The 'brain drain': Australian responsibility.

Recent discussion leading up to the G8 summit brought welcome initiatives in addressing the debt burden of some poor countries. The meeting also addressed a hotly debated but less well-reported issue, the economic results of the ‘brain drain’ from poor to rich countries. Immigration has become a common phenomenon in the global economy, although immigration barriers are low for those rich in capital or knowledge and often impossibly difficult for refugees. The particular focus of concern has been on African professionals who have been lured to rich countries in global migrations seen as akin to theft. These professionals are expensive to train and their skills are sorely needed in their home countries It is difficult to judge the full magnitude of the problem when migrants move to foreign countries to work both formally and informally. Each migrating health professional represents a loss estimated at US$184,0001 and the numbers involved are estimated as anything from 20,000 to 70,000 per year. South African medical schools have estimated that up to a half of their graduates emigrate,2 many to New Zealand, but the loss of nurses is likely to be more significant in a health sector crippled by the demands of the HIV epidemic so that 31% of public health care positions are vacant.3 The situation is said to be worse in many other African countries with the number of health care workers shrinking: in a few years Zambia has seen a workforce of 1,600 doctors dwindle to only 400.4 At the 2005 annual conference of the British Medical Association it was noted that Australia, Ghana and Mozambique, all countries with populations of about 20 million, have a total number of doctors of 48,000 to 1500 to 500.5 As a result, there are parts of Africa with no health care of any sort, with catastrophic results. The problem is not confined to Africa. The International Monetary Fund identified Iran and Taiwan as also suffering serious losses.6 To cope with the professional losses, foreign experts are then employed at high cost to provide essential services.7 To make matters worse, there is the phenomenon of ‘brain waste’ when skilled health workers face restrictive immigration practices in their adoptive countries and end up working as low-paid unskilled labour in health care positions or even in other industries. If up to a third of trained professionals leave poor countries for rich countries, this represents a substantial subsidy from poor countries to the education and health facilities of rich countries. The United Kingdom has been a major beneficiary. In London the estimate is that 23% of doctors and 47% of nurses are immigrants.8 After intensive lobbying, the UK Department of Health acknowledged that its recruitment practices for nurses and doctors should take account of the effect on their country of origin.9 Australia is also a beneficiary of this international phenomenon but our responsibility for the situation has been submerged by the concern that we ourselves are losing skilled professionals (especially computing experts and accountants) to the United States and Europe.10 In addition, Australian universities have enthusiastically embraced the lucrative enrolment of international students and the international record suggests that a sizable proportion of these students do not return to their home countries. One of the most famous expatriates in the United States is Philip Emeagwali, a Nigerian refugee who is hailed as the founder of the supercomputer. Writing from his personal experience, he warns of global economic reasons for the national deterioration in institutions, resulting in the departure of professionals and academics: