Shortage of Health Workers in Southern Africa Undermining Access to HIV/AIDS Services, Report Says
A shortage of health workers in Southern African countries is undermining access to antiretroviral drugs in the region, according to a Medecins Sans Frontieres report released on Thursday, the AP/Houston Chronicle reports. According to the AP/Chronicle, the report focused on the conditions in South Africa, Malawi, Mozambique and Lesotho.
The report found that South Africa has 393 nurses and 74 physicians per 100,000 people; Lesotho has 63 nurses and five physicians per 100,000 people; Mozambique has 20 nurses and three physicians per 100,000 people; and Malawi has 56 nurses and two physicians per 100,000 people. According to the report, Africa has increased access to antiretroviral drugs among people living with HIV/AIDS from 100,000 people in 2003 to 1.3 million in 2006. However, the shortage of health workers is preventing further expansion of drug access programs, the report found.
The report suggested that countries would be able to manage the crisis by shifting duties normally assigned to physicians to nurses. This would allow medical assistants to do the work normally done by nurses and increase the involvement of community health workers. Malawi already has adopted programs to shift work among nurses, physician and assistants, and a plan recently adopted by South Africa shifts treatment from hospitals to community-based care. Lesotho also has implemented a nurse-based treatment system; however, the country does not have enough nurses to successfully run the program (Nullis, AP/Houston Chronicle, 5/24).
The report promotes programs that allow qualified nurses and medical assistants to prescribe drugs to people living with HIV, as well as tuberculosis. It also called on governments to fund more health care workers and improve their wages and working conditions. It also asked donors, including the International Monetary Fund, to repeal policies that prohibit funding for health care salaries and other recurring costs.
"More pills and more infrastructure will not improve the problem," Eric Goemaere, head of MSF in South Africa, said at a press conference in Johannesburg, South Africa. He added, "We have another bottleneck, and that is health care staffing." It is "hypocrisy" for governments and international donors to commit themselves to the goal of providing universal access to antiretrovirals while failing to provide funding for the staff that prescribes the drugs, Goemaere said (Simao, Reuters Health, 5/24).
The report is available online. Note: You must have Adobe Acrobat to view the report.