A Peace Corps
For Global Health
Every day, 14,000 people across the world contract HIV and another 8,500 die from AIDS. The global effort that's necessary to combat the rapid spread of HIV/AIDS has no precedent. The volume of trained health care workers and support personnel needed to provide lifelong care for people with an incurable disease far surpasses what was needed to tackle smallpox, polio, or any other previous public health crisis.
Nothing less than a Peace Corps-scale contingent of health care professionals and other experts should be mobilized to plan, carry out, and sustain a campaign against the disease, says a new report from the Institute of Medicine. The report envisions a new Global Health Service with a pivotal "service corps" among its many elements -- a cadre of full-time, salaried clinicians, educators, and managers who travel overseas to work with other U.S. colleagues already in place and local counterparts in running treatment and prevention programs for HIV/AIDS as well as malaria and tuberculosis, diseases which often overlap with and are exacerbated by HIV/AIDS. Some 150 U.S. health professionals should be selected in the first year of the program for assignments lasting at least two years in hard-hit African, Caribbean, and Southeast Asian countries. Corps members would help train local professionals in addition to conducting hands-on treatment of patients or other activities.
Of course, the skilled professionals who are promising recruits for the service corps may have tens of thousands of dollars in debt remaining from their education and professional training, or mortgages, career commitments, and other ties that can make it difficult for them to travel abroad for an extended period. To encourage participation, incentives such as competitive salaries, a fellowship program offering awards of $35,000 annually, and a scholastic loan repayment program that would provide $25,000 for each completed year of service in the corps should be used to expand the pool of candidates.
These initiatives could mobilize thousands of health personnel to work abroad, providing desperately needed expertise in countries beset by critical shortages of doctors, nurses, and other health care professionals. There is only one physician for every 30,000 people in Mozambique and one nurse for every 5,000 Ugandans. Rwanda has just 11 pharmacists. "The dearth of qualified and trained workers in many low-income nations presents the single greatest obstacle to stemming the spread of AIDS, malaria, and tuberculosis," said study chair Fitzhugh Mullan. "Members of the Global Health Service Corps would offer both concrete assistance and hope for these nations by multiplying essential skills and services."
-- Christine Stencel & Vanee Vines
Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS. Committee on Options for Overseas Placement of U.S. Health Professionals, Board on Global Health, Institute of Medicine (2005, 264 pp.; ISBN 0-309-09616-2; available from the National Academies Press, tel. 1-800-624-6242; $38.00 plus $4.50 shipping for single copies).
The committee was chaired by Fitzhugh Mullan, clinical professor of pediatrics and public health, George Washington University, Washington, D.C. The study was funded by the Office of the U.S. Global AIDS Coordinator, located in the U.S. Department of State.