On 14 June 2005, the CNS handed down an opinion about the human resources crisis in the Southern countries, based on a report by the international commission, entitled, «The Human Resources Crisis in the Southern Countries, A Major Obstacle to Fighting HIV».
While access to treatment in the developing countries has seen a certain amount of progress, the lack of human resources seriously jeopardises any attempt at fighting the HIV epidemic. The number of caregivers in Africa needs to be increased three-fold. The poor working conditions, alongside a lack of safety measures and treatments, has led many workers to leave the profession, as is the case in Africa, where 40% have already left the healthcare sector. The migration of healthcare workers toward Western countries heightens the human resources issue and lays a heavy financial and human burden on the developing countries. For example, 70% of the nurses trained in the Philippines have emigrated, leaving 30 000 positions vacant. Lastly, the dearth of healthcare workers continues to deepen, as in some countries, over half of the healthcare worker population has died of AIDS.
In the face of such a challenge, an urgent response is needed, one in which the French authorities, which have already played an active part in the international mobilisation around access to anti-retroviral medication, must participate, both through their cooperation programs and in international bodies.
Part of the funding set aside for the fight against AIDS now needs to be dedicated to taking up the above challenge. Financial compensation needs to be paid to developing countries for the healthcare workforce provided to wealthy countries. The said funding needs to enable the creation of healthcare worker positions, increase wages, establish a population of replacement workers and, also, develop quality training. To that end, France could consider entrusting cooperation programme participants with positions as trainers and even caregivers. Such a strategy would need to be seen as a transitional measures, with the objective being skills transfer. However, only a true improvement in everyday job conditions for healthcare workers will make it possible to turn the drain on the healthcare sector around and help solve the present human resources crisis.
The responses suggested by Conseil national du sida obviously need to be conceived of and implemented as part of an overall healthcare system improvement effort.