Wednesday, October 20, 2010

Preventing Brain Drain

Recently, at the World Health Assembly in Geneva, international health leaders passed new guidelines to prevent health-worker brain drain, according to an article in the Seattle Times (May, 2010).

Brain drain is when professionals in developing countries receive their training in health professions or other professions and then move from their home country to a more developed country, such as the United States. "Approximately one in four U.S. physicians and about 220,000 nurses were trained abroad (largely in lower-income countries);" however, the article states that data concerning these statistics is difficult to gather because of lack of reliable information systems.

"Low-income countries invest significant resources to train health workers..." Developed countries allow the active recruitment of doctors and nurses from low-income countries. This is a huge problem in developing countries, equating to "a form of reverse foreign aid."

In the state of Washington, there are 11,000 doctors for its 6.6 million residents. In Ethiopia there are 2,000 doctors for 80 million people, (which would be equivalent to about "165 doctors for the entire state of Washington").

"Discovering vaccines does no good if there is no one to administer them." Brain drain "undermines the efforts of... organizations working to improve global health." This new passage by the World Health Assembly will provide guidelines for countries to implement to encourage less active-recruitment practices.

Some countries have already taken their own initiative to promote guidelines to reduce their active-recruitment practices. "The United Kingdom and Norway have adopted policies to refrain from recruiting health workers from severe-shortage countries. Canada, too, has ramped up training programs so as to create less demand for foreign-trained health workers."

Tracking the health-worker migrations is the most essential aspect of enforcing these new guidelines. Unfortunately, during "closed-door negotiations" and "U.S. lobbying," the "rich nations reduced their responsibility for tracking the movement of health workers or for providing technical or financial assistance to developing countries."

This issue is a difficult one. The U.S. relies heavily on foreign-trained physicians and nurses. It is extremely expensive for a government to educate health professionals, particularly physicians. It saves the U.S. government a lot of money to recruit, rather than educate. "The Council on Graduate Medical Education has predicted the U.S. will be short approximately 85,000 physicians by 2020."  I also understand why trained professionals in lower economically developed countries are easily recruited. (I would be too, if I were in their shoes.)

Hopefully, the United States will follow the examples of other developed countries and promote ideals of these new guidelines, rather than merely try to meet their minimal requirements (and get away with as much as possible in the meantime).

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