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Essay

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Medicines without Doctors: Why the Global Fund Must Fund Salaries of Health Workers to Expand AIDS Treatment

  • Published: April 17, 2007
  • DOI: 10.1371/journal.pmed.0040128

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Salaries without Doctors

Posted by plosmedicine on 31 Mar 2009 at 00:09 GMT

Author: Wouter Arrazola de Onate
Position: MD
Institution: Former Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo Mozambique
E-mail: woutera@hotmail.com
Submitted Date: May 29, 2007
Published Date: May 29, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Dear all,

As a former collaborator of the Faculty of Medicine of the Mozambican Eduardo Mondlane University, I have been screaming the same message for years now. I am glad that finally some attention is given to this fact.

In the case of Mozambique, brain drain is not the biggest problem. Neither are the salaries. It's the pure lack of doctors. Only up to 60 doctors a year are trained at the University for a 18 million population. In 2004, Mozambique had about 700 medical doctors, expatriates from all ngo's and projects included. I do not agree that increasing the salaries will be the most efficient solution. This will not create more doctors.

The Mozambican Ministry of Health received hundred of millions of dollars from international donors for the National Aids Plan. While the Faculty of Medicine, depending on the Ministry of Education, was struggling to survive. Not a single dollar from all the AIDS-millions went to support of the basic education of doctors. Not out of bad will, but because donors have to much restrictions.

Doctors are not only needed for the HIV/AIDS epidemic but they also treat the many malarias, tuberculosis, children with diarhea, leishmaniasis, fistula, STI,... They perfrom sectio's, other life saving surgery, etc...

It's my strong opinion that direct investment in training of medical doctors is the most Sector Wide Approach in Public Health. It is the most obvious and well defined contribution to health related MDG's and development in general. I do not understand why so little donors agree on this.

I can only speak for the case of Mozambique.

Kindest regards and "A Luta Continua",

Dr Wouter Arrazola de Oñate, MD
Former Faculdade de Medicina
Universidade Eduardo Mondlane
Maputo, Mozambique
woutera@hotmail.com

I declare that I have no competing interests

No competing interests declared.