Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Institute of Medicine news: Human resource crisis in HIV/AIDS

20.04.2005


The federal government should create and fund an umbrella organization called the United States Global Health Service (GHS) to mobilize the nation’s best health care professionals and other experts to help combat HIV/AIDS in hard-hit African, Caribbean, and Southeast Asian countries, says a new report from the Institute of Medicine of the National Academies. Full-time, salaried professionals would make up the organization’s pivotal "service corps," working side by side with other colleagues already on the ground to provide medical care and drug therapy to affected populations while offering local counterparts training and assistance in clinical, technical, and managerial areas. The proposal’s goal is to build the capacity of targeted countries to fight the pandemic over the long run. The dearth of qualified health care workers in many low-income nations is often the biggest roadblock in mounting effective responses to public health needs.
In January 2003 President Bush announced the President’s Emergency Plan for AIDS Relief (PEPFAR), which is directed at 15 countries that are home to half of the world’s HIV-infected people. PEPFAR’s "2-7-10" goals are to treat 2 million infected people with antiretroviral therapy, prevent 7 million new HIV infections, and care for 10 million people who are infected with HIV or affected by it. This comprehensive, five-year strategy is part of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which Congress passed in 2003. Among other measures, the legislation calls for a pilot program to test how U.S. health care professionals and others with technical expertise could help meet the "2-7-10" goals through public service abroad. The federal Office of the U.S. Global AIDS Coordinator asked the Institute of Medicine to study options for placing such workers in the 15 focus countries.

"In addition to this proposed corps of highly skilled health and management professionals, the Global Health Service would also have five other components. The individuals serving in all of these programs would constitute a critical driving force to carry out the president’s plan -- and to build the developing world’s capacity to control HIV/AIDS, tuberculosis, and malaria over time," said study committee chair Fitzhugh Mullan, contributing editor of the journal HEALTH AFFAIRS, and clinical professor of pediatrics and public health, George Washington University, Washington, D.C. "They would multiply essential skills and services, offering both concrete assistance and hope. In our interconnected world, such work benefits us all."


Creating The United States Global Health Service

Today HIV/AIDS is one of the world’s greatest health crises, the report emphasizes. Nearly 40 million people are infected with HIV, and 95 percent of them live in resource-poor countries. About 6 million HIV-infected people in these areas need antiretroviral treatment now. PEPFAR has provided such drug therapy in the 15 focus countries: Botswana, Cote d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia. However, a shortage of workers to administer medication and provide essential support could ultimately thwart PEPFAR’s efforts. Preventing and treating HIV/AIDS in these developing nations will require unprecedented health systems and human resource initiatives.

GHS should be based in the federal government, but private agencies should also play supporting roles, the report says. Furthermore, an international advisory committee should be established to provide input on the development, ongoing operation, and evaluation of the proposed service.

In the first year, 150 U.S. health professionals should be selected for the GHS service corps and deployed based on several criteria, including specific priorities that have been identified by each country’s health ministry in conjunction with federal PEPFAR teams already on the ground; the availability of people with the required skills; and the readiness of institutions to host corps participants. They would be assigned for at least two years to programs or geographic areas where they could have the greatest impact. Participants’ ability to help combat the spread of malaria and tuberculosis -- which often overlap HIV infections in the developing world -- would also be considered. On the whole, the initial cost of the GHS is estimated at about $100 million annually, or roughly 3 percent of PEPFAR’s current budget. About $35 million of this would be for the service corps, the report says.

Another component of the GHS would be a fellowship program, which should offer competitive awards of $35,000 annually for skilled professionals who want to make a difference overseas but are stymied by financial and logistical barriers. Fellows would provide health care, training, or technical assistance in a PEPFAR focus country for at least one year, the report says.

GHS also would include a loan-repayment program for student debt. Any participants who serve in a focus country could erase $25,000 of higher-education debt for each year of service completed, the report says. Given the heavy student-debt load that health professionals often carry, this incentive would expand the overall pool of candidates.

Broad Collaboration needed

Smooth, quick transfers of talented people to the targeted nations would be vital, the committee said. To that end, adequate funding would be needed to foster innovative, long-term partnerships between relevant institutions based in the United States and in PEPFAR countries. Such bilateral arrangements, known as "twinning," can strengthen institutional work forces in host countries by providing staff to fill vacancies and to offer specialized training and development opportunities. Partners could include hospitals, universities, nongovernmental organizations, and public health agencies.

Education and training offered by all GHS participants should encompass not only clinical and technical skills, but also management of finances, social services, and human resources. Developing effective new ways to deliver health care in impoverished regions should also be a priority, the report notes.

Education systems and health care infrastructure in developing countries are often weak and understaffed. In addition, skilled health professionals frequently accept job offers from wealthy countries that are experiencing their own shortages of health care workers. But the shortfall is dramatically worse in the developing world. Few African nations, for example, have more than one doctor per 5,000 people. Without an increase in the number of physicians, nurses, technicians, pharmacists, and other health care professionals, expanding the scope of antiretroviral drug therapy for HIV/AIDS would only exacerbate these personnel challenges.

The committee also recommended that GHS create a clearinghouse for comprehensive information about various groups that mobilize health professionals to work in PEPFAR focus countries. It would include a searchable, Internet-based directory of programs; an electronic job bank related to service in targeted countries; and information about cultural and logistical issues. To ensure that GHS participants are properly assigned, country-based teams of PEPFAR workers should collaborate with national health ministries to assess each country’s health personnel needs. The assessments would generate a baseline inventory for all mobilization programs and their subsequent evaluation, and could inform each nation’s human-resources plan. All assessment data should be collected the same way in each country, updated regularly, and stored in the job bank of the clearinghouse. Additionally, the report outlines several promising steps to enhance and sustain the health work force worldwide.

Vanee Vines | EurekAlert!
Further information:
http://www.nas.edu

More articles from Health and Medicine:

nachricht Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan

nachricht Prospect for more effective treatment of nerve pain
20.02.2017 | Universität Zürich

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Switched-on DNA

20.02.2017 | Materials Sciences

Second cause of hidden hearing loss identified

20.02.2017 | Health and Medicine

Prospect for more effective treatment of nerve pain

20.02.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>