The Lancet: Health workers as agents of change and curators of knowledge

14 July, 2022

Dear HIFA colleagues,

Below are selected extracts from a Lancet Comment that introduces a new report: Probable Futures and Radical Possibilities: an Exploration of the Future Roles of Health Workers Globally [ ], by the UK All-Party Parliamentary Group on Global Health (APPG).

CITATION: Health workers as agents of change and curators of knowledge

Nigel Crisp et al. The Lancet 2022

Published: July 12, 2022 DOI:


There are critical shortages of health workers globally... many health workers are exhausted and demoralised, and there are problems with recruitment and retention.

We, as a group of UK parliamentarians and expert advisers, undertook a review of the future roles of health workers globally, looking forwards 15–20 years... The report is based on discussions with people around the world that revealed much common thinking about probable futures...

Perhaps the biggest challenge for the future is how health systems and health workers can best address the wider social, commercial, environmental, and political determinants of health, which have far greater impact than health systems on wellbeing, health, life expectancy, and life chances. We argue... for health workers to become agents of change and curators of knowledge who, in addition to their clinical, research, management, or technology roles, can support, facilitate, guide, and influence all those actors outside the health sector in communities, local government, businesses, schools, and workplaces who do so much to shape health and wellbeing...

We recognise that some health professionals feel their roles have been diminished in recent years. Our vision for health workers as agents of change and curators of knowledge reasserts their professionalism in a new and different way...

The 15 recommendations in our report propose that governments and health leaders set out their vision, mobilise society around it, invest in health workers, and create more flexible working conditions for the health workforce...


As stated in the report's summary: 'The central message of the report is therefore that health workers will need to take on a strengthened role as agents of change and curators of knowledge able to support, influence and guide patients, the public and people working in other sectors.'

'The report proposes a vision for health for the future [where]

- There is a common effort across all sectors to improve care, prevent disease, and create health – with the links between health and education, employment, the physical, social and political environment and the economy well understood and providing the basis for shared policy and action

- Health professionals are agents of change and curators of knowledge – who as well as undertaking their own specific roles are able to influence, inform, support, develop and facilitate action by members of the public and organisations in all aspects of health and care

- Most care, treatment and support are delivered in homes and communities – in person and virtually by multi-disciplinary teams working in partnership with patients, families and communities, using the latest data and technology, and with easy access to more centralised specialist services when these are needed.'

I welcome the focus of this report on knowledge and indeed the ability to access, interpret and act on reliable healthcare information is the foundation of health.

I have not had a chance to read the report in full, but for me the report raises questions. Do (all/most) health workers 'need to take on a strengthened role as agents of change and curators of knowledge'? Or do they already, by and large, have more than they can handle without a massive increase in support for their core activities? On HIFA we have discussed at length about the SEISMIC needs of health workers [skills, equipment, information, systems support, medicines, incentives (including a decent salary), and communication support]. A health system that is more health-worker-centred (and not just patient-centred) is needed. There are no short-cuts.

I look forward to hear your thoughts. Please email the HIFA forum:

Best wishes, Neil

Neil Pakenham-Walsh, Global Coordinator HIFA,

Working in official relations with WHO