Lack of World-wide HIV Health Care Workers

From last week's NEJM, a telling chart which calls to arms armies of non-physicians treating HIV patients: 

Comparing the ratios of HIV+ patients:Doctors in Malawi (7435:1) with the US (0.6:1) explains the general disconcert physicians and nurses have doing work abroad.  Here in this country, DOCTORS have to see the patients and sometimes NURSES can do refills/shots/IVs, but everyone else gets relegated to "ancillary" roles.   And when these DOCTORS/NURSES travel abroad to do international work, they end up not fulfilling the mythical role of 'bush doctor', but rather taking a much more supervisor/administrator role...some are happy and others disappointed in the lack of direct patient care.

On the other hand, the way these countries overcome the relative lack of DOCTORS/NURSES is to use health-care workers who get trained over just a few months to follow simple protocols.  The logical question for the US health care system is why we don't do the same - muster a horde of NON-DOCTORS/NURSES to care for serious diseases-but-under-treated diseases, like hypertension, using straightforward protocols like JNC-7 - and if complications arise, refer to more advanced/trained professionals.