Risk of cancer from diagnostic X-rays.

efforts. But the extent of the human resource crisis in Africa in general and particularly in the countries with a high HIV/AIDS prevalence, forces us to act decisively. We believe that we need to reconsider approaches that used to be politically incorrect. If not, the current staff deficits will continue to undermine the absorption capacity of all the new international initiatives. PRSPs should be grasped with both hands if the root of the crisis is to be tackled across sectors. A national human resources for health plan should be part of any PRSP as a condition for approval. Moreover, the recruitment ceilings imposed under the structural adjustment programmes represent a relic from the past and need to be removed. International actors should no longer shun the funding of recurrent expenditure with the excuse that this amounts to unsustainable interventions. For example, international development agencies need to reconsider contributing to funding salaries and wages in the new recruitment drives. Also bilateral agencies need to critically review their policies. Sending out expatriate medical personnel as a short-term measure or hiring medical professionals from the brain drain diaspora are options. In short, the context and the challenges besetting health systems in developing countries have changed dramatically and paradigm shifts are called for to come up with effective strategies. *Bruno Marchal, Vincent De Brouwere