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Médecins Sans Frontières (MSF) hosted a satellite meeting on August 3, 2008 at the XVII International AIDS Conference in Mexico City on the impact of the health care worker shortage on access to HIV/AIDS treatment and lessons learned from clinicians and advocates working on the ground to overcome this gap.

Introduction

An estimated 70% of people who need antiretroviral treatment are still not getting it.  Recent advocacy efforts have brought more attention to the critical shortage of health care workers and how this shortage contributes to unnecessary illness and death.

In Malawi a medical assistant can see up to 200 patients per day, far too many to ensure quality HIV care. Patients in parts of Mozambique can wait up to two months to start AIDS treatment, and many have died during the wait. In parts of Lesotho, over half of nursing posts remain vacant, and the leading cause of staff attrition is death due to HIV/AIDS.

One strategy used by Médecins Sans Frontières (MSF) and others is task-shifting to lower levels of health care workers and lay health care workers. However, this strategy has its own limits and MSF teams and other implementers find themselves hitting a wall in terms of further scaling up and maintaining an acceptable level of quality care.

Urgent measures must be taken by donor and national governments to retain a skilled workforce and attract new staff by increasing pay, improving working conditions, and keeping staff healthy. The lack of health care workers must be confronted as an emergency for the millions of people with HIV/AIDS still waiting for treatment.

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