Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
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Wall Street Journal - August 16, 2006
Marilyn Chase, marilyn.chase@wsj.com
More than four million doctors, nurses and other health professionals will be needed across 60 countries, especially the nations of sub-Saharan Africa, and Asian countries such as Bangladesh, India and Indonesia, according to estimates prepared by the WHO, along with the International Labor Organization and the International Organization for Migration.
The international health body projects that providing that staffing will cost $7 billion to $14 billion over the next five years, a price tag that translates to an annual cost of 60 cents a person, or 2% to 5% of health-care outlays of low-income countries.
The WHO released its estimates in a report at the 16th International AIDS Conference here yesterday. Its plan is expensive but "doable," said Badara Samb, the agency's coordinator of health-system strengthening.
It isn't clear who will pick up the tab. The WHO's top AIDS official, Kevin De Cock, said in an interview that the agency and its partners will now appeal to a variety of deep-pocketed donors like the U.S. President's Emergency Plan for AIDS Relief, as well as from the less-rich Geneva-based Global Fund to Treat AIDS, TB and Malaria. The cost of inaction may be even greater, he noted.
One irony: Health-care workers themselves need HIV prevention and AIDS treatment, for the epidemic they are needed to treat has thinned their own ranks.
The WHO's Dr. Samb, citing a World Bank study, noted that countries where the overall HIV infection rate is 15% of the population can expect to lose 30% of their health-care work forces to HIV-related illness within 10 years.
Delegates at this meeting ranging from chanting activists to former U.S. President Bill Clinton and Microsoft Corp. founder Bill Gates have called for reinforcements to the fragile health infrastructure in countries suffering most grievously from the epidemic.
Health-care workers need retraining to do AIDS care, as well as "retasking" so that lay people can perform AIDS counseling and testing, freeing up doctors and nurses to give specialized care. Salaries must be enhanced, burnout prevented, and family benefits strengthened to keep critical personnel on the job.
Every country has a unique version of the medical-talent gap. Kenya needs to retain nurses, Mr. Clinton noted here, while in India, which has plentiful doctors, the need is for specialized AIDS training.
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