Confronting the health care worker crisis to expand access to HIV/AIDS treatment
Médecins Sans Frontières (MSF) began providing antiretroviral therapy (ART) in 2000 and has today reached over 80,000 people in more than 30 countries. However, efforts to further increase access to treatment and maintain and improve quality of care are coming up against a wall due to the severe shortage of health workers. This is contributing to unnecessary illness and death.
The impact of the human resource crisis is witnessed by MSF across southern Africa, the epicentre of the AIDS pandemic. Health workers are overwhelmed, overworked, and exhausted. In Thyolo district in Malawi, a single medical assistant can see up to 200 patients per day. In Mavalane district in Mozambique, patients are forced to wait for up to two months to start treatment because of the lack of doctors and nurse clinicians; many have died during the wait. In Lusikisiki, South Africa, utilisation of clinic services almost doubled in two years while the number of professional nurses remained constant. In Scott Hospital Health Service Area in Lesotho, over half of professional nursing posts at health centres are vacant while the HIV-associated workload is increasing sharply.
In all these cases the need for access to ART, as well as other health needs, is outstripping human resource capacity. Further progress will not be possible unless certain national and international barriers are overcome.
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