KAMPALA, 4 March 2008 (IRIN) - Poor working conditions and inadequate pay have driven away health professionals from developing countries, thereby undermining medical services, a conference to address the global shortage has noted.

"For too long we have watched this crisis unfold in front of our eyes - this is unacceptable," Francis Omaswa, head of the Global Health Workforce Alliance, told the first Global Forum on Human Resources for Health that opened in the Ugandan capital, Kampala, on 3 March.

The deficit, the conference heard, had reached four million doctors, nurses, midwives and other healthcare professionals. Of these, one million are needed in Africa alone.

Some 57 countries, especially in Africa and Asia, are particularly affected and unable to effectively provide access to essential health services, prevention and information campaigns, drug distribution and other life-saving interventions such as immunisation, maternity care and treatment of several diseases.

"The world is looking to us and encouraging us to be ambitious in our goals, open to innovation, and determined to implement solutions," Omaswa told the conference. "We want political will of the highest level [to] translate into concrete action."

Uganda's health minister, Stephen Malinga, said his country had lost more than 500 doctors and thousands of nurses, of whom 200 were working in South Africa.

"Our neighbours have also taken them ... they are paid in dollars in Sudan and others with indispensable expertise have gone to Rwanda," he said.

Those who opt to stay in Uganda, Malinga explained, were earning so little they could often not afford to pay the rent. Uganda thus had one doctor for 100,000 patients.

The Global Health Workforce Alliance said one in four doctors trained in Africa was working in western industrialised countries.

"They seek better employment and quality of life. Income is an important motivation for migration [as well as] better working conditions, career opportunities and more job satisfaction," Sigrun Mogedal, one of the conference organisers, said.

"Sub-Saharan Africa faces the greatest challenge and proportionately, is the most heavily affected region of the world. One million health workers are needed to bridge the gap in this region," the alliance noted. "While it has 11 percent of the world population and 24 percent of the global burden of disease, it has only 3 percent of the world's health workers."

The conference aims to produce a 10-year global action plan to deal with the problem, which would require US$3.3 billion per year to train 1.8 million health workers in Africa for the next eight years. Another $27 billion would be required to pay them to stay.

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