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The Cost of the Emigration of African Doctors
On 24 November 2011, the British Medical Journal published a research article on The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis. In the research, nine sub-Saharan countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/Aids and with at least one medical school was surveyed. These comprised the following countries; Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe.
The research analysed the cost of educating a doctor (through primary, secondary and medical school), assuming that migration occurred after graduation, using current country-specific interest rates for savings (converted to US dollars); cost according to the number of source-country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors.
The study found that in the nine source countries the estimated government subsidised cost of a doctor’s education ranged from $21 000 (£13 000; €15 000) in Uganda to $58 700 in South Africa. The overall estimated loss on returns from investment for all doctors currently working in the destination countries was $2,17 billion (95% confidence interval $2,13 billion to $2,21 billion), with costs for each country ranging from $2,16 million ($1,55 million to $2,78 million) for Malawi to $1,41 billion ($1,38 billion to $1,44 billion) for South Africa. The ratio of the estimated compounded loss on investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2,7 billion) and United States ($846 million).
Read the very interesting rebuttal article published on the Center for Global Development website which argues that African doctors’ reasons for emigration are far more complex and far reaching than Mills et al. would suggest in their research. Therefore, any policy suggestions should be based on sound economic considerations.
