Misplaced Help in Africa

Misplaced Help in the AIDS Fight (washingtonpost.com)


Holly Burkhalter is director of Physicians for Human Rights. She writes:

When it comes to the HIV-AIDS pandemic, generosity isn't enough. Wealthy nations' contributions to fight the disease are unwittingly and unnecessarily exacerbating another crisis in some poor countries: the staggering shortage of health care personnel. African doctors and nurses are leaving public-sector jobs in droves to take more lucrative positions in foreign-funded HIV-AIDS programs. Public hospitals and clinics are being stripped of staffers; rural and slum outposts are being abandoned. The United States, the world's largest donor in the HIV-AIDS crisis, must also take the lead in supporting primary health care infrastructure and nourishing Africa's overwhelmed, underpaid nurses, doctors and other health workers.

Burkhalter's solution is threefold:

1. Embed AIDS care into primary care


2. Appropriate more money


3. Directly fund African health care workers

I don't have a problem with any of those recommendations. They are worthy of implementation. But I have a few more.

• Develop sustainable potable water supplies in rural areas.


• Improve health education in primary and secondary schools.


• Expand adult HIV prevention outreach with emphasis on empowering women.


• Find a cure for malaria.


• Improve childhood nutrition.


• End the war(s) in the Sudan, Congo, Nigeria, . . .

And then there's the problem that hits a little closer to home: the Texas HIV Medication Program will begin the new fiscal year on September 1, 2004, with a $6 million shortfall. On that date, Texas will start implementing "cost containment" measures. That's government-speak for turning people away at the door.