Health+Care+Workers+1AC

NEW PLAN THE UNITED STATES FEDERAL GOVERNMENT SHOULD PROVIDE FINANCIAL INCENTIVES TO DOUBLE THE NUMBER OF HEALTH CARE WORKERS IN SUB-SAHARAN AFRICA

INHERENCY

Severe shortages in African Public Health Sectors Tamar Kahn, Science and Health Editor of Business Day, September 8, 2005 [L/N] [SL]

THE 2005 Health Systems Trust Review casts a harsh spotlight on the crippling shortage of staff in public hospitals and clinics. The review is a collaborative effort between the trust and the health department. Just more than 27% of posts for health professionals in the public sector are not filled. Assuming government creates an adequate number of posts, this means a shocking 45978 of the 169246 available positions are vacant. The shortage limits hospitals and clinics from providing quality health care to patients and places strain on overstretched staff. The problems are most acute in nursing, with the number of enrolled nurses declining from 59,7 for 100000 patients in 2000 to 51,5 this year. "On a busy night in casualty we can see 300 patients (who) will have to be seen by two professional nurses, two staff nurses, two nursing assistants, and two or three doctors... You just hope none of the staff are off sick," Sibonelo Cele, a nurse at the Mahatma Gandhi Hospital, told Health System Trust researchers

Even if there were more medicine, the lack of doctors destroys health care effectiveness Holly Burkhalter, Vice President of Government Relations for International Justice Mission, April 13, 2005, “Human Resources for Health and the Global HIV/AIDS Pandemic”, [SL]

If access to treatment had been withheld from poor countries until they secured the health infrastructure they needed to provide basic primary health care to all, as well manage an immense HIV/AIDS case load with medicines largely unknown to them, those countries would be waiting for anti-retrovirals to this day. Fortunately, the vision of treatment activists and now major donors as well has been to “build it as we go.”Accordingly, the President’s Emergency Plan for AIDS Relief (PEPFAR) has provided technical assistance, supplies, training, drugs, laboratory equipment, and other resources to countless hospitals and clinics in the fifteen focus countries to create capacity to scale up prevention and care, and graft antiretroviral therapy onto existing health services. That approach has helped enlarge the number of people receiving anti-retroviral treatment in sub-Saharan Africa from 50,000 in the end of 2002 to 310,000 in December 2004. But it has become increasingly clear that donors and national governments must simultaneously confront, ameliorate, and eventually remedy Africa’s disastrous shortage of trained health care workers. As Ambassador Tobias indicated in his first report to Congress in August of 2004, “Without a large increase in trained health workers, the human capacity to deliver ART [anti-retroviral therapy] and other therapies will simply be absent.”

The loss of skilled health-care workers destroys Sub-Saharan Africa’s ability to produce native workers UN News Service, September 28, 2005 [L/N] [SL]

A number of countries in Asia and sub-Saharan Africa remain well below the health worker density of 2.5 per 1,000 of the population required to meet the Millennium Development Goal targets that seek to cut maternal and infant mortality and sharply increase access to health care by 2015. The report also noted that "perhaps a more insidious but debilitating effect of the external migration of health professionals" is the loss of the skilled educators, trainers and specialists necessary to continue to produce native health-care workers. This could "erode ethics and professional standards," it added.

Plan Text: The USFG should provide sufficient funding to double the number of health care workers in Sub-Saharan Africa and increase the salaries of the health care workers in Africa. We reserve the right to clarify

ADV 1: The Big A Word

Shortage of Health-care workers impairs immunization, safe pregnancy, and treatments for HIV/AIDS, malaria and tuberculosis Chinadaily.com.cn, April 8, 2006 [L/N] [SL]

According to WHO, a serious shortage of health-care workers in many countries is impairing the provision of essential life-saving interventions such as childhood immunization, safe pregnancy, and access to treatment for HIV/AIDS, malaria and tuberculosis. More than 4 million doctors, nurses, midwives, managers and public health workers are needed to fill the gap in 57 countries, 36 of which are in sub-Saharan Africa. "It is high time health workers are paid decent salaries, and provided with the right working conditions and the right equipment to do the work they are trained to do," said Dr Shigeru Omi, WHO regional director for the Western Pacific. Omi called on governments to start providing better working conditions for health workers. In China, few doctors or medical school graduates want to work in rural and western areas, said Chen Xiaohong, vice-minister of health, at a World Health Day conference. Official statistics show that more than 90 per cent of China's doctors and nurses work in urban areas, which only account for 550 million of China's population of 1.3 billion.

Health Care Worker Crisis stops effective AIDS treatments Physicians for Human Rights, December 2, 2005 [L/N] [SL]

"The health care worker shortage is a crisis that could stop AIDS treatment in its tracks. And it is a crisis that violates the internationally recognized human right to health not only to people with HIV but to all - to women in labor, to people with tuberculosis, to children needing preventive care, and to everyone else in the society. But it is a fixable problem and solving this problem will have payoffs for the health of all," said Leonard S. Rubenstein, JD, PHR's Executive Director.

TENS OF THOUSANDS OF AFRICANS DIE A DAY FROM PREVENTABLE DISEASE. DOUBLING HEALTH WORKERS IS KEY TO ENSURE QUALITY MEDICAL CARE American Jewish World Service, News Periodical, 2007, “Take action to fight preventable disease in sub-saharan Africa,” http://action.ajws.org/campaign/HealthCareWorkers

Every day, tens of thousands of people die from preventable disease in sub-Saharan Africa. The impact and rapid spread of diseases like AIDS, malaria and TB have overwhelmed the small number of medical professionals working in the region. Sub-Saharan Africa needs to at least double its current number of doctors, nurses and other healthcare workers to ensure that everyone has access to quality medical care. Help the people of Africa by urging your Senators to co-sponsor the African Health Capacity Investment Act. This bill proposes allocating financial resources to train, build and retain a strong African healthcare workforce. This is a vital step in making improved access to healthcare a reality. Please act now!

AIDS is the greatest threat to humanity's survival – once sub-Saharan Africa is gone, the rest of the world will follow Muchiri, 2000 [Michael Kibaara Staff Member at Ministry of Education in Nairobi, "Will Annan finally put out Africa 's fires?" Jakarta Post, March 6, LN] [Sekaran]

The executive director of UNAIDS, Peter Piot, estimated that Africa would annually need between $ 1 billion to $ 3 billion to combat the disease, but currently receives only $ 160 million a year in official assistance. World Bank President James Wolfensohn lamented that Africa was losing teachers faster than they could be replaced, and that AIDS was now more effective than war in destabilizing African countries. Statistics show that AIDS is the leading killer in sub-Saharan Africa, surpassing people killed in warfare. In 1998, 200,000 people died from armed conflicts compared to 2.2 million from AIDS. Some 33.6 million people have HIV around the world, 70 percent of them in Africa, thereby robbing countries of their most productive members and decimating entire villages. About 13 million of the 16 million people who have died of AIDS are in Africa, according to the UN. What barometer is used to proclaim a holocaust if this number is not a sure measure? There is no doubt that AIDS is the most serious threat to humankind, more serious than hurricanes, earthquakes, economic crises, capital crashes or floods. It has no cure yet. We are watching a whole continent degenerate into ghostly skeletons that finally succumb to a most excruciating, dehumanizing death. Gore said that his new initiative, if approved by the U.S. Congress, would bring U.S. contributions to fighting AIDS and other infectious diseases to $ 325 million. Does this mean that the UN Security Council and the U.S. in particular have at last decided to remember Africa ? Suddenly, AIDS was seen as threat to world peace, and Gore would ask the congress to set up millions of dollars on this case. The hope is that Gore does not intend to make political capital out of this by painting the usually disagreeable Republican-controlled Congress as the bad guy and hope the buck stops on the whole of current and future U.S. governments' conscience. Maybe there is nothing left to salvage in Africa after all and this talk is about the African-American vote in November's U.S. presidential vote. Although the UN and the Security Council cannot solve all African problems, the AIDS challenge is a fundamental one in that it threatens to wipe out man. The challenge is not one of a single continent alone because Africa cannot be quarantined. The trouble is that AIDS has no cure -- and thus even the West has stakes in the AIDS challenge. Once sub-Saharan Africa is wiped out, it shall not be long before another continent is on the brink of extinction. Sure as death, Africa's time has run out, signaling the beginning of the end of the black race and maybe the human race.

ADV 2: Children Die Millions of children die yearly from preventable causes – problem acute in sub-Saharan Africa. US Coalition for Child Survival, collaboration of organizations and individuals that are working together to strengthen the United States and global commitment to child survival, (fill in), p. http://www.child-survival.org/WhyCS/whatiscs.cfm

Today, almost 30,000 children under age 5 will die from preventable or treatable causes, such as pneumonia or diarrhea. This loss of nearly 11 million children each year - equivalent to every child living in the eastern half of the United States - has humanitarian, economic, and political consequences - a global tragedy. And nearly 4 million of these children die within the first month of life. A majority of these child deaths are from preventable or treatable causes: pneumonia, diarrhea, malaria, and measles. Malnutrition, which weakens children’s ability to ward off illness, contributes to more than half of all child deaths. A large gap exists between the health of children in developing and developed countries; on the average the risk of death for children before reaching the age of five is twelve times greater in the developing world. Most of these deaths take place in the first year of life. Threats to health are exacerbated by the growing number of orphaned infants and children, generally due to the poor health conditions experienced by their parents—notably HIV/AIDS and mother's deaths in pregnancy and childbirth. While child mortality rates have declined by about 1 percent every year for the past 20 years, millions of children (particularly in sub-Saharan Africa and parts of South and Southeast Asia) still die every year because they lack access to vaccines and other basic care.

Child health is the moral and public health issue of our time – It is bigger than AIDS, TB, and malaria. David McAlary, science correspondent for the Voice of America, 6/27/03, Voice of America News: Health Section, p. ln

Global health experts say two-thirds of the more than 10 million young children who die each year from preventable diseases could be saved with inexpensive, available treatments. They call the high child death rate in poor nations the most pressing moral, public health, and political issue of our time. The international child survival campaign of the 1980s has long since faltered. During that decade, a program led by the United Nations Children's Fund helped reduce child mortality significantly with cooperation from rich and poor governments and non-governmental groups. With simple interventions, the average number of deaths for every 1,000 births dropped from 117 to 93. Encouraged by that progress, the 1990 World Summit for Children called for a further drop to 70 deaths for each 1,000 births. But that goal has not been reached. As of 2000, the worldwide average was still 83 deaths, according to Dr. Robert Black of the Johns Hopkins University Department of International Health in Baltimore. "The effort was sustained for some period, but unfortunately has not been continued with the same degree of vigor," he said. "The effort was abandoned before the job was done." Overtaking child survival programs were other seemingly more important public health priorities, such as the growing HIV pandemic, the re-emergence of tuberculosis, and the continuing malaria problem. But the experts do not rule out complacency. They point out that the child mortality problem is bigger than AIDS, TB, and malaria combined and involves other ailments such as diarrhea, pneumonia, and measles. Premature birth, lack of breastfeeding, unsafe drinking water, and tetanus also play a large role. Underlying half of all child deaths is malnutrition. At a Washington news conference on the topic, Dr. Black emphasized that these issues are neither exotic nor defy medical understanding. "At least six million deaths could be averted if we are able to implement the interventions that we have now," he said. That means using existing drugs, vaccines, and low-cost techniques such as breastfeeding, bednets treated with insecticide, and oral rehydration therapy. Where most child deaths occur is no surprise. They are in the world's poorest countries. "The very simple message is poor children die first and are served last," stressed Dr. Black. Six developing countries account for half of all deaths under age five - India, Nigeria, China, Pakistan, Democratic Republic of Congo, and Ethiopia. Forty-two countries account for 90 percent of all child deaths. To measure another way, 40 percent occur in sub-Saharan Africa and 35 percent in South Asia. Forty percent are of infants less than one-month-old. ... The experts who gathered in Washington to discuss the problem say that the cost of saving the lives of six billion children each year is between $7 billion and $8 billion. Can the world afford it? The Lancet papers note that this is only about twice the cost of putting two new aircraft carriers to sea. "That sounds like a lot of money, but if you realize that North Americans spend $17 billion a year on pet food, I think we can say this is an investment we should be able to make," noted Robert Black of Johns Hopkins University. The experts say that by failing its children, the world is failing its own future.

Adv 3: Poverty EMIGRATION OF SKILLED WORKERS SLOWS GDP, CAUSES POVERTY, AND INEQUALITY—EMPIRICAL EVIDENCE B. Lindsay Lowell, dir poli studies Georgetown U, and Allan Findlay, prof pop geography U Dundee, 12/01, International Labour Office Geneva, “Migration Of Highly Skilled Persons From Developing Countries: Impact And Policy Responses”, http://www.ilo.org/public/english/protection/migrant/download/imp/imp44.pdf, p. 6-7 [Helen] However, subsequent work recast the assumptions of the first analysts and agreed that neoclassical models of economic development generated an expectation that brain drain has adverse effects on sending country development.7 In particular, high levels of skilled emigration slow economic (GDP) growth and, adversely affect those who remain. As a consequence poverty and inequality are likely to increase. More recent economic theory, a.k.a. new or endogenous growth theory, also typically predicts that high skilled emigration reduces economic growth rates. Indeed, research finds that the average level of human capital in a society has positive effects on productivity and growth. One study of 111 countries 1960 to 1990 found that a one-year increase in the average education of a nation’s workforce increases the output per worker by between 5 and 15 per cent.8 Conversely, low average levels of education can slow economic growth, damage the earnings of low-skilled workers, and increase poverty. Models of high skilled emigration support the expectation that reductions in the average level of human capital slow economic development; and the first order effect of emigration is unambiguously to reduce human capital. Empirical research finds that Eastern Europe’s economic growth was slowed by skilled emigration during the 1990s.9 The loss of human capital holds back potential economic growth. Further fallout would be upward wage pressures for remaining skilled workers and hence increased inequality.

POVERTY KILLS MORE THAN A NUCLEAR WAR Mumia Abu-Jamal, former Reporter and Death Row inmate, 1998, [“A QUIET AND DEADLY VIOLENCE,” 9/19/98, http://www.mumia.nl/TCCDMAJ/quietdv.htm]

The deadliest form of violence is poverty. -- Ghandi

It has often been observed that America is a truly violent nation, as shown by the thousands of cases of social and communal violence that occurs daily in the nation. Every year, some 20,000 people are killed by others, and additional 20,000 folks kill themselves. Add to this the nonlethal violence that Americans daily inflict on each other, and we begin to see the tracings of a nation immersed in a fever of violence. But, as remarkable, and harrowing as this level and degree of violence is, it is, by far, not the most violent feature of living in the midst of the American empire. We live, equally immersed, and to a deeper degree, in a nation that condones and ignores wide-ranging "structural" violence, of a kind that destroys human life with a breathtaking ruthlessness. Former Massachusetts prison official and writer, Dr. James Gilligan observes; "By `structural violence' I mean the increased rates of death and disability suffered by those who occupy the bottom rungs of society, as contrasted by those who are above them. Those excess deaths (or at least a demonstrably large proportion of them) are a function of the class structure; and that structure is itself a product of society's collective human choices, concerning how to distribute the collective wealth of the society. These are not acts of God. I am contrasting `structural' with `behavioral violence' by which I mean the non-natural deaths and injuries that are caused by specific behavioral actions of individuals against individuals, such as the deaths we attribute to homicide, suicide, soldiers in warfare, capital punishment, and so on." -- (Gilligan, J., MD, Violence: Reflections On a National Epidemic (New York: Vintage, 1996), 192.) This form of violence, not covered by any of the majoritarian, corporate, ruling-class protected media, is invisible to us and because of its invisibility, all the more insidious. How dangerous is it -- really? Gilligan notes: "[E]very fifteen years, on the average, as many people die because of relative poverty as would be killed in a nuclear war that caused 232 million deaths; and every single year, two to three times as many people die from poverty throughout the world as were killed by the Nazi genocide of the Jews over a six-year period. This is, in effect, the equivalent of an ongoing, unending, in fact accelerating, thermonuclear war, or genocide on the weak and poor every year of every decade, throughout the world." [Gilligan, p. 196] Worse still, in a thoroughly capitalist society, much of that violence became internalized, turned back on the Self, because, in a society based on the priority of wealth, those who own nothing are taught to loathe themselves, as if something is inherently wrong with themselves, instead of the social order that promotes this self-loathing. This intense self-hatred was often manifested in familial violence as when the husband beats the wife, the wife smacks the son, and the kids fight each other. This vicious, circular, and invisible violence, unacknowledged by the corporate media, uncriticized in substandard educational systems, and un-understood by the very folks who suffer in its grips, feeds on the spectacular and more common forms of violence that the system makes damn sure -- that we can recognize and must react to it. This fatal and systematic violence may be called The War on the Poor.

OBS 2 Solvency Increased salaries are needed to retain African doctors Physicians for Human Rights, December 2, 2005 [L/N] [SL]

Right now, thousands of trained physicians and nurses leave African countries every year to work in the US, Canada, and elsewhere, because they are unable to afford to live in their home countries. Many, however, want to stay and work to save lives at home in the midst of the AIDS pandemic. One answer, the speakers agreed, was in finding ways to increase their salaries so that they can afford to support themselves and work in their home countries as doctors and nurses. Methods for achieving this range from asking US medical facilities to pay for fellowships that allow doctors to split their time between the US and Africa, to the need to relax International Monetary Fund rules that cap spending on health workers. All agreed that health care worker shortage is one of the more tractable problems related to the AIDS epidemic. Said PHR's Health Action AIDS Media Coordinator, Katie Krauss, "The health care worker shortage isn't as hard as trying to find a cure for AIDS. It's basically a very large management problem. It can be fixed." Right now, 1.3% of the world's health workers are struggling to care for 25% of the world's disease burden. Doctors and nurses are flooding out of Africa into the United States and other G8 countries because they face poverty wages if they stay. In Uganda, physicians make about $250 per month, not enough to support themselves, let alone a family. Some sleep in their examining rooms to save costs. Without access to latex gloves, many face contracting HIV in the workplace. Medical schools, like those at Makerere University Medical School in Uganda, are overflowing with medical students, yet right now only a small fraction will be able to stay at home after graduation.

US workers train native workers for self-sufficiency. Institute of Medicine, distinguished professors researching for a private, nonprofit society to advise the federal government, 05, Healers Abroad

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THE WINDOW IS CLOSING. WE MUST REVERSE THE AFRICA DISEASE CRISIS BEFORE IT IS TOO LATE Vanguard (Nigeria), Nigerian Newspaper, 12-11-06, “Nigeria: Health Rights Activists Demand 15% Budgetary Allocation From African Leaders” We also urge you to ensure that a significant percentage of the 15 per cent is dedicated to resolving Africa's health worker shortages, which is indisputably the most crucial component of every health sector. Without them to diagnose, prescribe or otherwise prevent, treat and care, no amount of medicines will resolve Africa's Public Health crisis. The World Health Organisation report for 2006 states that although there is a universal health worker shortage, it underlines that Africa is the only continent where the total number of health worker shortages (817,992) exceeds the existing number of health care workers (590,198). Lack of financial resources for the health sector and policies of some developed countries means that 'Brain Drain' has exacerbated this problem. Consequently, Africa has more health workers working outside Africa than any other continent. A failure to reverse these health worker shortages within the next 4 to 6 years means that all of Africa's 2010 Universal Access targets for prevention, treatment and care for HIV/AIDS, TB and malaria will definitely not be met. Even worse the three 2015 health related Millenium Development Goals-- based on scaling up reproductive health, children's health, and tackling the HIV/AIDS, TB, malaria and other diseases-- may be an impossibility. Without doubt, the future of Africa hinges on whether or not its public health crisis, (its overall human resource crisis) and in particular its health worker shortage is resolved.

Ethical imperative now to prolong survival. Institute of Medicine, distinguished professors researching for a private, nonprofit society to advise the federal government, 05, Scaling Up Treatment for the Global AIDS Pandemic [MP]

[This card is also from a book]