Premed Perspective From Switzerland: Part VII
Believe it or not, migration trends have a direct impact on public health. Before coming to Geneva, all my word associations involving “health” and “migration” would have focused on the health of immigrants themselves, or, perhaps, the incidence of communicable diseases in a refugee camp.
After visiting the International Organization for Migration (IOM), I discovered an often overlooked issue in migration health: the migration of health professionals and the ensuing tension between the right to health and the right to mobility.
Article 12 of the International Covenant on Economic, Social, and Cultural Rights (ICESCR, 1966) provides the most comprehensive articulation of the universal right to the highest attainable standard of physical and mental health. At the same time, Article 13 in the Universal Declaration of Human Rights (UDHR, 1948) gives individuals the right to mobility and cross-state travel. While at first these two articles may seem unrelated, there is actually a conflict of interest in the context of migration of healthcare professionals.
It makes sense that doctors, nurses, and other healthcare personnel have the right to better their situation and migrate, just like everyone else. The challenge is that this emigration often occurs out of developing countries, resulting in a brain drain that impacts the population health of the originator country. In fact, at the IOM we learned that in 2013, there were 83 countries below the basic threshold of 23 skilled health professionals per 10,000! Many of these countries are top originator countries of migrants in the healthcare field and across the Organization for Economic Cooperation and Development (OECD, a group to which the United States belongs), more than 24% of nurses and doctors are trained abroad.
Image Source: Bloomberg
For developing countries, healthcare workers are both an expensive and limited resource. After spending a portion of their budget on training, infrastructure, and hospital management, the least they can expect is a return on their investment. However, because of improved financial considerations, increased opportunities for career development and continuing education, and better hospital management abroad, developing countries have a hard time retaining their health workers. What’s tricky is that there seems to be no right answer – how do you decide which human right “wins”? Moving forward, global organizations like the IOM and WHO will face this challenging but important question as they develop policies that juggle both.
Source: Meme Better, meme by Lochan Shah
< Part VI: The Inside Scoop on the Sustainable Development Goals: UN Edition
Part VIII: De-linking R&D From the Price of Drugs: Fantasy or Future? >
Featured Image Source: Jorge Díaz
