IV 
118TH CONGRESS 
1ST SESSION 
H. RES. 389 
Acknowledging the essential contributions of frontline health workers to recov-
ering progress and further expanding and sustaining gains in global 
health, saving the lives of millions of women, men, and children around 
the world, and strengthening the United States national security and 
global economic prosperity. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 11, 2023 
Mr. BERA (for himself and Mrs. KIGGANS of Virginia) submitted the following 
resolution; which was referred to the Committee on Foreign Affairs 
RESOLUTION 
Acknowledging the essential contributions of frontline health 
workers to recovering progress and further expanding 
and sustaining gains in global health, saving the lives 
of millions of women, men, and children around the 
world, and strengthening the United States national se-
curity and global economic prosperity. 
Whereas frontline health workers are a critical and cost-effec-
tive component to building country resilience and the ca-
pacity to save lives, foster inclusive economic growth, de-
velop a strong primary health care system that delivers 
essential life-saving services, and prevent and respond to 
humanitarian crises and global health security threats 
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•HRES 389 IH 
from infectious diseases, including COVID–19, Ebola, 
and HIV/AIDS; 
Whereas the estimated 235,000,000 people in 2021 affected 
by humanitarian crises, including public health emer-
gencies, conflicts, and natural disasters, was 67-percent 
higher than the 4 years prior; 
Whereas, every day, more than 15,000 children die world-
wide, mostly from preventable causes, and 810 women die 
due to pregnancy or childbirth-related complications; 
Whereas, every year, millions of people succumb to HIV/ 
AIDS, tuberculosis, malaria, and other treatable and 
often preventable chronic conditions; 
Whereas an estimated 665,000,000 people contracted 
COVID–19 from 2020 through January 2023, and the 
World Health Organization recorded close to 15,000,000 
excess deaths globally in 2020 and 2021, making it the 
most devastating pandemic in modern times; 
Whereas the COVID–19 pandemic threatened the global 
economy and caused trillions of dollars in economic 
losses; 
Whereas a shortage of available health workers was the larg-
est constraint to ensuring the continuity of essential 
health services during the COVID–19 pandemic, leading 
to service disruptions and gaps in care; 
Whereas frontline health workers are leaving the profession 
at alarming rates due to being overburdened and high 
levels of burnout; 
Whereas frontline health workers include a range of occupa-
tions who work for salaries, stipends, nonmonetary incen-
tives, or on a volunteer basis, including community health 
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•HRES 389 IH 
workers, midwives and other perinatal health workers, 
nurses, pharmacists, doctors, and surgeons; 
Whereas the World Health Organization reports that the 
world will face a shortfall of at least 10,000,000 health 
workers by 2030 without immediate and concerted action, 
particularly in low- and middle-income countries, many of 
which are in sub-Saharan Africa and Asia, and these are 
regions that have the greatest share of the global disease 
burden and the highest number of preventable deaths, 
and from which many emerging and reemerging global 
health threats originate; 
Whereas nations with healthy populations are more likely to 
be productive, prosperous, and peaceful, while countries 
with poorer health are more prone to instability, conflict, 
and extremism; 
Whereas the United Nations Secretary-General’s High-Level 
Commission on Health Employment and Economic 
Growth found that health employment is a force-multi-
plier for inclusive economic growth and that health in-
vestments provide a 9-fold economic return; 
Whereas frontline health workers are particularly crucial dur-
ing natural or complex emergency situations to saving 
lives and aiding communities to recover, rebuild, and be-
come more resilient; 
Whereas health workers provide lifesaving care at great per-
sonal risk in fragile settings and during disease out-
breaks, such as the between 80,000 to 180,000 health 
and care workers estimated to have died from COVID– 
19 in the period between January 2020 to May 2021; 
Whereas, since 2020, there have been more than 2,350 at-
tacks on health care facilities, transport, and personnel, 
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•HRES 389 IH 
leading to more than 750 health workers killed in coun-
tries in conflict and impeding access to essential health 
services for millions while exacerbating crises; 
Whereas United States leadership and investment have led to 
dramatic successes in global health outcomes, including 
the reduction of child mortality by 60 percent and of ma-
ternal mortality by 38 percent from 1990 to 2020, the 
reduction of new HIV infections by 31 percent from 2010 
to 2020, and the decrease in malaria mortality by 38 per-
cent from 2000 to 2019, and this progress has contrib-
uted to corresponding productivity and economic growth; 
Whereas access to a well-trained, well-equipped, and well-sup-
ported frontline health workforce is critical to reversing 
lost gains from COVID–19, including the first global re-
duction in life expectancy in over half a century, and the 
efficacy and sustainability of United States global health 
programs; 
Whereas frontline health workers are a trusted workforce who 
are the first, and often only, link to health services for 
millions of people living in low- and middle-income coun-
tries and provide services where they are most needed, es-
pecially in rural and hard-to-reach areas; 
Whereas frontline health workers too often work without reli-
able access to the resources and equipment they need to 
adequately protect themselves and their patients, includ-
ing personal protective equipment, clean water, decent 
toilets, and handwashing facilities with soap, limiting 
their ability to provide essential health services to the 
communities they serve; 
Whereas partnerships with civil society organizations and the 
private sector in adequately training, equipping, compen-
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•HRES 389 IH 
sating, protecting, and supporting frontline health work-
ers help countries achieve progress toward global health 
goals; 
Whereas, despite the key role of frontline health workers in 
improving health, advancing peace and security, and 
spurring economic growth, the World Bank and the 
World Health Organization estimate that, prior to the 
COVID–19 pandemic, at least half the world’s population 
lacked access to essential health services, and health sys-
tems have been further strained since the COVID–19 
pandemic began; 
Whereas the Commission on Health Employment and Eco-
nomic Growth found that increased health workforce em-
ployment is critical to saving lives, spurring inclusive eco-
nomic growth, and promoting women’s empowerment, as 
women comprise at least 70 percent of the health work-
force and make up 90 percent of health workers in pa-
tient-facing roles, but they face a significant gender pay 
gap and hold just 25 percent of health leadership posi-
tions; and 
Whereas successful implementation of the United States glob-
al health contributions and improved health and socio-
economic outcomes for those served by these programs 
requires integrated, flexible, and cross-sectoral program-
ming: Now, therefore, be it 
Resolved, That the House of Representatives— 
(1) reaffirms the central role of local frontline 
health workforces in achieving the objectives of glob-
al health programs administered by the Department 
of State, the United States Agency for International 
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•HRES 389 IH 
Development, the Department of Health and Human 
Services, including the Centers for Disease Control 
and Prevention, the Department of Defense, and 
other relevant agencies, as well as multilateral insti-
tutions, nongovernmental organizations, and private 
sector organizations supported by the United States; 
(2) acknowledges that in the aftermath of nat-
ural disasters, disease outbreaks, and conflicts, 
frontline health workers perform critical services 
under difficult working conditions, often at great 
personal risk, to save the lives of those without ade-
quate access to medicines, equipment, or safe water 
and sanitation; 
(3) recognizes the damaging effects of gender 
and economic disparities in the health workforce, 
given that most frontline health workers are women, 
and that most of them are unpaid or underpaid; 
(4) urges greater global attention and support 
for local frontline health workers to ensure their pro-
tection and ability to respond effectively during hu-
manitarian and public health crises, including with 
adequate personal protective equipment and other 
essential health product supplies to guard against 
disease, and protection of frontline health workers 
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•HRES 389 IH 
and populations in conflict-affected States from de-
liberate and indiscriminate attacks and targeting; 
(5) calls on all relevant Federal agencies to uti-
lize existing flexibilities to implement integrated and 
cross-sectoral programming across global health ac-
counts to strengthen frontline health workforce 
teams and the systems supporting them with con-
crete targets and clear accountability mechanisms to 
support delivery of resilient and sustainable access 
to essential, quality health services; and 
(6) encourages all relevant Federal agencies to 
facilitate collaborative learning between domestic 
and global frontline health workforce strengthening 
programs to improve effectiveness and health out-
comes, and to prioritize the mobilization of addi-
tional private and public resources to ensure that 
frontline health workers are able to advance sustain-
able global health progress around the world. 
Æ 
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