South African Press Association - April 12, 2007
Thomas Hartleb

The deficit worldwide is about four million, said the executive director of the Global Health Workforce Alliance, Dr Francis Omaswa.

"Africa is a real catastrophe," he told reporters on the margins of an African health ministers' conference. As a result of the shortage and Africa's burden of disease, average life expectancy in some parts of Africa has dropped to 30, while 60 is the expected maximum.

Global warming is causing malaria to spread, which adds to the pressures created by Aids and new epidemics such as bird flu and severe acute respiratory syndrome.

A 2006 WHO report identified 57 countries -- 36 of them in sub-Saharan Africa -- that had such critical shortages that they could not provide basic healthcare.

The alliance, established in May last year, has as its aim the strengthening of the world's health workforce and the creation of better working conditions.

Omaswa said that following the independence of African countries, many training institutions were not upgraded and health was not made a priority. In addition, the economies of the continent do not perform well and foreign donors impose policies that lead to a reduction in civil servants.

The former chief executive of the United Kingdom's National Health Service, Sir Nigel Crisp, said people in Africa are dying largely of preventable diseases. "If you train medical assistants, they can do 'simpler' but fantastically important things. A lot of those people you can train quite quickly."

Dr Lincoln Chen, president of the United States-based China Medical Board, said Africa's health worker shortage is not yet past its worst point due to the time lag involved in training new doctors and nurses. "I think that it will get worse."

Workers themselves are susceptible to diseases like HIV/Aids and often find themselves playing the role of "terminal-care workers" to those beyond hope, which has a demoralising effect.

Chen said that within Africa, South Africa and Botswana's health workers are the best paid. While the two countries are also net importers of staff on the continent, in a global context they lose workers to the north.

Aid agency Oxfam urged governments and donors to provide more aid to solve the shortage.

In a report, Paying for People, published on Thursday, Oxfam estimated that $13,7-billion has to be invested every year to fund the additional 2,1-million teachers and 4,2-million healthcare workers, half of them in Africa, who are needed to break the cycle of poverty.

"The International Monetary Fund should stop imposing ceilings on the wage bills for health and education budgets in developing countries and should leave such decisions to individual countries which are in a better position to judge the most appropriate use of their budgets," Oxfam wrote in a statement.

Africa is estimated to have 3% of the world's health workers, but 25% of the world's burden of disease.

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