The World Health Organisation (WHO) had declared 2020 as the “International Year of the Nurse and the Midwife” in order to mark the bicentenary of the birth of the founder of modern nursing, Florence Nightingale. As the COVID-19 pandemic spreads across the world, nurses and other health workers have been praised for their commitment, beyond and above the call of duty. As the decision-making body of the premier institution for global health dedicated its two-day virtual meet to the world’s response to COVID-19, did the international community do enough to address the issues they face?
The virtual 73rd World Health Assembly (WHA) was held between May 18 and May 19, 2020, and dedicated itself to discuss the countries’ response to COVID-19. Delegations from member countries of the WHO unanimously adopted the Resolution on COVID-19 response.
The Resolution recognises the key role played by health professionals, health workers and other relevant front-line workers, in responding to the COVID-19 pandemic. It urges countries to take measures to ensure the safe movement of humanitarian and health workers, including community health workers and medical equipment, to fulfill their duties. The resolution recommends providing health workers “personal protective equipment and other necessary commodities and training, including in the provision of psychosocial support” as well as ensuring safety at work and the “provision of adequate remuneration (to health workers)”. The WHA-73 urged countries and all relevant parties to fully implement the recommendations of the WHO Expert Advisory Group on the relevance and effectiveness of the WHO Global Code of Practice on the International Recruitment of Health Personnel.
In his opening address, Tedros Ghebreyesus, the Director-General of the WHO, stated: “The World Health Organization is committed to defeating the coronavirus pandemic with science and public health measures, and supporting the health workers who are on the front-lines of the response….When health workers are at risk, we’re all at risk,” he added.
Country representatives also commended the work put in by health workers and expressed their gratitude towards them and other front-line workers in the fight against the COVID-19 pandemic. In their interventions, they covered a wide range of issues. They emphasised on the need for necessary PPEs and training for front-line workers. China mentioned that it has trained more than 2.6 million health workers in 23 languages. In response to increasing infection and deaths among healthcare workers, Tunisia called on the WHO to take immediate measures to ensure access to appropriate Personal Protective Equipment (PPE) and a better plan for dealing with the crisis. Bahrain stated that it had taken special measures to ensure that workers were well prepared through timely training of health professionals. San Marino said that it had commenced serological screening with health workers. Nigeria spoke of the insurance cover it will ensure for all health workers, while Cyprus mentioned having implemented a helpline for health workers.
However, some critical issues were not addressed. In a statement submitted online, the global union federation of public service workers, Public Services International, stated that “economic considerations should not define required PPE and workplace safety. Member states have to address PPE shortages to save lives. This requires enhanced global collaboration, including for building stockpiles and supply.”
The Resolution largely failed to address the working conditions of health workers and other front-line workers. The emergencies posed by COVID-19 have put health workers under high risk due to shortage of PPE, exposure to an overwhelming number of infected cases, long shifts without adequate resting periods and the lack of adequate preventive measures and surveillance systems in healthcare facilities. Moreover, the lack of training and access to necessary commodities places community health workers and sanitation workers under higher risk of getting infected. Perhaps the major issue still remains the shortage of PPE, as reports indicate that health workers are reusing their protective wear or trying to find a quick fix by using plastic bags and the like. A large number of front-line health workers are women, and their safety and menstrual needs are not addressed.
There is recognition that health workers face a greater risk. The chief executive director of the WHO Health Emergencies Programme, Michael J. Ryan, said in a press conference ahead of the WHA session that “Health workers have always been, unfortunately, the mine’s canary in epidemic response, particularly in areas that don’t have strong surveillance systems.” There is growing evidence that rise in coronavirus infection leads to increased number of health workers and other front-line workers getting ill. Despite this, a recognition of COVID-19 as an occupational disease, was fully missing. There is a huge lacuna in ensuring adequate compensation for health workers who acquire the illness, despite a broad based demand from the international trade union movement. “WHO's Considerations for public health and social measures in the workplace has serious flaws. Prepared without involvement of workers, its recommendations on physical distancing, strategy for testing, and long-term psycho-mental risks are inadequate to safeguard workers’ lives and well-being. We call for its review to adequately address these and for consideration of COVID-19 as an occupational disease,” the statement by the Public Services International mentioned. For health workers, compensation for occupational hazards and trade union involvement were two major missed opportunities at this WHA.
The above article is compiled with contributions from Ben Eder (UK), Gargeya Telakapalli(India), Michael Ssemakula (Uganda) Osama Ummer (India), Kriti Shukla (India), Matheus Z Falcao (Brazil), Sophie Gepp (Germany) and Natalie Rhodes (UK).