Migration, Disease Resurgence Gut Africa of Much-Needed Health-Care Workers

UNITED NATIONS, New York—The loss of workers to migration is “overwhelming” the world’s health-care systems, according to a new report released by UNFPA, the United Nations Population Fund, at a High Level Panel on International Migration and the Millennium Development Goals held here today.

The organization reports that migration, coupled with a resurgence of infectious diseases and the HIV/AIDS pandemic, is “exacerbating” an already “acute” shortage of health care workers in Africa. The report, International Migration and the Millennium Development Goals says that poor countries—many of which have the lowest numbers of health-care workers but the highest infectious disease burden — are “subsidizing” the health-care systems of wealthier countries.

Despite being home to fully one quarter of the world’s disease burden, Africa has only 1.3 per cent of its health-care workers. The problem is even worse in English-speaking African nations. Ghana, for example, reports a health-care specialist vacancy rate of 72 per cent, while landlocked Malawi, one of the countries hardest hit by the HIV/AIDS pandemic, is short of nursing staff to the tune of 52.9 per cent.

Among the beneficiaries are wealthier industrialized countries, which are now feeling the pinch owing to an ageing population and low fertility rates. This is contributing to a growing demand for health-care services, coupled with a precipitous drop in the number of new workers. In 2002, the United Kingdom’s Nurses Council Register reported that more than 50 per cent of its new recruits came from outside of the country.

Although some countries, such as the Philippines, India and Cuba, actually produce a surplus of migrant health-care workers whose remittances play a huge role in boosting local economies, the same cannot be said for others. A number of countries in Asia and sub-Saharan Africa remain well below the health worker density of 2.5 per 1,000 of the population required to meet Millennium Development Goal targets. The UNFPA report also notes that “perhaps a more insidious but debilitating effect of the external migration of health professionals” is the loss of the skilled educators, trainers and specialists necessary to continue to produce native health-care workers. This could “erode ethics and professional standards.”

The report also explores migrant remittances and to what degree they contribute much-needed resources to “sender” economies. “We see that the remittances sent by migrants certainly help reduce poverty in their families back home,” said Thoraya Ahmed Obaid, UNFPA Executive Director, during the release of the report. “Last year, migrants sent home at least $124 billion to their countries in remittances – a significant amount more than the $60 billion those countries received in development assistance.”

However, added Ms. Obaid, “remittances cannot be seen as a general panacea to poverty alleviation because we need to look at the root causes of migration, which include lack of economic opportunities and the many facets of poverty and inequality.”

Interestingly, the report’s authors found that male and female immigrants spend remittance income differently. Men on the whole tend to purchase “conspicuous consumer goods,” such as cars and television sets, while women are far more likely to invest remittance income in schooling, food and health care. Author Colleen Thouez, a researcher with the United Nations Institute for Training and Research, says that female spending patterns may “raise families out of poverty in the long run while conspicuous consumption may not”.

Other key findings of the report include:

• The number of international migrants has increased by 75 per cent since 1980, with more than a third of that increase attributable to the break-up of the Soviet Union.

• The three largest beneficiaries of remittances sent by migrants are India ($8.4 billion); Mexico ($13.2 billion) and the Philippines ($8 billion).

• The International Labour Organization estimates that 2.5 million people are forced to labour for free as a result of human trafficking, with global profits that exceed $32 billion.

• The European Union estimates that, worldwide, human trafficking nets 8.5 billion to 12 billion euros per year. This makes it one of the largest and most lucrative of organized crime businesses.

The report is a compilation of selected papers presented at the UNFPA Expert Group Meeting in Marrakech, Morocco, in May 2005.

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Contact Information:

Patricia Leidl, leidl@unfpa.org, tel:+1-212-297-5088.