2 million healthcare workers by 2020, says African Union
The African Union endorses two health plans to transform health systems and end AIDS by 2030 in the region.
African Heads of State at the 29th African Union Summit in Addis Ababa, Ethiopia have endorsed a new plan to deploy two million community healthcare workers across sub-Saharan African, in a bid to improve the reach, impact and efficacy of health services.
The African Union also endorsed an HIV catch-up plan for West and Central Africa, who are lagging behind East and Southern Africa in getting people tested and linked to treatment.
Community health workers – the ‘missing link’
Community health workers are those from and deployed by the community itself, who need far less training than doctors, but can deliver health services when other human resources are limited.
Much research has been conducted showing that community health workers increase uptake of health services, reduce inequalities, provide a high quality of services and improve overall health outcomes.
The plan recognises that these community health workers should not be a substitute for investment into existing medical education programmes – a criticism of the scale-up of community health workers generally.
But meeting the unmet need of doctors in Africa will require a three-fold increase in the capacity of medical schools on the continent – of which an estimated US $17 to $23 billion would go on construction alone. So it is clear that innovative solutions are needed to fill the health worker gap, and bolster health system weaknesses.
The report highlights the key role these health workers could play in the ‘HIV testing revolution’ – reaching population groups that are unlikely to use other types of health services.
Community health workers have also played a key role in the innovation of health service delivery in the communities they serve. In response to clinic congestion, health workers went out into the community to distribute antiretroviral treatment – meaning more people adhered to their medication, while also increasing HIV treatment uptake. Training community health workers to deliver medicines, monitor patients and support adherence has achieved health outcomes exceeding those reported by health facilities.
West and Central Africa – the catch-up plan
While West and Central Africa have lower prevalence rates compared to other parts of Africa, the statistics from the region are alarming – a large proportion of global AIDS-related deaths occur in this region as most countries continue to struggle to offer treatment to those who need it.
New infections among children has dropped as prevention of mother-to-child transmission services have been scaled up. Despite this, in 2015, the region accounted for nearly half of the global total of new HIV infections among children.
In 2015, just 36% of people were aware of their status, 28% were on treatment and 12% of people living with HIV were virally suppressed. This is compared to global stats of 57%, 46% and 38% respectively for the same year. Some 4.7 million people were without treatment in the region, and 330,000 people died from AIDS-related illnesses in 2015.
“We cannot accept a two-speed approach to ending AIDS in Africa,” said UNAIDS Executive Director Michel Sidibé. “To put western and central Africa on track to end AIDS, we must address stigma, discrimination and other challenges to an effective response, allocate funding to support the most effective strategies and implement delivery strategies that reach the communities most in need.”
The first step in the plan will be to ensure the structural and policy environment is in place to accelerate the response in the region. The plan aims to increase the number of people on treatment from 1.8 million to 2.9 million by mid-2018, giving an additional 1.2 million people, including 120,000 children.