Severe Shortages of Health Workers Threaten Health Initiatives

Nov 25, 2004, 00:00 ET from Rockefeller Foundation

    LONDON, Nov. 25 /PRNewswire/ -- A new study has for the first time
 quantified the dangerous scarcity of health care workers around the globe,
 ensuring future failures of most developing country health initiatives without
 the effective addition of 4 million health workers to stave off catastrophic
 health, economic and political consequences.
     The report's executive summary will be published in the Lancet's 27
 November edition, along with an accompanying editorial.
     The unprecedented report, Human Resources for Health: Overcoming the
 Crisis, was sponsored by the Rockefeller Foundation, in partnership with the
 World Bank and the World Health Organization, with donors including the Bill &
 Melinda Gates Foundation, Swedish Sida and Atlantic Philanthropies.  The study
 was conducted under the auspices of the Joint Learning Initiative (JLI).  More
 than 100 global health leaders worldwide, coordinated through Harvard
 University, spent two years documenting health worker patterns and developing
 viable solutions.
     "At stake is nothing less than the course of global health and development
 in the 21st century," warns Lincoln C. Chen, MD, JLI co-chair and director of
 the Global Equity Initiative at Harvard University.
     The equivalent of one million new health workers-triple the current
 number-are needed immediately in sub-Saharan Africa to boost collapsing health
 systems.  Climbing rates of HIV, TB, malaria and other pathogens are highest
 in this region, while the density of health workers is the lowest.
     Exacerbating the lean numbers are what the report terms "fatal flows," the
 so-called brain drain of medical professionals from poor countries to wealthy
 ones, and from rural to urban regions.  For example, there are more Malawian
 doctors in Manchester, UK, than in Malawi.  And a scant 50 of the 600 doctors
 trained in Zambia remain in that country.  In wealthy nations, foreign-trained
 doctors often constitute a third of working doctors.  Meanwhile, even in
 developing countries with reasonable health worker populations, rural and
 urban slum communities are often left without the health care they need.
     Health workers are lured by the exponentially greater salaries and safer
 working conditions in richer countries or urban areas.  "I have always wanted
 to go abroad.  I am looking forward to a new life out there," said Melanie
 D'sa, a nurse from Bangalore, India.  "We will be paid $30 an hour in the US.
 Here the average salary for nurses is about 6,000 rupees ($120) a month."
     The JLI's recommendation to scale up the global health work force by at
 least 4 million refers to community health workers as well as doctors, nurses
 and midwives.  These auxiliary workers are vital, making up 75 percent of the
 global health sector.  They substitute for university trained professionals,
 and along with family members, make up the bulk of frontline health workers in
 poor countries.
     In Uganda, there is currently 1 nurse or midwife per 11,365 people, while
 Liberia and Haiti have 1 per 10,000 people.  The whole continent of Africa
 graduates a mere 5,000 doctors a year.  JLI suggests a standard of at least
 2.5 health providers for every 1,000 population.
     Long-term strategies to boost and balance the health work force include a
 call for countries to draft national plans where health human resources are
 prioritized.  Additionally, donor countries and organizations should
 coordinate efforts to earmark $400 million annually to help countries develop
 strategies and capacities for education, retention and recruitment of their
 health work force.  This represents 10% of the estimated $4 billion in aid
 that is devoted to human resources in health.  Even rich countries need to
 become self-sufficient in their health workforce, ending unethical recruitment
 from low-income nations.
     JLI also recommends the creation of an Action Alliance, a short-term
 international body launched to bring together health care and human resource
 experts, to advocate for the importance of sustained attention to workforce
 issues and to hold responsible actors' feet to the fire.
     "While resources like money and drugs become increasingly available, these
 inputs will be wasted without a motivated, skilled, and supported workforce,"
 said Chen.  "The lack of health workers poses perhaps the greatest threat to
 the achievement of the Millennium Development Goals for health by 2015."
     Press Conference
     An international telephone press conference will be held on Wednesday, 24
     9:30 a.m. EST (14:30 London)
     From USA: Dial 1-800-890-8202
     Internationally: Dial + 44 207 081 7190
     Please tell the operator that you would like to join the "Human Resources
 for Health Press Conference."
     Dr. Lincoln Chen, Harvard University, co-author of the report
     Dr. Jo Boufford, New York University, co-author of the report
     Dr. Marian Jacobs, University of Capetown
     Dr. Suwit Wibulpolprasert, Thailand Ministry of Health
     Dr. Giorgio Solimano, University of Chile

SOURCE Rockefeller Foundation