Canada has saved nearly $400-million by poaching doctors from Africa, while the African countries that trained those doctors have lost billions of dollars as a result of medical migration.
Wealthy countries such as Canada are benefiting significantly from those African losses as thousands of trained doctors continue to emigrate from African countries that already suffer a severe shortage of health workers, new research shows.
The study casts a new light on the issue of foreign aid, showing that the relationship between Canada and Africa is not merely a story of Canada giving and Africa receiving. In fact, Canada benefits enormously from Africa's human resources.
More than 22 per cent of Canada's physicians are foreign-trained, and Africa (especially South Africa) has been the biggest source of those doctors in recent years. In Saskatchewan, more than half of the practising doctors are foreign-trained, including hundreds from South Africa.
The new study argues that Canada and other recipient countries should do much more to compensate the African countries that trained those physicians, ideally by boosting their support for medical training in Africa. "Our study highlights that the loss to developing countries is substantial and that any compensation should be more than token," the authors said.
The study, published in the British Medical Journal, is the most ambitious attempt to quantify the economic losses and benefits from the recruitment of African doctors by Canada, Britain, Australia and the United States.
Those four wealthy countries have saved more than $4.5-billion (U.S.) in education costs by recruiting doctors from the nine African countries covered by the study, while the nine source countries have lost nearly $2.2-billion as a result of medical emigration. If a less conservative calculation is made, the costs to Africa ballooned to $13.5-billion.
The nine countries were chosen for the study because all of them have high rates of HIV/AIDS, covering at least a million people or 5 per cent of their population. While Africa has 24 per cent of the global burden of disease, it has only 2 per cent of the world's supply of doctors, the study noted.
Edward Mills, a professor of health sciences at the University of Ottawa who was the principal investigator for the study, said the estimated losses to Africa would be vastly greater if the study had included other professions such as nurses and engineers – or if it considered the doctors who emigrated to wealthy countries and were unable to get licensed as doctors.
"This isn't about blame," he said in an interview. "I can understand why someone would want to emigrate. But there's a lot of money involved, and we need to find a solution that's equitable. The numbers show that this is a lot more than anecdotal – we're talking billions of dollars here."
While a few institutions such as the University of Calgary and the University of Toronto are helping to train doctors for Sudan and Ethiopia, the level of Canadian support for medical training in Africa is relatively small, Prof. Mills said. The United States, by contrast, is aiming to train 130,000 health workers in Africa, and even Cuba has a bigger presence in Africa's medical sector than Canada, he said.
Under a voluntary code adopted by the World Health Assembly last year, wealthy countries are supposed to provide financial assistance to source countries that suffer losses because of the foreign recruitment of their health workers.