Forecasting the global shortage of physicians

Using the most updated information on the supply of physicians over a 20-year period, the size of the future global need for, demand for and supply of physicians is projected to 2015, the target date for the Millennium Development Goals.

Needs-based estimates use an exogenous health benchmark to judge the adequacy of the number of physicians required to meet MDG targets. Demand estimates are based on a country's economic growth and the increase in health-care spending that results from it, which primarily goes towards worker salaries. We then compare the needs-based and demand-based estimates to the projected supply of physicians, extrapolated based on historical trends.

Our results point to dramatic shortages of physicians in the WHO African Region by 2015. We provide estimates of shortages by country in Africa and discuss their implications for different workforce policy choices.

Our projections suggest that, by the year 2015, the global supply of physicians will be roughly in balance with demand, while a significant surplus will arise according to the needs-based model. However, regional trends show that distributional problems will likely persist. More than any other region of the world, Africa will likely experience most of the physician shortages in 2015. Given the disproportionate burden of disease in this region, policies for increasing the supply of physicians are urgently needed to stem projected shortages.

According to our needs-based target of 80% coverage of live births by a skilled attendant, a 65% increase in the physician supply in the WHO African Region will be required compared to an increase of 44% of physicians to equilibrate demand with supply. These enormous increases will require significant increases in health-care spending and active policy intervention.

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