(adopted on the 5^th March 2008)

We, the International Federation of Medical Students’ Associations (IFMSA), are an internationally diverse group of future health care professionals concerned with global health issues. We are alarmed by the large numbers of Health Care Professionals (HCPs) emigrating from underserved areas, particularly from low-income to high-income nations, and the resulting brain drain in the migrants’ countries of origin. This phenomenon leads to a worsening of health indicators in countries already suffering from an acute lack of healthcare workers. We advocate for policies that reverse negative effects of brain drain and make this declaration in the IFMSA spirit of solidarity.

In the 2006 World Health Report, the WHO reports that migration of HCPs from rural to urban areas, as well as from low-income to high-income nations, exacerbates poor health conditions in largely underserved areas.  The WHO emphasizes that global shortage of HCPs is a significant barrier in access to health care, and appeals to the international community to collectively address this issue. (1)

We, the IFMSA, as future health care providers, recognise the worldwide shortage of HCPs as a global challenge requiring urgent assessment and action.  The worldwide need for HCPs creates a competitive environment which ultimately favours nations able to offer the most enticing incentives for migration.   We are concerned by the ethical implications of these active recruitment strategies which weaken precarious health care systems, particularly in the lowest-income nations. 

While we recognise human freedom to migrate, we strongly believe that higher-income nations should not exercise HCP recruitment at the expense of the right to basic health of the populations in lower-income countries.   

Moreover, we acknowledge that those nations actively recruiting HCPs from low-income nations often devote large sums in development aid to these same countries.  However, we believe that the impact on impoverished health care and higher-education systems cannot be fully compensated with monetary contributions.

In order to move forward, we believe governments must implement ethical recruitment practices and develop national strategies to strengthen their health care workforces. Ultimately, we believe that all countries should strive to limit reliance on foreign-trained professionals, thereby developing self-sufficiency.  Thus, we recommend that countries currently profiting from brain gain should assess their national situation and

• increase training capacity of national HCPs
• gear training of national HCPs towards serving in underserved areas
• develop internal incentives aiming to relocate national HCPs to underserved areas
• implement ethical recruitment principles according to the Commonwealth Code of Practice for the International Recruitement of Health Workers (2)
• provide technical, financial and educational assistance to strengthen healthcare systems in countries from which they recruit
• develop strategies to utilise the skills of currently unemployed immigrant HCPs who have migrated for personal reasons, prior to any further recruitment of foreign-trained professionals (3).

However, we appreciate that migration is a natural phenomenon unlikely to recede in the future.  In light of this, the establishment of international guidelines for the ethical recruitment of HCPs will be vital in ensuring that migration is of equal benefit to all involved parties. Furthermore, it is imperative that recruitment be part of a fully transparent agreement, with both parties adhering to the proposed ethical guidelines. 

We believe that all future action taken regarding migration should strive to achieve balance between the individual freedom to move and the right to health. 

(1) World Health Organization (2006a) The World Health Report 2006: Working Together for Health. World Health Organization, Geneva. Available at http://www.who.int/whr/2006/en/index.html

(2) Commonwealth Code of Practice for the International Recruitment of Health Workers, adopted in Geneva in 2003. See also the companion document. Available at http://www.who.int/whr/2006/en/index.html

(3) World Organization of Family Doctors (2002) A Code of Practice for the International Recruitment of Health Care Professionals: The Melbourne Manifesto. 5th Wonca World Rural Health Conference. WONCA. Melbourne. Available at http://www.rudasa.org.za/download/melbourne_manifesto.pdf

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This entry was posted on Friday, March 14th, 2008 at 10:56 pm and is filed under Student Organisations, IFMSA, Articles. You can follow any responses to this entry through the RSS 2.0 feed. You can trackback from your own site.