Global Health Service needed to fight AIDS

Apr 20 2005

A report by the non-partisan Institute of Medicine is calling for the creation of a U.S. Global Health Service comprised of doctors, nurses and other health care workers to help combat HIV/AIDS in the world's hardest hit countries.

A lack of highly trained medical personnel is the biggest obstacle to caring for people with the life-long illness say the authors of the study which has produced an outline for a federal "service corps" made up of full-time, salaried medical professionals.

Under the proposed Global Health Service, medical personnel would be offered monetary incentives, such as loan repayments and fellowships, to sign up for the service program and doctors, nurses and other health-care workers, would at first be sent to 15 countries hardest hit by HIV/AIDS, including Haiti, Botswana, Ivory Coast, Ethiopia, Guyana, Kenya, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia.

According to Fitzhugh Mullan of George Washington University in Washington, who chaired the committee that issued the report, the main problem is a lack of qualified and trained medical personnel, there are for example only 11 pharmacists in all of Rwanda.

The report recommends stationing 150 highly-trained GHA workers overseas during the first year to help administer anti-retroviral therapy to infected individuals, many of whom may not be receiving the complex regimen properly, if at all.

Mullan further illustrates the situation saying there is approximately one physician for every 350 people in the United States, Mozambique has one physician for every 30,000 people.

Last year Congress enacted President Bush's Emergency Plan for AIDS Relief, or PEPFAR, a five-year strategy which set aside $15 billion to fight the disease globally. The plan's goal is to treat two million people with anti-AIDS drugs, prevent seven million new infections and care for 10 million people living with HIV/AIDS. Fifty five percent of the plan's funds are earmarked for anti-AIDS therapy.

Although the Emergency Plan for AIDS Relief has provided treatment in countries where the disease is rampant, the shortage of health-care workers is so severe, it could ultimately get in the way of efforts to distribute medication.

Harrison Spencer of the Association of Schools of Public Health, a commission member, says the idea is to make nations struggling with the chronic illness both stronger and more independent of donor countries. Spencer says because countries in which these programs are being implemented lack the human capacity to treat the people with AIDS, malaria and TB, a volunteer and possibly a paid global health service from the United States could help build sustainable workforce capacity to help these countries better address their health needs.

The report proposes that Global Health Service workers have a range of technical skills, from managing finances to strengthening public health care systems and calls for an international advisory committee to make suggestions to the Global Health Service.

The study was requested by the U.S. Global AIDS Coordinator at the State Department.

The report, entitled Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS, is a blueprint on how best to use the AIDS treatment dollars.