 Hi everyone and welcome to a new issue of the People's Health Dispatch and this week we are having a special on global health governance and we are going to discuss what has been happening at the World Health Assembly in Geneva and what's going to happen at the World Trade Organization ministerial conference that's starting this weekend that's June 12th and for our section on the World Health Assembly we are joined here by Babai from Public Services International which is a global union confederation who's doing some amazing work with health workers and other workers in the public sector and so Babai was at the World Health Assembly when the delegates were discussing topics related to the health workforce and so we're hoping to learn a bit more what the WHO is planning in this field and what we can expect in the next months and years so welcome Babai thank you so much for joining us thank you very much Anna it's a pleasure to be here and with People's Health Dispatch thank you and so just to kick us off maybe can you tell us a bit more what the World Health Assembly discussed when they touched upon the health workforce yeah this year was quite interesting quite significant in that the agenda item 15 which dwelt on human resources for health had four important sub items and all of which PSI had been engaged with over the years in several ways and and we we did come up with a constituency statement there I would look at each of these four quickly if you don't mind and take on them one was on the working for health action plan 2022 to 2030 working for health draft action plan 2022 to 2030 the second was on the global health and care worker compounds then the third was on the code of practice for international recruitment which had to do with health worker migration and the last which actually the sense is a spinal hinge for for for demo is the WHO global strategy for human resource for health by 2030 which came up in which was drafted in 2015 well first putting things in perspective the action plan is the second action plan of working for health the first action plan which was a five-year action plan 2017 to 2022 came out of the the discussion subsequent to the 2016 United Nations High-Level Commission on Health Employment and Economic Growth that commission which was chaired co-chaired by then the Francois land the then president of France and Jacob Zuma the then president of South Africa sat between March and September 2016 and the PSI General Secretary Rosa Pavanelli was one of the commissioners they represented organized label and this commission amongst other things confirmed the the the fears raised in the global health workforce strategy that there will be a shortfall of 18 million health and care workers by 2030 if if decisive actions were not taken by governments and uh internationally uh and uh in December 2016 so many governments you know they may be very fine sounding political declarations to take the necessary steps to fund human resource for health and and and this will them will until not just employing more health workers but within the context of the decent work agenda however considering the fact that this is taking place after clapping for health workers who were on the front line this past two and a half years of the pandemic in fact they they they they made last year uh the international year of the health and care worker it is indefensible we addressed these concerns during the consultation uh process on on on this draft as well employ more health workers and employ them under decent working conditions and part of the the the the the issues we also have with the current draft is that it does not necessarily prioritize public funding it sees public and private funding investment in human resource for health has been more or less the same like it doesn't matter whether the cat is black or white too long as it catches right but things are not as simple as that private investment in human resource for health drives precarity of health and care work with that I go to the next which is the global health and care worker combat and that we uh we we we are also part of um formulating that because uh uh the the PSI General Secretary Zappa Vanelli again was a member of the steering committee of the international year of the health and care worker last year and that steering committee played a central in coming up with uh the compact the health and care uh compact to put in context to to put in perspective the compact what it is is a compendium of all international covenants recommendations guidelines that in any way safeguard health and care workers the professional safety and health uh freedom of association the entire gamut of of of you know of of safeguarding health and care workers uh and the associativeness but the main problem is this a lot of uh those international um documents agreements are best recommended so uh what it gives is at best uh moral a basis for moral situation so to speak what it does is it makes it easier to grab to now okay uh refer to this refer to that so what's but what we can what we and which um for affiliated in is is how in in different countries and which we also put forward to the world health assembly for governments to show commitment genuine commitments uh to the concerns uh and the well-being of the health and care worker um they should take steps uh to translate those I mean where these are largely international recommendations into national laws or policies on the code of uh the code of practice you know on international health worker migration psi has also been quite involved uh in that you you have uh we've been our migration um project officer uh has been part of the body of experts the advisory body of experts uh we continue to do um current round of review uh and um some of the things in the area in which we stress uh at the world health assembly uh are these we we we do think that uh government to government agreements should be strengthened and bilateral labor uh agreements um should serve as the plank for um for international migration to save god health workers health and care workers coming from countries of origin to countries of destination we also feel very concerned that health worker migration is usually from countries where health workers are more critically needed to wealthier countries like for example 80 percent of the projected um workforce shortage are in the low and middle income countries the amount spent to train medical and health workers uh was the opportunity cost times is even much more significant than uh what is spent in the in the global nuts but then also particularly for the health and care workers improved wages improved working conditions uh uh this this are important things to um for for retaining more of the health and care workers that are trained in lmi system you know so uh then the last bit we spoke on was on the the global health uh um workforce strategy on each other this there's this um view which was expressed in the um in the documents for the for the WHO 75 that uh uh well now instead of the 18 million we probably will be having just a 10 million shortfall by 2030 and this is seen as progress uh that probably member states have been employed we don't think so you have a clue to what has actually happened as at the time the global strategy was put together WHO had zero percent of reporting on human resource for health now it has over half of the states member states reporting through the national health workforce accounts i will say that it is more about access to information for projection than that there has been improvements in recruitment because of burnout because of disillusionment because of and that four wages because the because they are they they they they they are health and care have not been given the the the requisites consideration we are active uh as agency in these historic moments uh included in trying to better our lots uh it's unfortunate that across the world health workers have been forced into what has turned out to be waves of strikes and protests uh and which which we have won some concessions uh we we hope that internationally international politics uh governments will work their talk of appreciation of health and care workers uh but we are not going to go to sleep and just pray that that should be done we'll fight to win so that to me is the greatest uh is the greatest hope at the moment it's yeah it's quite a powerful hope uh and uh yeah so in the people's health dispatch we have seen this basically what you have just explained that you know uh even during the pandemic uh and health workers have worked together with people to protect health systems and to you know uphold their rights so i think that's uh you know something that's uh going to be increasingly important in the next months as we face additional austerity measures uh we have seen health workers who were recruited during the pandemic losing their jobs now that their governments are cutting off some of the emergency measures so uh i completely agree that the good times are not ahead and it's going to be a lot of fighting for health workers if uh if you know if we all want to have strong and public health systems anytime soon um and actually that's uh that's my last question and something to toss up here uh based on the discussions that were held at the WHL uh and based on what you are seeing on the ground uh what do you expect uh to see in the future so uh are there any particular worries that uh are uh you know psi seeing uh when it comes to to your membership and what's anyway what what are you expecting to see uh yeah well um talking of the future i want to start from the immediate future and i'm talking of this from now which is the ministerial the WTO ministerial um we we feel disappointed at the uh so-called consensus resolution imagine after uh um two years of struggle for a people's vaccine which uh is hinged on uh um the trips waiver but just like um when i talked about mixed feelings regarding WT 75 looking further into the future um i still have mixed feelings um but i i i draw from Gramsci um to have pessimism of the of the intellect and optimism of the of the of the will for us and this is why i come with the WTO even within the WTO we're fighting for that um we have five key um takes which we have put before the intergovernmental negotiating body you first is you cannot separate crisis preparedness from the the nature of the health system itself so and um publicly funded and delivered uh health for all uh as a right is is is the point of departure is the bedrock for crisis preparedness uh secondly we're also happy at uh you know this talk about uh the one health approach and all the other we would rather have for the alignment uh the perspective of a one structural uh health approach which looks at and addresses uh uh the political and economic structural basis of the web of life and that leads us to uh stressing the need for uh fundamental reforms of um the the financial trade and uh and taxation architecture uh globally um then we the the issue of corporations profiting from pandemics to it is not sitting it it is like it is blood money it is a shame that you have some 40 million COVID-19 billionaires and many of these from this vaccine cooperation fight vaccine developers so for us a very key element of our demands also is that there should be mechanism for automatic trigger uh of waiver of intellectual property rights on what could be pandemic products where and when uh a public health emergency of international concern effect is declared circling back to the heart of your of your of your question and talking now um from the heart the optimist here uh even whilst I see the land mines uh there's hope there's hope in that the pandemic has opened people's eyes on several things uh for example a lot of people couldn't connect the dots between you know trades uh finance and health I mean you know so people people will will are more ready to ask questions uh more ready to fight and then the challenge is for us also uh to be dear in front with programs with alternatives uh and um ceaselessly and tenaciously uh mobilizing and organizing to bring to birth uh a new world uh from the ashes of the old to borrow from the solidarity some of rough chaplain and I think now more than ever trade unions and civil society organizations need to um blast that trumpets even louder now more meaningfully uh uh that we blew uh 20 years back in struggling to make sure that uh that's other world which is possible where right to health would be would be fully realized and yeah that is my my take on that Anna thank you so much baba so uh that actually covers everything that we had in mind for the WHO for the World Health Assembly and of course we're still looking ahead to the WTO ministerial is going to be interesting the so-called consensus is not looking so consensual at all and of course we're we're all looking forward to see what how how that ends uh but yes thank you for sharing the hopes and you know the outlooks for the health workers fights that are coming up and that are going to be supported by people or all around the world so thanks again for joining us baba and hope to see you in the next issue also