MDG 5, HUMAN RIGHTS, AND MATERNAL HEALTH IN AFRICA
only 21,000 of the 110,000 in need of this life-saving intervention. 89
This vignette is not unique to Botswana, but is replicated in one form or
another, throughout Africa. The South African case of Minister of Health v.
Treatment Action Campaign No. 2 is quite illustrative. 90 One of the claims
relied upon by the government of South Africa for restricting the
administration of nevirapine, 91 to designated pilot sites, and not throughout
the country, was that it lacked an adequate number of SHP to scale up
intervention as urged by the respondent. 92 The Constitutional Court
roundly rejected the claim. 93 While HIV/AIDS continues to wreak havoc in
Third World countries, the biggest constraint on treatment is a shortage of
appropriately trained health workers. 94 As an apparently worried United
States government official put it, “[w]e are going to run out of people
before we run out of money.” 95 Although the SHP shortage is undeniably a
worldwide phenomenon, nowhere is worse hit than Africa. 96 The region
bears more than twenty-four percent of the global burden of disease, but has
only three percent of the global health workforce. 97 In contrast, the
Americas, including the United States and Canada, shoulder only ten
percent of the global burden of disease, but are home to almost thirty-seven
percent of the world’s health workers. 98
The WHO has developed a method for estimating the availability of
health workers required to deliver a package of essential health
interventions and achieve the MDGs. 99 The organization, citing the Joint
Learning Initiative, projects that, on average, countries need to have no
fewer than 2. 5 SHP (doctors, nurses and midwives) per 1000 population
and must attain a minimum coverage level of eighty percent. 100 Countries
falling below this threshold are said to be suffering critical shortages. 101
There are a total of fifty-seven such countries, of which thirty-six are in
90. Minister of Health v. Treatment Action Campaign No. 2, 2002 ( 5) SA 721 (CC) (S.
91. Id. Nevirapine is a drug that prevents intrapartum mother-to-child transmission of
92. Id. at 748.
94. Burkhalter, supra note 88.
96. WHO, THE WORLD HEALTH REPORT 2006: WORKING TOGETHER FOR HEALTH XVIII-
XIX (2006), available at http://www.who.int/whr/2006/whr06_en.pdf.
97. Id. at 8.
99. Id. at 11.
101. Id. at 12.