More African health staff are being lost to Aids than are being
enticed to work abroad, a study says.
The death rate in Zambia's Lusaka and Kasama districts is double
the number who applied to work in the UK - the so-called
brain-drain, the Lancet said.
Researchers from Boston University in the US found that the
average age of death from Aids was just 38.
Experts said the major problem was that people with HIV struggled
to get access to antiretroviral drugs.
Report author Frank Feeley, from the university's international
health and development centre, said: "Policymakers might be
tempted to focus on stopping emigration as the best strategy to
strengthen the African civil service.
"Undoubtedly, the pay of health professionals is low and the
burden of disease in the population makes the job difficult. But
the dead do not complain about conditions of service.
"It is time to put more effort into keeping HIV-positive
professionals alive and serving in national institutions."
His research showed that there was an annual death rate of 3.5%
for nurses and 2.8% for clinical officers - medical assistants -
in the Lusaka and Kasama districts.
If this was applied to all the nurses in the country it would
mean the number of deaths in a year - 298 - would be nearly
double the number applying for registration in the UK - 169.
He said the low average age of death suggested that "Aids rather
than diseases of advancing age is responsible for most of the
And he called on governments to make antiretroviral therapy more
"Stopping the brain drain requires an unprecedented level of
"Keeping HIV-positive professionals alive and at work in their
home countries is a simpler task and one that we know how to do."
A spokeswoman for the Terrence Higgins Trust charity said: "HIV
affects all levels of society - the medical profession is no
"We know that the health workforce is losing workers and this is
partly because of a lack of access to drug treatment which can
keep people working.
"This has the added problem that there is then less professionals
to look after the sick. Action is needed."