US funding to train 140,000 African health workers

The United States will fund training for 140,000 African health care workers in an initiative to "transform and dramatically increase" medical education on the continent, the top U.S. AIDS official announced Tuesday.

Ambassador Eric Goosby said the plan will bring partnerships between African and U.S. medical schools by "really fostering and strengthening a collegial network" to empower medical professionals on the continent that shoulders the worst of the world's HIV-AIDS epidemic and its heaviest load of other chronic diseases.

He said he hoped it also would help stem, and even reverse, the brain drain of doctors and nurses who receive expensive, subsidized training in Africa, only to be recruited to work overseas amid a worldwide shortage of health professionals.

Some African countries have trained more doctors and nurses working abroad than remain in their countries, prompting critics to suggest recruiting countries should pay African governments for their lost expenses.

The British Medical Association reported that in 2005 sub-Saharan Africa had only 600,000 health care workers for a population of 682 million; Ghana had nine doctors for every 100,000 patients and Mozambique had 500 doctors for a population of 18 million. Only 60 of the 500 doctors trained in Zambia since independence remain in the country, the association said.

"People want to come home more often than not because they know the devastation that these diseases have wrought" and want to help, Goosby said.

The director of the U.S. National Institutes for Health, Dr. Francis S. Collins, said it is a "specific goal" of the Medical Education Partnership Initiative to "improve and help create environments that will make professionals want to remain in a country" including by encouraging clinical research currently carried out in Africa, but by non-Africans.

A measure of the program's success could be how many peer-review research projects will be attracted by the network being created, Collins said.

Many African health workers are discouraged by poor salaries, poorly equipped hospitals and other conditions that can make healing difficult. It is not unusual for patients undergoing surgery to be asked to provide syringes, surgical gloves, bandages and other necessities for an operation.

Some $130 million from the U.S. President's Emergency Plan for AIDS Relief and the National Institutes of Health will be awarded as grants over five years to medical schools across sub-Saharan Africa to work with partner schools in the United States.

Twelve countries and 13 schools, two in South Africa, already have had grants approved. South Africa's University of KwaZulu-Natal, for example, has received a grant to work with Columbia University to "enhance training, research capacity and expertise in HIV care."

Dr. Jean Nachega, a clinical researcher and dean of South Africa's Stellenbosch University, said he hoped its grant would strengthen a program to recruit students from rural communities, who appeared more committed to returning home to work once qualified.

KwaZulu-Natal's dean of medicine, Dr. Umesh Lalloo, said nothing could replace the satisfaction he gets from his work in the country with the highest number of people living with AIDS - 5.7 million of the a population of 50 million.

"I would not want to work anywhere else in the world because here in South Africa I can make a difference," Lalloo said. "Practicing as a doctor where there are none of the challenges I face here can be extremely boring!"