In the battle against the "brain drain" that is robbing poor countries of their qualified health professionals, a report by the United Nations Conference on Trade and Development (UNCTAD) points the finger at a lack of political will in developed countries. And it calls upon these countries to "do something" to halt this exodus.

The figures are around 45% in Liberia, 10% in Zambia, Ethiopia and Uganda . And this haemorrhage of health workers is such that if measures aren’t rapidly taken, the states of sub-Saharan Africa will no longer be able to save their health systems.

"The problem extends far beyond the countries affected by the brain drain. It is imperative that rich countries take adequate measures to combat this scourge", warns Charles Gore, head of research and political analysis at UNCTAD and principal author of the report.

Among the different salvage measures advocated is "local salary support". The principle is simple: rich countries could "directly or indirectly" help health professionals to stay at home by supporting them financially. Return incentive programmes have also been proposed. "Following the example of Great Britain, it would be effective to help health professionals who have emigrated to return to their country of origin".

Charles Gore believes that this should be possible "by recruiting on fixed term contracts and not on a permanent basis, as if often the case".

Source: BMJ, 200 ; 335:119