GENEVA, April 6, 2006 (AFP) - Poor countries from Asia to Africa are in urgent need of 2.3 million doctors, nurses and other medical staff to deal with major diseases such as HIV/AIDS and everyday health care, the World Health Organisation said Friday.
"The magnitude of the health workforce crisis in the world's poorest countries cannot be overstated and requires an urgent, sustained and coordinated reponse from the international community," the agency's 2006 World Health Report warned.
The overall global shortage of health workers, including support staff, reaches 4.3 million, according to the report.
But 57 countries, mainly in sub-Saharan Africa and south or southeast Asia, face "critical shortages", the WHO added.
"The global population is growing, but the number of health workers is stagnating or even falling in many of the places where they are needed most," said WHO Director-General Lee Jong Wook.
Currently there are an estimated 59.2 million health workers in the world, including doctors, nurses, midwives, managers and support staff.
They are mainly in wealthier nations and the concentration drops sharply in countries blighted by poverty, endemic tropical diseases and major health threats.
The shortage affects the whole line of care from prevention to treatment through childbirth, shattering those countries' slim hopes of raising their health standards to meet United Nations development targets, the report said.
One of the report's authors, Tim Evans, said the main message was that the situation was likely to get worse.
"We'll be in much bigger trouble 10, 15 years down the line," he told journalists.
"We need to anticipate and very little anticipation has been done so far."
The countries with the biggest shortfalls include the world's second most populous nation India, as well as Indonesia, Africa's biggest nation the Democratic Republic of Congo, Kenya, Tanzania and most of West Africa, and Peru.
Health workers in Africa are thin on the ground, with just 2.3 to serve every 1,000 people on average, compared to 18.9 in Europe or 24 in the Americas.
Africa has the highest share of disease, 25 percent, of any region in the world yet it commands only one percent of global health expenditure, according to the WHO.
Less than 30 percent of government health budgets in Africa are devoted to staff, compared to 35 percent in southeast Asia, 42 percent in Europe and nearly 50 percent in the Americas.
Southeast Asia needs about 1.16 million doctors, nurses and midwives to add to its existing 2.3 million, the report said.
In some instances, countries with shortages have large numbers of health professionals, but they are unemployed.
"Poverty, imperfect labour markets, lack of public funds, bureaucratic red tape and political interference produce this paradox of shortages in the midst of underutilised talent," the report said.
Some poor countries have suffered from a "brain drain" as their few trained doctors and nurses leave for industrialised nations, where they could command wages some 15 times higher.
At home, medical staff often face "daunting working environments -- poverty level wages, unsupportive management, insufficient social recognition and weak career development," the report underlined.
The cost of tackling the shortage will be huge.
Training costs for doctors nurses and midwives would range up to 2.0 billion dollars (1.65 billion euros) a year in India alone, according to the UN health agency.
Annual employment costs are estimated at 311 million dollars (257 million euros) per country, without taking into account a UN Millenium Development Goal of doubling wages that would raise costs in the 57 countries by 53 billion dollars (43.8 billion euros).
The WHO advocated a "50-50" guideline, whereby 50 percent of international development assistance is assigned to national health systems, and half of that in turn is devoted to strengthening the local health workforce.
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