Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa

Peer reviewed article

R. Zachariah, N. Ford, M. Philips, S.Lynch, M. Massaquoi, V. Janssens, A.D. Harries,

Publication details

Number of pages: 10
Publication date: 2009
Languages: English


This paper, drawing on Médecins Sans Frontières experience of scaling-up antiretroviral treatment in three sub-Saharan African countries (Malawi, South Africa and Lesotho), highlights the main opportunities and challenges posed by task shifting and proposes specific actions to tackle the challenges.

The opportunities include: increasing access to life-saving treatment; improving the workforce skills mix and health-system efficiency; enhancing the role of the community; cost advantages and reducing attrition and international ‘brain drain’. The challenges include: maintaining quality and safety; addressing professional and institutional resistance; sustaining motivation and performance and preventing deaths of health workers from HIV/AIDS.