Rodney Kort

1
Scaling Up to Universal Access Strengthening the
Health Care Workforce

• Rodney Kort
• Senior Writer and Initiatives Manager

2
International AIDS Society

• Membership association of individuals working
  professionally in HIV/AIDS
• Over 7,000 members from 153 countries
• 28 member Governing Council Elected from 5
  regions
• IAS secretariat based in Geneva (from 2004)
• Custodian/lead organizer of the International
  AIDS Conferences and IAS Pathogenesis, Treatment
  Prevention Conference
• Regional Development/Educational Initiatives

3
Lessons from 3 by 5

• Leadership, commitment and resources produces
  results WHO, Global Fund and bilateral
  commitments through PEPFAR and others
• Targets mobilize action
• Interim step on road to universal access
• Strengthening and expanding health systems
  critical to achieving universal access

4
Challenges

• Shortage of health care workers where they are
  most needed
• Rising mortality among health care workers
• Falling productivity due to absence, illness and
  personal caregiving pressures
• Demoralization, stress and burnout
• Stigma and discrimination
• Additional skills and competencies required by
  health personnel to order to address the complex
  nature of HIV/AIDS, TB, malaria
• Migration

5
Opportunity and Innovation

• In-Country
• Decentralization of health care provision
• Task shifting/delegation
• Standardized approach to treatment and simplified
  clinical monitoring
• Integrating evidence-based prevention, care and
  treatment programmes, together with impact
  mitigation
• Appropriately trained and remunerated
  professionals
• Treat, train, retain placing health care
  providers at the centre of scale-up
• Public/private sector partnerships through CCM
  Three Ones approach important in ensuring
  consistency/coordination

6
Opportunity and Innovation

• External
• Long-Term political and financial commitment
  required for scale up Global Fund and bilateral
  donor
• Leadership, guidance and support from
  multilateral agencies
• Bilateral and multilateral agreements on
  migration that develop creative solutions to the
  outflow of skilled health care workers
• Incentives to encourage retention
• Partnerships international agencies/NGOs can
  support scale- up

7
Time to Deliver

• Anniversaries and benchmarks
• 25 years since first reports
• 10 years since HAART
• Knowledge, evidence and tools are available
• Health care workers must be seen as critical to
  the global response as treatment, care and
  prevention
• Momentum must not be lost