PHR Library

June 17, 2005

FOR IMMEDIATE RELEASE

Africa Cannot Stop Poverty Without More Health Workers

PHR Releases New Figures: G8 Must Commit $2B in 2006 to Double Doctors, Nurses and Other Health Workers in Africa

Citing a devastating shortage of health care workers in AIDS-burdened countries, Physicians for Human Rights (PHR) today released new cost estimates that would double the number of health workers in sub-Saharan Africa in order to confront the AIDS pandemic and reduce maternal and child mortality over the next five years. PHR is calling for a global investment of US $2 billion in 2006, rising to $7.7 billion in 2010 by all donors, and has calculated the U.S. share as being one-third of the sum needed, or $650 million for 2006, rising to $2.5 billion in 2010. US spending could focus on countries funded under the President’s Emergency Plan for AIDS Relief. The figures released today were calculated by a group that included Lincoln C. Chen, MD, MPH, the Director of the Harvard University Global Equity Initiative and co-chair for coordination of the Joint Learning Initiative (JLI) and Eric A. Friedman, JD, Policy Analyst for Physicians for Human Rights.

Commented Hetherwick Ntaba, OBE, the Health Minister of the African nation of Malawi and a surgeon: “Some countries' health delivery systems are in danger of collapsing because of this human resource crisis. The AIDS pandemic itself impacts negatively on our ability to deal with AIDS because of the toll it takes on our work force. In the middle of all this, the migration of health workers from poor to the rich countries is very unfortunate. It is like the biblical saying, ’For those who have more, more is being given; for those with less, even that is being taken away.’ We ask the G8 to really look at this issue very seriously and offer their support.”

Right now in Africa, a mere 1.3% of the world’s health workers struggle to care for people suffering 25% of the global disease burden. In Malawi, only 10% of the physician slots are filled, while 10 people die every hour of AIDS. 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.

The March 11, 2005 report of the UK Commission for Africa, commissioned by Prime Minister Tony Blair, called for a tripling of the healthcare workforce in Africa:

Training and retaining doctors, nurses and other health service personnel has been neglected. Numbers are down, but so is the quality of work. Many of the best have been attracted abroad. Others – frustrated by working without the drugs or equipment they need – have found better paid jobs outside the health service. Radical action is required. Africa’s health workforce should be tripled through the training of an additional one million workers over a decade. Salaries should be increased to ensure staff are not wooed from their jobs.

Dr. Ntaba noted that the UK government has begun to partner with Malawi on a human resource retention program: “We think this is a good start and urge other countries to do the same.”

The investments in PHR’s costing estimate include:

• Salaries, benefits, and incentives (including salaries and benefits for new health workers, improved salary packages, and economic incentives to encourage health professionals to work in rural and other underserved areas)
• Expanded health worker pre-service training capacity and development of continuous learning and professional development opportunities
• Human resource management and planning
• Training and support for community and home caregivers
• Improving health workplace safety (including universal precautions and other forms of infection prevention and control, post-exposure prophylaxis, psychosocial support, and HIV prevention programs)
• Regional and global support and learning for health workforce strengthening

Modeling on a continent-wide scale suggests that $7.7 billion annually by 2010 could support a doubling of the health workforce. A discussion of the methodology used to calculate these figures is attached, which were calculated by a follow-up study group of the influential Joint Learning Initiative.

PHR observes that the removal of debt from African countries is also an important key to helping countries reach Millennium Development Goals, internationally agreed targets that include large reductions in maternal and child mortality, and improved control and treatment of major diseases.

“African nations must be relieved of debt payments, which currently soak up $1 dollar out of every $2 dollars in foreign aid they receive. But no real gains can be made without a minimum number of health workers on the ground fighting AIDS and these other diseases,” commented Friedman, citing malaria and tuberculosis. “Health care workers represent the very heart of Africa’s health system. The dollars required are eminently affordable and the lives at stake can be measured in the millions. The G8’s responsibility is clear: It must invest in lives to save lives.” 

Related Links

See PHR’s report An Action Plan to Prevent Brain Drain

See Cost Analysis for Health Care Workers for Sub-saharan Africa

Read Related Editorial in the Boston Globe

Physicians for Human Rights (PHR) mobilizes the health professions to advance the health and dignity of all people by protecting human rights. As a founding member of the International Campaign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize.