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
"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
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."
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