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 New antibody analysis accelerates rational vaccine design
09.08.2018 | Scripps Research Institute

nachricht Distrust of power influences choice of medical procedures
01.08.2018 | Johannes Gutenberg-Universität Mainz

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: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

Im Focus: Lining up surprising behaviors of superconductor with one of the world's strongest magnets

Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur

What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...

Im Focus: World record: Fastest 3-D tomographic images at BESSY II

The quality of materials often depends on the manufacturing process. In casting and welding, for example, the rate at which melts solidify and the resulting microstructure of the alloy is important. With metallic foams as well, it depends on exactly how the foaming process takes place. To understand these processes fully requires fast sensing capability. The fastest 3D tomographic images to date have now been achieved at the BESSY II X-ray source operated by the Helmholtz-Zentrum Berlin.

Dr. Francisco Garcia-Moreno and his team have designed a turntable that rotates ultra-stably about its axis at a constant rotational speed. This really depends...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

2018 Work Research Conference

25.07.2018 | Event News

 
Latest News

'Building up' stretchable electronics to be as multipurpose as your smartphone

14.08.2018 | Information Technology

During HIV infection, antibody can block B cells from fighting pathogens

14.08.2018 | Life Sciences

First study on physical properties of giant cancer cells may inform new treatments

14.08.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>