PIH calls for support for U.S. funding to train and retain health care workers in Africa

Over the past few weeks, Partners In Health has been hard at work with colleagues at other organizations and in Congress to get a piece of legislation introduced that addresses the catastrophic shortage of health care workers in Africa. The final text of the bill incorporates ideas and language that we urged the drafters to include, recognizing the critically important role of paid community health workers. Now the drafting is over, the bill has been filed, and it is time to pitch in to get it passed.

Starting on Friday, March 9, we're working to generate thousands of emails and calls to the Senate supporting the bill. Call your Senators and encourage their support of the African Health Capacity Investment Act of 2007. You can reach your member by calling 202-224-3121 (connecting to all offices).

	Village health worker training in Lesotho

In Sub-Saharan Africa, a mere 3 percentof the world's health workers struggle against all odds to combat 24 percent of the global disease. Millions of people in Africa are suffering and dying from HIV/AIDS and other preventable and treatable diseases. In early March, Senator Richard Durbin (D-IL) introduced the African Health Capacity Investment Act of 2007, which would help African countries to develop a stable health infrastructure and better address their health crises.

The time to act is now. Please call and email both of your Senators and ask them to co-sponsor the African Health Capacity Investment Act.

Please ask both of your Senators to:

• Co-sponsor the African Health Capacity Investment Act of 2007;
• Work with Senate colleagues to pass the bill quickly and ensure that Congress appropriates at least $150 million for the African health workforce this year, by including at least that amount in their appropriations "wish lists."

The original co-sponsors of the African Health Capacity Investment Act include Senators Durbin, Bingaman (D-NM), Coleman (R-MN), Dodd (D-CT), Kerry (D-MA), and Feingold (D-WI). If one of the preceding is your Senator, you may contact them to thank them for their support of the Act and encourage their dedication to passing and appropriating full funding for the bill.

For maximum impact, please follow up your calls with emails to your Senators.

If you would like to see sample text for a letter to your Senator or to read some background information before placing a call or writing an email, read on.

Sample letter

Dear Senator __________________,

I am writing to respectfully urge you to co-sponsor the African Health Capacity Investment Act, and to help make sure it passes quickly with the full amount of funding appropriated.

In Africa, people are dying unnecessarily because there are simply not enough doctors, nurses, pharmacists, and other health care workers. The World Health Organization has identified 57 countries, including 36 in Africa, facing critical shortages of health workers that make them "very unlikely" to achieve goals in fighting diseases like AIDS and malaria and reducing child and maternal mortality. In Africa, a mere 3% of the world's health workers struggle against all odds to combat 24% of the global disease burden.

The causes of the shortage are complex, and include HIV/AIDS, poor working conditions, insufficient capacity to train new health workers, the overall lack of funding for health, ceilings on government wage bills, and the "brain drain" of health workers to countries like the United States, which need to do more to address their own health worker shortages. A recent estimate of the funds needed to double the health workforce in sub-Saharan Africa placed the cost at an additional $2 billion in the first year, and more in ensuing years.

Strengthening the health workforce in Africa will bring enormous health benefits to millions of people and save untold numbers of lives. That is why I am asking you to co-sponsor the African Health Capacity Investment Act, and to ensure that it passes and is fully funded this year. To help ensure full funding, I hope that you will include in your appropriations "wish list" at least $150 million for Africa's health workforce.

Thank you.

Background information

The World Health Organization has identified 57 countries, including 36 in Africa, where the current level of health workers make it "very unlikely" to achieve health-related Millennium Development Goals, internationally agreed upon goals on reversing the spread of AIDS, malaria, and other major diseases, and significantly reducing child and maternal mortality. A recent estimate of the funds needed to double the health workforce in sub-Saharan Africa placed the cost at an additional $2 billion in the first year, and more in ensuing years.

In Africa, people are dying unnecessarily because there are simply not enough health care workers. Health workers--nurses, doctors, pharmacists, community health workers, laboratory technicians, physician assistants, nurse assistants, mental health workers, and many more-are at the core of health systems everywhere, diagnosing and treating diseases, educating and caring for patients, and developing and implementing policies and strategies to combat disease. But in sub-Saharan Africa, a mere 3% of the world's health workers struggle against all odds to treat 14% of the worlds population and combat 24% of the global disease burden. The World Health Organization estimates that sub-Saharan Africa is suffering a shortage of more than 800,000 doctors, nurses, and midwives, and an overall shortfall of nearly 1.5 million health workers. At present, sub-Saharan Africa has little over 1 million health workers, and fewer than 600,000 doctors, nurses, and midwives.

The causes of the shortage of health workers are complex, and include HIV/AIDS, which is decimating much of the continent's workforce. In South Africa, it is conservatively estimated that 16% of the existing health workforce are HIV+ and in Malawi the government assumes they will lost 3% of their health workforce each year to the disease. Additionally, there is a lack of sufficient and relevant training capacity to produce the number of health workers required; an inability to retain health workers due to poor working conditions and lack of funding for adequate salaries, sometimes due to wage caps imposed by the International Monetary Fund; and "brain drain," the large-scale emigration of health care workers seeking better paying and more secure jobs in countries with greater resources such as the United States, England, and Canada.

If the international community is committed to reaching universal access to prevention, treatment, and care, governments must show leadership in addressing the health workforce crisis. Today, you can be part of the solution.

[published March 8, 2007]