IV 118th CONGRESS 1st Session H. RES. 389 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 security and global economic prosperity.

Whereas frontline health workers are a critical and cost-effective component to building country resilience and the capacity to save lives, foster inclusive economic growth, develop a strong primary health care system that delivers essential life-saving services, and prevent and respond to humanitarian crises and global health security threats 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 emergencies, conflicts, and natural disasters, was 67-percent higher than the 4 years prior; Whereas, every day, more than 15,000 children die worldwide, 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 largest 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 occupations who work for salaries, stipends, nonmonetary incentives, or on a volunteer basis, including community health 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-multiplier for inclusive economic growth and that health investments provide a 9-fold economic return; Whereas frontline health workers are particularly crucial during natural or complex emergency situations to saving lives and aiding communities to recover, rebuild, and become more resilient; Whereas health workers provide lifesaving care at great personal risk in fragile settings and during disease outbreaks, 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 attacks on health care facilities, transport, and personnel, leading to more than 750 health workers killed in countries 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 maternal 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 percent from 2000 to 2019, and this progress has contributed to corresponding productivity and economic growth; Whereas access to a well-trained, well-equipped, and well-supported frontline health workforce is critical to reversing lost gains from COVID–19, including the first global reduction 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 countries and provide services where they are most needed, especially in rural and hard-to-reach areas; Whereas frontline health workers too often work without reliable access to the resources and equipment they need to adequately protect themselves and their patients, including 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, compensating, protecting, and supporting frontline health workers 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 systems have been further strained since the COVID–19 pandemic began; Whereas the Commission on Health Employment and Economic Growth found that increased health workforce employment is critical to saving lives, spurring inclusive economic growth, and promoting women’s empowerment, as women comprise at least 70 percent of the health workforce and make up 90 percent of health workers in patient-facing roles, but they face a significant gender pay gap and hold just 25 percent of health leadership positions; and Whereas successful implementation of the United States global health contributions and improved health and socioeconomic outcomes for those served by these programs requires integrated, flexible, and cross-sectoral programming: Now, therefore, be it

That the House of Representatives— (1) reaffirms the central role of local frontline health workforces in achieving the objectives of global health programs administered by the Department of State, the United States Agency for International 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 institutions, nongovernmental organizations, and private sector organizations supported by the United States; (2) acknowledges that in the aftermath of natural 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 adequate 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 protection and ability to respond effectively during humanitarian 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 and populations in conflict-affected States from deliberate and indiscriminate attacks and targeting; (5) calls on all relevant Federal agencies to utilize existing flexibilities to implement integrated and cross-sectoral programming across global health accounts to strengthen frontline health workforce teams and the systems supporting them with concrete 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 outcomes, and to prioritize the mobilization of additional private and public resources to ensure that frontline health workers are able to advance sustainable global health progress around the world.