Global Shortage of Health Workers Needs Urgent Attention: Lancet Editorial

Only half of all countries have the health care workers required to deliver quality health care (estimated at 30 physicians, 100 nurses or midwives, and five pharmacists per 10,000 people), the 2017 Global Burden of Disease Study estimates.

An editorial posted Nov. 10 by The Lancet concerns the 2017 Global Burden of Disease Study and the warning signs it contains. Since the first GBD more than a decade ago, "every new iteration has brought improvements in data quality and quantity. With the sharpening of these estimates came a reassuring message: year on year, they portrayed an ever-healthier world. Careful reading of the results of GBD 2017 shatter this comforting trend of gradual improvement and instead show plateauing mortality rates on a background of faltering and uneven progress, era-defining epidemics, and dramatic health worker shortages. Instead of the progress updates we have become accustomed to, GBD 2017 comes as an urgent warning signal from a fragile and fragmented world," it says.

The editorial, "GBC 2017: a fragile world," was one of the most popular articles on The Lancet's website as of Nov. 16.

It cites violence, epidemics such as opioid dependence, noncommunicable diseases, depression, and dengue fever. "Opioid dependence has grown to an unprecedented scale, with 4 million new cases in 2017 and 110,000 deaths. Non-communicable diseases accounted for 73% of all global deaths in 2017, with over half of all deaths (28.8 million) attributable to just four risk factors: high blood pressure, smoking, high blood glucose, and high body-mass index. Obesity prevalence has risen in almost every country in the world—leading to more than a million deaths from type 2 diabetes, half a million deaths from diabetes-related chronic kidney disease, and 180,000 deaths related to non-alcoholic steatohepatitis," the editorial warns. "In 2017, depressive disorders were the third leading cause of years lived with disability after low back pain and headache disorders, and deaths from dengue fever, a disease often associated with struggling development and urbanisation, increased substantially in most tropical and subtropical countries, rising from 24,500 deaths globally in 2007 to 40,500 in 2017."

For the first time in the history of the GBD, health worker density estimates were included. They show a global shortage and unequal distribution of health workers, which the editorial argues requires urgent attention in order not to undermine attainment of WHO's Sustainable Development Goals. The authors estimate only half of all countries had the health care workers required to deliver quality health care (estimated at 30 physicians, 100 nurses or midwives, and five pharmacists per 10,000 people). Also, GBD 2017 reports no country is on track to meet all of WHO's health-related SDGs by 2030.

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