High-level UN Commission recommends reform of health systems

Focus instead on community-based, people-centred primary care

The Sustainable Development Goals (SDGs) set an ambitious agenda to improve the lives of all. Recent outbreaks have additionally confirmed the urgency of building resilient health systems and strengthening global health security. Health workers and health employment reside at the heart of the SDG agenda. However the rising global demand and need for health workers over the next fifteen years, presents significant challenges.

Earlier this year the United Nations Secretary-General announced the appointment of a Commission on Health Employment and Economic Growth co-chaired by François Hollande, President of France, and Jacob Zuma, President of South Africa. The Commission was tasked to make recommendations which will stimulate and guide the creation of at least 40 million new jobs in the health and social sectors, and to reduce the projected shortfall of 18 million health workers, primarily in low- and lower-middle-income countries, by 2030.

In September 2016 findings of the Commission were presented at the United Nations’ General Assembly. Based on its findings the Commission has made ten recommendations. Six related to what needs to be changed in health employment, health education and health service delivery to maximise future returns on investments. Four focused on how to enable the necessary changes. All important, and all highly relevant to primary care and family medicine.

Recommendation number four on Health Service Delivery and Organisation drives home that health systems organised around clinical specialities and hospitals will need to shift towards prevention and primary care.
It reads:
“Reform service models concentrated on hospital care and focus instead on prevention and on the efficient provision of high-quality, affordable, integrated, community-based, people-centred primary and ambulatory care, paying special attention to underserved areas.”

The recommendations of this Commission alongside the recent WHO Framework on Integrated People-Centred Health Services and the Human Resources for Health Global Strategy: Workforce 2030 make a strong case, both economic and moral, for countries to invest in primary care and provide a platform for WONCA and family doctors worldwide to demonstrated the vital contribution of family medicine to achieving high-quality and comprehensive primary care and universal health coverage.