Efforts to combat diseases such as malaria, AIDS, tuberculosis and polio in the developing world are being thwarted by a critical shortage of 4 million health care workers, a new report has found.
Money is beginning to flow for health programs in poor countries and drugs, vaccines and technologies are now more available than ever, but it is of little use without the health workers to deliver the care, concluded the report outlined this week in The Lancet medical journal.
"What we do, or what we fail to do, will shape the course of global health for the entire 21st Century," said lead investigator Dr. Lincoln Chen of Harvard University.
The report is the result of two years of analysis by the Joint Learning Initiative -- a consortium of more than 100 health leaders worldwide.
It documents for the first time the dangerous scarcity of doctors, nurses, midwives and community health workers in the developing world.
"On the front line of human survival, we see overburdened and overstressed health workers, too few in number, without the support they so badly need, losing the fight," said the report.
Many of the weakest health systems are the most besieged by HIV. In some countries, it is killing health workers faster than they can be replaced.
The ones that are left are often working in dire conditions, where supplies, drugs and facilities are depleted, the report found.
Scores of doctors and nurses are fleeing to richer countries for a better life and more rewarding work.
The report found, for instance, that there are more Malawian doctors in Manchester, England than in Malawi, and that only 50 of the 600 doctors trained in Zambia since that country's independence stayed.
Experts estimate that countries need at least one health worker for every 400 people. About 75 countries, with 2.5 billion people, fall below that minimum thres-hold, the report found.
In Uganda, for example, there is only one nurse or midwife for every 11,365 people, while Liberia and Haiti have one per 10,000.
"It is people, not just vaccines and drugs, who prevent disease and administer cures," the report said.
Shortages are most severe in sub-Saharan Africa, where HIV medications sometimes exist, but hardly anyone is available to distribute them.
About 1 million new health workers -- triple the current number -- are needed immediately there to boost collapsing health systems, the scientists found.
The scientists found that overall, 4 million new health workers are needed to meet the minimum health goals set by the UN at the turn of the millennium.
The report calls for national work force plans addressing health needs and the creation of a so-called Action Alliance, an international body charged with bringing together health and human resource experts to advocate the cause and monitor progress.
The Joint Learning Institute is funded by the Rockerfeller Foundation, the World Bank, the World Health Organization, the Bill & Melinda Gates Foundation, among others.