Opinions: Doctor shortages; harm reduction

America's Role In Developing Country Doctor Shortages

In his column in the Guardian, Jonathan Wolff, a professor of philosophy at University College London, says despite the U.S. being viewed as having the best system of higher education in the world, the country "simply does not train enough doctors to meet its voracious appetite for medical attention" and therefore "is compelled to raid the world to make up the difference."

"For decades about 25% of doctors practising in the U.S. received their training elsewhere. This now amounts to close to 200,000 doctors educated abroad. Around 5,000 were trained in sub-Saharan Africa; predominantly Ghana, Nigeria and South Africa, but also elsewhere. In 2002, there were 47 Liberian-trained doctors working in the U.S., and just 72 working in Liberia. And even when a doctor is recruited from Canada, Canada then looks to South Africa, and South Africa to wherever it can. The poorest will always lose out," according to Wolff.

"So while we look with envy at the wealth and achievements of the top American universities, we should bear in mind that not all is as well as it seems. In fact, it may be that the weakness of the U.S. higher education system is contributing to the health and development crisis in some of the world's poorest regions," he concludes (4/4).

Use Evidence-Based Outcomes On Harm Reduction To Prevent New HIV Infections

A Lancet editorial highlights a document released during the 22nd International Harm Reduction Conference, which is taking place in Beirut, Lebanon, this week, saying it "sets out how the international community has failed people who inject drugs and the actions now required by governments." According to the Lancet, "Crucially, evidence-based programmes ... targeting the 16 million people who inject drugs worldwide need to be financed, implemented, and scaled up across all settings to prevent and treat HIV infection. Ineffective drug policies also need to end, funding for harm reduction needs to be vastly increased, and vulnerable groups who inject drugs ... need access to integrated health and harm-reduction services."

The editorial calls for implementation of the recommendations "in the new global declaration on HIV/AIDS" set to be discussed at the U.N. High Level Meeting on HIV/AIDS in June. According to the Lancet, "it is wholly immoral to let people become infected with HIV or die when evidence-based interventions exist to prevent these outcomes. A bold and humane response is needed from governments at the June meeting and beyond. Millions of lives are at stake" (4/4).