Health crisis in Malawi undermines efforts to treat those with HIV and AIDS
(22 November 2004)Just 1.6 doctors per 100,000 in a country ravaged by HIV and AIDS
International development charity VSO today warned that World Health Organisation (WHO) targets on the delivery of vital HIV and AIDS drugs are unlikely to be met in Malawi.
16.5% of 15 to 49 year olds in Malawi have AIDS. Anti-Retroviral drugs (ARVs) are vital to their survival. But, the charity claims, the Malawian health sector does not have the capacity to ensure that these drugs are delivered to those who need them most.
WHO’s 3 June 2005 target of providing drugs to 35,000-45,000 patients in Malawi will require one dedicated nurse plus one clinician at 54 health centres. There are only 28.6 nurses per 100,000 people in Malawi (In Botswana the figure is 241 per 100,000). Already overwhelmed, the Malawian health system simply cannot meet the needs of those in need of treatment.
The UN special envoy on HIV and AIDS, Stephen Lewis’ recent optimism over WHO’s 3 by 5 campaign was rightly measured by a recognition that success would depend on the response to the current health sector crisis.
VSO is responding and has announced that it will send an increased number of doctors and nurses to Malawi. As part of an initiative with the Department for International Development (DfID) and United Nations Volunteers (UNV), 100s of nurses and doctors will be sent to Malawi over the next few years. However the charity emphasises that simply filling gaps is not the answer.
Penny Lawrence, VSO’s Director of International Programmes says:
It is vital that Malawi has extra doctors and nurses but the long term solutions lie in an international and Malawian commitment to addressing the causes of this shortage and building a training programme to ensure that there are well qualified Malawian health professionals in the future.
VSO says that underlying this crisis are the poor pay and conditions of health workers. This has led to a significant migration of health workers, both to the private sector within Malawi and to neighbouring countries and overseas (predominantly the UK).
New research undertaken by the charity has found that in 2003 only an estimated 70 of approximately 500 nurses graduating from government-funded training remained in the public health service. Almost 15,000 new recruits are required for the health sector over the next ten years to replace leavers.
Meeting these needs will require significant investment in the public health sector. It also requires an end to the active recruitment of skilled health professionals from Malawi. The UK government recently put in place measures to restrict NHS staff being recruited from developing countries but a major loophole exists, which allows private firms to continue this practice. VSO’s research found that 84% of nurses leaving Malawi in 2003 came to the UK.
Penny Lawrence says:
The UK government needs to join up their thinking on the whole issue of migration and put the needs of developing countries first. Although the situation in Malawi is critical, it is not a unique case and action needs to be taken now to prevent the UK exacerbating human resource crisis in other developing countries.
Editors' notes
- To talk to a spokesperson in the UK or Malawi, please contact Adam Bowers.
- A full copy of the report on the impact of migration on the Malawian health service and VSO’s full recommendations is also available on request.
- For more information on the health crisis in Malawi visit www.vso.org.uk/malawi.
