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PHR and African Health Professionals Discuss Bold Solutions to Solve the Health Worker Shortage

For Immediate Release

(Toronto) Physicians for Human Rights (PHR) and colleagues working in sub-Saharan Africa discussed today innovative solutions to the health worker shortage now paralyzing Africa’s health sectors and crippling efforts to fight AIDS, TB, and Malaria. PHR released a document, "Bold Solutions to Africa’s Health Worker Shortage,” highlighting current programs from around the world that are working to solve the health worker shortage. "Building better health systems in Africa takes sustained financial investment and innovation, but big improvements can happen quickly. We wanted to show inventive programs that are already making a big difference on the ground. Solutions are needed immediately. In some areas, whole hospitals have been forced to close their doors because there is not a single nurse or doctor to staff them,” said PHR Senior Global Health Policy Advisor Eric A. Friedman, JD.

"The most pressing issue is ensuring that we retain the health workers trained at our medical schools amidst all these challenges. We need to increase the equipment available to treat the patients, the drugs and all the necessary facilities. The salaries of the health workers need to be increased, and working conditions need to be improved, including protection and insurance for them. This would definitely help some of our health workers remain in this health system, which should be the ultimate goal. Health workers, too, would be a lot happier then,” said Nixon Niyonzima, a medical student who spoke at today’s press conference and a founder of Students for Equity in Health Care, in Kampala, Uganda.

Bold Solutions addresses such issues as retention of health workers in rural areas, AIDS treatment for health workers, and participation of paraprofessionals to extend health care access deeper into communities and ensure community involvement in decisions related to health needs. A majority of these examples focus on rural areas, which typically have only a fraction of the number of health workers as urban areas. This is due to more difficult living conditions, social and professional isolation, and weaker health infrastructure.

PHR, together with allied groups and experts, has determined the need for an investment of more than $2 billion in new funds globally in 2007 (with more to follow in subsequent years) to build the African health systems workforce by increasing pay for workers, providing better training, buying medical supplies, and providing other essentials needed for a functioning health system. Please see the PHR document: 15 Principles for Building African Health Systems. The crisis has been exacerbated by aggressive migration and recruitment of African doctors and nurses by the US and other wealthy countries and by international monetary economic policies that discourage health spending.

Some examples from "Bold Solutions"

UGANDA: A sophisticated training program run by Makerere Medical School in Kampala trains and deploys up to 800 students per semester to work in rural areas, preparing them to return to these areas after graduation. The program addresses complex cultural and practical issues that health professionals must master to be able to provide high quality care in these areas.

SWAZILAND: In a region where advocates say that many health workers would rather die than disclose being HIV-positive to their colleagues, advocates have started the first-ever medical center for health workers to educate, test and care for those at risk or who are HIV-positive. Deaths among health workers due to AIDS are an important contributor to the health worker shortage.

IRAN: "Health Houses" serve 1500 community members each (a village, and a few smaller villages within an hour's walk) and are staffed by two behvarz (trained community health workers) responsible for conducting outreach and health surveillance, often on foot or on motorbike, as well as maternal and child health care, family planning, health education, occupational and environmental health services, disease prevention and follow-up, immunizations and limited treatment.

The World Health Organization and the US President's Emergency Plan for AIDS Relief (PEPFAR) have both identified the lack of qualified health workers and degraded health infrastructure as primary obstacles to the fight against AIDS and to the effective use of foreign aid. Two weeks ago, a bipartisan group of US Senators introduced a bill to help alleviate the problem, the Durbin/Coleman/DeWine/Feingold Senate bill 3775.

Right now in Africa, fewer than 3% of the world's health workers struggle to care for people suffering 24% of the global disease burden, at less than 1% of world health expenditure. According to Malawi's Presidential Political Advisor Hetherwick Ntaba, only 10% of the physician slots are filled, while 10 people die every hour of AIDS in that country. Across Africa AIDS has killed thousands of health care workers, and large numbers of doctors and nurses are migrating to the West, driven out by impoverished health care systems and lured by elaborate recruiting packages by hospitals in G8 countries. For example, while 1200 physicians were trained in Zimbabwe during the 1990s, by 2001 only 360 remained. More than 3,000 nurses from African nations migrated to the United Kingdom in 2002-2003.

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.

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