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PhD defence Remco van de Pas

A cosmopolitan outlook on health workforce development

14 sept. 202016:00

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  • Prof. Dr. Wim Van Damme (ITM)
  • Prof. Dr. David Townend (Maastricht University)
  • Prof. Dr. Anja Krumeich (Maastricht University)


Over the last few decades, the global health workforce (HWF) gap has increased.
This gap concerns the skilled HWF required for providing essential health care
services across the world in an equitable manner. This thesis takes a cosmopolitan
outlook, as coined by Ulrich Beck to describe a reflexive modernity, to study what
is required to develop the global health workforce in an equitable manner. It looks
into principles and policies of global health governance to assess what has been
done to strengthen the health workforce. It also shows that there is a paradox in
economic globalization, which leads to a structural problem to invest (sufficiently)
in the health workforce at the national level. Via different methodologies, several
levels of global health policy and health workforce development are studied. This
includes a comparative policy analysis between countries as well as a specific study
on health workforce investment in post –Ebola Guinea. Institutional reform of
the WHO is studied alongside an analysis on the implementation of WHO’s Code of
Practice on the international Recruitment of Health Personnel. The implications of
the securitization of health policy on attacks against humanitarian health workers
are researched. The thesis includes a critical analysis of the current resilience focus
in health systems development. It analyses to what extent global health approaches
in the Sustainable Development Goals are grounded in the Right to Health.

The discussion then outlines the democratic space to reform and strengthen
health workforce development across the different policy levels of global health
governance. This is possible with a more cosmopolitan, transnational outlook to
the health workforce challenge and international labour migration. This requires
that countries take a shared sovereignty approach and find ways to regulate
economic globalization so that it benefits the public good rather than the wealth
of a few. However, current policy trends suggest that countries move away from
these principles, instead of towards them. The thesis ends with suggestions on how
to move beyond this ‘gridlock’ in global health workforce cooperation. It argues
for moving beyond economic growth as a policy imperative, and instead take into
account the planetary boundaries and social foundations as a basis for future global
health workforce governance, known as the Doughnut Economics model.

The thesis is publicly available: