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BRUCE COMPTON

Rapid and transformative change has profoundly affected nearly every aspect of our lives these last few years. Health care workers around the world have endured high stress levels and enormous tolls on their well-being, leading to burnout and staffing shortages. The confrontation between science and politics around COVID-19 showed how easily trust could be eroded, exacerbating challenging pandemic circumstances for those in health care. The pandemic also significantly magnified long-existing health inequities, including the disproportionate toll of COVID on under-resourced communities early on and at the height of the pandemic. These and many other challenges are realities both at home and abroad. As a ministry of the universal Church, we must think globally, even as we attend to urgent local matters, recognizing the potential impact of our actions on people worldwide.

To examine changing global health and technology trends and their impact on the future of global health partnerships, CHA enlisted the support of Accenture's social impact business, Accenture Development Partnerships, to address social, economic and environmental issues globally. Their findings reveal close alignment of global and domestic health trends and challenges brought by either the pandemic or other recent factors, highlighting the critical importance of strategic global health partnerships.

FUTURE OF GLOBAL HEALTH PARTNERSHIP MODELS
COVID served as a reality check for countries worldwide, raising questions about the overall state of global health security. Global health security is the existence of strong and resilient public health systems that can prevent, detect and respond to infectious disease threats wherever they occur in the world.¹ CHA and Accenture Development Partnerships explored the immediate impacts of the pandemic over the past several years in these areas: the health sector; significant shifts in the global health agenda; and technological changes that will revolutionize the future of health care. Findings and recommendations from the study will support the Catholic health ministry's future thought leadership and advocacy agendas.

Even with all we have recently experienced, most countries are still unprepared for future pandemic threats. The push to build more resilient health systems has never been more significant. As the world seeks to increase global health security and preparedness for future pandemics, the importance of working together and rebuilding trust cannot be underestimated.

CHA's study with Accenture points to four critical elements — in addition to top trends to consider (see sidebar on page 70 for further details) — to create successful future global health partnership models.

1. Creating More Horizontal and Equitable Relationships: Growth of relationships between donors and grantees and high-income and low-income countries.
2. Building Strategic Partnerships: Fewer, bigger and better partnerships to address health challenges at scale.
3. Using Untapped Collaborators: Emergent and underutilized health partners, such as community health workers and others, are valued as part of mainstream and integrated health strategies.
4. Partnership Growth Through Digital Technologies: Expansion of partnerships through digital technologies, enabling accessibility, ease of collaboration and real-time communication.

MOST SIGNIFICANT TRENDS IN GLOBAL HEALTH

Health Equity
In the U.S., nearly 90% of all health care executives have health equity initiatives as part of their core business strategies. As a Catholic health ministry, a similar percentage of systems have pledged to confront racism by achieving health equity in CHA's We Are Called pledge.² Those on the margins often struggle to navigate the complexities of traditional health paradigms, leaving people lost or altogether excluded. We cannot deny the reality that COVID's impacts were experienced unequally across the world, with already vulnerable groups enduring far more significant disease burden. Again, Catholic health care's work in this area is substantial at home and abroad. If we do not put our own houses in order, we cannot influence the world stage.

Workforce Shortage
The World Health Organization estimates a global shortage of 10 million health care workers by 2030, with nurses representing a majority of this gap.^{3, 4} Globally, 90% of national nurse associations reported concerns that the pandemic is driving increasing numbers of people to leave the profession.⁵ The ongoing workforce shortage crisis, fueled by decades of underinvestment, was intensified by COVID, leading to an acceleration of staffing shortages and increased burnout.

In "From Competition to Collaboration," a policy brief on global workforce developed by the UK Tropical Health Education Trust, partners are offered guidance by suggesting an ethical route through workforce shortage challenges, focusing on the fate and well-being of each country's national health service and strengthening the health care of low- and middle-income countries.⁶

Many health care professionals from low- and middle-income countries migrate to other nations to find employment, as their home countries are unable to allocate enough resources to health. These workers are a precious resource to these nation's communities, something that their vulnerable populations so desperately need. As we continue to struggle with our workforce issues, the effects of recruitment from low- and middle-income countries is an important factor to consider.

Climate Change
Recognized by many as the most significant global health threat of the 21st century, climate change is identified as a global health emergency by leading health institutions worldwide. Human health is affected by climate change's direct and indirect impacts as a significant determinant of our health outcomes. The pandemic exposed the weak public health systems and disaster preparedness strategies currently in place in many countries. Many voices call for a renewed and integrated approach to global health to prepare for future international health threats.

Established by the Centers for Disease Control and Prevention, the One Health initiative is a collaborative strategy uniting experts from multiple disciplines and sectors.⁷ The initiative works at local, regional, national and global levels to achieve optimal health outcomes. One Health recognizes the interconnectedness of all living creatures and their shared environment. As a Catholic health ministry, we share in this initiative as a vital partner in Pope Francis' Laudato Si' Action Platform, which calls us to sustainability and a spirit of integral ecology.⁸

CONCLUSION
With changing population dynamics and the use of virtual technology for better access to care, opportunities exist for transformation in global health, including the possible expansion of more Catholic health care outside of the U.S. As we think about the trends and issues identified through this recent research, we should continue to discern how we are called to continue the healing ministry of Jesus in a changing world.

To see the full findings of this report, "View From 2022: A Look at the Changing Global Health Landscape and Future of Partnerships," visit chausa.org/globalhealth.

BRUCE COMPTON is senior director, global health, for the Catholic Health Association, St. Louis.

NOTES

1. "What is Global Health Security?," Centers for Disease Control and Prevention, May 2022, https://www.cdc.gov/globalhealth/security/what.htm.
2. "We Are Called," Catholic Health Association, https://www.chausa.org/cha-we-are-called.
3. "Health Workforce," World Health Organization, https://www.who.int/health-topics/health-workforce#tab=tab_1.
4. "Nursing and Midwifery," World Health Organization, March 2022, https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery.
5. "COVID-19 Pandemic One Year On: ICN Warns of Exodus of Experienced Nurses Compounding Current Shortages," International Council of Nurses, March 11, 2021, https://www.icn.ch/news/covid-19-pandemic-one-year-icn-warns-exodus-experienced-nurses-compounding-current-shortages.
6. Graeme Chisholm, "From Competition to Collaboration," Tropical Health and Education Trust, https://www.thet.org/wp-content/uploads/2019/07/From-Competition-to-Collaboration_THETPolicyReport-1.pdf.
7. "One Health," Centers for Disease Control and Prevention, https://www.cdc.gov/onehealth/index.html.
8. Laudato Si' Action Platform, https://laudatosiactionplatform.org/.

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