Global Policy Forum

Throughout much of Africa, the shortage of trained medical personnel is hurting the effort to prevent and treat HIV/AIDS, not to mention other diseases, including malaria and tuberculosis, that are endemic in parts of the continent. Nongovernmental organizations, including Cambridge-based Physicians for Human Rights, had hoped that leaders of the Group of Eight nations would agree to commit major new resources to this problem at their recent meeting in Russia, but they failed to do so. This should not prevent the United States from taking a strong position on its own.

According to an estimate last year by Physicians for Human Rights, doubling Africa's health workforce, which would still not meet the full need, would cost about $2 billion in the first year and $7.7 billion by the fifth year.The shortage of doctors, nurses, and community health workers is a two-sided problem in many developing countries. Not only do many countries lack the universities to train and educate all the personnel they need, but often the nurses and doctors they do produce decide to leave Africa for the better pay and more comfortable living and working conditions of the industrialized world. This brain drain is worsened by the inability of many countries, including the United States and Britain, to provide enough nurses and doctors for their own populations' needs, especially in inner-city clinics and rural areas.

It would be unjust and a violation of Africans' rights to deny them the right to work in other countries. But a comprehensive solution to this problem would go beyond funds for training and better pay for medical personnel in Africa to include commitments by industrialized nations to educate more of their own doctors and nurses and to curb recruitment in underserved areas. The leaders of the industrialized countries should also review the terms that developing countries must meet to secure international loans. Governments are often required to shrink the public sector, including health services, to meet lenders' demands.

Some of the shortage can be addressed by ensuring that trained personnel are not burdened with tasks that could be done by others. It does not take a doctor to draw blood, and community health workers can be trained to do much of the HIV/AIDS counseling that nurses do. US officials have assisted countries with this task-shifting, which often requires changing local regulations. US officials are also helping countries get trained professionals to serve -- and remain -- in African rural areas.

Providing AIDS drugs is a great step forward, but the industrialized countries will fail in addressing the full dimensions of the AIDS pandemic if they do not help Africa build a stronger corps of trained health workers.

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