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New initiative seeks practical solutions to tackle health worker migration

The Health Worker Migration Policy Initiative held its first meeting today at the WHO headquarters in Geneva. The initiative, led by Mary Robinson, President of Realizing Rights: the Ethical Globalization Initiative, and Dr Francis Omaswa, Executive Director of the Global Health Workforce Alliance (GHWA), is aimed at finding practical solutions to the worsening problem of health worker migration from developing to developed countries.

WHO Director-General Dr Margaret Chan said, "International migration of health personnel is a key challenge for health systems in developing countries." The new initiative has a Technical Working Group housed at WHO.

The Health Worker Migration Policy Initiative is made up of two groups that will work closely together over the coming months to develop recommendations. The Migration Technical Working Group, which is being coordinated by WHO, brings together the International Organization for Migration, the International Labour Organization, professional associations, experts and academics.

The Health Worker Global Policy Advisory Council, under the leadership of Ms Robinson and Dr Omaswa and with Realizing Rights serving as its secretariat, is made up of senior figures from developed and developing countries. It will develop a roadmap and a framework for a global code of practice for health worker migration and seek high-level political backing for its recommendations.

A recent study1 has shown that the number of foreign-trained doctors has tripled in several OECD countries over the past three decades. The number of foreign-trained doctors from countries with chronic shortages of health workers is relatively small (less than 10% of the workforce) in developed countries. However, for some African countries, the migration of a few dozen doctors can mean losing more than 30% of their workforce, even as basic health needs remain unmet.

Other health professions are also affected by this phenomenon. The study showed that from Swaziland, 60 to 80 nurses migrate to the United Kingdom each year, while fewer than 90 graduate from Swazi schools. GHWA partner and member Save the Children UK estimates that the United Kingdom saved £65 million in training costs between 1998 and 2005 by recruiting Ghanaian health workers.

Ms Robinson summarized the need for urgent action: "We cannot stand alone as individual countries continue to address their own increased needs for health workers without looking beyond their shores to the situation these migrating workers have left behind in their homelands. We cannot continue to shake our heads and bemoan the devastating brain drain from some of the neediest countries on the planet without forcing ourselves to search for – and actively promote – practical solutions that protect both the right of individuals to seek employment through migration and the right to health for all people."

One of the initiative's first priorities will be to support WHO in drafting a framework for an International Code of Practice on Health Worker Migration, as called for by a resolution of the World Health Assembly in 2004. This framework will promote ethical recruitment, the protection of migrant health workers' rights and remedies for addressing the economic and social impact of health worker migration in developing countries. The Code of Practice will be the first of its kind on a global scale for migration.

The initiative will also promote good practices and strategies to enable countries to increase supply and retain their health workers more effectively. The new tools and policy recommendations developed by the initiative will support better management of migration through North-South collaboration.

Dr Omaswa emphasized the importance of addressing both the 'push' and 'pull' factors simultaneously. "Health workers are a valued and scarce resource. Demand is increasing worldwide, but not enough are being trained – in the developed or the developing world. Developing countries must prioritize health and health workers, with better working conditions and incentives so its workforce can stay and be more efficient, while developed countries must train more of their youth and try to be self-sufficient."

The Health Worker Migration Policy Initiative is due to make initial policy recommendations by the end of 2008. Its operations are co-funded and coordinated by Realizing Rights, the Global Health Workforce Alliance, and the MacArthur Foundation.

1 Connell J, Zurn P, Stilwell B, Awases M, Braichet J-M, Sub-Saharan Africa: Beyond the health worker migration crisis, Social Science & Medicine 64 (May 2007) 1876-1891.

List of members

Health Worker Global Policy Advisory Council
Co-Chairs
  • Hon. Mary Robinson, President, Realizing Rights
  • Dr Francis Omaswa, Executive Director, GHWA
Members
  • Hon. Major Courage Quarshie, Minister of Health, Ghana
  • Hon. Erik Solheim, Minister of International Development, Norway
  • Hon. Patricia Aragon Sto Tomas, Minister of Labor and Employment, the Philippines
  • Hon. Rosie Winterton, Minister of State for Health Services, United Kingdom
  • Dr Lincoln Chen, Director, Global Equities Initiative, Harvard University
  • Dr Anders Nordström, Assistant Director-General, Health Systems and Services, WHO
  • Ms Janet Hatcher Roberts, Director, Migration Health Department, IOM
  • Mr Ibrahim Awad Director, International Migration Programme, ILO
  • Lord Nigel Crisp, Co-Chair, GHWA Task Force on Scaling up Education & Training
  • Dr Percy Mahlati, Director of Human Resources, Ministry of Health, South Africa
  • Huguette Labelle, Chancellor, University of Ottawa
  • Dr Titilola Banjoko, Managing Director, Africa Recruit
  • Prof. Ruairi Brugha Head, Department of Epidemiology & Public Health, Ireland
  • Ms Sharan Burrow, President, International Confederation of Free Trade Unions
  • Ms Ann Keeling, Director, Social Transformation Programs Division, Commonwealth Secretariat
  • Mr Markos Kyprianou, Director General, Health & Consumer Protection, European Commission
  • Mr Peter Scherer, Directorate for Employment, Labour and Social Affairs, OECD
  • Prof. Anna Maslin, Nursing Officer, International Nursing & Midwifery Health Professions Leadership Team, Department of Health, United Kingdom
  • Dr Mary Pittman, President, Health Research & Education Trust, American Hospitals Association
  • Dr Jean Yan, Chief Scientist for Nursing & Midwifery, WHO, chair of the Migration Technical Working Group
Health Worker Global Policy Advisory Council Secretariat:
  • Ms Peggy Clark, Managing Director, Realizing Rights
  • Dr Ita Lynch, Health Advisor, Realizing Rights
For more information, please contact:

P. Ben Fouquet
Communications officer
GHWA, Geneva
Telephone: + 41 22 791 3554
Mobile: +41 79 467 1370
Fax: +41 22 791 4747
E-mail: fouquetp@who.int

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