EU Council Conclusions on the EU Strategy for Action on the Crisis in Human Resources for Health in Developing Countries

Conclusions from the GENERAL AFFAIRS and EXTERNAL RELATIONS Council meeting, Luxembourg, 10 April 2006.

The Council and the representatives of the governments of the member states meeting within the Council adopted the following conclusions:

"THE COUNCIL OF THE EUROPEAN UNION AND THE REPRESENTATIVES OF THE GOVERNMENTS OF THE MEMBER STATES MEETING WITHIN THE COUNCIL,

RECALLING the resolution on enhancing capacity building in global public health adopted at the 60th Session of the UN General Assembly;

RECOGNISING the high priority given to addressing the shortage in health workers in developing countries by the 57th World Health Assembly;

RECALLING the value of the principles of policy coherence for development, ownership, alignment, harmonisation and coordination set out in the European Consensus on Development, as well as in the Paris Declaration on Aid Effectiveness, and the need to implement these principles aimed at delivering a better and more effective aid in the framework of EU horizontal strategies;

RECALLING the EU Strategy for Africa, endorsed by the European Council on 16 December 2005, and in particular the commitment to agree approaches on migration to optimise the benefits of migration for all partners in a spirit of joint partnership;

RECALLING the Council conclusions of November 2004 on a coherent European Policy Framework for external action to confront HIV/AIDS, Malaria and Tuberculosis as well as the European Programme for Action to Confront HIV/AIDS, Malaria and Tuberculosis through External Action, and in particular, the need to address the crisis in human resources for health as a priority to secure progress on the three diseases;

RECALLING the Council Conclusions of May 2005, which expressed the readiness of the European Community (EC) and its Member States to support innovative responses to the human resources crisis and invited the Commission to present by 2006 a policy document proposing an EU strategy to address the human resources crisis for health providers within the broader health context;

RECALLING the conclusions of the 3rd High Level Forum on Health MDG Meeting held in Paris on 14 and 15 November 2005 and RECOGNISING the need for a global alliance of existing organisations and agencies to address the crisis in human resources for health;

RECALLING the Council Conclusions of 21 November 2005 on Migration and External Relations and the Conclusions from the Brussels European Council of 15/16 December 2005 on a "Global Approach to Migration: Priority Actions Focusing on Africa and the Mediterranean" ;

RECOGNISING the important role that Europe has to play in the global response to the crisis in human resources for health,

WELCOME the EU Strategy for Action on the Crisis in Human Resources for Health in Developing Countries and the proposed actions set out in annex to this Communication;

AGREE on the importance of developing a comprehensive, coherent and large scale response to the crisis in human resources at country level, supporting and strengthening country plans of action in all developing countries with regional, European and international actions;

Moreover, THE COUNCIL OF THE EUROPEAN UNION AND THE REPRESENTATIVES OF THE GOVERNMENTS OF THE MEMBER STATES MEETING WITHIN THE COUNCIL,

I. CALL on the EC and its Member States to develop a coordinated EU response to the global call for action on Human Resources, and prepare an EU Statement of Commitment, demonstrating a strong and visible European response to the Human Resource in Health Crisis to be announced at international meetings on the crisis that will be held throughout 2006;

II. CALL on the Commission and Member States to coordinate support to country level efforts to address the human resource in health crisis by strengthening national health systems and supporting the development of comprehensive national human resources for health strategies, within the context of national poverty reduction strategies;

III. URGE the Commission and the Member States to support partner countries to:

• prioritise and champion policy dialogue and action on the health worker shortage at country and regional levels;

• promote decent work as a global goal for all; and

• strengthen public administration, develop human resources policy and undertake comprehensive and coherent health sector planning;

IV. CALL on the Commission and Member States to support partner countries to strengthen financing for enhanced health workers salaries, terms and conditions of service and incentive mechanisms in order to increase health workers retention and access to services for poor people and remote areas;

V. CALL on the Commission and Member States to work jointly with multilateral donors and international financial institutions, as well as with partner countries, to develop long term and predictable financing mechanisms necessary for sustained human resources capacity building and to make effective use of budget support and sector wide approaches and of new modalities which increase the volume of aid, such as the resources released by debt relief, to support actions on human resources for health crisis;

VI. URGE the Commission and the Member States to support and facilitate the development of a global health workforce alliance and a global action plan to be taken forward by existing organisations and agencies and to ensure a strong and supportive European stance in coordinated international efforts to address the crisis;

VII. UNDERLINE the need for an EU Action Plan to take forward the actions outlined in annex to the Communication on an EU Strategy for Action on the Crisis in Human Resources for Health in Developing Countries. In particular, the EU Action Plan will consider how to take forward the following priority actions:

• The development and implementation of an EU Code of Conduct for ethical recruitment of health workers, drawing upon existing Member States' best practices;

• The identification of a programme of collective work in support of country and regional mapping of human resources for health and the development of regional and global observatory functions to track health workforce numbers, training needs, distribution and mobility patterns, taking into account health services for poor and marginalised groups;

• The identification of strategies to support the mobilization of financial resources and the development of technical capacities to manage human resources for health at national and regional levels, particularly in Africa;

• Support of research into innovative and effective ways of increasing human resource capacity for health, drawing upon Member States, other donors and developing countries' experience and best practice, including the exchange of "know-how" among developing countries and between these and the Member States, as well as evaluations of the role of middle-level technicians, auxiliary and community workforces in health system strengthening;

• The identification of strategies to support the development of regional networks of civil society, academic, professional, private sector and technical organisations and agencies to support regional capacity building and training efforts;

• Increased support for training programmes to raise the output of trained human resources in the health sector of developing countries, thereby aiming at win-win situations in terms of sufficient capacities in developing countries and the development benefits from remittances;

• Strengthen European health workforce planning, promote better documentation of training, recruitment, deployment and retention of health workers and improve tracking of health worker mobility within, to and from the EU;

• Develop mechanisms and guidelines for supporting 'circular migration' of health workers, facilitating health workers to return to support health sector development in their home country after periods of training and career development working in wealthier countries, as well as for constructively engaging health worker diaspora in country level action to overcome the shortage of health workers;

• Include the gender perspective in all actions that may be taken in the framework of this strategy; in particular, identify mechanisms to support the role of women as an important part of health workforce and give particular attention to gender equality issues in matters of recruitment, salaries, career development, and decision-making positions;

• Consider, in the framework of an EU coordinated response in this field, the comparative advantages of each Member State in assisting specific countries to take a lead role in this issue;

VIII. CALL on the Commission to convene a working group of the Commission and the Member States, with the task of developing a coherent approach to strengthen Human Resources for Health in developing countries, as well as the EU Statement of Commitment and the EU Action Plan, drawing upon Member States' experience, expertise and plans, with the aim of presenting the outcome of its work with a view to its submission to Council in October 2006;

IX. ENCOURAGE the EC and its Member States to work in partnership with other donors, UN organisations such as WHO, UNAIDS, UNFPA and UNICEF and through the governance structures of global initiatives and instruments, such as the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GFATM), the Global Alliance for Vaccines and Immunisation and public-private partnerships, to increase commitments and actions to improve human resources for health in their work plans and financing decisions;

X. CALL on the Commission and the Member States to support the African Union (AU) and the New Partnership for Africa's Development (NEPAD) lead and coordinate a strong African response to the human resource crisis, given the severity of the shortage of health workers in many African countries;

XI. CALL on the EC and its Member States to ensure coherence between policies and approaches on human resource for health and policies on migration and on Africa;

XII. CALL on the EC and its Member States to establish links between existing initiatives and efforts to improve human resource planning within the EU, such as the work of the High Level Group on Health Services and Medical Care, and to strengthen international efforts to better manage flows of human resources to ensure that the needs of countries facing a crisis in human resources for health are fully considered, while fully respecting the right of individuals to legally cross national borders."

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