Medicus Mundi Italia
Miriam's story

Like many other women from Burkina Faso, Miriam lives in Ivory Coast with her husband. Her family had emigrated there to find work. After some years, still in her twenties, she goes back to her native village in Burkina. She has lost weight, feels miserable, alone, abandoned by her husband and excluded by everyone because she does not have children. She has only had several miscarriages and stillbirths, and everyone thinks she is a cursed woman... (contribution to MMI Annual Report)

> www.medicusmundi.org/en/contributions/reports/2013/miriams-story

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Members of the MMI Network:
Annual Reports

First Annual Reports 2012 of Network members are published on the organizations’ website. Have a look at them – and let us know when further reports are available.

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MMI Network: People’s Health Movement
Global Health Watch 4: Call for case stories

"The Global Health Watch (GHW) is an alternative World Health Report that incorporates the voices of marginalized people and civil society into discussions around social justice and global health. The GHW coordinating group has identified broad areas to be covered in the 4th issue of the Watch, which is officially scheduled for release in October, 2014. We are now seeking your assistance in sourcing case studies that can add value to each of these important topics.”

> www.medicusmundi.org

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Members of the MMI Network: Federation of Medicus Mundi Spain
Health in development cooperation and human action. Report 2012

The "Health in development cooperation and human action report" made by Medicus Mundi Spain, Médicos del Mundo and Prosalus, was published for the first time in 2002. The original 2012 report in Spanish can be found on the website of Medicus Mundi Spain. An executive summary in English is available now on the MMI ePlatform.

> www.medicusmundi.org/en/contributions/reports/2012/salud

 

International Health Policy: MMI Updates

Bits and pieces of news on international health policy: each “MMI update” is 140 characters or less - these are the rules of the game on twitter. Just enough for a headline, eventually an author, a date, the source – and a link to the website where you find the full information. Have a look at some of our “tweets” published during the last month. As usual, it’s a bit much, so take it or leave it.

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Upcoming events

Events of the MMI Network and its members:
See above and in the MMI Network events guide

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Health systems strengthening
Health services, health financing
Universal health coverage

MMI thematic guides:
www.bit.ly/mmi-hss

www.bit.ly/mmi-uhc

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Human resources for health
Migration of health professionals

MMI thematic guides:
www.bit.ly/mmi_hrh

www.bit.ly/mmimigrationguide

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Access to medicines and vaccination
Medical research and development
Neglected diseases

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Women’s and children’s health
Sexual and reproductive rights and health

MMI thematic guide:
www.bit.ly/mmi-mch

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Equity and human right to health
Social determinants of health, Health in All Policies
Poverty and social protection

MMI thematic guide:
www.bit.ly/mmi_sdh

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Global health governance and policy

MMI thematic guide:
www.bit.ly/ghgovernance

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Framework Convention on Global Health

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Health beyond 2015, MDGs and SDGs

MMI thematic guide:
www.bit.ly/mmi-beyond2015guide

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World Health Assembly 2013
WHO reform

MMI thematic guide:
www.bit.ly/whoreformguide

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Debates: Development Assistance, NGOs

MMI thematic guide:
www.bit.ly/mmi-ngoguide

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Other topics

 

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MMI Network News are edited and distributed by e-mail by the secretariat of Medicus Mundi International. Network members (only) are kindly invited to send us your contributions.

You can get the monthly MMI Network News by sending a simple "subscribe" message to the secretariat. Please conctact us also if you have received the newsletter by e-mail, but do not want to be included any more in our mailing list.

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https://twitter.com/mmi_updates

 

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