HRSA eNews

For Africa, No Better Time
“Hopeless Africa,” said the headline in one of London’s most respected and widely distributed journals. It was May, 2000, and as Dr. Francis Omaswa read the litany of problems – civil war, malaria, tuberculosis, an unchecked epidemic of HIV/AIDS sweeping the continent – it pained him.

“Africa was dying,” he said. “Before PEPFAR, we were dying … There was not much to be hopeful about.”

On a recent visit to Washington, DC one of Uganda’s leading physician-educators and an international authority on public health in developing countries talked about the latest phase of the President’s Emergency Plan For AIDS Relief (PEPFAR): a new initiative to train a “next generation” health care workforce for Africa.

“The timing is as good as I have ever seen it,” Omaswa said. “Today, we are a Hopeful Africa.”

Omaswa was referring to the Medical Education Partnership Initiative (or MEPI): a 5-year, $130 million project involving 13 medical schools in 12 African countries, with George Washington University as its coordinating center, administered by the HRSA HIV/AIDS Bureau and the NIH Fogarty International Center.

In its third year, the project aims to build faculty in the grantee schools, promote cross-border cooperation, and train and retain 140,000 health care workers to secure the progress made under PEPFAR and other public/private international relief projects in the fight against communicable diseases on the continent.

For Omaswa, a leading advocate for a solution to out-migration of the African health care workforce to industrialized countries in recent decades, MEPI represents a reversal of the tide. Ironically, the workforce crisis in Africa was “exposed” by the sudden arrival of PEPFAR and the rapid expansion of relief efforts in the face of the HIV/AIDS epidemic.

“Once we introduced anti-retroviral drugs,” Omaswa noted, the world community recognized “that we also need people: lab people, pharmacy people, clinicians to make the diagnosis, counselors and so on.”

“Helping people in rural areas remains a challenge still … so what we are doing now is training others -- non-physicians, non-nurses -- to do some of these things. That’s almost getting accepted now, the para-professionals.”

MEPI, he said, is a chance to re-build health care systems across the continent, renew the research capabilities of Africa’s 100 medical schools and provide the kind of career incentives that “motivate clinicians to stay at home.”

“MEPI,” he said, “is a breath of fresh air … at a very good time.”