[e-drug] Brain drain of health professionals (cont'd)

[Susan Foster <sfoster@bu.edu>]

E-drug: Brain drain of health professionals (cont'd)
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I have followed this discussion with interest. I'd like to contribute
my observation that richer countries have little incentive to stem the
influx of qualified professionals from lower income countries. First,
it absolves them of the need to fund that training themselves -- it
shifts that burden back to the lower income country which is stuck
paying for training of people who leave for greener pastures, and
having to train 2 people for every 1 who stays behind to work. If
the US or Britain had to pay for the training of all the nurses it
needs, for example, it would add considerably to the health
expenditure. The Philippines, Jamaica, Zambia, Malawi, and South
Africa in essence are paying for the training of the doctors, nurses
and pharmacists to staff British and American hospitals, or to staff
facilities in remote or unpopular areas. It also happens with teachers
and other professionals.

A second benefit to the richer country is that in general they get
caring, well trained people who are willing to work for lower
salaries than are locally trained staff, or to take jobs which locals do
not want. The low salaries in turn discourage local (e.g. American
or British) people from going into those professions or practicing in
those areas, thus completing the cycle. So viewed in this way, the
brain drain becomes yet another subsidy by the lower income
countries of the (health) consumption patterns of the richer
countries. There is very little in it for the lower income country.
best wishes,

Susan Foster, PhD
Chair, Department of International Health
Boston University School of Public Health
715 Albany Street
Boston MA 02118 USA
phone: 617 638 5234, 638 5397
fax: 617 638 4476
sfoster@bu.edu
http://www.bumc.bu.edu/ih (the department)
http://dcc2.bumc.bu.edu/sfoster/ (my courses)

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