From Egypt to Afghanistan—A South-to-South Leadership Development Exchange In May 2005, 15 Afghan doctors visited Upper Egypt's Aswan region, where health staff are continuing the leadership development begun with Management Sciences for Health under the USAID-funded cooperative agreement, Management and Leadership Program (M&L), from 2002-2003.

In many countries, the health system is undermined not only by a lack of resources, but a lack of systems to effectively manage the people, medicines, money, and information that contribute to improved health outcomes. The situation is especially acute in fragile and post-conflict states, where services are hampered by political instability, economic uncertainty, grave security concerns, and natural disasters. In such environments, there is an urgent need for large-scale responses that have a lasting impact on health.

Addressing the human resource needs of a Kenyan hospitalEven before the ARV targets had been introduced, there were not enough nurses to provide the quality of care the Director aspired to. The patients had to wait a long time for basic care, and by the time the overworked nurses finally came to the bedside, they were rushed and exhausted. The Director understood why the patients felt neglected and the staff demoralized.Hiring new staff was not an option. A donor-imposed hiring freeze made it impossible to employ any new staff—not just nurses, but other essential employees as well.