Debt cancellation sign-on letter for health professionals
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Support 100% Multilateral Debt Cancellation (a sign-on letter
and action alert from Physicians for Human Rights)
The debt relief movement is poised for a historic day this Octo-
ber 1st when G-7 finance ministers discuss 100% multilateral
debt cancellation for impoverished countries. Debt cancellation
would free up significant funds for development, including
fighting AIDS and strengthening health systems. You can help
make this happen in two ways.
1. If you are a health professional, please lend your name to an
international health professional sign on letter that will reach
all G-7 finance ministers and presidents/prime ministers before
this important meeting. This letter is copied below. If you
would like to add your name, please respond by September 20th to
aidsact@phrusa.org <mailto:aidsact@phrusa.org> with your full
name, degree, affiliation, and state/country.
2. If you are not a health professional, please consider e-
mailing or calling the White House or the US Treasury Depart-
ment, or other G-7 leaders and finance ministries. To partici-
pate in the campaign and find talking points and additional
background information (including contact information for the
White House and the US Treasury Department), please go to:
http://www.phrusa.org/campaigns/aids/action_debt_relief.html
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International Health Professional Sign-on Letter
September X, 2004
Dear G-7 Presidents and Prime Ministers:
We write to you as health professionals from diverse countries
in Africa, Asia, Latin America and the Caribbean, North America,
Europe, and Australia who strongly support debt cancellation for
poor countries. Debt cancellation is a prescription urgently
needed to help heal seriously ailing health systems - some of
which cannot even provide minimal care - in many of the coun-
tries in which we live and work.
Debt cancellation would free large sums of money, funds that
should be used to build stronger and more equitable health sys-
tems, which are desperately needed if the fight against AIDS and
other killer diseases is ever to be won. Right now we are losing
that fight. AIDS alone kills about 3 million people per year, as
another 5 million people becoming infected with HIV annually. At
the end of June 2004, fewer than 10% of people in developing
countries in urgent need of AIDS treatment were receiving it. In
light of the health crises that many of our countries face, debt
cancellation is necessary on human rights and humanitarian
grounds. We therefore urge you to endorse 100% multilateral debt
cancellation for impoverished countries when the issue is dis-
cussed at the meeting of G-7 finance ministers this October 1.
We know that poor countries need this debt relief urgently. Af-
rican countries alone are collectively spending about $15 bil-
lion per year servicing their debts to wealthy creditors, in-
cluding multilateral institutions. The fifteen focus countries
of the U.S. President's Emergency Plan for AIDS Relief spent
$10.3 billion servicing their debts in 2001; this is more than
the $9 billion these countries are scheduled to receive over the
Emergency Plan's entire five years. The World Bank, IMF, and re-
gional development banks are typically the largest creditors of
the most impoverished nations.
Relief from debt could be instrumental in enabling countries to
meet AIDS treatment targets, as well as other health goals. Your
governments all support the World Health Organization's (WHO's)
3 by 5 initiative, which aims to get 3 million people in devel-
oping and middle-income countries on AIDS treatment by the end
of 2005. Yet treatment goals cannot be achieved without health
workers. And as so many of us know through our own experiences,
many countries, particularly in Africa, have nowhere near the
necessary numbers of health personnel. For example, WHO and the
World Bank have reported that Tanzania and Chad, both countries
that would benefit greatly from debt cancellation, require their
health workforces to triple and quadruple in size, respectively,
to achieve the Millennium Development Goals.
The connection between suffering health systems and the debt
payments that limit funds available to them is palpable. To a
significant degree, the severe shortage of health workers in Af-
rica is a symptom of acute underinvestment in health systems,
many of which suffer from too few staff, too few supplies, and
too few drugs. This underinvestment is a central cause of the
migration of health professionals to wealthy nations, where
health systems are stronger and pay is better. Creating the con-
ditions that will enable health professionals to remain in their
home countries and allow them to provide the best care possible
for their patients will cost money. Health care workers will
continue to leave if they are unable to meet the charge of our
professions: serving our patients. Our colleagues will continue
to emigrate so long as they do not have medicines for their pa-
tients, or functioning equipment, or proper supervision. And
they will continue to leave so long as they cannot support their
families or be confident of their own safety. They need fair
salaries, equipment to protect themselves from occupational in-
fections of HIV and other diseases, and psychosocial support to
help cope with the constant death and stressors they face.
Full multilateral debt cancellation for impoverished nations
could go a long way towards meeting people's right to the high-
est attainable standard of health. Indeed, debt relief that
countries have received under the Heavily Indebted Poor Coun-
tries (HIPC) initiative has already begun to do so. In Malawi,
savings from debt relief have paid for extra staff and support
in primary health centers, nurse training, and improving the
supply of essential drugs in health facilities. In Mozambique,
debt relief funds helped increase the number of children receiv-
ing immunizations for tetanus, whooping cough, and diphtheria.
Debt relief savings have also helped fund primary health care in
Uganda, including salaries of health care workers, while coun-
tries including Uganda and Cameroon have used debt relief sav-
ings to help finance HIV/AIDS programs.
Debt cancellation is an excellent investment not only in peo-
ple's health, but also in countries' economic well-being. In-
creased spending by impoverished countries in health, education,
and other fields that promote human development, which will re-
sult from debt cancellation, goes hand-in-hand with economic
growth. As WHO's Commission on Macroeconomics and Health has
highlighted, investments in health will increase worker produc-
tivity, creating economic gains that would far exceed the ini-
tial cost to creditors of debt relief. Debt cancellation will
help put countries that are economically marginalized and heav-
ily dependent on foreign aid onto paths towards economic auton-
omy and integration in the world economy. By contrast, without
debt cancellation and other investments to reverse the spread of
and treat people with HIV/AIDS, decreased worker productivity
will make countries increasingly dependent on foreign assistance
and unable to participate in the global economy.
We therefore urge you to support 100% multilateral debt cancel-
lation for impoverished countries, including HIPC countries and
as well as non-HIPC countries that are in need of this relief.
We hope that your finance ministers will announce your govern-
ments' support for such an initiative at their October 1 meet-
ing. And we encourage you to work with countries whose debts are
cancelled to ensure that their savings from debt payments are
used on poverty reduction and human development. Countries can
establish mechanisms to ensure that savings from debt services
payments are used to reduce poverty and to promote human devel-
opment. Uganda has established a Poverty Action Fund into which
savings from debt relief are channeled, and which includes a se-
ries of procedures to ensure that the debt relief savings are
well spent. Other countries, including Tanzania and Malawi, have
established similar mechanisms.
We also encourage you to work towards a permanent solution to
the debt of impoverished countries - including for countries
that do not receive 100% multilateral debt cancellation and for
any new debt assumed by those countries whose debts are can-
celled - by creating a new understanding of what level of debt
countries are expected to repay. In particular, we urge you to
announce that from this time forward, countries will be neither
obliged nor expected to make debt payments that would compromise
their ability to meet their people's basic needs or otherwise
fulfill their people's human rights.
We are health professionals. Our job is to heal. So it pains us
to see debt payments siphoning away funds that could go far to-
wards enabling our colleagues and ourselves do our jobs and meet
the needs of the patients we serve. We fervently hope that you
will help enable us to be the healers that we were trained to
be.
Sincerely,
[To add your name, respond to this email with your full name,
degree, affiliation, and state/country.]
G-7 Deputy Finance Ministers