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Media releases > Human resource crises
Human resource crises undermines global efforts to fight HIV and AIDS
(1 December 2004)
In Malawi there are just 1.6 doctors per 100,000
On World AIDS Day, International development charity VSO warns that the fight against HIV and AIDS in countries like Malawi is being thwarted by a desperate shortage of health workers.
There are just 28.6 nurses and 1.6 doctors per 100,000 in Malawi. South Africa has 56.3 doctors per 100,000; Zimbabwe 13.9 and Tanzania has 4.1. In Malawi, the crisis is being exacerbated by the migration of key staff both to surrounding countries and in particular to the UK. The extremely poor pay and conditions in Malawi has understandably led many health workers to look for better pay elsewhere.
New research undertaken by VSO has found that in 2003 only an estimated 70 of approximately 500 nurses graduating from government-funded training remained in the public health service. The charity’s research also found that 84% of nurses leaving Malawi in 2003 have come to the UK (Source: Malawi MoH). Almost 15,000 new recruits are required for the health sector over the next ten years to replace leavers.
VSO’s research is backed up by a recent study on behalf of the Lancet, which concluded that:
Sub-Saharan Africa needs to triple its current human resources infrastructure by creating one million extra workers to deliver health services.
The paper suggested that:
Effective country strategies should be backed by international reinforcement. Ultimately the crisis in human resources is a shared problem requiring shared responsibility for cooperative action.
Without this extra human capacity, global efforts such as the World Health Organisation's (WHO) 3 by 5 campaign and increased flows of aid money from bodies such as the Global Fund will mean little.
WHO’s 3 June 2005 target of providing vital drugs to 35,000-45,000 patients in Malawi will require one dedicated nurse plus one clinician at 54 health centres. Already overwhelmed, the Malawian health system simply cannot meet the needs of those desperate for treatment.
The capacity issue is not limited to doctors and nurses, the Malawian Ministry of Health itself already running at low capacity, has been affected by the impact of HIV and is struggling with the demands placed upon it. As a result, millions of dollars from the Global Fund, essential to ensure the roll out of antiretrovirals, are not being spent.
VSO has responded and has announced that it will send an increased number of doctors and nurses to Malawi. As part of an initiative with the Department for International Development (DFID) and United Nations Volunteers (UNV), 100s of nurses and doctors will be sent to Malawi over the next few years. However the charity emphasises that simply filling gaps is not the answer.
Penny Lawrence, VSO’s Director of International Programmes says:
It is vital that Malawi has extra doctors and nurses but the long term solutions lie in an international and Malawian commitment to addressing the causes of this shortage and building a training programme to ensure that there are well qualified Malawian health professionals in the future.
Meeting these needs will require significant investment in the public health sector. It also requires an end to the active recruitment of skilled health professionals from Malawi. The UK Government recently put in place measures to restrict NHS staff being recruited from developing countries but a major loophole exists, which allows private firms to continue this practice.
Penny Lawrence says:
The UK Government needs to join up their thinking on the whole issue of migration and put the needs of developing countries first. Although the situation in Malawi is critical, it is not a unique case and action needs to be taken now to prevent the UK exacerbating human resource crisis in other developing countries. Editors' notes- To talk to a spokesperson in the UK or Malawi, please contact Adam Bowers
- A full copy of the report on the impact of migration on the Malawian health service and VSO’s full recommendations is also available on request
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