Europe’s ticking time bomb: the case for an Africa-Europe partnership on health workforces

As with every political issue, the tides have – expectedly yet disappointingly – turned for health, which now struggles to keep the attention of Europe’s political leadership amid the Russian invasion of Ukraine and associated energy crisis.

While the immediate threat of a continent-wide gas shortage understandably grabs political focus, the deadly, long-lasting impacts of the COVID-19 pandemic and chronic underfunding of European health systems have not been fully reckoned with – least of all for the exhausted, burned-out and ageing health workforce. As we move towards winter, hospitals are again set to be overrun with COVID-19 infections, alongside an explosion of health issues born out of growing energy poverty.

Health ministers across Europe share one concern: the health workforce. And it’s not just about money. The health workforce is simply missing.

In its latest report published in September, the World Health Organization Regional Office for Europe (WHO/Europe) sets out some worrying figures. While 40% of medical doctors are close to retirement age in one-third of countries in the ‘WHO European Region’, which includes countries in Western and Central Asia, at least a quarter of European health and care workers report symptoms of burnout, anxiety and depression. Health worker absences in the region increased by 62% in March 2020 and 50,000 health and care workers may have lost their lives due to COVID-19 in Europe alone. 

European health systems are faced with a ticking time bomb and there is no easy fix.

In the short term, many European countries continue to resort to recruiting outside of their borders. This means that African health workers are filling gaps in the European healthcare workforce. For example, as part of its aggressive recruitment campaign for health workers across the African continent, the United Kingdom introduced the Health and Care Worker visa, aiming to “make it cheaper, quicker and easier for healthcare professionals to work in the UK” at the height of the COVID-19 pandemic. But the problem is that Europe’s recruitment practices to address its workforce shortages are exacerbating concerns for African countries already experiencing many challenges in developing, managing and retaining their human resources for health.

In its report ‘Health and Care workforce in Europe: time to act’, the WHO sets out a ten-step action plan for European health systems to address their health workforce crisis. While this analysis provides valuable insights into the dire state of Europe’s health workforce, the wider picture and especially the repercussions of Europe’s policies on Africa’s health workforce is missing.

There is a clear case for an Africa-Europe joint approach on planning, training and managing the health workforce they both need. As Europe’s population ages and healthcare demands rise, the health sector is a driver for employment in Africa, where the population is predominantly young and keen for more education and skilled job opportunities.

In its forthcoming new Global Health Strategy, the European Union stakes a claim for its leadership in health to be demonstrated by meeting its responsibilities as a credible external actor. A clear first step in this regard would be for European healthcare systems to finally recognise the costs of recruiting African health workforces and to compensate their African counterparts when doing so. In the long run, the artificial division between the EU’s internal and external policies must be addressed and African health policymakers should be included in discussions when European health workforce policies are being shaped.

Health workforce mobility will always be a reality and workers should not be punished for seeking better living and employment conditions. However, Africa will not be able to meet its goal of building a resilient health workforce if the EU does not shift its practice of recruiting outside of its borders when addressing worker shortages. Solutions for shortages across Africa and Europe should be evaluated in partnership and supported by systemic investments. With proper planning, a common skills agenda and enhanced retention strategies, the workforce situation could improve on both continents, while also ensuring better working and living conditions.

As we prepare for a cold and long winter, let’s not forget about our health and especially those who care for it.

This article highlights key themes that will be discussed at our annual State of Europe event, entitled ‘Making sense of transitions in an age of crises: a new social contract for a new era‘, on 27 October 2022.

The views expressed in this #CriticalThinking article reflect those of the author(s) and not of Friends of Europe.