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Global Health in the Americas

HRSA Administrator Dr. George Sigounas and Principal Deputy Administrator Brian LeClair (far right) convened Senior Staff and the agency's Office of Global Health on April 19 to confer with a delegation from the Pan American Health Organization.

HRSA Administrator George Sigounas, MS, Ph.D. and Principal Deputy Administrator Brian LeClair (far right) convened Senior Staff and the agency's Office of Global Health last month to confer with a delegation from the Pan American Health Organization. PAHO represents 52 member countries and territories in the Americas on behalf of the World Health Organization.

The organization's Director, Dr. Carissa Etienne (second from left), applauded HRSA's efforts in workforce development, disease surveillance through its Regional Offices and grantees, and pioneering work in telehealth - "which extends back to a time when telehealth was science fiction," added Dr. Sigounas. HRSA now funds 3,100 sites nationwide and has spawned a movement in the Americas - with some 100,000 clinicians trained last year alone, according to PAHO.

Dr. James Fitzgerald (far left), PAHO's director of health systems, noted that HRSA is a test bed agency in the western hemisphere for addressing some of the most pressing concerns in global health, chiefly workforce shortages. The migration of healthcare workers from less-developed countries to the industrialized world is a global phenomenon.

"This isn't just an issue here," Fitzgerald said, referring to  care scarcity in the rural America, "it's an issue everywhere."

Moreover, he said, migration trends are hampering efforts abroad to move from an acute, specialty care model to one centered on primary, preventive care and population health - as exemplified by HRSA's half-century-old Community Health Center approach.

He cited Jamaica as one example of a country that is rapidly "losing their nursing workforce to places like the U.S, and Canada" -- accelerated by recent natural disasters that have wracked healthcare facilities in the Caribbean islands. Similar concerns have been heard throughout HRSA from officials in the U.S. Virgin Islands and Puerto Rico in recent weeks and months.

Dr. Sigounas observed that the percentage of foreign-born clinicians in U.S. health care is fast approaching 30 percent. BPHC Associate Administrator Jim Macrae added that "primary care doesn't necessarily get always the attention, it's the hospitals and the specialty practices ... primary care is tough. It's hard to do if you're on the front lines," so better incentives are needed to retain the workforce.

The health center emphasis on collaborative care in an integrated "one-stop shop" allows ambitious clinicians to practice at the highest level in primary care. Among them have been more than 50,000 medical, dental, and mental and behavioral health professionals in HRSA's National Health Service Corps since 1972.

"We have the same interests, we have the same problems, and we are in the same place," Dr. Fitzgerald of PAHO told Dr. Sigounas, who spent 20 years as a professor at the Brody School of Medicine at East Carolina University, specializing in training rural clinicians.

Date Last Reviewed:  May 2018