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The AIDS Epidemic Has Revealed Health System Weaknesses
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Monday 04 August 2008

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by: AFP, Le Devoir


Life expectancy in Malawi in 2005 was 42 years. While great strides have been made there in AIDS prevention and treatment, a single nurse may keep 400 HIV-AIDS patients alive and be paid $3 a day herself.

    Mexico - Nurses paid $3 a day in Malawi, sick people who wait for months to be cared for due to the absence of medical personnel: participants at an AIDS conference in Mexico yesterday emphasized the holes in health care systems the pandemic has revealed.

    "A nurse keeps 400 patients alive by giving them treatment, but she's paid $3 a day," noted Dr. Moses Massaquoi, coordinator for the humanitarian organization Doctors Without Borders (MSF) in Malawi, in a preamble to the conference opening last night.

    Tesfa Ghebrehiwet from the International Nurses Council emphasized the "double crisis" developing countries experience: lack of nurses and doctors, and the desire of health care personnel who are there to leave a country where they are undervalued. "Overloaded with work, underpaid, and undervalued," summarized MSF's Dr. Mit Philips.

    The AIDS virus has aggravated the situation, all the more so in that it attacked health care workers first of all.

    However, the virus has also forced people to reflect on the improvement of health care systems, several participants noted, and has allowed - according to Mexico's former Minister of Health Julio Frenk - a "transformation of the health care system for everyone."

    The Global Fund to Fight AIDS, Tuberculosis, and Malaria recently authorized use of the funds it distributes to improve health care systems.

    One of the possible improvements consists of decentralizing tasks by confiding some of them to personnel with few diplomas, but specific training.

    Ethiopian Health Minister Dr. Tedros Adhanom Ghebeysus deemed that "the essential strategy is prevention," for which "high level professionals" are unnecessary. Along the same lines, according to MSF, it's better to use health care workers, especially in rural areas, "by training them better and giving them more support" to take over tasks that have previously been reserved for the medical corps.

    Just before the conference, Professor Jean-François Delfraissy, director of the French Research Agency for AIDS and Viral Hepatitis, emphasized that it was necessary to "abandon the Northern model" of highly specialized doctors and personnel.

    

    Translation: Truthout French language editor Leslie Thatcher.

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