The united nations (UN) formulated the 2030 Sustainable Development Goals (SDGs) (Figure 1). These are the blueprint to achieve a better and more sustainable future for all people worldwide, according to the UN. They address global challenges, including those related to poverty, inequality, climate, environmental degradation, prosperity, peace, and justice. The Goals interconnect and are planned to be reached by 2030. Goal number 3 states: “Ensure healthy lives and promote well-being for all people of all ages.” This specific goal consists of several points (Figure 2) which includes a substantial increase in health financing and the recruitment, development, training, and retention of the health workforce. Currently, there is a shortage of 18 million health workers around the world, to meet the demands expected to be present n 2030. To achieve the various health-related goals by 2030, these are the additional number of workers that are needed. In 2017, the health workforce was defined as a key mandate in the WHO cancer resolution, showing the importance the UN sees in the health workforce.
Figure 1 - The united nations 2030 Sustainable Development Goals:
Figure 2 – United Nations sustainable development goal 3:
The mapping of medical and clinical oncology workforce around the world demonstrated the clear inequalities between high income and low-income countries worldwide. Cancer itself is also different in all countries worldwide, with different country-specific distributions.
According to the WHO workforce staffing tool, there are optimal provider estimations for the various physicians required per 100 patients:
Medical oncologist: 0.5-0.8, radiation oncologist 0.2-0.3, medical physicist 0.1, surgical oncologist 0.2, pediatric oncologist 6.6.
Another important goal mentioned is to achieve universal health coverage by expanding coverage and services. This should be done by identifying gaps and inefficiencies in the cancer workforce and estimating workforce requirements for strategic staffing. Policy formulation and technical support need to be standardized. The health system capacities and workforce competency need to be defined.
Dr. Trapani concluded his talk with some take-home messages. The supply and demand gap analysis is the starting point for a cancer workforce dialogue, but it is not the only goal. Appropriate organizational and managerial solutions are needed to optimize the existing workforce, ensuring the quality of training and service delivery. Universal health coverage cannot be achieved without rapid scale-up of the workforce. The workforce needs must be linked to national priorities and implemented in cancer programs. Effective short-, medium-, and long-term strategies need to be implemented. Finally, WHO provides technical support and policy guidance for workforce capacity building.
Presented by: Dario Trapani, European Institute of Oncology, Milan, Italy
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 European Society for Medical Oncology Congress (#ESMO18), October 19-23, 2018, Munich Germany