seas Placement of U.S. Health Professionals. In carrying out this study, the committee:

  • Reviewed available data sources to project the optimum size and composition of a U.S. global health professions service program to augment, train, and collaborate with the public health and clinical professionals residing in the host countries

  • Assessed the relative strengths and weaknesses of existing and potential organizational models for such a program that could rapidly be activated or adapted to recruit, train, and place program participants

  • Articulated principles that can be applied in evaluating the advantages and disadvantages of those models

  • Examined other contextual issues bearing on the successful implementation of a U.S. global health professions service program

In this report, the committee recommends a set of interconnected workforce enhancement programs that would meet the need to augment the health professional currently waging the fight against HIV/AIDS and other global diseases. The committee believes that, given adequate resources, talent, and political will, these programs would make an enormous contribution to the eventual control of these terrible afflictions.

HUMAN RESOURCES FOR HEALTH

The health workforce in low-income countries has suffered from years of national and international neglect. Indeed, the dearth of qualified health care professionals represents the single greatest obstacle to meeting health care needs in most low-income countries (Narasimhan et al., 2004). The World Health Organization’s (WHO) Commission on Macroeconomics and Health recently advocated a greatly increased investment in health, reaching a per capita expenditure of $34 per year in low-income countries. At the same time, WHO stated that the main barrier to implementing this increased investment is not funding, but the capacity of the health sector itself to absorb the increased flow (Habte et al., 2004). As new resources continue to be mobilized to fight HIV/AIDS, tuberculosis, malaria, and other diseases, it is most unfortunate that an insufficient workforce is impeding the success of these investments. External grants and funding to address global HIV/AIDS, estimated at $5 billion in 2003, could reach $20 billion by 2007 (UNAIDS, 2004). At present, however, there is simply too little human capacity in many developing countries to absorb, apply, and make efficient use of these new funds and critical health initiatives.

What underlies the health workforce crisis? In many countries, including those with a high prevalence of HIV/AIDS, the inability to recruit and



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