Sub-Saharan African countries that invest in training doctors have ended up losing $2 billion as the expert clinicians leave home to find work in more prosperous developed nations, researchers say.
A study by Canadian scientists found that South Africa and Zimbabwe suffer the worst economic losses due to doctors emigrating, while Australia, Canada, Britain and the United States benefit 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 lose out.
“Many wealthy destination countries, which also train fewer doctors than are required, depend on immigrant doctors to make up the shortfall,” Mills’ team wrote in a study, which was published in the British Medical Journal.
“Developing countries are effectively paying to train staff who then support the health services of developed countries.”
Experts say the migration, or “brain drain”, of trained health workers from poorer countries to richer ones exacerbates the problem of already weak health systems in low-income countries battling epidemics of infectious diseases like HIV and AIDS and tuberculosis (TB) and malaria.
The World Health Organisation adopted a code of practice in 2010 on international recruitment of health personnel that highlighted the problem of doctor brain drains and called on wealthy countries to offer financial help to poorer ones affected.
The code is seen as particularly important for sub-Saharan Africa, which suffers from a critical shortage of doctors and has a high prevalence of diseases such as HIV, TB and malaria.
The latest United Nations global HIV and AIDS report released on Monday found that 68 percent of the around 34 million people worldwide who have the human immunodeficiency virus (HIV) that causes AIDS live in Africa.
Using various data including published reports on primary and secondary school spending from UNESCO, 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 in employing them.
The results show that these governments spend between $21 000, the figure for Uganda, and $59 000, in 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 and 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 the benefit to Britain was around $2,7 billion, and to the United States was around $846 million.
Australia was estimated to have benefited to the tune of $621 million and Canada was $384 million better off.