preventing progress towards attaining the health Millennium Development Goals (MDGs) and the goals of universal access to essential health care, including antiretroviral treatment.

This crisis has developed over time due to poverty, under investment and inappropriate policies, and poor salaries and incentives.

Some of these have been imposed by international partners. Many industrialised countries still rely on being able to attract health professionals out of Africa rather than training sufficient numbers in their own countries — a key driver of the crisis.

Although Africa suffers 25% of the global burden of disease the continent has only 3% of the global health workforce.

Africa is short of 800,000 doctors and nurses yet currently trains only 10-30% of the skilled health workers needed ; it loses 20,000 per year to migration, with up to 60% of doctors trained in some countries migrating within two years of graduation.

Ahead of global developments, the NEPAD Health Strategy recognised the critical importance of addressing the Human Resources for Health (HRH) challenge and the NEPAD Secretariat has put much effort towards building global and continental action on the crisis.

The global movement to address the HRH challenge began with the Joint Learning Initiative (JLI) on Human Resources for Health, with NEPAD a member of the African Working Group which developed an analysis and strategies.

This led to participation in the high level forums on the health MDGs where tackling the HRH crisis was again moved towards the top of the health development agenda.

This advocacy and strategy development was supported by successful inputs into the African Partnership Forum and the Blair convened Commission for Africa. Among others, this has led to increased support by donor countries and UN agencies.

Scaling up training and education These developments have also led to the establishment of the Global Health Workforce Alliance (GHWA), with NEPAD as the African institution on the founding board. (NEPAD will be hosting the next board meeting).

This has seen funding provided to five initial pathfinder countries to establish country action teams on HRH. The support to Angola, Benin, Cameroon, Ethiopia and Zambia will be complemented by support to eight more countries this year.

Africa also has to scale up its training of health professionals and the GHWA has established a task force on scaling up training and education, which will be co-chaired by the Commissioner of Social Affairs of the African Union, Advocate Bience Gawanas.

Recognising that Africa’s health burden cannot be overcome if the continent continues to bleed its health professionals, the GHWA has also established a migration task team under the leadership of the former President of Ireland, Mary Robinson.

NEPAD provided a keynote contribution to the colloquium held in London on mobilising the African Diaspora, health care professionals and resources for capacity building in Africa.

But, the central action must come from an African determined and driven response to the crisis, at country level.

NEPAD has played a key leadership role in promoting this. NEPAD and the African Council on Sustainable Health and Development (ACOSHED) hosted a dialogue on HRH in Abuja in 2004 that set the direction for future developments.

The senior representation from many countries enabled development of strategies and action on the key areas of training, retention, migration, research and linking human resources to health systems development and priority health programmes.

It also mandated the development of an African Platform on Human Resources for Health to bring together and accelerate the efforts of countries and all stakeholders and supporters. The Steering Committee selected NEPAD as its chair.

The Platform will focus on support for enhanced productivity of the existing workforce, improved professional training and density and development of mid-level and community health workers.

It has also established an African Human Resources for Health Observatory to collate and analyse information on the continent to improve the evidence base for action.

Working closely with AU Commission NEPAD recognises the central role played by Regional Economic Communities (RECs) and they and countries provided the majority membership of the African Platform Steering Committee. The African Platform also hosted a consultation in Brazzaville for Central African human resources directors to contribute to sharing regional experiences and co-ordination.

The NEPAD Secretariat’s ever closer work with the AU Commission has seen co-ordination of the effort to move HRH towards the top of the health development agenda.

One of the critical obstacles to effective health system and health workforce performance is weak district level management capacity. To this end NEPAD, in partnership with the School of Health Systems and Public Health of the University of Pretoria in South Africa has completed two courses for district health managers from nine Southern African Development Community Countries with further annual courses planned. The plan is to develop courses in Central, Eastern and Western Africa as well.

There is no doubt that NEPAD has played a catalytic role in the field of Human Resources for Health and helped to ensure the African relevance of its solutions, even if all the products do not have a visible NEPAD brand.

There is a global and continental movement developing and NEPAD is at the forefront. This involvement has been an expression of a new style of partnership. Source : NEPAD News, March 9, 2007