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To the Editor: The Commentary on health worker migration by Mr Gostin¹ rightly focused attention on nurses. Nurses are the backbone of primary care services in developing countries, particularly Africa. The rapid expansion of human immunodeficiency virus (HIV)/AIDS and tuberculosis has resulted in a major increase in nurses' workloads: in some parts of Africa, HIV/AIDS has doubled the patient load for nurses, with no commensurate improvement in salary or working conditions.²

The demands placed on nurses will likely increase with the current drive toward task shifting. Task shifting is a successful and necessary strategy to increase access to HIV/AIDS treatment in settings with severe human resource constraints. In particular, nurse initiation of antiretroviral therapy has allowed rapid expansion of treatment in settings where physicians are scarce.² Donors are showing a keen interest in task shifting for HIV care, and the President's Emergency Plan for AIDS Relief and World Health Organization . . . [Full Text of this Article]

Sharonann Lynch, BSc
Médecins Sans Frontières
Johannesburg, South Africa

Pheello Lethola, MD
Médecins Sans Frontières
Morija, Lesotho

Nathan Ford, BSc, DHA
nathan.ford@joburg.msf.org
Médecins Sans Frontières
Johannesburg

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The International Migration and Recruitment of Nurses: Human Rights and Global Justice
Lawrence O. Gostin
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