AIDS deaths are depleting the ranks of health professionals more rapidly than recruitment abroad in some countries in sub-Saharan Africa, according to the author of a Comment in this week's issue of The Lancet.
From the annual death rate, Frank Feeley (Boston University School of Public Health, Boston, MA, USA) and colleagues estimated that over a decade, death would claim more nurses (37%) and clinical officers (68%) in two districts in Zambia than resignation (23%) or normal retirement (9%). They found that the average age of death for these health professionals was 38, suggesting that AIDS, rather than diseases of advancing age, was responsible for most of the deaths. In addition, when they applied the same death rate to all 8500 nurses and midwives serving in the public sector in Zambia in 2000, they found the number of deaths (298) would be nearly double the Zambian nurses (169) who applied for registration in the UK in 2003-04.
Feeley calls on governments to make antiretrovirals more available and convenient to address premature deaths in the civil service. In his Comment, he lists components for governments to consider in programmes to tackle this problem, such as special provision for treatment in remote locations.
Dr Feeley comments: "If the death rate of Zambian nurses could be cut by 60%, Zambian health institutions would benefit more than they would from a total ban on recruitment to the UK."
He concludes: "Stopping the brain drain requires an unprecedented level of cooperation. Keeping HIV-positive patients alive and at work in their home countries is a simpler task, and one that we know how to do."
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Boston University School of Public Health
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