Transforming Global Health Recruitment: Elevating Africa’s Health Workers for a Brighter Future – Health Policy Watch

When Dr. Biira* finished medical school in Uganda, she felt excited about her future. But soon, she faced a tough reality: there were no jobs available. Despite the urgent need for doctors, many qualified professionals like her are left jobless and find themselves seeking opportunities abroad.

Across Africa, many skilled healthcare workers encounter serious challenges. They work hard to train, only to confront poor working conditions, low salaries, and limited growth prospects. Meanwhile, wealthy countries actively recruit these professionals, promising better pay and career paths.

This migration is a symptom of a broken system. Africa needs to address these imbalances and create a healthcare workforce that meets its own demands.

Healthcare workers are crucial. They form the backbone of healthcare systems, acting as the first line against diseases. Without a strong workforce, achieving universal health coverage becomes nearly impossible.

African countries are home to 18.8% of the global population but bear 24% of the world’s disease burden, yet they account for only 3% of the world’s healthcare workers. By 2030, Africa could face a shortfall of 6.1 million health workers, according to recent studies.

The cause of this shortfall is clear. African nations struggle to train and retain these workers while high-income countries often import them instead. A World Health Organization (WHO) report highlights that wealthy countries have ten times the number of nurses compared to poorer nations, while 23% of nurses in wealthy countries are from abroad.

A key component of this issue is the WHO Global Code of Practice, intended to guide ethical recruitment. Unfortunately, its recommendations are not mandatory and often ignored, allowing countries like Zimbabwe and Nigeria to continue facing active recruitment from abroad, despite their designation as “red list” nations.

This trend is not only unfair but also damaging. Training a doctor in Africa can cost between $21,000 and $59,000, and between 2010 and 2018, nine African nations lost around $2 billion in investments due to the emigration of trained doctors.

African nations cannot continue to be seen as training grounds for the world’s health workforce. A strong review of the WHO Code is vital. Here are some suggested changes:

• Stricter Rules: The WHO should enforce binding rules and penalize countries that ignore them.
• Ethical Temporary Migration: Programs should allow skill exchange for a limited time, by design, not by chance.
• Reinvestment: Wealthy nations benefiting from overseas-trained workers should contribute to the training and health systems of those countries.

However, just a revised code won’t fix the issue. Fundamental changes in investment and support are necessary, especially in light of recent freezes in foreign aid.

Investing in healthcare workers is essential. These employees often wear many hats, from treating HIV to managing chronic illnesses. Financing their training and career development can create jobs, support gender equity—since 70% of healthcare workers are women—and build resilience against health crises.

In Malawi, for example, with only 43 pediatricians for a population of over 20 million, programs that partner universities with healthcare institutions are helping train more professionals. Yet, to succeed, countries need not just training programs but also effective retention strategies.

Organizations like Amref Health Africa are working to enhance collaboration across sectors, finding better ways to support and motivate healthcare staff. This is key to building a resilient health workforce in Africa.

As the Africa CDC emphasizes health workforce development, the need for funding and political backing grows. Long-term, sustainable solutions are vital to address the continent’s unique healthcare challenges.

The stakes are high. We must choose whether to continue losing healthcare workers to wealthier nations or to invest in our own systems. The future of healthcare in Africa and globally could hinge on the actions we take now.

* Dr. Biira is a pseudonym.

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