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Summary of the NIH International Representatives MeetingMay 8, 2007
Dr. James Herrington, Director, Division of International Relations, Fogarty International Center, welcomed the NIH IC representatives to Building 31's Conference Center room 6. He noted that one of today's proposed presenters, Dr. Kate Tulenko of the World Bank, was unable to attend the meeting due to a sudden scheduling issue at the World Bank. As such, he noted that USAID's Dr. James Heiby, M.D., M.P.H., would make the sole presentation at the meeting on the topic of "The Africa Health Capacity Investment Act of 2007." Dr. Heiby serves as a Medical Officer in the Office of Health, Infectious Diseases and Nutrition of the USAID Bureau for Global Health. Since 1985, his work has focused on adapting quality improvement approaches for health systems in lower and middle income countries. Africa Health Capacity Investment Act of 2007: Dr. Heiby noted that a bipartisan group of Senators led by Senator Durbin of Illinois introduced the "African Health Capacity Investment Act of 2007" (S. 805) on March 7, 2007, in the U.S. Senate. This Act, if enacted, would seek to address serious health personnel shortages in sub-Saharan Africa due to, among other things, the out-migration of health workers (e.g., nurses, doctors, pharmacists, community health workers, lab technicians, physician assistants, nurse assistants, etc.) from the continent and resulting in extremely low physician-to-population ratios, e.g., 5 physicians per 100,000 population. This is a leading obstacle in providing health care to millions of people in sub-Saharan Africa. These shortages are impeding achievement of internationally recognized goals in treating many disease conditions as well as the UN's health-related Millennium Development Goals. Dr. Heiby outlined the findings that are contained in the Bill, including issues highlighting: inefficient human resources (HR) management; inadequate institutional capacity in HR; other related system weaknesses - including quality assurance and adequate financial management. He noted that the proposed Act seeks to address problems posed by these issues as well as "brain drain/brain flight" concerns, urban/rural imbalances in healthcare delivery at the national level, the need to expand numbers of paraprofessionals, and address and improve "unattractive" working conditions (such as salaries, working environment, general health management, career development, broadening of educational opportunities and institutional capacity development). The general actions called for in the proposal Act directs the Executive Branch to help countries develop comprehensive plans - beyond single disease plans - that address workforce issues and improve overall health system delivery performance, increase use of paraprofessionals, and increase investments in education and health in sub-Saharan African countries, including through public-private partnerships, greater investment in Africa educational institutions, and "twinning" of African and U.S. universities. More specific actions would also be pursued under the proposed Act to improve national capabilities related to: HR management, recruitment, monitoring and evaluation and quality assurances, training capacity in HR and health management, improving the capacity of medical and nursing schools, use of salary incentives and career development incentives, increasing productivity and seeking development of a "global clearinghouse" for HR knowledge sharing. In closing, Dr. Heiby noted that the proposed Act calls for the Executive Branch to establish a monitoring and evaluation system to assess implementation of the Act's proposed actions, consult with sub-Saharan African countries as well as the African Union regarding the Act and its implementation, conduct a detailed analysis in 2 to 3 countries in the region on best use of external funds in carrying out the Act's provisions, and consult with key international agencies and international donors. Moreover, provide an assessment of best practices in knowledge sharing for HR. He expressed his view that there was a good likelihood that the Act would be passed by the current Congress, given the keen bipartisan interest in the issue. Finally, given NIH interests in this issue, Dr. Heiby was asked to coordinate with NIH/FIC, who in turn would coordinate NIH review of the measures related to the Act's implementation after its enactment in consultation with USAID. A link to the proposed act is at: http://thomas.loc.gov (then insert search for "S. 805"). NIH IC Information and Announcements:
Next Meeting: Tentatively set for July 10, 2007, at 1 p.m. in a location to be determined. Attendance: Archives of Past IC Reps Meetings
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