Tobias Billström and Gunilla Carlsson, respectively Sweden's justice and development ministers, argued last week that there should be greater coherence between European migration and international development policies (“Time for the EU to acknowledge the advantages of migration”, 15-21 October).
They are right. More than that: it should be an urgent priority. The latest human development report by the United Nations Development Programme reinforces the points made by Billström and Carlson by highlighting the undeniable development gains associated with migration.
But one particular form of migration – of publicly trained health workers from developing countries – does lead to serious losses for resource-poor nations. Unless recognised and addressed, the migration of health workers will continue to impede the ability of countries already facing severe health workforce shortages to provide basic health services to their populations.
Concern over the migration of highly skilled workers, including health workers, was expressed in 1968 in a resolution by the UN General Assembly. That call went largely unnoticed. Two further resolutions have since emerged from the World Health Assembly focusing on the need to mitigate the negative effects of migration by health workers, again reflecting the concerns felt by many developing nations.
Today, finally, there is greater awareness of the need to manage the migration of health workers more ethically. Europe is playing a leading role in that encouraging development. The European Commission and the World Health Organization, European Region, with whom Realizing Rights is working, have both championed the call for strong regional and global codes of practice.
Countries such as Norway and the Netherlands are working to ensure their policies help, rather than undermine, efforts to address global health-workforce shortages. This involves striving to train a sufficient number of health workers at home, refraining from actively recruiting from countries where health professionals are in short supply unless mutually agreed arrangements are developed, and helping develop human resources in the health sector in countries that require such assistance.
The migration of health workers is fundamentally linked to human rights and of the right to health. It is clear that every individual has the right to leave her/his country, but the International Covenant on Economic, Social and Cultural Rights also obligates state parties to “respect, protect, and fulfil” the right to health within their own borders and to “respect the enjoyment of the right to health in other countries”. Experts agree that the latter essentially means refraining from policies or actions that may undermine the efforts of neighbours to realise the right to health. States that rely on foreign health workers should therefore pay greater attention to the impact of international recruitment on health in source countries.
Despite the particularity of the issue of migration by health workers, the approach necessary to address this challenge remains very much that espoused by Billström and Carlsson. All donor nations, particularly those who for the foreseeable future will continue to rely on foreign health workers, should do more to achieve coherence among their migration, domestic health and education, and international development efforts.
Senior health policy analyst
Realizing Rights: The Ethical Globalization Initiative
Return to the list <<<<<