Higher salaries needed

There is a significant shortage of skilled personnel in the public services of many developing countries. According to figures from the World Health Organisation (WHO, 2006), more than four million more healthcare specialists are needed worldwide, including doctors. As a result, millions of people are sick or dying. Oxfam (2007) estimates that around two million additional teachers are needed. The shortage means that 80 million children are not able to go to school.

The situation is being exacerbated by population growth and because qualified people move abroad to take up better paid positions. International development strategies must be directed towards helping to resolve the problem.

Development cooperation is most effective when the recipient countries decide for themselves how to use the funds they receive. Consequently, there is much to be said for the idea of providing official development assistance (ODA) in the form of general and sectoral budget support, so as to encourage the successful implementation of national poverty reduction strategies. We have already seen some positive results where basic public health and education services have been expanded by direct support to national budgets, rather than tying assistance to specific projects or budgetary items. Donors should grant budget support of this kind for longer periods of time than they have in the past. This would make it easier to calculate the funds poor countries will receive.

A major drawback to the funding approaches followed in the past is that not enough money is allocated to pay skilled local workers. Oxfam has calculated that currently only eight per cent of global ODA is provided in a manner which is sufficiently flexible and pledged for long enough periods that it can be used for this purpose. The international donor community must do more in this respect.

Urgent action is needed in Africa in particular. There are currently only 600,000 skilled health workers in sub-Saharan Africa. At least one million more are needed. In the health sector, for example, Tanzania trains only 640 nursing staff and doctors each year. However, it would need an additional 3,500 skilled workers each year to reach the minimum staff level recommended by WHO by 2015.

The situation is similar in the education sector. UNESCO estimates that, in sub-Saharan Africa alone, at least 1.7 million additional teachers would have to be recruited by 2015, if every primary school aged child is to be able to attend a school with trained teachers and a maximum class size of 40 pupils.

The shortage of skilled workers is a problem affecting many developing countries. Some have considerably increased staff numbers in the health and education sectors. Recruitment and training programmes tailored to meet the needs of the local people are essential, and so are higher salaries. This is particularly true in rural areas. More employment opportunities for women, better management of the sectors affected and increased investment in infrastructure are also important.

Useful initiatives

The debt relief initiatives for highly indebted poor countries (HIPCs) agreed upon by the G8 in 1999 and 2005 have increased the scope for social spending. A World Bank report published in 2006 shows that HIPC countries which were granted debt relief doubled their spending on poverty reduction programmes between 1999 and 2005. As a result of this, it was possible to recruit additional skilled workers in Mozambique, Uganda and Malawi.

The “Education for All – Fast Track Initiative (FTI)” created in 2002 has been a key factor in progress. It is a ground-breaking example of a new form of development cooperation. The FTI is a global mechanism based on mutual and coordinated commitments. The governments of poor countries develop ten-year plans for the education sector and increase their spending in that sector. The plans are submitted for approval to the FTI secretariat, which is based at the World Bank. In return, the donor countries commit themselves to fund the education plans. The FTI secretariat reports on the financial cover and on funding gaps in implementing the education strategies.

A similar coordinated approach could also be helpful in the health sector, specifically, to draft integrated strategies and ensure health care for the whole population. This would help poor countries formulate comprehensive plans (Sector-Wide Approaches, SWAps) and refine existing concepts. Donor countries should make a long-term commitment to provide financial support for the reforms. A small secretariat could be set up at the WHO to assess the health strategies.

During Germany’s G8 presidency, the Federal government initiated debate over an initiative to strengthen the health sector in developing countries. This must now be continued.

According to official estimates, approximately seven billion dollars is the absolute minimum amount needed to train and pay skilled workers in the health sector of the countries affected by a shortage of workers. In the education sector, the comparable amount is 6.7 billion dollars. However the actual amount required could be considerably higher (Oxfam, 2007).

The official figures are derived from current salaries, but these are generally regarded as being too low to prevent the brain drain. Nor do they allow for the fact that additional training opportunities are needed. UNESCO estimates that, globally, an additional nine billion US dollars is needed annually just to achieve the second Millennium Development Goal of universal primary education by 2015.

Germany too should demonstrate greater commitment for the support of basic public services in poor countries. Something urgently needs to be done in the education sector in particular. According to figures from the Global Campaign for Education, the German government would have to provide an additional sum of about 470 million US dollars for basic education in developing countries, if it is to contribute an appropriate share of the global funding requirement to achieve the second MDG.

In June, a hearing conducted by the German Bundestag’s economic cooperation and development committee revealed that, in 2005, Germany’s aid for the entire education sector was 985 million Euro. However, more than two thirds of the amount, or 745 million Euro, went towards providing places for foreign students at German universities. It is not clear whether this benefits Germany’s higher education or the health and education systems of poor countries.