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International Nurse Migration and HIV/AIDS—Reply
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In Reply: Ms Lynch and colleagues draw attention to what I believe is the single most important challenge facing sub-Saharan Africa and other extremely poor regions. That problem is a generally weak public health and health care system that cannot meet the basic survival needs of the world's poorest and least healthy people.1 Although donor states and philanthropies care passionately about crumbling health infrastructures in poor countries, they do little to solve the problem and they unwittingly contribute to it.
Rich countries contribute to the problem in at least 3 ways. First, donors want rapid, measurable successes so they invest in discrete disease-specific projects rather than in longer-term, sustainable solutions, such as building human resources. Second, they actually compete with domestic health services. By offering more lucrative salaries and attractive working conditions, donors make it harder for local government and businesses to retain physicians, nurses, and allied health professionals. Third, . . . [Full Text of this Article]
Lawrence O. Gostin, JD
gostin@law.georgetown.edu
O’Neill Institute for National and Global Health Law
Georgetown University Law Center
Washington, DC
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