Question

Most migrants do not return to their home country; Kollar & Buyx offer suggestions to remady the situation. Identify these suggestions/policy propsals. Which one(s) seem most resonable?

article: "Ethics and policy od medical braiin drain: a review" by Eszter Kollar and Alena Buyx

Answer 1

As per the review of the article Health care worker migration commonly called medical brain and drain and what its say author based on the situations such as

• large problem known as shortage health workforce crisis
• critical shortage in where there high disease rate countries like communicable disease TB, Ebola, Swine flu
• Highly developed counties are sufficient health care resources where there as poor or low income countries are shortage of health resources due t most of health staff are working in High incoming countries

It is thus fair to say that a broad consensus exists that when medical brain drain exacerbates critical staff shortages in vulnerable regions, it is unethical. Notwithstanding this general agreement, which policies to tackle brain drain are justifiable on ethical grounds and how to best go about implementing them remains highly controversial. It is therefore necessary to elaborate on two more specific ethical challenges and highlight their complexity

Source countries are also thought to benefit from returning migrants and the related knowledge transfer. However, diaspora network efforts are voluntary and often limited to assisting new emigrants. Data also suggest that few migrants in fact return, and that targeted “return of talent” programmers to attract doctors and nurses to their country of origin either fail or come at a very high cost . The real beneficiaries of medical migration are the destination countries. As noted by a recent report of the American Medical Association, “the entry of approximately 6,000 international medical graduates into the United States every year contributes a few billion dollars to the US economy, which is equal to the output of 50 additional medical schools without any cost to the taxpayer.” In the United Kingdom, medical education costs up to £250,000 ($460,000) per individual, whereas immigrant health workers come at close to zero costs. Packer et al. suggest that just the South African physicians registered in Canada in the 10 years after the apartheid saved the country

Second-step policies are those that would decrease the flow of migration by reducing demand. Source countries should devote more investment to improving their health systems, scaling up education and introducing measures to make staying more attractive to their local work force, so that the push-factors for brain drain are reduced. Destination countries should make enforceable commitments not to recruit from countries with critical shortages as well as strong efforts to become self-sufficient in their health workforce, thus minimizing the pull-factors. This should be coupled with the aforementioned financial and development assistance for source countries, to help improve local working conditions and build capacities in local health systems. If conditions in source countries improve without sufficient impact on migration flow, restriction of movement through staff retention measures can be discussed as a third-step policy intervention. In all this it is vital to be aware that national levels are important but insufficient for effective policy implementation owing to collective action problems, and lack of continuous financing and binding governance tools. Some therefore suggest setting up a Global Health Resource Fund to provide continuous funding and coordinated global governance in addressing medical brain drain . Finally, the search for novel ideas to address medical brain drain should be continued. For example, a recent innovative model called “third-country development” envisages health-workers who have emigrated from the Global South being mobilized for humanitarian work on a mission in another country that has critical shortages. In effect, this would be a temporary migration scheme establishing a sort of “international health-keeping corps” Motivation might be a problem for this model, but it points towards some as yet unexplored potential to address medical brain drain.