Four Million Additional Health Workers Needed Worldwide to Fight HIV/AIDS, TB, Malaria, Other Diseases, Analysis Says

Fighting a "massive global shortage" of health care workers through the "mobilization and strengthening of human resources for health ... is central to combating health crises in some of the world's poorest countries and for building sustainable health systems in all countries," according to an analysis by the Joint Learning Initiative -- a consortium of more than 100 health care leaders -- that was published in the Nov. 27 issue of the journal Lancet (Chen et al., Lancet, 11/27). Approximately four million health care workers are needed worldwide in order to effectively fight diseases such as malaria, HIV/AIDS and tuberculosis in developing nations, according to the group, Long Island Newsday reports. The most heavily affected countries are in sub-Saharan Africa, where one million health care workers are needed, according to the analysis (Ricks, Long Island Newsday, 11/27). Three major forces are creating the global shortage of health care workers. First, the "triple threat" of the HIV/AIDS pandemic is increasing workloads among health care workers, exposing them to possible infection and straining their morale, according to the analysis. Second, nurses and physicians moving from poorer nations to wealthier countries is creating a "brain drain" in the most-needy countries, the analysis says. Finally, two decades of "underinvestment in human resources" has "hit economically struggling and politically fragile countries the hardest," according to the analysis (Lancet, 11/27).

Reaction, Recommendations
Lincoln Chen, an author of the report and the director of the Global Equity Initiative at Harvard University, said, "It's scary. Over the last 100 years, we have never had anything like this. Twenty countries are actually losing life expectancy, mostly because of HIV/AIDS" (Long Island Newsday, 11/27). The authors recommend that wealthy nations educate enough of their own residents as nurses and physicians rather than rely on health care workers from African nations. The African Union estimates that developing countries spend $500 million annually to educate health workers who then migrate to Western nations, according to the New York Times. The authors also support efforts to funnel health care workers from wealthy nations and those that voluntarily export health workers -- such as Cuba, India and the Philippines -- to developing nations that are experiencing shortages. The authors also call for the creation of an education fund that would help train health care workers who are not physicians but who can diagnose and treat major diseases in Africa -- such as HIV/AIDS, TB, pneumonia and malaria -- and perform some surgeries, including caesarean-section deliveries, according to the Times (Dugger, New York Times, 11/26). The authors conclude, "Millions of people around the world are trapped in a vicious spiral of sickness and death. For them there is no tomorrow without action today" (Lancet, 11/27).

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