Responding to the global human resources crisis.

The global community is in the midst of a growing response to health crises in developing countries, which is focused on mobilising financial resources and increasing access to essential medicines. However, the response has yet to tackle the most important aspect of health-care systems--the people that make them work. Human resources for health--the personnel that deliver public-health, clinical, and environmental services--are in disarray and decline in much of the developing world, particularly in sub-Saharan Africa. The reasons behind this disorder are complex. For decades, efforts have focused on building training institutions. What is becoming increasingly clear, however, is that issues of supply, demand, and mobility (transnational, regional, and local) are central to the human-resource problem. Without substantial improvements in workforces, newly mobilised funds and commodities will not deliver on their promise. The global community needs to engage in four core strategies: raise the profile of the issue of human resources; improve the conceptual base and statistical evidence available to decision makers; collect, share, and learn from country experiences; and begin to formulate and enact policies at the country level that affect all aspects of the crisis.

Roll back malaria? The scarcity of international aid for malaria control.

The WHO announced the Roll Back Malaria (RBM) movement in 1998, with the goal of halving malaria deaths by 2010, and halving again by 2015. It is widely agreed that reaching this goal requires a major increase in international aid funding for malaria control, to a budget of perhaps 1.5 - 2.5 billion dollars annually. To ascertain whether progress is being made, we compiled data self-reported by the donors to the Development Assistance Committee of OECD, and also to ourselves directly. We find that, in fact, the total amount of international aid dedicated to malaria control, from the 23 richest donor countries plus the World Bank, remains in the range of 100 million dollars annually - a figure that is virtually unchanged since the start of RBM. This lack of progress toward increasing funding very seriously threatens RBM and demands that WHO regularly audit and report on malaria control funding, with the certainty that RBM will fail to meet its deadline of 2010 if this is not done.