Drivers of medical migration

Writing in the British Medical Journal, John Zaracostas reports that globalisation has made it easier for rich nations to "pull in" skilled migrants such as healthcare workers from poor nations, according to a report from the International Organization for Migration, which promotes humane and orderly migration. Such migrants include a large number from sub-Saharan Africa, the region with the greatest shortage of healthcare personnel, and the trend is unlikely to abate, the report says.

"Their [rich countries'] ability to offer higher pay, better working conditions and greater opportunities in safer environments will continue to pull foreign health workers until supply exceeds demand," says the report.

It says that the search for employment is at the heart of most migration and concludes that pressures "are set to increase."

There are "more than 200 million international migrants in the world today, two and a half times the number in 1965," it says, and most countries are now simultaneously countries of origin, transit, and destination.

Nearly a quarter of foreign trained doctors in countries of the Organisation for Economic Co-operation and Development were trained in sub-Saharan Africa, and the report suggests a series of possible policy options to limit the negative effects of emigration on the countries of origin.

Countries of destination should continue to develop guidelines for recruiting skilled professionals from poor nations, the report recommends, but it emphasises that self imposed restraints on recruitment by public sector employers "have not been effective in limiting the migration." It says that "exhorting private-sector employers to recruit ethically" is also likely to prove equally ineffective.

"These [guidelines] can serve as a benchmark against which civil society organisations and the nationals and governments of destination and origin countries can evaluate the practice of destination countries."