Zeroing In: AIDS Donors and Africa’s Health Workforce

Nandini Oomman , David Wendt and Christina Droggitis
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During the past decade, global AIDS donors’ attempts to strengthen the health workforce in Africa have been temporary and HIV/AIDS-specific, doing little to address the long-term sustainability and capacity of the workforce to handle all health needs. The policies and practices of the major donors have included varying degrees of support for strengthening human resources in health; most have been directed toward short-term interventions such as in-service training for existing health workers and temporary hiring in nongovernmental organizations or on special contracts in the public sector.

Systematic monitoring and reporting of donor’s strategies, however, has been scarce. This report fills the void by focusing on the workforce strengthening strategies of three of the major HIV/AIDS donors: the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), and the World Bank’s Africa Multi-country HIV/AIDS Program (the MAP). The report identifies six tasks for donors, national governments, and country stakeholders to undertake to reverse the severe shortage of skilled, motivated, and productive health workers. Each task includes recommendations focused to minimize negative effects of AIDS programs on the health workforce; maximize AIDS programs contributions to health workforce development without compromising AIDS program objectives; and expand the health workforce in the longer term.

The bottom line: AIDS donors need to move away from temporary and project-specific interventions and support instead more sustainable and long-term solutions to improve and strengthen Africa's health workforce, which is necessary to achieve national and global health outcomes.