Poor countries should improve their working conditions to keep hold of their doctors and nurses, an international meeting on the global shortage of healthcare workers was told. But rich countries should also train more of their own healthcare workers, the conference agreed.
Experts and policy makers resolved at the five day conference in Uganda, organised by the Geneva based Global Health Workforce Alliance, that countries should strive for self sufficiency in their health workforce, with richer countries giving priority to training and recruiting personnel from their own populations, and governments from poor nations increasing spending on their own health workforce.
The World Health Organization formed the alliance two years ago to tackle the global shortage of healthcare workers.
In the alliance’s first conference, held in Kampala last week, more than 1000 delegates agreed that international institutions and donor countries should provide “sustained and dependable financial support” and that they should begin by immediately fulfilling pledges already made to the health sectors of developing countries.
Low wages, poor working conditions, political instability, and lack of equipment for specialised health personnel are forcing doctors and nurses to leave their home countries and seek better conditions and pay in the United States, Canada, and Europe and in rich African states such as South Africa.
“Rich nations are snatching our doctors,” Uganda’s health minister, Stephen Malinga, told the conference. “We have lost five surgeons recently. We spend a lot of money training doctors, and they are taken away—there are 200 Ugandan doctors in South Africa.” Uganda has 1900 doctors, 350 of whom work abroad.
A 2006 WHO report says that 57 countries have a shortage of healthcare workers, of which 36 are in Africa—which is grappling with epidemics of HIV and AIDS, malaria, and tuberculosis. The report says that there are 59 million health workers worldwide and that an additional 4.3 million are needed.
“Sub-Saharan Africa faces the greatest challenge,” WHO says. “One million health workers are needed to bridge the gap in this region. While it has 11% of the world’s population and 24% of the global burden of disease, it has only 3% of the world’s health workers.” In Asia the gap in the healthcare workforce is three million.
Michael Cordy, an expert at the Global Health Workforce Alliance and chief rapporteur of the conference, said, “The deficit of health workers in Africa is due to lack of resources and poaching by rich countries. The moment for taking action on a global scale has come. The behaviour of rich countries has to change, and the working conditions in poor countries must improve.”
The alliance has drafted an ambitious plan for sub-Saharan Africa. It says that with a top-up investment of $24bn (£12bn; €16bn) over the next eight years the region can overcome its health workforce crisis by 2015.
The plan includes training 1.5 million health workers in the region by 2015 at a cost of over $3bn each year. Funds would come from national governments and international donors, the alliance’s executive director, Francis Omaswa, said.
In addition, $27bn needs to be mobilised by 2015 to pay the salaries of these health workers, Professor Omaswa told reporters.