XIX International AIDS Conference, Washington DC, USA 24 July 2012

1. HIV Health Workforce Crisis: An international perspective on Human Resources Gaps and Needs for HIV CareDr. Mubashar SheikhGlobal Health Workforce Alliance XIX International AIDS Conference, Washington DC, USA 24 July 2012

2. Fast facts – Health Workforce Crisis • One billion people have no access to a skilled health worker. • WHO estimates - four million health workers are needed to improve child and maternal health and treat diseases like HIV/AIDS. • WHO recommends a minimum of 23 health workers per 10 000 people to provide the most basic health coverage. • "expanding coverage is often hindered by the severe lack of human resources, especially in rural areas and slums" (UNAIDS, 2011) • Sub-Saharan Africa requires two times its current HRHA population to be added every year for the next 10 years to achieve universal coverage" (Barninghausen 2007) Source: WHO, WHR 2006; UNAIDS 2011; Barninghausen et al AIDS Patient Care and STDs, 2007

3. The human resources for health crisis in Sub-Saharan Africa Source: HHA

4. HRH labor market dynamics Source: WHO, 2006.

5. HIV and HRH: a multi-faceted interface "…increasing human resource capacity for the response, including by scaling up the training and retention of human resources for health policy and planning, health-care personnel…" (UNGASS 2011) Source: WHO, 2006, UNGASS 2011.

6. Universal Access to HIV/AIDS Services - Can MDG 6 be achieved with the Health Workforce we have? • Insufficient financial resources • Low salaries, large workloads, and difficult working environment • Basic HRH information is often unavailable or fragmented • Excessive focus on in-service training instead of pre-service education • Insufficient focus on HIV prevention workforce. • Ethiopia: 2009 public sector healthcare workforce was 66,300. Strategic plan 2009-2020 calls for scale up to 193,264 by 2020. • Côte d’Ivoire: Structural adjustment measures and financing gaps have limited recruitment of health workers. New hires in 1996 - 2005 represented only 40 percent of the needs identified by the MoH. Source: GHWA, WHO, 2011. Will we achieve universal access to HIV services with the health workforce we have. Task Force on Human Resources for Universal Access .

7. Source: “Institute of Medicine Committee on Envisioning a Strategy to Prepare for the long-term burden of HIV/AIDS UNAIDS’ perspective”, Karl L Dehne, 3 March 2010

8. Task sharing to improve the skills mix efficiency Source: Fulton B et al HRH 2011; Callaghan et al HRH 2010; UK APPG, 2012; GHWA 2010; Lewin et al, Cochrane database 2010; GHWA 2012, forthcoming

9. HRH actions needed for an effective HIV/ AIDS response • Government ownership, political will, and commitment • Preparation and implementation of costed human resources for health strategic plans embedded in national health strategies, and facilitating the coherent involvement of all stakeholders. • Estimate numbers and types of health workers needed to reach national universal access targets for HIV services • Integration of HIV services into mainstream health services • Strengthen HRH management systems • Address health worker retention, motivation, and job satisfaction   • Training on universal access to ARVs and task sharing for ARV delivery to follow-up patients • Increase attention given to HIV prevention Source: GHWA, WHO, 2011. Will we achieve universal access to HIV services with the health workforce we have. Task Force on Human Resources for Universal Access .

10. Aligning partners' support for HRH to national priorities Source: Vujicic et al, HPP, 2012

11. Progress is possible: % ART coverage in selected countries Source:UNAIDS, 2008; UNGASS progress report, 2010 .

12. For further information http://www.who.int/workforcealliance/en/ ghwa@who.int http://www.who.int/workforcealliance/knowledge/resources/uareport_en/en/