UK 'crippling Africa healthcare' (2)
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Dear Colleagues
Economic forces are very powerful. The migration of people from
low wage and low opportunity to high wage and high opportunity
is natural, and will go on as long as it is allowed.
And I believe it should be allowed. From the African health sec-
tor point of view it is a disaster to allow it, but the individ-
ual value of allowing it is huge, and though I do not have
enough numerical information, Africa may well be ahead having
its para-professionals properly paid in rich countries rather
than not paid at all in their own country. Remittances may well
justify the staff migration. If there are limits and quotas, it
is just another way for the elite to benefit at the expense of
others.
Obviously rich countries should plan on balancing their needs
with their student training ... but rich countries have been
quite dumb about this and have fetched up with a huge shortage
of trained staff. Pretty silly really, but sadly to be expected.
This is not, after all, a problem for major industrial organiza-
tions, capital markets and their political friends.
The key thing that needs to be done is to find a way to pay
proper salaries to medical professionals and paraprofessionals
in Africa. This is something that the Global Fund for AIDS, Tu-
berculosis and Malaria should have as priority one ... but as
far as I know it does not rank very high, and in many places not
at all. I would like to work on this, but cannot devote much
time to it now, but hope to return to it again in due course.
The world should also be looking at how to pay informal groups
for the amazing work that they do in communities all over Af-
rica. Grandma looking after orphans in a poor community should
not be hungry ... and where the community support system has
broken down because of AIDS deaths ... the world should be plan-
ning on helping out.
The fund flows in the global health industry are absolutely bi-
zarre. AIDS research in the USA has huge funding ... I think
twice as much per annum as cancer research. But this is focused
almost exclusively on research that is relevant to the AIDS cri-
sis in the USA, and rather little of it on the global AIDS cri-
sis. To the extent it might be helpful in the global context it
is likely to end up under the control of "big pharma" in the
"north" and totally unaffordable in the places where it is
needed most. AIDS fund flows from the USA into the global crisis
are quite modest ... and reach only a small percentage of those
needing and deserving help.
With better management information about fund flows and what is
being accomplished, we might do a better job of getting value
for money. At the moment it is a mess, and medical people in Af-
rica have every right to be demoralized. In spite of very little
going for them, they are, however, doing amazing things. And for
that we should thank them.
And we should figure out how to get people paid properly to at-
tend to the global health crisis in the "south"
Peter B