News Release

Active recruitment of health workers from sub-Saharan Africa should be viewed as a crime

Peer-Reviewed Publication

The Lancet_DELETED

Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm; the practice should, therefore, be viewed as an international crime. These are the conclusions of authors of a Viewpoint in this week’s Human Resources for Health Special Edition of The Lancet.

Dr Edward Mills, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, and colleagues, say that high-income countries, such as UK, USA, Australia, Canada, Saudi Arabia, and the United Arab Emirates have sustained their relatively high physician-to-population ratio (PPR) by recruiting medical graduates from developing regions, including countries in sub-Saharan Africa.

Meanwhile, over half of these sub-Saharan African countries do not meet the minimum acceptable PPR of one per 5000 – WHO’s Health for All Standard. The authors say: “Nurses, pharmacists, and other health workers are systematically recruited from a region struggling with the greatest burden of infectious and chronic illness and the specific challenge of HIV/AIDS.” While the UK, for example, has 2.30 doctors per 1000 population, and the USA 2.56, Tanzania has just 0.02 and Ethiopia and Madagascar 0.03.*

Recent reviews of health workers employed in the UK, USA, Canada, and Australia have shown the extent of this “brain drain”- estimating that more than 13000 doctors trained in sub-Saharan Africa are now practising in these high-income countries. Despite pleas to discontinue active recruitment from local and international ministries of health, western recruitment agencies continue with this practice – including advertising in newspapers, emails, websites, recruitment workshops and other practices. O’Grady Peyton International (USA, UK) and Allied Health (Australia) are named in the Viewpoint as examples of such agencies with offices based in South Africa. The numbers of nurses and pharmacists migrating from many of these countries in sub-Saharan Africa now exceed the numbers graduating in these disciplines in those countries.

The authors say: “Although the active recruitment of health workers from developing countries may lack the heinous intent of other crimes covered under international law, the resulting dilapidation of health infrastructure contributes to a measurable and foreseeable public health crisis…There is no doubt that this situation is a very important violation of the human rights of people of Africa.”

The Viewpoint refers to many statements and declarations from state bodies that active health-worker recruitment is wrong, eg, The UK National Health Service’s (NHS) code on ethical recruitment – and say that recipient countries should receive new health workers only when there is compensation to the delivering state to contribute to health structure. A 2004 report estimated that Ghana has lost around £35 million of its training investment in health professionals to the UK – and the UK, by recruiting these Ghanaian doctors – saved around £65 million in training costs between 1998 and 2002.

The authors conclude: “Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm: the practice should, therefore, be viewed as an international crime.”

###

Dr Edward Mills, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, T) +1 778 317 8530 E) emills@cihhrs.org

PDF OF VIEWPOINT: http://multimedia.thelancet.com/pdf/press/Crime.pdf


Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.