View all newsletters
Sign up to our newsletters

Support 110 years of independent journalism.

  1. World
  2. Africa
6 November 2014updated 27 Sep 2015 5:30am

Ebola: how the west made things worse

The severe shortage of medical staff in African countries is not simply a result of failures in government planning. One major contributing factor is the high demand for trained health workers in rich countries.

By Desmond Cohen

It is easy to blame the governments of Liberia, Sierra Leone and Guinea for their failure to contain the spread of ebola. Some have argued that they should have put more resources into developing their health-care systems – but these are resources the countries of West Africa don’t have and that the international community has been unwilling to provide. At the same time, the severe shortage of medical staff in these countries is not simply a result of failures in government planning. One major contributing factor is the high demand for trained health personnel in rich countries.

Around 30 per cent of NHS doctors and 40 per cent of nurses were born outside the UK. Some medical schools and nursing colleges, particularly in India and Pakistan, have aligned their training and degree programmes with UK requirements. The NHS has direct recruitment systems in place that ensure special access to British citizenship. In 2013, 6,000 foreign nurses were recruited. At the same time, despite receiving 226,400 nursing applications that year, the NHS cut the number of nursing training places to 17,219, down from 20,829 in 2010. The UK is not alone in raiding health personnel from developing countries: many other rich countries behave in the same way.

Not only does this mean that poorer countries end up with too few health staff, as we have observed in Sierra Leone and Liberia. They also end up, in effect, subsidising richer countries by training nurses, doctors and other health technicians. Local medical education is distorted as a result. To give an example, I once travelled to Malawi on a UN mission in which one of our aims was to look at how to improve nurse training for HIV/Aids. The UN suggested that it would be cost-effective to develop a two-year in-service nursing diploma, yet this was instantly ruled out, in large part because the existing nurse training had been developed to meet international recruitment needs. Malawi needs more staff to address a growing HIV epidemic and other diseases but instead it is training nurses who tend to migrate.

Efforts to contain ebola have also been hampered by changes to global policymaking. In 2002, members of the G8 group of advanced nations launched a new international agency, the Global Fund to Fight Aids, Tuberculosis and Malaria. The fund has an annual expenditure of about $4bn, with 94 per cent of funding coming from the usual donor governments: the UK, France and US.

At the same time, the World Health Organisation’s (WHO)budget has been more or less frozen in monetary terms since 2006-2007. In its budget for 2013-2014, WHO expenditure for communicable diseases has been cut by 8 per cent; its allocations for emergency responses has been reduced by 51 per cent; funding for research into tropical diseases has fallen by 52 per cent. The Global Fund and WHO now have a similar budget but the WHO’s remit is much broader. The result? While there have been welcome advances in the response to malaria, HIV, Aids and TB, the international community diverts fewer resources to tackling epidemics such as ebola and other emerging global health problems.

Select and enter your email address Your weekly guide to the best writing on ideas, politics, books and culture every Saturday. The best way to sign up for The Saturday Read is via saturdayread.substack.com The New Statesman's quick and essential guide to the news and politics of the day. The best way to sign up for Morning Call is via morningcall.substack.com Our Thursday ideas newsletter, delving into philosophy, criticism, and intellectual history. The best way to sign up for The Salvo is via thesalvo.substack.com Stay up to date with NS events, subscription offers & updates. Weekly analysis of the shift to a new economy from the New Statesman's Spotlight on Policy team. The best way to sign up for The Green Transition is via spotlightonpolicy.substack.com
  • Administration / Office
  • Arts and Culture
  • Board Member
  • Business / Corporate Services
  • Client / Customer Services
  • Communications
  • Construction, Works, Engineering
  • Education, Curriculum and Teaching
  • Environment, Conservation and NRM
  • Facility / Grounds Management and Maintenance
  • Finance Management
  • Health - Medical and Nursing Management
  • HR, Training and Organisational Development
  • Information and Communications Technology
  • Information Services, Statistics, Records, Archives
  • Infrastructure Management - Transport, Utilities
  • Legal Officers and Practitioners
  • Librarians and Library Management
  • Management
  • Marketing
  • OH&S, Risk Management
  • Operations Management
  • Planning, Policy, Strategy
  • Printing, Design, Publishing, Web
  • Projects, Programs and Advisors
  • Property, Assets and Fleet Management
  • Public Relations and Media
  • Purchasing and Procurement
  • Quality Management
  • Science and Technical Research and Development
  • Security and Law Enforcement
  • Service Delivery
  • Sport and Recreation
  • Travel, Accommodation, Tourism
  • Wellbeing, Community / Social Services
Visit our privacy Policy for more information about our services, how Progressive Media Investments may use, process and share your personal data, including information on your rights in respect of your personal data and how you can unsubscribe from future marketing communications.
THANK YOU

To prevent a future ebola crisis, the health-care systems of countries such as Sierra Leone and Guinea need to be strengthened. But that also requires carrying out reforms closer to home: reducing rich countries’ dependence on medics trained in poorer countries and increasing funding to the WHO. 

Desmond Cohen is a former director of the HIV/Aids programme at the United Nations Development Programme

Content from our partners
What is the UK’s vision for its tech sector?
Inside the UK's enduring love for chocolate
Unlocking the potential of a national asset, St Pancras International

Select and enter your email address Your weekly guide to the best writing on ideas, politics, books and culture every Saturday. The best way to sign up for The Saturday Read is via saturdayread.substack.com The New Statesman's quick and essential guide to the news and politics of the day. The best way to sign up for Morning Call is via morningcall.substack.com Our Thursday ideas newsletter, delving into philosophy, criticism, and intellectual history. The best way to sign up for The Salvo is via thesalvo.substack.com Stay up to date with NS events, subscription offers & updates. Weekly analysis of the shift to a new economy from the New Statesman's Spotlight on Policy team. The best way to sign up for The Green Transition is via spotlightonpolicy.substack.com
  • Administration / Office
  • Arts and Culture
  • Board Member
  • Business / Corporate Services
  • Client / Customer Services
  • Communications
  • Construction, Works, Engineering
  • Education, Curriculum and Teaching
  • Environment, Conservation and NRM
  • Facility / Grounds Management and Maintenance
  • Finance Management
  • Health - Medical and Nursing Management
  • HR, Training and Organisational Development
  • Information and Communications Technology
  • Information Services, Statistics, Records, Archives
  • Infrastructure Management - Transport, Utilities
  • Legal Officers and Practitioners
  • Librarians and Library Management
  • Management
  • Marketing
  • OH&S, Risk Management
  • Operations Management
  • Planning, Policy, Strategy
  • Printing, Design, Publishing, Web
  • Projects, Programs and Advisors
  • Property, Assets and Fleet Management
  • Public Relations and Media
  • Purchasing and Procurement
  • Quality Management
  • Science and Technical Research and Development
  • Security and Law Enforcement
  • Service Delivery
  • Sport and Recreation
  • Travel, Accommodation, Tourism
  • Wellbeing, Community / Social Services
Visit our privacy Policy for more information about our services, how Progressive Media Investments may use, process and share your personal data, including information on your rights in respect of your personal data and how you can unsubscribe from future marketing communications.
THANK YOU