REPORTING FROM SOUTH AFRICA -- South Africa, the nation with the highest number of people living with HIV/AIDS, has spent more than $1.4 billion training doctors, only to see them emigrate overseas for jobs. It's part of a massive flow of expertise from poor and developing countries to rich nations such as the United States, Canada, Britain and Australia.
A Canadian study in the British Medical Journal estimated the cost of lost doctors in nine sub-Saharan African countries at nearly $2.2 billion. And that didn't take into account the large numbers of nurses who leave Africa for the West.
With more than 5 million people living with HIV/AIDS, South Africa has just eight doctors for every 10,000 people. Its public hospitals are understaffed and overburdened because of HIV/AIDS, according to medical analysts. It costs the South African government $58,700 to educate a doctor.
Zimbabwe lost $40 million, Ethiopia $25 million and Nigeria $654 million to emigrating doctors, according to the study led by Edward Mills, a global health expert at the University of Ottawa. A World Health Organization report in 2006 said Africa was facing a critical shortage of medical staff.
The report said the doctor drain weakened health systems in developing countries and threatened the capacity of African countries to reach Millennium Development Goals, a broad group of targets aimed at reducing scourges such as child and maternal mortality rates and poverty.
South Africa, where HIV/AIDS has sharply increased the burden on the medical system, hasn't seen an increase in medical staff, so those who stayed in the country suffer burn-out and fatigue because of the heavy workload, according to the report. The finding is backed by South African medical analysts.
The report called on wealthy nations benefiting from the import of African doctors to take action to compensate poor countries for the loss of physicians.
"Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable," the report concluded. "Destination countries should consider investing in measurable training for source countries and strengthening of their health systems."
The report also noted the imbalance of need versus know-how.
"While Africa experiences 24% of the global burden of disease, it has only 2% of the global supply of doctors, and less than 1% of expenditures are on global health," the report found.
Rich countries saved money by training fewer doctors than they needed and making up the gap by importing medical staff, according to the report.
"Developing countries are effectively paying to train staff who then support the health services of developed countries,” the report found. “Although developed countries often provide development assistance to resource limited countries, the amount that goes into the training of health workers is variable and limited.”
-- Robyn Dixon
Photo: In this Nov. 2010 photo, Thandazile Majozi is tested at an AIDS clinic near Johannesburg. Credit: Jerome Delay / Associated Press