Addis Ababa — "There are more Ethiopian doctors in the United States than there are in Ethiopia," Prime Minister Meles Zenawi told a forum on Africa's brain drain meeting in Addis Ababa last week. Africa has the "most mobile population in the world," according to Ndioro Ndiaye, deputy director general of the International Organization for Migration (IOM), whose presentation provided the statistical basis for the two days of deliberations.
Hilde Johnson, Norway's minister of international development, said she learned on a just-completed visit to Malawi that more Malawians practice medicine in Manchester, England than in Malawi, where most received at least some of the training they now use in their profession. Of every four nurses who complete their education in Malawi, she said, one migrates, one takes a better paying job in another sector, one dies of Aids and one remains active in nursing.
The IOM calculates that poor nations are spending U.S.$500 million a year training medical workers who migrate to richer nations. The cost to the industrialized world of training the estimated three million health professionals who were educated in poor countries but are now working in Europe, North America and South Asia, according to IOM, would have been a "staggering" U.S.$552 billion, at an average of U.S.$184,999 for each of those professionals.
The Global Coalition for Africa, an independent non-governmental organization based at the World Bank that organizes annual fora on a variety of pressing issues, brought some 75 participants to Ethiopia for the event. Attendees included four former heads of state or government, ministers and members of Parliament from a number of African countries, experts in migration and related topics, along with representatives of international agencies and NGOs from Africa, Europe and North America. The largely informal deliberations were moderated by three of the GCA's seven co-chairs, including Meles, Johnson and Frene Ginwala, former speaker of the South African Parliament.
The migration of skilled professionals from Africa has a two-fold negative impact, Meles said. "We lose the expertise that we need to spur and manage development, and we also lose the return of the investment we have made in education and training," he said.
According to Nenandi Usman, Nigeria's minister of state for finance, there are at least 25,000 doctors in the United States and United Kingdom whose education was financed by her government. The IOM estimates that 23,000 African health professional leave home every year, "leaving their own stretched health service in dire straights." On the other side, Valeria Goodling, chief executive of the British health care company BUPA, told Time magazine recently that the British and U.S. medical system would collapse without immigrant nurses from places like Nigeria and India.
Industrialized nations that recruit professionals from Africa should invest in training, Meles said, by financing the education of two skilled Africans for every one that their economies need.
Participants agreed that migration is not only the result of the 'pull' labor demand from the West. There is also a 'push' effect from Africa. "The pressure to migrate will continue to build unless and until greater opportunities - particularly for young people - are available in all African countries," Ginawala said in her statement opening the meeting. "We train people for a globalized economy but have not created conditions where their skills can be fully utilized at home, " said Babacar Ndiaye, former president of the African Development Bank.
The International Labour Organisation estimates there are some 7.1 million Africans living outside their home country. The number is rising rapidly and by 2025 could climb to one in ten, the IOM says.
An increasing portion of these migrants is women, Mrs. Ndiaye from the IOM told the forum. Nearly half of African migrants are female, she said, a result of increased access to education and higher participation in the labor force by women in recent years. While migration "can release women from traditional roles and enable them to exercise their rights more effectively in the family," she said, women are also more likely to fall victim to human rights abuses, "since they work in gender-segregated and unregulated sectors of the economy, such as domestic work, entertainment and the sex industry."
Alongside the negative impact, "labor migration offers significant actual and potential gains for Africa," Ndiaye told the forum. "Business connections and export opportunities generated by expatriates expand economic activity," she said. When they return home, they bring skills and experience that contribute to development. "To what extent is it possible," Ginwala asked, to make migration a "net benefit for the continent?"
In financial terms, the most significant positive effect is from the remittances migrant workers send to their relatives and friends at home. According to estimates Ndiaye cited, recorded transfers to Africa totaled about U.S.$12 billion in 2002, of which U.S.$4 billion went to sub-Saharan Africa. "If unofficial transfers were also counted, the volume could double this amount," she said.
In considering proposals for tackling the problems and maximizing the benefits of migration, participants suggested "a wholistic and comprehensive approach, integrating migration into development strategies and formulating inclusive migration policies." A number of participants stressed the importance of supporting implementation of the "strategic framework for a policy on migration" that has been drafted by the African Union for deliberation by member states.
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"We have to deal with the factors that encourage or force people to go out," said Miria Matembe, a member of Parliament and former minister of ethics and integrity in Uganda, "and there is an urgent need for research to establish the impact of feminization on migration."
Another recommendation that received wide support was the emphasis on improved governance, sound economic policies, and resolution of conflicts so that more skilled workers would decide to return home or remain home when they complete their education.
Participants also weighed ways to build links between Africans living abroad and their home countries and between the Diaspora made up of salve descendents and the continent as a whole. Mel Foote from the Constituency for Africa in Washington, DC, emphasized the spending power and political clout of African Americans who he said must be included in any effective strategy for dealing with brain drain and development.
The importance of technology was also raised during the discussions, not only as a key to the creation of attractive jobs but also as a way to engage more actively with the diaspora and to leapfrog development obstacles.
"The challenge we face is to minimize the negative effects and enhance its positive impact," Meles said. This requires a willingness to "think outside the box" and a determination to shape migration policies both in Africa and internationally that support African development.
