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World Health Organization
We now have abundant evidence demonstrating that progress in health in the poorest countries will not be possible without strong national health systems for which the workforce is essential. The workforce determines health outputs and outcomes, drives health systems performance, and commands the largest share of health budgets. Yet shortages are widespread, with a gap of more than 1 million health workers estimated for Africa alone. Uneven distribution deprives many groups of access to life-saving services, a problem compounded by accelerating migration in open labour markets that draw skilled workers away from the poorest communities and countries. In many public systems, worker productivity is very low, and some private systems suffer from poor work quality because of commercial pressures. Unless we are able to overcome the workforce crisis, neither priority disease initiatives nor health systems strengthening will succeed.