There’s a Healer Abroad, at a Clinic Near You
The brain drain of qualified health care personnel from the developing world to more privileged countries is well-documented, devastating and an issue of fierce debate. The migration of physicians, nurses and other health workers to greener pastures further weakens many developing world health care systems already lacking material resources and overburdened by the HIV/AIDS pandemic, tuberculosis, malaria, and diarrhea.Thus endeth the rant. - Stuart Rennie [thanks Lara Vaz]
This week, a panel convened by the Institute of Medicine has announced a bold new plan to tackle the brain drain problem -- or rather -- a plan to address the problem only in so far as it threatens to undermine the $15 billion President's Emergency Plan for AIDS Relief (PEPFAR). Unpretentiously entitled “Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS”, the proposed program is described as a ‘Peace Corps for Health’ where American health professionals do stints in the 15 developing world countries targeted by PEPFAR. Any illusions about the altruistic motives of prospective participants are swiftly deflated by the press release:
". . . the plan envisions about 1,000 people from various health fields receiving fellowships to work abroad for at least one year for $35,000. While the stipend would be less than what a person's regular job pays, the program would be designed to make motivated people believe they can afford to interrupt their career for such work. Ideally, the fellowships would expand their skills and marketability. "I think this gives them [the employees] some leverage that they never had before," said Andre-Jacques Neusy, the director of the Center for Global Health at New York University School of Medicine."
You seem to get a cynical message – emanating from the Institute of Medicine – that only the prospect of future self-enrichment will motivate your average health care professional to heal the impoverished sick. But there are more carrots where they came from:
"A third component would provide money to newly trained physicians, nurses and other health professionals to pay back school loans. One year of work in an approved overseas AIDS program would earn $25,000 in loan repayment."
Interestingly, the unveiling of the Institute’s plan comes the same week as a news item in the British Medical Journal entitled “Developed world is robbing African countries of health staff.” [link] Here we are reminded that countries like the US, UK and Canada have been actively recruiting the manpower of developing world health systems for years. According to Richard Cooper of the Health Policy Institute at the Medical College of Wisconsin, up to 22% of doctors in the US, a total of 170,000, were born and trained abroad, some of them from countries like Ghana, which now has only 1500 doctors serving a population of 20 million people. Alas, Ghana is not one of the lucky PEPFAR countries slated to receive the inexperienced doctors up to their ears in debt benefits of ‘Healers Abroad.’
It is not clear how Healers Abroad can address the deeper geopolitical and economic causes of the brain drain or how importing foreign health professionals (at zero cost to ministries of health in developing countries) won’t make it worse. Those interested can access the Institute of Medicine’s document here.
