Nurses and other health and social care workers have been on the frontline of the pandemic response. Health systems across the world are generally understaffed. This put resulted in severe pressures on nurses and other health workers who had to work around the clock. They often had to work in unsafe conditions. Many were not provided with appropriate personal protective equipment.
Nurses have faced the trauma of being the last to see COVID-19 patients take their last gasps of breath in ICU units. They have equally been traumatised time and again from losing colleagues who became infected. Yet, they have also had to carry on with providing health services not related to COVID-19 response.
Incidentally, last year was celebrated as the International Year of the Nurse and Midwife (IYNM), haven been so designated by the World Health Assembly in 2019. And this year is the International Year of the Health and Care Worker (IYHCW).
World leaders have applauded nurses and other health and social care workers. But we need much more than that. We need to ensure that every country has enough nurses and other health workers. They must also be adequately renumerated, have their working conditions improved and be protected from occupational hazards.
It has to be emphasized that the dire situation faced by nurses and other health workers did not start with the pandemic. Years of austerity measures with cuts in public funding of health and social care led to decline in the real wages of nurses and increasing precarious work. Adequate numbers of nurses have also not been employed as required for safe and effective staffing for health.
This worrisome situation had led to rising incidence of burnout and exit from the profession. The impact of this on the mental health of nurses is devastating. Depression set in for many. And a higher-than-average suicide risk was established in the profession. As Judy Davidson (RN, DNP) of the University of California San Diego ((UCSD) said last year, when a study she led before the pandemic was released: "we do know that suicide amongst nurses is a real issue and that the job has something to do with it".
Governments across the world have to take concrete steps to enable improved employment and protection of nurses and other health workers. In 2016, the United Nations High-Level Commission on Health Employment and Economic Growth established a projected shortfall of 18 million health and care workers by 2030. It noted that, without addressing this envisaged shortage, it would be impossible to achieve the SDG 3.8 target of universal health coverage.
Governments made political declarations of commitment to implementing the far-reaching recommendations of the High-Level Commission. And in 2017, these recommendations were developed into the Working for Health: Five-Year Action Plan for Health Employment and Inclusive Growth which was adopted by the 70th World Health Assembly (WHA).
But the declarations and WHA resolution were not matched with action. If they had been, the impact of the pandemic on nurses, other health workers and indeed the entire populations they care for, would have been less dire than it has been.
Public Services International and its affiliates have been at the fore of efforts to make governments walk their talk and to deepen international norms and conventions that would enable greater investment and protection for nurses and other health and care workers.
We are playing an active role in the ongoing ILO General Survey on “Decent work for care economy workers in a changing economy”, with particular attention to the Nursing Personnel Convention, 1977 (No. 149) and Nursing Personnel Recommendation, 1977 (No. 157). A series of webinars were organised over the last few months which brought together nurses’ unions in all the regions of the world, as part of a robust consultation process.
Civil society and trade unions from the Global South are calling on rich countries’ leaders to stop blocking a proposal to waive vaccine patents.
Monopoly patents or vaccines for all?
PSI also serves as the trade union voice of nurses and other health and care workers in the World Health Organization where we currently represent workers interests in the International Year of the Health and Care Workers Steering Committee, and other international bodies such as the OECD.
Our perspective and demands in all of these are clear and always boldly stated: governments have to invest in universal public health systems, employ adequate numbers of nurses and other health and care workers, and ensure their workplace safety and occupational health.
As we fight and advocate for these fundamentals, we remain unrelenting in demanding that steps are taken to mitigate the impact of the pandemic on nurses and other health workers in every part of the world. One of such steps is ensuring vaccine equity.
In about two thirds of the world’s countries, most nurses and health workers have not been able to get vaccinated, while in the richest countries, the vaccination process is already on full steam. This “vaccine apartheid” is as a result of the for-profit interests of big pharmaceutical corporations, resting on intellectual property rights.
At the beginning of the pandemic, we were the first workers’ voice to demand the suspension of patents on COVID-19 medications and vaccines to “avoid commercial activities”, as part of our “COVID-19 Emergency – PSI priorities and perspectives”. PSI and its affiliates have since then led advocacy for the WTO TRIPS waiver. PSI affiliates across the world piled up pressures on the governments of their countries to support the call for a waiver.
We are thus happy that these efforts seem to be making a headway, with the recent support of the United States government for the waiver. But we must not rest on our oars. We must set it as a standard that people always come first before profit. And health, particularly of those who take care of the health of all of us, always come before the wealth of a few corporations and billionaires.
As we commemorate this year’s International Nurses Day, we salute all nurses and our affiliates organising in the nursing profession across all regions of the world. Standing together, we will continue to organise and advocate for the required investment and protection of nurses and the provision of well-funded universal public health services. From lessons that we can all draw from the pandemic, and which must be made clear to decision-makers globally and in every country, taking these steps is a necessity to safeguard humanity.