'Treat, Train, Retain' - Human Resource for HIV/AIDS Prevention & Care

[Guest guest]

WHO launches new plan to confront HIV-related health worker shortages

Crisis in human resources for health poses significant obstacle to global

HIV/AIDS prevention and treatment More than 4 million health workers needed to

fill gaps in 57 countries

15 AUGUST 2006 | TORONTO -- The World Health Organization (WHO), in

collaboration with the International Labour Organization and the International

Organization for Migration, today announced the launch of a coordinated global

plan to address a major and often overlooked barrier to preventing and treating

HIV/AIDS: the severe shortage of health workers, particularly in developing

nations.

Called 'Treat, Train, Retain', the plan is an important component of WHO’s

overall efforts to strengthen human resources for health and to promote

comprehensive national strategies for human resource development across

different disease programmes. The plan is also part of WHO's work to promote

universal access to HIV/AIDS services. Through its HIV/AIDS Programme, WHO is

playing a central role in making the goal of universal access a reality.

Fifty-seven countries, mostly in sub-Saharan Africa and Asia (particularly

Bangladesh, India, and Indonesia) face crippling shortages of health workers.

WHO estimates that more than four million health workers are needed to fill the

gap. Sub-Saharan Africa faces the greatest challenges. With 11 percent of the

world's population and almost 64 percent of all people living with HIV, the

region has only 3 percent of the world's health workers. Globally, health

workers are also concentrated in urban areas, leaving shortages in rural areas.

In sub-Saharan Africa and elsewhere, the HIV/AIDS epidemic is contributing to

health worker shortages. HIV/AIDS is an emerging source of mortality, loss of

productivity and demoralisation among health workers. HIV/AIDS also has changed

the way young people view health work, making it a less desirable career choice

and leading to a lack of health workers trained to prevent and treat AIDS. In

addition, many health workers trained in developing world health systems leave

their jobs (or countries) for better-paying jobs in wealthy countries, in bigger

cities or at non-governmental organizations (NGOs).

“WHO has a unique role to play in helping countries mount an effective,

comprehensive and sustainable response to the AIDS epidemic,” said Dr. Anarfi

Asamoa-Baah, Assistant Director-General of WHO. “The shortage of health workers

is devastating public health systems, particularly in the developing world, and

it is one of the most significant challenges we face in preventing and treating

HIV.

WHO is launching ‘Treat, Train, Retain’ to confront this crisis.”

“WHO’s ‘Treat, Train, Retain’ plan provides a much-needed boost to national

health systems that will have an impact far beyond HIV/AIDS,” remarked Dr Sigrun

Mogedal, the Norwegian government’s Ambassador for HIV/AIDS. “By increasing the

number of well-trained, healthy and motivated health workers, the plan will

provide significant benefit to health systems generally.”

The ‘Treat, Train, Retain’ plan will be implemented under the umbrella of the

Global Health Workforce Alliance, hosted by WHO, which was established in May

2006. The Alliance is a partnership of governments, aid agencies, civil society

groups and multilateral organizations.

" 'Treat, Train, Retain' draws on the growing body of evidence and experience of

what works in improving the performance of the health workforce, " said Dr

Francis Omaswa, Executive Director of the Global Health Workforce Alliance. " It

will accelerate the adoption of best practices on critical issues like the

increased roles and responsibilities of community health workers in combating

HIV/AIDS and promoting better health at household and community level. "

'Treat, Train, Retain' will focus on those countries most severely affected by

HIV/AIDS, and incorporates a menu of options that countries can adapt to their

specific needs. WHO estimates that it will cost a minimum of US$7.2 billion over

the next five years to implement the plan in the 60 countries with the highest

HIV burden, and it could cost substantially more – up to US$14 billion. This

corresponds to an annual per capita cost of approximately US$0.60 in the

countries concerned, or between two percent and five percent of the levels of

health expenditure typically found in low-income countries.

'Treat'

Although health workers are at the frontline of national HIV/AIDS programmes,

they often do not have adequate access to HIV/AIDS services themselves. The

'Treat' component of the plan represents a full package of HIV/AIDS prevention,

treatment and care services that should be made available to health workers on a

priority basis and tailored specifically to their needs. These include:

Specially designed awareness and anti-stigma and discrimination campaigns

Testing and counselling services

Priority access to antiretroviral treatment for health workers and their

families

Protection from HIV transmission in the health care environment, including

access to post-exposure prophylaxis

'Train'

The 'Train' aspect involves strategies for countries to expand the numbers of

new health workers and maximize the efficiency of the existing workforce. These

include:

Recruiting and training additional health workers

Shifting tasks from more- to less-specialised health workers (e.g., from

specialists to physicians, physicians to nurses, and nurses to community health

workers and lay providers including people living with HIV)

Increasing the number of graduates by improving and expanding pre-service

training in medical and nursing schools, and incorporating AIDS-specific

training

Providing in-service training to health workers already in the health system to

empower and better equip them with the skills needed to more effectively care

for patients living with HIV/AIDS

'Retain'

'Retain' relates to a set of interventions to help ensure that countries are

able to keep existing workers employed in the health system. These include:

Instituting policy changes, codes of practice and ethical guidelines to minimize

migration of health workers from low-income countries to developed countries

Diminishing the draw of private-sector and NGO HIV/AIDS programmes on workers in

public health systems

Improving the quality of the workplace environment, including establishing

occupational health and safety procedures, reducing the risk of contracting HIV

and other blood-borne diseases and addressing workplace issues such as stress

and burnout

Supporting staff and families with HIV by guaranteeing job security, prohibiting

discrimination, providing social benefits and adjusting work demands

Providing financial incentives, as well as non-financial incentives such as

career and training opportunities, transport and HIV treatment access for family

members

WHO’s Priority Action Steps

To ensure the success of 'Treat, Train, Retain', WHO has identified the

following priority action steps:

Establish a special steering committee that will advocate for the 'Treat, Train,

Retain' plan, guide the implementation of its activities, and monitor progress

Provide guidance and technical assistance to national governments for the

implementation of the activities outlined in the 'Treat, Train, Retain' plan

Promote global recognition of the health workforce as a 'vulnerable group', with

campaigns targeted specifically to the well-being of health workers within the

context of the HIV epidemic

Design and facilitate the implementation of a global agenda on task shifting to

expedite the world’s response to the human resource crisis

Advocate for financial incentives to retain health workers and research

potential options for non-financial incentives.

For more information contact:

In Toronto:

Anne Winter

WHO

Telephone: +41 79 440 6011

E-mail: wintera@...

Bartley

WHO

Telephone: +44 7958 561 671

E-mail: cathy.bartley@...

In Geneva:

Iqbal Nandra

WHO

Telephone: +41 22 791 5589

Mobile phone: +41 79 509 062

E-mail: nandrai@...

Tunga Namjilsuren

WHO

Telephone: +44 22 791 1073

E-mail: namjilsurent@...

_____________________________

Dr.Nabeel.M.K.

Alliance for Social Health Action (ASHA)

Academy of Medical Sciences,

Kannur, Kerala

e-mil: <drnabeelmk@...>