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Critical shortage of doctors in developing world - WHO

01.01.70

By Shapi Shacinda
LUSAKA (Reuters) - A critical shortage of doctors and nurses is causing unnecessary disease and death across much of the developing world as health-care workers seek jobs in rich nations, the World Health Organisation said on Friday.

More than 4 million more health professionals are urgently needed to fill the medical gap in 57 countries, mostly in Africa and rural areas of Asia, the United Nations agency said in its annual World Health Report 2006.

"On average one in four doctors and one nurse in 20 trained in Africa is working in (developed) countries. Some countries have been hit harder than others, for example 29 percent of Ghana's physicians are working abroad, as are 34 percent of Zimbabwe's nurses," the WHO report said.

WHO Director-General Lee Jong-wook said the shortage of health workers in the developing world was critical and could threaten the U.N.'s Millennium Development Goals, a blueprint to halve poverty 2015.

"If we don't take action now, the millennium development goals will remain an empty promise and there are many empty promises in this world," he told a news conference in Zambia.

"There is a need to increase spending on health and to improve the supply of medicines and equipment too," Lee said.

Worst-hit countries, which spend an average $33 per person per year on health care, need to boost their annual budgets to at least $43 per person within the next 20 years to tackle the crisis, WHO said.

"There is a shortage in 57 countries across the globe that is inhibiting provision of essential life-saving interventions such as childhood immunisations," WHO Assistant Director-General Tim Evans said.

The WHO report highlighted huge inequities in the global health-care system, which threatened to deepen as rich countries attracted doctors and nurses from poorer nations which bear the brunt of health crises like AIDS, malaria and tuberculosis.

British-based charity Save the Children placed much of the blame squarely on the International Monetary Fund (IMF), which it accused of imposing spending restrictions on African governments which prevent them from investing in healthcare.

"It is shameful that thousands of children across Africa continue to die every day from diarrhoea, malaria and measles," Save the Children UK Chief Executive Jasmine Whitbread said in a statement.

"This is primarily because hospitals and clinics suffer from under-investment, migration of doctors and nurses, and crippling restrictions on spending imposed by the IMF."

34 PCT OF ZIMBABWE NURSES ABROAD

The Americas, which account for just 10 percent of the global disease burden, has 37 percent of the world's healthcare workers and spends more than 50 percent of the world's health-care budget, the WHO report said.

Africa, by contrast, has 24 percent of the disease burden but just 3 percent of the health-care workforce and accounts for less than 1 percent of the health-care spending.

British-based charity Oxfam says there is one doctor per 14,000 people in Zambia compared with the ratio of 1 to 600 in Britain.

The WHO report said rapid urbanisation and a demographic "youth boom" in many developing countries was exacerbating the problem while richer countries were expected to import even more health professionals to treat their ageing populations.

WHO recommended that aid donors arrange immediate and longer-term financing of health-care training to help poor countries meet immediate threats such as a potential global bird flu pandemic as well to scale up domestic health-care networks.

Charities called for aid for medical staff training.

"Rich country governments must ensure the aid promised last year is used to pay for the millions of doctors, nurses and teachers, which are so badly needed," Barbara Stocking, director of British-based charity Oxfam, said in a statement.

Zambia, one of the world's poorest countries, has already announced free health care for millions living in rural poverty, using funds made available under debt relief and aid increases agreed at the G8 in Scotland last July.

Expert opinion

Halter Marek

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Halter Marek
Le College de France
Olivier Giscard dEstaing

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COPAM, France
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Bill Pace

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Peter I. Hajnal

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Toronto University, G8 Research Group