Justine Gerardy, Mail & Guardian
The report, Help Wanted, focusing on
, indicates that more than one million people need AIDS treatment but are not
"If these people do not receive access to treatment,
they will die," Sharonann Lynch, of MSF in
, told a media briefing in
AIDS-drug prices have dropped and funding has increased,
but there is little support for increasing human resources for health.
Treatment deficits are 40 300 in
, 109 100 in
, 192 900 in
and 718 000 in
"More pills, more infrastructure will not improve the
situation ... the bottleneck is health staff," said Dr Eric Goemaere, head
of MSF's programme in Khayelitsha in the
Health workers are dying of HIV/AIDS, overwhelmed by the
HIV-related workload, and leaving the sector for better-paying jobs.
Proposed interventions include allowing nurses to prescribe
antiretroviral drugs and empowering and recognising community workers as key
collaborators. Emergency measures are also needed to retain staff, and salaries
and working conditions need to be improved.
Goemaere pointed to "hypocrisy" in
, where a "radical policy change" is needed to meet targets such as
those set by the National Strategic Plan for HIV/AIDS. The plan has been
"applauded and rightly so", but policy change is needed to meet
targets. "To put into practice, it needs major policy changes ... People
know this change needs to happen, but I don't see that happening."
Hypocrisy also exists on the side of donors who fund
HIV/AIDS programmes, particularly in surrounding countries, but do not fund
salaries, he said.
An exception is
, where donor money has gone towards improving salaries by 30%. Field nurse
Veronica Chikafa said this has slowed the migration of nurses. In that country,
the number of doctors and nurses has decreased, but the number of patients has
increased. A medical assistant could see as many as 100 people in a day, she
has 89 doctors for 1,8-million people -- one doctor per 20 200 people -- but
nurses are allowed to prescribe ARVs. Field doctor Dr Pheelo Lethola said the
major challenge is a shortage of professional nurses, which leads to workload
increases, demotivated nurses, an increased waiting period for nurses, and
shorter consultation times.
Mozambican medical technician David Nhantumbo said more
ARVs can be given out if nurses are allowed to prescribe them.
has more healthcare workers who are better paid in comparison, but there is
unequal distribution of health workers between the private and public sectors,
and urban and rural areas. Combined with inadequate numbers of staff, this leads
to delays in expanding treatment. -- Sapa