Health Care Workers for HIV/AIDS programs: Can the buck stop at training?

July 25, 2006

According to Reuters:

Microsoft founder Bill Gates has donated $900,000 to set up a training facility for health professionals working with AIDS in Africa's Great Lakes region. On a low-profile visit to Rwanda on Sunday and Monday, Gates offered the funds to set up the Center for Training and Operation Research to serve five nations: Rwanda, Uganda, Burundi, Tanzania and the Democratic Republic of Congo...The ultra-modern facility will be run from Kigali by international experts under the coordination of Rwanda's AIDS Treatment and Research Center.

One can't help but applaud Bill and Melinda Gates for their generosity, although on the Gates scale of giving, this is an uncharacteristically non-technological initiative supported by a relatively small grant. Is the Gates Foundation a tad skeptical about an ultra-modern training facility as an easy solution? I am. Will this type of facility train and retain health care workers? As the health care worker crisis intensifies in several African countries, we know that training is only one part of a solution to the problem. If the buck stops here, will it further aggravate the crisis? Will trained health care workers seek better opportunities if there are no incentives for them to use their newly acquired skills in the health care systems they already work in?

Our CGD colleague, Michael Clemens, in his ongoing work on migration of health care workers out of Africa to countries like the U.S., hypothesizes that health care shortages occur as a result of underlying problems with health care systems in developing countries rather than migration, per se. At a recent CSIS event on Sustaining U.S. Global Leadership on HIV/AIDS, Tim Evans, Assistant Director-General for Evidence and Information for Policy at the World Health Organization, suggested that "hotel trainings" supported by donors in several African countries do little to build a truly skilled health-care work force and are inefficient health investments for donors. Clearly, building capacity -- including training and retaining health care workers -- and a functioning health care system should be among the highest priorities for HIV/AIDS donors (including PEPFAR, the Global Fund and the World Bank) and governments of HIV/AIDS affected countries in Africa. CGD’s HIV/AIDS Monitor country studies in Africa will provide some insight on these very issues. Stay tuned!


CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.