Oxfam Press Release – 13 April 2007

More money to pay for health workers and teachers not short-term solutions

International agency, Oxfam today urges governments and other major donors to provide more aid to solve the chronic shortage of doctors, nurses and teachers in poor countries around the world.
In a new report, "Paying for People," published today Oxfam estimates that US$13.7 billion must be invested every year to fund the additional 2.1 million teachers and 4.2 million health care workers – half of them in Africa – urgently needed to break the cycle of poverty.

 “What is needed are doctors not band aids. You can teach a child without a classroom but not without a teacher. There is no use building new clinics and schools or funding drug programmes for different diseases if the doctors, nurses and teachers are nowhere to be found. Education and health care are crucial in saving lives and helping people escape poverty yet only eight cents of every dollar in aid goes to paying for the people that deliver these essential services,” said Elizabeth Stuart, Senior Policy Advisor, Oxfam International.

Oxfam calls for 25 per cent of bilateral aid to go directly to support the health and education budgets of poor country governments for a minimum of six years. This long-term, predictable aid is the only way to help governments solve the staffing crisis in these vital services. With salaries barely above the poverty line and a shortage of training institutions in poor countries, recruitment of workers has not just stalled, it has gone into reverse.

The IMF should stop imposing ceilings on the wage-bills for health and education workers in developing countries and should leave such decisions to individual countries which are in a better position to judge the most appropriate use of their budgets.

“Today in too many of the world’s poorest countries health and education services are dependent on a handful of workers struggling heroically to do their jobs on pitiful wages and in appalling conditions. Becoming a doctor, nurse or teacher is like signing a contract with poverty,” said Stuart.

Oxfam accuses some G8 and EU countries of side-stepping their responsibility and concentrating their aid in short-term, quick fix projects. This includes Germany - president of the G8 in 2007 - and France who continue to provide bilateral aid in a form that does not pay for teachers and health workers.

The warning comes a week after the publication of the OECD overseas aid figures for 2006 which show that aid from the richest 22 countries fell by 5.1 per cent, the first time aid had fallen since 1996.

In the past aid for health and education has concentrated on individual projects rather than building public services that have the potential for the greatest benefit to the poorest people. Later this week the World Bank will discuss its Action Plan for Africa. But a real plan for Africa – and all developing countries – must focus on working with individual governments to deliver these essential services.

There is already proof that a closer partnership between donor and poor country governments on long-term aid is benefiting poor people.  Countries like Zambia, Tanzania, Mozambique and Uganda have either used the money freed up from debt relief or invested vital donor aid in their hospitals and schools. Now, children in these countries have free access to primary school and the sick in rural areas can go to the doctor for free.

World leaders have promised to increase both the quantity of aid they provide for health and education, and to ensure that aid can be spent where it’s most needed – such as on salaries and training. But those promises have been repeatedly broken. Oxfam’s new report calls for urgent action to help poor countries pay for the six million teachers and health workers who would deliver health and education for all.

Notes to Editors
1. At least US$13.7bn must be invested every year in the training and salaries of the 6.2 million extra doctors, nurses and teachers required - the same amount that will be spent on mobile music downloads in 2007.

2. Africa has 13 per cent of the global population, 25 per cent of the global burden of disease but only 1.3 per cent of the global workforce.

3. According to the latest aid figures published by the OECD on 3 April 2007, aid to sub-Saharan increased by just 2 per cent in 2006 when debt relief to Nigeria was excluded. This is despite G8 promises in 2005 to increase aid to Africa by US$25 billion per year until 2010.

4. Tanzania produces 640 doctors, nurses and midwives each year. To reach the WHO recommended staffing levels in ten years, it would need 3500 each year.

5. In Malawi, only 9 per cent of health facilities have adequate staff to provide basic health care and the country loses around 100 nurses each year who emigrate in search of a better wage.

6. By increasing its education budget from1.6 per cent to 4 per cent of GNP at the expense of its defence budget and using debt relief and foreign aid, the Ugandan government managed to double the number of children in school. Quality improved with teacher training and salaries increased dramatically from around US$8 to US$72 per month.