Biggest Challenge In Fight Against HIV/AIDS Is Shortage Of Health Workers In Developing Countries

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A shortage of health care workers in developing countries mostaffected by HIV/AIDS is the biggest challenge facing efforts to combatthe disease, Debrework Zewdie, the World Bank's director for the Global HIV/AIDS Program, said Monday at the 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Sydney, Australia, Reutersreports. According to Zewdie, although about two million people livingwith HIV/AIDS are receiving treatment access, the lack of healthservices and "brain drain" of physicians and medical researchers indeveloping countries are adversely affecting treatment programs (Perry,Reuters, 7/23).

According to the World Health Organization's World Health Report 2006,there is a shortage of more than four million health care workers in 57developing countries. The report said one-quarter of physicians and onein 20 nurses trained in Africa currently work in 30 industrializedcountries in the Organization for Economic Cooperation and Development.Sub-Saharan Africa has 24% of the global disease burden but only 3% ofthe health care work force worldwide and accounts for less than 1% ofglobal health care spending, the report said. The Americas have 10% ofthe global disease burden, 37% of the health care work force andaccount for more than half of global health care spending, the reportfound (Kaiser Daily HIV/AIDS Report, 4/5).

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"Ourmost difficult challenge is not funding but the limited health systemcapacity in countries with the highest disease burden," Zewdie said,adding, "There is a desperate shortage of doctors, health care workersand researchers who would not only deliver treatment services but alsocoordinate local operations." According to Zewdie, there also is a needfor proper pharmaceutical storage to preserve antiretroviral drugs. "Wewant to reverse the lack of research culture" in developing countries,Zewdie said, adding, "We want to reverse the brain drain and bring ourdoctors home."

MSF Report

In related news, Medecins Sans Frontieresat the conference released a report that found although there had beena price reduction in some antiretrovirals, newer and less toxic drugsrecommended by WHO have become more expensive. According to the report,the price of some newer antiretrovirals has risen by nearly 500% from$99 to $487. The report also found that issuing compulsory licenses tomanufacture generic versions of antiretrovirals and other medicationsis more effective in reducing prices, compared with negotiating pricereductions with pharmaceutical companies.

Karen Day of MSF said,"The lack of competition and dramatically higher prices for the newlyrecommended WHO first-line (drugs) could mean that people in developingcountries may not be able to benefit from improved treatment" (Reuters, 7/23).
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Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily HIV/AIDS Report, search the archives, and signup for email delivery at kaisernetwork.org/email. The Kaiser Daily HIV/AIDS Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation.

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