G8—Why Is There Still No Doctor in the House?

For Immediate Release

• G8 has no strategy for training and retaining the health workers needed to treat millions of people
• G8 has no finance strategy for achieving universal access by 2010: 12 million people need treatment by 2013—but there are only funds to treat 3.5 million, despite a G-8 commitment two years ago at Gleneagles for universal treatment access by 2010
• On June 7, Physicians for Human Rights will take out an advertisement in the World News section of www.nytimes.com to draw attention to the problem

G8 countries meeting this week in Heiligendamm, Germany June 6-8 are still debating how much money to dedicate to fighting AIDS. Yet on the eve of the G8 meeting, and despite a recent declaration to focus on African issues by G8 leaders, so far there are only funds to treat a fraction of the people with AIDS who need medications. Other AIDS services are similarly underfunded, and there is no plan to alleviate the health worker crisis.

"The G8 needs to focus on meeting goals and securing rights, not offer up half measures. Half measures don't work in a fast-moving, infectious epidemic like AIDS," said Physicians for Human Rights' Senior Global Health Analyst Eric A. Friedman.

Two years ago at Gleneagles, Scotland, the G-8 committed in its final communiqué to providing universal treatment access by 2010. But despite the Bush administration's plan to double the President's Emergency Plan for AIDS Relief (PEPFAR) from $15 billion to $30 billion, there remains a huge gap of dying people who are going untreated. PEPFAR has committed to treating 2.5 million people by 2013, when the second phase of the program would be completed. The Global Fund to Fight AIDS, Tuberculosis, and Malaria has committed to continuing treatment for one million people and is currently seeking to triple its budget, which would presumably increase the number of people on treatment.

Emerging UNAIDS estimates put the number of people urgently needing AIDS treatment by 2013 at 12 million. This leaves a massive gap of more than eight million people who will likely die without treatment unless the US Congress expands upon the President's targets, and other G8 countries fill a large portion of the remaining gap.

In addition, Africa is facing a catastrophic lack of health workers, many of whom are immigrating to Western countries. In countries like Malawi, Kenya, Lesotho, Uganda, Nigeria, and others, hundreds of thousands of people are dying from lack of medical attention.

Doctors and nurses in these countries don't make enough money to support themselves and lack the medicines and equipment they need to help patients. They immigrate to countries wealthy enough to pay them and provide decent working conditions, like the United States, Canada, and the United Kingdom. Right now, Lesotho has only 89 doctors for its two million citizens. Ethiopia has only 2,000 doctors for 75 million people. If the ratio were comparable for the US, there would be 8,000 doctors in the US instead of the actual number, which is 800,000.

G8 countries have all endorsed the UN Millennium Development Goals, which include achieving significant reductions in child and maternal mortality and reversing the spread of AIDS, malaria, and other major diseases by 2015. To do this, to save these lives, Africa needs more health workers — by World Health Organization estimates, at least one million more. It needs stronger health systems, and governments that can pay health workers at least enough to support themselves. It needs better human resources management, to make the most of the doctors and nurses who do stay at home.

• Meet its own commitments to universal access to ARV treatment as outlined in the 2005 Gleneagles communiqué.
• Mobilize long-term, predictable funding and technical resources required to enable African countries to develop and fully implement national health plans that include comprehensive, budgeted health workforce strategies that will train, retain, and sustain sufficient numbers of health workers.
• Ensure that the International Monetary Fund and other international financial institutions reform their policies to remove budget and wage ceilings that effectively limit spending on health and education, and that limit countries' ability to invest in health workers and teachers.
• Train enough doctors and nurses to meet needs in their own countries, and implement ethical recruitment practices to avoid actively recruiting from developing countries that would be harmed by losing their health workers.
• Better align financial assistance with countries' own health strategies, and ensure that disease-specific initiatives also invest in health systems.
• Commit to ensuring that African countries have equitable access to a skilled, motivated, and equipped health workforce with decent wages and good working conditions, and, with partners, develop ambitious yet achievable timelines and benchmarks to achieving this goal.

There is considerable attention to the health workforce crisis being paid by African governments and NGOs.

HERE ARE THE DEMANDS OF PHR'S AFRICAN COLLEAGUES:

The Advocacy Working Group of the Global Health Workforce Alliance has issued a call to the G8 to state decisive action on health workforce and health systems.
http://www.healthworkforce.info/advocacy/g8_flyer_v2.pdf

The African Council for Sustainable Health Development, AMREF (African Medical and Research Foundation), and more than 40 other African NGOs have also expressed their view of the importance of health systems and what the G8 needs to do in partnership with African governments and civil society.
Read their statement.

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.