WHO Recommends More Than 4M Workers Be Hired To Provide HIV/AIDS Services In Developing Countries

Main Category: HIV / AIDS
Article Date: 15 Jan 2008 - 12:00 PDT

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The World Health Organization is recommending that more than four million workers be hired to administer antiretroviral drugs, provide HIV/AIDS counseling and handle other tasks in developing countries as part of its new guidelines on task shifting, Bloomberg/China Post reports (McLure, Bloomberg/China Post, 1/11).

WHO last week at a conference in Addis Ababa, Ethiopia, released new-task shifting guidelines to address health worker shortages and help expand access to HIV/AIDS prevention, treatment and care services. According to one recommendation included in the task-shifting recommendations, community health workers -- including people living with HIV/AIDS -- safely and effectively can provide HIV/AIDS services in a health facility and in the community (Kaiser Daily HIV/AIDS Report, 1/9). According to UN News Service, the plan aims to expand to "free up" time for physicians and nurses by allowing "less specialized" health workers to perform tasks. It is estimated to take a few months to one year to train a community health worker, compared with three to four years for a nurse and up to eight years for a doctor (UN News Service, 1/10).

According to Bloomberg/China Post, the plan is expected to cost about $7 billion over five years and calls for hiring an additional 2.4 million physicians, nurses and midwives in developing countries to meet the United Nations' goal of providing universal access to antiretrovirals by 2010 (Bloomberg/China Post, 1/11).

Health ministers and experts from 57 countries worldwide participated in the three-day conference, which is expected to produce a call for action on task shifting in an effort to expand access to universal health services. According to Fritz Lherisson, a conference delegate from UNAIDS, 36 of the 57 countries worldwide that face critical health care workers shortages are in Africa (Kaiser Daily HIV/AIDS Report, 1/9).

Related Study
Many African countries have more health care professionals working in wealthier nations abroad than they have working within their borders, according to a study published in the Jan. 10 issue of the journal Human Resources for Health, BBC News reports.

The study, which was conducted by the Center for Global Development, examined census data collected between 1999 and 2001. It focused on the employment of health workers originally from other countries in Australia, Belgium, Canada, France, Portugal, Spain, South Africa, the United Kingdom and the U.S.

The study counted health workers who were born in Africa rather than those who were trained on the continent. Concentrating on the training location rather than place of birth can substantially underestimate the effect of shortages on a country's health system, according to the researchers.

The study found that health care worker losses often occur in countries that experience civil strife, political instability and economic stagnation, BBC News reports. Angola, Congo, Guinea-Bissau, Liberia, Mozambique, Rwanda and Sierra Leone all had civil wars in the 1990s and lost about 40% of their doctors by 2000, according to the study. Mozambique and Angola have more health workers in a single foreign country than domestically, and for every doctor living in Liberia, there are two working abroad, the study found. In Kenya and Zimbabwe, which have experienced economic and political problems, more than half of health workers have left to work abroad, the study found. Mozambique has 75% of its doctors working abroad, followed by Angola with 70%, Ghana with 56%, Kenya with 51%, Rwanda with 43%, Sudan with 13% and Niger with 9%.

Meanwhile, African countries that experience greater economic and political stability, such as Botswana, retained a higher number of health workers, the researchers found. The same was true for poorer countries like Niger, which could be because impoverished countries do not produce many aspiring doctors with the connections or resources necessary to emigrate, the researchers said.

Nick Corby, a policy officer at ActionAID, said brain drain is a "huge threat" to Africa. He added that one of the best ways for countries to retain health workers is to pay them higher salaries, but "health systems in many African countries are woefully underfunded" (BBC News, 1/10).

The study is available online.

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