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Botswana�s Brain Drain Cripples War on AIDS
November 13, 2003
By CELIA W. DUGGER
WASHINGTON, Nov. 12 - As the Bush administration shapes its
plan to combat AIDS in Africa, Botswana's president, Festus
G. Mogae, said Wednesday that one of the biggest obstacles
to a rapid expansion of treatment for people with AIDS in
his country is not so much a lack of money or drugs as a
dearth of doctors, nurses, pharmacists and other health
workers.
The nonprofit groups, foreign governments and international
organizations that have come to help Botswana cope with its
AIDS crisis have hired away many skilled health
professionals in the country's public health system with
offers of better pay and benefits, he said.
Mr. Mogae, who spoke at a day-long conference on the
lessons of Botswana's experience sponsored by the Center
for Strategic and International Studies, a research
organization in Washington, said this internal brain drain
had been compounded by the departure of doctors and nurses
for other countries. Britain alone has recruited more than
120 of Botswana's nurses, Mr. Mogae said.
Botswana, where more than a third of adults in their prime
are infected with H.I.V., the virus the causes AIDS, has
sought to counter the loss of talent by recruiting health
professionals from poorer African countries, which have
their own AIDS crises, as well as from India and Cuba.
"We'll be lucky if we get them," Mr. Mogae said at a news
conference on Wednesday.
The shortage of people and a slower-than-expected pace in
building clinics, laboratories and drug warehouses have
delayed the expansion of Botswana's AIDS program.
It has been almost two years since Botswana - one of the
most prosperous, well-run countries in Africa - began a
national effort to provide free drug treatment to the
estimated 110,000 people who need it.
So far only about 10,000 people are getting the help - far
fewer than Mr. Mogae had expected.
Botswana is paying for 70 percent of its AIDS program and
the Bill and Melinda Gates Foundation and the Merck Company
Foundation, the philanthropic arm of the pharmaceutical
company, have each donated $50 million.
The Senate majority leader, Bill Frist, in introducing Mr.
Mogae, hailed his outspoken leadership on AIDS in Botswana
and noted Mr. Mogae's decision to publicly announce that he
had been tested for H.I.V. Dr. Frist, who visited Botswana
this year with a delegation of senators, said, "We can't
underestimate the need for knowledgeable people."
President Bush has committed to a five-year, $15 billion
AIDS plan for Africa and the Caribbean, more than half of
it for drug treatment. Congress is expected to appropriate
about $2 billion this year.
Dr. Ernest Darkoh, operational manager for Botswana's
effort to expand treatment with antiretroviral drugs, said
the loss of skilled people to the government's private
partners, who can pay 5 to 10 times as much as the
government, was a serious problem.
http://www.nytimes.com/2003/11/13/international/africa/13AIDS.html?ex=1070117418&ei=1&en=71164b5b714f3d85
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