Work in Progress: Human Resources for Health
Building Knowledge Sharing Capacity for Health Security: a Network of Centers of Global Public Health Excellence
Many of health systems in CAREC countries have a shared legacy, the Soviet-era Semashko model, one of the most influential models in health care organization, management, and financing in the world. This imprint of this model can still be seen in modern-day public health across the region. The Semashko approach was very much focused on epidemiology, with a heavy emphasis on certain communicable diseases and localized threats. It did not address the issues that now preoccupy health system managers across the region: how to manage not just local, but global, health threats, and how to effectively manage the increasing complexity of public health systems.
The consequences of this mismatch between public health systems and the challenges they face came into sharp focus during the novel coronavirus (COVID-19) pandemic that swept the world in 2020. Health system workforces across the CAREC region were stretched to the limit, and at times overwhelmed, exposing gaps in health workforce capacity and governance.
Lack of foundational knowledge
The COVID-19 pandemic revealed a hidden problem: under a legacy system, without the foundational knowledge of health systems governance, social determinants of wealth, and health care financing, the existing curricula of much of the public health training available was often inadequate, failing to equip health system managers to meet the challenges of today and tomorrow. As well as a shared history of the Semashko system, it emerged that CAREC countries also faced common challenges, and could benefit from sharing expertise and knowledge.
In 2024, the CAREC health team began to tackle this issue by forming a human resources for health sub-working group, convening participants from the health authorities of 10 CAREC countries, as well as development partners and Asian Development Bank staff and consultants. Members were mainly interested in investing in education, with a focus on public health and global health. When it came to filling these knowledge gaps, the region wasn’t starting from zero. Research into existing curricula from universities across the CAREC region revealed that the necessary courses were being offered, but they weren’t available across the whole region, with knowledge siloed in individual institutions, with no mechanism for sharing with regional peers.
Centers of Excellence
What was needed was a way for this knowledge to be more widely accessed, and for mutual recognition of academic achievements. The sub-working group set about identifying five centers or academic institutions that were offering degrees in public and in global health, ideally located in five different CAREC countries. These five centers would either have the potential and interest to offer mutually recognized degrees in global public health (e.g., MSc. Global Public Health) or would already be offering mutually recognized degrees in global public health, and would have capacity for becoming a regional center of excellence. These founding institutions would form the CAREC Centers of Global Public Health Excellence Network.The aim of the network was to become a platform for regional collaboration in the field of public health education and a knowledge hub for ministries of health and education. They could twin with local training institutes to develop CPD courses, in-house training and curriculum development. This network was to actively promote knowledge exchange between academic staff members, health experts and students through regular field trips and virtual exchange on pre-selected global health topics relevant to improve health security in the region. Potential topics included health systems for all; globalization and global health governance; global burden of disease; climate change and health; and leadership for global health. In the long term, these five centers of excellence would serve as a network of academic institutions from all over CAREC.
By early 2025, the sub-working group had identified seven selection criteria:
- A competence-based education approach, or the ability to do so, based on the World Health Organization (WHO) competency model for preparing workforce to deliver essential public health functions;
- At least 80% of modules in line with the WHO competency model;
- At least 80% of modules in line with the core subject domains to be included in Master of Public Health Curricula as required by the Agency for Public Health Education Accreditation;
- Willingness to offer continuing professional development (CPD) in the field of public and global health;
- Instruction offered in English and/or Russian;
- National and regional institutional accreditation; and
- Willingness to contribute staff time, effort and potentially other resources to the establishment of a regional network.
Members of the CAREC Centers of Global Public Health Excellence Network
| Country | Institution and program | Strengths |
|---|---|---|
| Georgia | Ilia State University Faculty of Life Sciences and Medicine Master in Public Health and Health Policy | Comprehensive MPH curriculum with relevant modules, including global health. International focus Good ranking International cooperation agreements already in plac |
| Kyrgyzstan | Osh State University International Medical Faculty Master in Public Health | Old, renowned university International focus, including international students Good ranking within Central Asia New Master in Public Health program Interesting CPD courses |
| Pakistan | Health Services Academy Master in Public Health | Comprehensive curriculum with some relevant modules Upcoming Master in Global Health Global Health Institute has research arm under the School of Public Health Long-standing history and good reputation Strong leadership and will for cooperation |
| People’s Republic of China | School of Global Health (co-sponsored by Shanghai Jiao Tong University School of Medicine as well as the National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention (China CDC) Master in Public Health | Renowned Head of newly established Global Health Institute with focus on One Health and Global Health Excellent short-term courses Good existing record of collaboration Strong connections to CDC Innovative One Health focus which is also covered in CPD courses |
| Uzbekistan | International University of Westminster in Tashkent Economics Department Master of Science in Public Health | Strong public health curriculum, including health economics, financing and Interdisciplinary, with a focus on health policy for future policy makers Accredited by University of Westminster, UK Good CPD topics |
Now that the network is formed, the first step will be to develop a joint a master curriculum global public health, common to all of the affiliated network members. This will be available to all 10 CAREC countries can use. The sub-working group is also keen to see the network offer CPD.
The network will also benefit from relationships with three advisory partners: these are, most likely, three universities, the Charité Center for Global Health, the Government of Singapore Department of Health, and the University of Hong Kong’s School of Public Health. They will support the network and its affiliated members with advice on, for example, curricula content, and global certification standards in public health, as well as participating in international conferences. Knowledge exchange in the form of CPD is extremely important, because shared knowledge in health security, health diplomacy, and global health governance, for example, helps the CAREC region to become stronger as a whole. The next step is mutual recognition of each other’s credentials.
Strengthening this foundation will ensure CAREC countries are better prepared for regions health threats and can combine their efforts to protect regional health security.
Written by Jane Parry.
