Sheila Tlou on the White House Health Workforce Initiative

As the White House develops a new initiative to strengthen the global health workforce around the world, we spoke with Dr. Sheila D. Tlou, the Co-Chair of the Global HIV Prevention Coalition, the Co-Chair of the Nursing Now Global Campaign, and former Member of Parliament and Minister of Health of the Republic of Botswana. We talked about what she thinks the Biden Administration needs to consider in order to help build a strong and sustainable health workforce in Africa.

What should the initiative prioritize?

The forthcoming Biden initiative should put a strong emphasis on educating the educators. We have capacity to educate trainers and we can admit X number from various countries, but we don’t have the trainers. In the facility where I work, we don’t have enough educators.

It must also address remuneration. We have had instances where we come up with a program to train community health care workers. The idea was to train 2 million health care workers. But we must look at the countries closely and see what are the payment rates that are going on? How are the workers paid? And what about the private sector? There needs to be a push to increase the wages a bit in the public sector to then push the private sector to do the same.

The US must also align efforts with the Global Fund and others. The Global Fund is funding important programs that need to be coordinated. They should have a health systems focus.

Are countries ready to increase their own investments in the workforce?

A US initiative could encourage countries in our region to invest more in the workforce and address poor working conditions. We need to design a program and then push countries to take the next steps, while ensuring policy flexibility. We need this investment, but with a plan to transition to governments.

What US agency should be in the lead?

Strong leadership by US technical agencies is important. PEPFAR is doing great work in health systems, and CDC is very specific in their work. Unfortunately, CDC and USAID are always fighting. But I think USAID should lead this initiative, since they have the most programs and the widest reach.

Dr. Sheila D. Tlou is the Co-Chair of the Global HIV Prevention Coalition and the Co-Chair of the Nursing Now Global Campaign. From 2010 to 2017 she was Director of the UNAIDS Regional Support Team for Eastern and Southern Africa. She is a former Member of Parliament and Minister of Health of the Republic of Botswana (2004-2008). She is also former Professor of Nursing at the University of Botswana and Director of the WHO Collaborating Centre for Nursing and Midwifery Development in Primary Health Care for Anglophone Africa. She has conducted research and taught courses to nursing, pre-medical and social science students on Gender issues relating to HIV/AIDS, Sexual and Reproductive Health and Rights, and Ageing and Older Persons. She has played a key role in the development of national nursing and medical education curricula, working to broaden the scope of Health Sciences education in her home country of Botswana.