Biggest Challenge in Fight Against HIV/AIDS Is Shortage of Health Workers in Developing Countries, World Bank Official Says
A shortage of health care workers in developing countries most affected by HIV/AIDS is the biggest challenge facing efforts to combat the disease, Debrework Zewdie, the World Bank's director for the Global HIV/AIDS Program, said Monday at the 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Sydney, Australia, Reuters reports. According to Zewdie, although about two million people living with HIV/AIDS are receiving treatment access, the lack of health services and "brain drain" of physicians and medical researchers in developing countries are adversely affecting treatment programs (Perry, Reuters, 7/23).
According to the World Health Organization's World Health Report 2006, there is a shortage of more than four million health care workers in 57 developing countries. The report said one-quarter of physicians and one in 20 nurses trained in Africa currently work in 30 industrialized countries in the Organization for Economic Cooperation and Development. Sub-Saharan Africa has 24% of the global disease burden but only 3% of the health care work force worldwide and accounts for less than 1% of global health care spending, the report said. The Americas have 10% of the global disease burden, 37% of the health care work force and account for more than half of global health care spending, the report found (Kaiser Daily HIV/AIDS Report, 4/5).
"Our most difficult challenge is not funding but the limited health system capacity in countries with the highest disease burden," Zewdie said, adding, "There is a desperate shortage of doctors, health care workers and researchers who would not only deliver treatment services but also coordinate local operations." According to Zewdie, there also is a need for proper pharmaceutical storage to preserve antiretroviral drugs. "We want to reverse the lack of research culture" in developing countries, Zewdie said, adding, "We want to reverse the brain drain and bring our doctors home."
In related news, Medecins Sans Frontieres at the conference released a report that found although there had been a price reduction in some antiretrovirals, newer and less toxic drugs recommended by WHO have become more expensive. According to the report, the price of some newer antiretrovirals has risen by nearly 500% from $99 to $487. The report also found that issuing compulsory licenses to manufacture generic versions of antiretrovirals and other medications is more effective in reducing prices, compared with negotiating price reductions with pharmaceutical companies.
Karen Day of MSF said, "The lack of competition and dramatically higher prices for the newly recommended WHO first-line (drugs) could mean that people in developing countries may not be able to benefit from improved treatment" (Reuters, 7/23).
Kaisernetwork.org will serve as the official webcaster of the IAS conference. Individuals can sign up for a free daily update e-mail and find more information about conference webcasts online.