Doctor brain drain costing sub-Sahara Africa $2bn

2011-11-26 09:43

London – Sub-Saharan African countries that invest in training doctors have ended up losing $2 billion (R17 billion) as the expert clinicians leave home to find work in more prosperous developed nations, researchers said yesterday.

A study by Canadian scientists found that South Africa and Zimbabwe suffered the worst economic losses due to doctors emigrating, while Australia, Canada, Britain and the US benefited the most from recruiting doctors trained abroad.

The scientists, led by Edward Mills, chair of global health at the University of Ottawa, called on destination countries to recognise this imbalance and invest more in training and developing health systems in the countries that lost out.

“Many wealthy destination countries, which also train fewer doctors than required, depend on immigrant doctors to make up the shortfall,” Mills’ team wrote in a study that was published in the British Medical Journal.

“Developing countries are in effect paying to train staff who then support the health services of developed countries.”

Vicious cycle
Experts said the migration of trained health workers from poorer countries to richer ones exacerbated the problem of already weak health systems in low-income countries battling epidemics such as HIV/Aids, tuberculosis and malaria.

The World Health Organisation adopted a code of practice in 2010 on the international recruitment of health personnel that highlighted the problem of the doctor brain drain. It called on wealthy countries to offer financial help to the poorer nations affected by the brain drain.

The code is seen as particularly important for sub-Saharan Africa, which suffers from a critical shortage of doctors and a high prevalence of HIV/Aids, tuberculosis and malaria.

The latest United Nations global HIV/Aids report, which was released on Monday, found that 68% of the 34 million people worldwide who had contracted HIV lived in Africa.

Cost of education
Using various data, including published reports on primary and secondary school spending from the United Nations Educational, Scientific and Cultural Organisation, Mills’ team estimated the cost of educating a doctor through primary, secondary and medical school in nine sub-Saharan countries with some of the world’s highest rates of HIV.

The countries studied included Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia and Zimbabwe.

The research team then added the figures together to estimate how much the origin countries paid to train doctors and how much the destination countries saved by employing them.

The results showed that these governments spent between $21 000 (the figure for Uganda) and $59 000 (South Africa) to train a doctor, only to see them, in many cases, migrate to richer countries.

“Among the nine sub-Saharan African countries most affected by HIV/Aids, more than $2 billion of investment was lost through the emigration of trained doctors,” the researchers said.

“Our results indicate that South Africa incurs the highest costs for medical education and the greatest lost returns on investment.”

The findings suggested that the benefit to Britain and the US stood at $2.7 billion and $846 million, respectively. Australia was estimated to have benefited to the tune of $621 million and Canada was $384 million better off.

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