Rapid Expansion of the Health Workforce in Response to the HIV Epidemic

The authors describe the global shortage of health care workers and the inadequate personnel available to care for patients with HIV infection. They review evidence showing the benefits of delegating tasks to less specialized workers (task shifting) and promote the expanded use of such services in countries with inadequate supplies of doctors and nurses. The authors describe the global shortage of health care workers and the inadequate personnel available to care for patients with HIV infection. They review evidence showing the benefits of delegating tasks to less specialized workers. The World Health Organization (WHO) estimates that there is now a global deficit of more than 4 million trained health workers. The shortages in health workers are critical in 57 countries, mostly in sub-Saharan Africa and parts of Asia. The situation is further exacerbated by the direct effect of the human immunodeficiency virus (HIV) on health workers in resource-constrained countries in which the disease is epidemic. Poor working conditions and low pay conspire with the risks of occupational transmission and the stress of working in communities devastated by the HIV epidemic to drive up rates of attrition. Many health workers . . .