16th Meeting of Senior Fellowships Officers of the ... - Development

Operational Issues 23
F. Presentation on South-South Cooperation: the Case of
Fellowship Placements in Africa, by Dr. Akpa R. Gbary,
Regional Adviser, Human Resource for Health, WHO/AFRO
79. Dr. Gbary took the floor to present the successes and challenges faced by WHO/AFRO
in the framework of South-South cooperation when managing fellowships in Africa,
in particular, the issue of placement. The fellowships programme was one of the most
popular in the UN and especially in WHO. In Africa, after independence, the public
health specialties were not very popular. WHO had to scale up a fast-track programme
in order to reach a critical mass of health practitioners in the area of public health.
80. One of the success stories was the increase in the number of training activities. Of the
forty six African countries and seven African countries belonging to the Eastern and
Mediterranean Region (EMR), thirty five experienced a shortage of public health. Fellowships
had played a vital role in filling in those gaps. Until 1978 only a low number
of fellows, no more than 65%, had been placed in Africa. In 1979, the Ministers of 46
African countries came up with a resolution 12 which requested to drastically increase
the rate of placement of fellows in Africa in order to recognize the potential offered by
African countries and to curb the brain drain of fellows who could be placed in North
America and Europe. Statistics of the last 5 years indicated that the rate of placement
in Africa, including Morocco, Tunisia and Algeria, rose from 65% in 1979, to 92% in
2001, to 93% in 2003 and up to almost 95% in 2006.
81. Each country which hosted fellows in Africa had a regional WHO training center. Such
centers were situated in Lome, Togo, where WHO trained specialized nurses and midwives;
in the small town of Ouidha in Benin where post-graduate studies were offered in
epidemiology and public health. In addition, there were centers of excellence in South
Africa, Kenya and Zimbabwe. WHO/AFRO awarded training and fellowships within
Africa to undertake undergraduate studies in medicine, midwifery, nursery, laboratory
technicians and other health workers. It also provided post-graduate studies in clinical
medicine, various areas of public health and health management. Nevertheless, WHO
still continued to send fellows to countries in Europe and Northern America, to specialize
particularly in dentistry and some very high level clinical specialties such as cardiology,
surgery, neurology, forensic medicine and in exceptional cases to pursue PhD studies.
82. In terms of costs, fellowships across Africa recorded substantial savings. The average
cost per fellow in this continent was about 18,000 US dollars as compared to 45,000
US dollars in Europe and 42,000 US dollars in the United States of America. Surveys
of costs by region further showed that fellows placed in Eastern and Mediterranean
countries, such as Morocco and Tunisia, as well as in the South East Asian Region
(SEAR) incurred comparable expenditures to the fellows placed in the African Region
whereas the Western Pacific Region had slightly higher rates but still remained in the
range of the African, EMR and SEAR rates.
12
Regional Committee 39, resolution 39/5