Prescription for Africa
The infectious diseases and high rates of infant and maternal mortality that cast such a shadow over the future of Africa will never be prevented or treated successfully as long as the continent lacks a basic corps of nurses, doctors, pharmacists, and other health-care workers. When the G8 industrialized nations gather in Scotland next month, they should commit to subsidizing the salaries of African health workers to keep them from leaving their home countries in search of higher pay and better conditions in wealthier countries.
AIDS has both put this shortage in sharp relief and worsened it, since the disease has killed thousands of health workers in the prime of their careers. All the well-intentioned efforts of non-government organizations, the UN's Global Fund to Fight AIDS, Tuberculosis, and Malaria, and President Bush's initiative to combat AIDS are limited by the lack of personnel on the ground for both prevention and treatment programs.
Inadvertently, wealthier nations contribute to this problem by wooing African health professionals with salaries that their home countries cannot come close to matching. In 2002-2003, more than 3,000 nurses from African countries moved to the United Kingdom. Of the 1,200 physicians trained in Zimbabwe in the 1990s, just 360 remained by 2001. At last year's international AIDS conference in Bangkok, the US AIDS coordinator, Randall Tobias, said that an Ethiopian had told him there were more Ethiopian-trained physicians in Chicago than in all of Ethiopia.
While health-care workers from Africa should not be prevented from seeking work in wealthier countries, the G8 nations should agree not to recruit on the continent, while they are simultaneously trying to bolster health cadres in sub-Saharan Africa. In some countries, public funding is so weak that trained workers cannot find jobs. Kenya has 4,000 unemployed nurses.
Physicians for Human Rights, a Boston-based non-profit, consulted with international public official experts to put a figure on what it would cost to fill the gap of about 1 million health professionals: $2 billion in 2006, more in succeeding years. African countries, which would be expected to provide a portion of the total, would use donations not to try to equal Western salary levels but just to provide decent wages, incentives to practice in underserved areas, more training, and improvements in workplace safety.
British Prime Minister Tony Blair has said he wants the G8 nations to focus more on relieving poverty in Africa. The PHR report provides a blueprint and a cost estimate for one necessary step in achieving this goal. An Africa without a stable workforce of trained health professionals will never escape the grip of disease or poverty.
