GENEVA, Dec 18 (AFP) - The world is facing a critical shortage of nurses and doctors which is blighting attempts to tackle major infectious diseases such as HIV/AIDS, the World Health Organisation warned Thursday.
WHO said in its World Health Report 2003 that the "health workforce crisis" is stopping poor countries from providing basic health care for millions of people who could otherwise escape death and disability.
The gaps in health care, particularly in the developing world, need to be filled urgently to prevent the global spread of infectious or new diseases like AIDS and SARS, it added.
"The most critical issue facing health care systems is the shortage of the people who make them work," the annual report on major health challenges underlined.
"Although this crisis is the greatest in developing countries, particularly in sub-Saharan Africa, it affects all nations."
"It severely constrains the response to the AIDS treatment emergency and development of health systems driven by primary health care," WHO added.
The report berated governments and "international agencies" for regarding the issue as "relatively unimportant". It gave no figures showing the extent of the shortage.
WHO Director-General Lee Jong Wook later told journalists that the issue would be a matter for "intensive discussion" at the organisation's Executive Board meeting next month.
A strengthened health workforce was "urgently required" to take advantage of funds targeting major diseases and making cheaper drugs more widely available, which have been set up in recent years by WHO, pharmaceutical giants or the World Bank, WHO said.
"A key message of this report is that real progress in health depends vitally on stronger health systems based on primary health care," it said, signalling that the agency would be an "aggressive" advocate for improvement.
"But it takes local knowledge and sustained international support to turn that possibility into a reality," Lee said.
The shortage of health workers is jeopardising the "three by five programme" launched in 2003, which aims to provide three million HIV/AIDS patients in Africa adequate care by 2005, Lee revealed.
"This will not succeed if we plan to rely on existing doctors and nurses alone. We are planning to embark on the large-scale training of community health workers," he said.
Developing countries represent a reservoir for infectious diseases. Even without AIDS, 34 percent of children born in African countries are at greater risk of dying before the age of five than they were a decade ago, according to the report.
Industralised countries accounted for less than 20 percent of the world's population but took 90 percent of health spending.
The report highlighted "shocking" maternal mortality data illustrating the gap in health care between rich and poor. The risk of woman of dying in childbirth is 250 times higher in poor countries than in wealthy ones.
"While a baby girl born in Japan today can expect to live for about 85 years, a girl born at the same moment in Sierra Leone has a life expectancy of 36 years," WHO pointed out.
Life expectancy is also diminishing in more ill-prepared developing countries under the onslaught of a double burden of chronic diseases, such as heart disease or cancer, and infectious disease.
"What little progress there has been was reversed by the current epidemiological and economic trend," Lee commented.
The emergence of the deadly Severe Acute Respiratory Syndrome, which affected 32 countries, mainly in Asia, showed both the value of international cooperation and the dangers of having gaps in health care around the world, according to the report.
The spread of the newly-discovered virus around the world might not have been stopped if SARS had struck poor countries with feeble health care, it revealed.
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