Medical charity Médecins Sans Frontière (MSF) said in August that a wage-bill imposed by donors on poor countries was complicating the roll-out of an effective antiretroviral treatment plan to reach millions of needy recipients.
MSF told the XVII International Aids Conference in Mexico that the wage-bill has blocked efforts by some countries like Rwanda to recruit qualified staff to manage the ART programme.
In a new policy note to coincide with World Aids Day (December 01), UK’s Department for International Development (DFID) says the fight against HIV should not just be about halting and reversing the spread, “we also need to improve health care”.
“Because in the real world, we cannot prevent or treat AIDS without better equipped health facilities and well trained doctors, nurses and other health workers”, the agency said.
An estimated 70 percent of people living with HIV/AIDS who need antiretroviral therapy (ART) are still not receiving it, and MSF says the growing numbers of those who have been started on ART have only increased the burden on existing health care staff.
These workers have little time to dedicate to proper treatment and follow up of their many patients, potentially resulting in low quality of care and treatment interruption as patients become discouraged by the long waiting times for consultations.
In several countries, the shortage of qualified health staff in public-health services is linked to constraints in attracting, recruiting, and retaining health staff who are actually present in the country but are unable to join the workforce, MSF experts told delegates.
Rwanda, Zambia, Kenya, and Tanzania are said to have substantial numbers of unemployed clinicians and nurses in their capitals. In these countries, MSF says recruitment of extra qualified staff available on the local market would seem a rational adjunct, which could be coupled with task-shifting initiatives to achieve a stronger strategic skills mix.
Low salaries, poor working conditions and a lack of support and supervision are just a few of the reasons why it is growing increasingly untenable for many health care staff to stay and keep providing quality care, the medical charity said.
The UK says when it launched its strategy to tackle HIV/AIDS earlier this year, £6 billion was pledged to strengthen health systems and improve services.
The “investment”, as the UK describes its funding, will help to get antiretrovirals for those who need them. The programme is to also cover the shortfall of some 800,000 health workers in the 36 worst-hit African countries.
In March 2008, the United Kingdom launched a £12 million programme to help strengthen health sector delivery and increase utilisation of health services in Rwanda by the poor, especially women and vulnerable groups.
The UK has also provided some Frw 2.5 billion ($4.5million) since 2006 in medical care and anti-retrovirals to women survivors of the Genocide infected and affected by HIV/AIDS.
Meanwhile, British Minister for International Development Ivan Lewis is scheduled to visit Rwanda next week (Dec 06-09).
Mr. Lewis will meet President Paul Kagame and other senior government officials. He is also planned to participate in a high-level panel discussion on civil society and governance organised by the Institute of Policy Analysis and Research.