Africa: Lack of Doctors and Nurses Killing AIDS Patients, Says Doctors Without Borders

According to a new report by Doctors Without Borders (DWB), a severe lack of health workers is one of the biggest impediments to providing people with HIV/AIDS drug therapy in southern Africa.

In the Thyolo district of Malawi, a single medical assistant sees up to 200 patients per day, the report said. At a DWB clinic in Khayelitsha, a suburb of Cape Town, nearly 6,000 people are currently receiving antiretrovirals. However, the number of people starting treatment dropped from 270 last May to 100 in December mainly due to the lack of health workers.

"The international community says it wants to achieve universal access, and in Khayelitsha we were coming close, but at a certain point things started to collapse," said Eric Goemaere, who heads DWB in Khayelitsha.

More than 70 percent of Africans who need treatment are still waiting. South Africa has 74 doctors and 393 nurses per 100,000 people, compared to 247 doctors and 901 nurses per 100,000 in the United States. In Lesotho, there are only five doctors and 63 nurses per 100,000. In Malawi, there are two doctors and 56 nurses per 100,000; Mozambique has three doctors and 20 nurses per 100,000.

The report said countries could cope with the crisis by "task-shifting" -- allowing nurses to do work normally assigned to doctors, medical assistants to take over the work of nurses, and enlisting more community workers.

The report said donor governments that pay for antiretroviral treatments and new clinics are not willing to contribute toward the salaries of staff needed to operate them. It said the US Millennium Challenge Account had contributed $140 million to improve physical infrastructure at health facilities, but no plans had been made to recruit the estimated 600 additional health care workers needed to staff the facilities.

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