There are more than a hundred million health care workers around the world, but in many poor countries, there are only a handful of doctors and nurses to care for tens or, even hundreds of thousands of people.
When poor countries do have medical and nursing schools to train new workers, many of those graduates end up leaving home to work in wealthier countries. A new study puts a dollar amount on the money poor countries lose when their doctors emigrate.
Last year, members of the World Health Assembly in Geneva adopted a voluntary code of practice that discourages wealthy countries from actively recruiting health care workers away from poor countries.
Part of that document called for countries such as the United States, the UK, Canada and Australia to compensate less affluent nations when their doctors and nurses emigrate to work there. But until now, no one had put a dollar sign on the economic value of those medical professionals.
“On average, it’s around $2.2 billion for the number of physicians that are currently practicing in those four wealthy countries,” says Ed Mills, professor of global health at the University of Ottawa in Canada. “That's the cost to African countries. That's using very conservative estimates. If we were to use far more lenient estimates, it could be more than $10 billion in estimated costs to the African countries.”
Mills looked at data on how much it costs to educate doctors in nine countries in Sub-Saharan Africa, all countries, incidentally, with high rates of HIV infection.
“The costs range anywhere from about $21,000, which is in Uganda, to around $41,000, which is in South Africa," he says. "And that's just the medical education up to the end of medical school. That doesn't include the residency.”
According to Mills, it costs a lot more to train a doctor in the U.S., the UK, Canada or Australia. So, by Mills' calculation, those countries win big when doctors migrate there, saving about about $4.5 billion.
He believes it's important that wealthy countries pay attention to the problem. He praises a U.S. government program to train 140,000 health care workers in the next five years. Short of paying African countries for their immigrants, he says, that program is an example of the kinds of things wealthy countries can do to make up for all those doctors and nurses they've lured away from home.