The first decade of the 21st Century can well be called the decade of the health workforce with a number of global initiatives launched during this period in response to the emerging and worsening crisis of the HWF that threatened improvement of health outcomes in most of the developing world. The initiatives were undertaken by WHO (2005, 2006), the World Bank (2004, 2005), UNAIDS (2003), the Joint Learning Initiative on Human Resources for Health and Development sponsored by the Rockefeller Foundation and other donors (2004). These initiatives identified acute shortage of health workers, made worse by gross imbalances in deployment and skill mix, as posing the greatest challenge. This is recognized as a consequence of inadequate production (not even meeting population growth rates) and a legacy of chronic underinvestment in human resources. It is estimated that SSA needs one million additional health workers to reach a health worker to population ratio comparable to that of other least developed countries. This shortage is exacerbated by international migration of health workers, a symptom of unfriendly work environment resulting in low motivation and lack of incentive, but also inadequate production of workers in rich countries. Quality concern is also a problem affecting the diverse stock of health worker members to deliver equitable, effective, efficient and responsive health services. Quality is determined by the skill of health workers as well as by the supportive infrastructure of the health system, both of which are wanting. The devastation brought about by HIV/AIDS (the straw that broke the camel’s back), and a rising concurrent non-communicable disease morbidity is swamping the health services, increasing the workload and demanding new skills and also directly affecting health workers’ health. Countries and the global health community have come to appreciate that a new health system model is required to meet developing countries health care needs. In addition to training more of the traditional health workers, i.e. medical doctors, nurses, specialists, etc., the emphasis has moved to producing what are incorrectly referred to as substitute health workers such as clinical officers/medical assistants, community health workers, etc. that are trained to have adequate level of skills to manage most of the common disease burdens over a much shorter period and at a lesser cost, and are not exportable. An example is surgical training of clinical officers in some African countries who are able to provide care for common morbidity requiring surgery at district hospitals and health centres, including provision of safe and effective emergency surgery. In addition, a resurgence of the spirit of primary health care has resulted in increasing focus on provision of community based health workers providing curative/preventive services at the village level. Task shifting is also a relatively new development where use is made of community resources to undertake specific tasks under the supervision of a health post (e.g. provision of ART and DOTS, promoting positive health seeking behavior in the community, facilitating access to public health interventions, etc). While some progress has been accomplished in mitigating the health workforce crisis, more has to be done to improve coverage, enhance motivation and improve competence of health workers. A major challenge is lack of resources to achieve these.