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What about governments with no need for well motivated HCWs?

Posted by plosmedicine on 31 Mar 2009 at 00:07 GMT

Author: Wayengera Misaki
Position: M.B, Ch.B, MSc
Institution: Pre-doctorial Scholar
Additional Authors: None
Submitted Date: April 21, 2007
Published Date: April 23, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Two years ago, following the GFATM scandal in Uganda that involved huge misappropriation of funds meant to avail HAART to peasants by several political figures, I responded to an article by Peter Mozynski in the BMJ by calling for more accountability from the leaders involved through a commission of inquiry before funds were reinstated. Two years later, that commission's report is out and highlights a hole in the mechanism of handling the GFATM funds within this setting that otherwise would have gone unnoticed

I agree with the thoughts of Gorik Ooms. et al, who call for the global fund to offer salary support for HCWs within this setting - as I know, and have served in the sorry state of welfare for HCWs here. However, the approach should not overlook the loopholes involved in transferring those monies to the HCWs. Unless mechanisms are put in place that ensure that such monies reach the persons they are intended for, lest they end up buying more guns to keep rogue dictatorial regimes in power, regimes that have no respect for the welfare of HCWs, regimes lead by politician that downplay all efforts of HCWs to serve the countries peasants, those who have daughters fly to Germany to give birth by C-S, a C-S that would be done by a well motivated HCW within the same setting.

My point is that, whether or not the GFATM takes on this task, the real onus lies on sub-Saharan governments prioritizing the health of their citizens. This in turn will put in place the favorable conditions that will allow the channeling of such salary monies to HCWs.


1. Peter Mozynski. Global fund calls for more AIDS fundingBMJ 2005;331:533 (10 September), doi:10.1136/bmj.331.7516.533
2. Ooms G., et al.Medicines without Doctors: Why the Global Fund Must Fund Salaries of Health Workers to Expand AIDS Treatment

No competing interests declared.