Brain Drain and Brain Gain:
Problems, Paradoxes, and Trends in International Skill Flows
Katarzyna Hadaś, Annette Lang
Introduction
Brain drain is a kind of trap for developing countries, which, deprived of their most
highly-educated people who would be natural leaders in terms of economic and social
development, are unable to come out of poverty, which is often worsened by violence and
extremism, as well as passiveness and hopelessness. The achievement of many developing
countries' Millennium Development Goals and particular national targets is threatened or
hampered due to inadequate human resources and this situation is compounded by the loss of
both essential and beneficial professionals such as scientists, medical doctors, engineers,
academics, nurses, technicians, administrators and managers who emigrate
to more
economically-developed countries (Dassin, 2005).
Approximately 3% of the world's population live in a country other than their country of
birth. International migration is an established feature of contemporary economic, social and
political life, driven by the seemingly-unstoppable forces of globalization and demography.
Modern communications and transportation ensure that more and more people have access to
formerly distant and unreachable lands of promise with regard to their well-being and progress.
It is only the matter of the last two decades that the availability of new communication
technologies have made the former
sporadic, exceptional and limited connections more
systematic, dense and multiple.
The term ”brain drain”, although considered by some authors (Clemens, 2009) as oldfashioned and pejorative, is still used to describe the international movement of resources in the
form of human capital, represented by relatively highly-educated individuals, from developing
countries to wealthier ones. The outflow of these professionals is narrowed in the non-academic
literature and limited to the migration of engineers, physicians, scientists or other very highlyskilled professionals with university degrees. In scientific analyses of census data, however,
skilled immigration is defined with the inclusion of
professionals with advanced degrees,
workers with tertiary education, mid-level technical personnel and professional workers. Skilled
labour migration also includes: scientific trainees studying at Master's degree and PhD levels
who go overseas for training but do not return upon completion of their studies; professionals
who receive advanced training in developed countries, return upon completion of their studies
and then emigrate again after working for some period; and professionals who are trained in
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domestic institutions but emigrate upon completion of their studies and/or after working for some
period of time.
There are three different meanings associated in the literature with the notion of “brain
gain”. First, it is viewed as the other side of the coin; while the flow of skilled migration is
considered to be a brain drain of human resources from the less to more developed nations, the
latter automatically experience a beneficial “gain”. Nonetheless, there also exist two-way and
multiple flows, and the return of former migrants can be considered as a “reversed brain drain”
for the host country or a “brain gain” for the country that they initially left. The third meaning
covers the benefits derived from the extended human capital formation in developing countries,
where people are driven to improve their education and professionalism by the prospect of
emigrating. Reports of the successes of their co-nationals abroad and the realization that highlytrained professionals can get lucrative jobs may be effective in persuading young people to
continue their education, thus increasing a developing country's levels of skills and know-how.
Such incentive-influenced decisions made by “those remaining behind” to invest in their
education may be one of the key determinants of the long-term economic growth of these
countries (Lucas, 2005).
There are two ways of facilitating brain gain: either through the return of expatriates to
their country of origin (the return option) or through their remote mobilization and association to
its development (the diaspora option). The impressive case of emigrants who have returned
from Silicon Valley and invested
their talent, knowledge and finance in the information
technology industries in Taiwan, China and India in order to push their economies forward is
unfortunately the exception rather than the rule. Migrants often do come back but it is not
always the case that their return has such a significant effect. Returnees are likely to have
enthusiasm for institution building, and furthermore they are
often politically-active and
motivated to push for reform and to stimulate business in their home countries, even if these are
stereotypically perceived as not being able to offer significant incentives for people to return.
The most remarkable cases of return can be found in the biographies of the 46 current and 165
former heads of government, who received their higher education in the United States after
1950. However, these are exceptional, although significant, returns. In case of some countries,
the majority of returnees, due to a lack of productive and legal opportunities at home, are hardly
able to have any essential input into their domestic trade or industry. For instance, some surveys
have found that less than 5% of skilled migrants from Tonga, Micronesia and Ghana have ever
helped a company from their home country in a trade deal, and when they have, the values of
these deals have been modest. Cases of philanthropic activity occasionally performed by émigrés
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in their countries of origin, who have successfully built their businesses abroad, are rather
singular. More common is a lack of involvement in trade and investment due to circumstances
which are unfavourable to business, and not because of a lack of interest on the part of the
migrants in helping their home countries (Clemens, 2009). Countries which are more
economically developed, and that can offer better opportunities, especially those identified as
new industrialized countries (NICs), such as Singapore and the Republic of Korea, or major
developing nations, such as India and China, have implemented strong repatriate programmes
since the 1980s. They have created conditions in which returnees could effectively channel their
activities and funds, enabling them to be operational. It was the incentives that skilled workers
could expect to find back home that shaped their decisions to return. Nevertheless, the physical
return of skilled migrants is not necessary in order to gain from their expertise. Both China and
India learned how to take advantage of the skilled diaspora as a valuable and influential “brain
bank” bringing remotely-gained benefits in the forms of business, political and cultural linkages.
This is an essential ability because the reality is that migrants who have successfully settled
abroad and built their professional and personal lives there, may not be likely to come back. This
happens despite any incentive policies that are introduced, even though the émigrés may still be
very concerned about the development of their home countries due to sentiments and attachments
to their home cultures, and because of family ties and lasting friendships. Some emigrants may
from the beginning plan their eventual returns only for their retirements.
Amongst the many categories of entrants: unskilled immigrant workers, undocumented
workers, refugees, asylum seekers and students, skilled immigrant workers have for a long time
been a topic of intense interest in socio-economic research. In the 1970s, the literature on brain
drain and brain gain concluded that the emigration of skilled workers adversely affects the
welfare of those who remain in the source countries (Bhagwati and Hamada, 1974). A series of
recent empirical studies, however, provides evidence that emigration may actually contribute to
the long-term development of these countries because emigration encourages human capital
investment (e.g., Stark et al., 1997; Beine et al., 2006; Beine et al., 2008). For example, Beine
found “a significantly positive developmental effect of migration on human capital accumulation
in their cross-country analysis of 37 developing countries”. In the long-term the departure of the
highly skilled may have beneficial effects in the form of a counter-flow of remittances,
investments, trade relations, new knowledge, innovations, attitudes and information. Moreover,
migrants may return with a much better knowledge of the markets beyond their borders and the
financial capital to invest in export businesses. If they are successful, these businesses provide
employment and income growth for their poorest co-nationals.
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Problems with estimating the scope of the phenomenon
Several publications have analysed and aggregated the international data on migration
flows by country of origin and education level (Carrington and Detragiache,1998, Adams, 2003,
Docquier and Marfouk, 2004, Dumont and Lemaitre, 2004). Attempts to estimate brain drain
encounter difficulties as the relevant national authorities maintain very limited databases. In fact,
many countries do not have systems for the continuous recording of international migration and,
where they do, they do not process and publish the data. Taking into account those countries that
do produce statistics on international migration, their meaning and scope vary considerably, e.g.
due to inconsistent categorisation of skill and education levels. Researchers have also found it
difficult to assess the economic impact of brain drain in developing countries where there is
imperfect information on return migration.
In the absence of systematically-gathered and
credible material, the debate remains almost exclusively theoretical, political, anecdotal and
emotional. It is also worth addressing two different opinions on the difficulties in reaching
objective conclusions about the real impact due to the flaws in the existing data. The first
shortcoming, according to Meyer and Brown, originates from the omission of the numerous
funded education opportunities in receiving counties: “entries and exits registered at the borders
only keep record of the number of already skilled migrants entering a definite country when it is
clear, today, that the majority of skilled people of foreign origin acquire their professional
qualifications in the host country” (Meyer and Brown 1999). Beine, Docquier and Rapaport
conclude that such imprecision may cause an over-estimation of the intensity of the brain drain
as well as
“possible spurious cross-country variation in skilled emigration rates.” (Beine,
Docquier and Rapaport 2006). Generally it leads to conclusions of which those of the ACP-EU
Joint Parliamentary Assembly are typical: „The brain debate is still marked by a considerable
amount of confusion and frustration, especially due to the lack of reliable statistical data and the
lack of impact assessment studies on potential policy recommendations to address the ‘brain
drain’ phenomenon” (ACP-EU, 2007).
The same problem concerns the estimation of economic losses. Attempts have been made
to calculate the financial cost of a single emigrant departure, taking account of the lost returns
from the investment made in educating a doctor or an engineer, plus the amount that the
expenditure on this training would have earned, had it been invested in a financial institution, and
the additional potential revenues that would have been raised from the taxes he or she would
have paid. An example of such a calculation is the one made by Kirigia, Gbary, Muthuri, Nyoni,
and Seddoh: “The United Nations Commission for Trade and Development (UNCTAD) has
estimated that each migrating African professional represents a loss of US$ 184,000. Our study
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estimated economic loss incurred by African countries as a result of emigration of one doctor to
be about US$ 517,931 and one nurse to be US$ 338,868. Our estimates are higher than those of
UNCTAD for two reasons: (i)we take into account the investments made into production of
doctors and nurses from primary school to tertiary training institutions; and (ii) we take into
account the cumulative financial effects of the lost returns from investments”. The authors
calculated that on average, an emigrant doctor would have worked for 32 years before retiring.
They then multiplied this number of years by the average interest rate on fixed deposits in Kenya
(6.65%). (Kirigia, et al., 2006.) In response to this, Clemens claimed that these amounts were
“astronomical in a country where the average person earns about US$1.30 per day”. His first
reservation relates to the fact that many skilled emigrants have already served their countries for
long periods before emigrating. His second questions the rationality of subsidizing the training
of very highly- educated health professionals using the state budget, when much more mid-level
health workers (with skills exactly tuned to local needs - endemic diseases and sanitary
conditions) might have been trained for the same cost, with a much greater impact on the
nation's health. Alternatively, he subsequently argued, some of this money could be used on
preventive public health measures, such as improved sanitation, basic hygiene education, and
HIV education, which would be more effective and sustainable (as they are “immobile”) than
when spent on training of very highly-educated doctors who are most likely to emigrate.
(Clemens, 2009) The conclusion he reached was that the training of highly-skilled future
emigrants is not an optimal use of scarce public resources. At first glance, this reduces the
problem of brain drain to absurdity – likewise described in nonsensopedia1 as “an employment
trick which results in a situation that researchers (and other highly-skilled professionals), who
should work in favour of development of the country that educated them and now is expecting
the return of this investment, departure to another country which is able to pay them because it
does not waste money for training of those who left the country just after studies”. Such a
“definition” may be humorous but it highlights one crucial aspect – the contribution of publiclysubsidized tertiary education to the emigration of highly-skilled workers. The solution to this
problem is dependent on the policy decisions of the individual governments. A flag comparison
of two approaches to this problem is illustrated by the Philippines and various African countries.
In the Philippines, the great majority of registered nurses who depart the country pay for their
own education. Their emigration is then supported by the government and, rather than being
shamed, they are praised for working overseas in order to send remittances back to the home
1
Satiric, internet para- encyclopedia http://nonsensopedia.wikia.com
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country. In Africa, however, the opposite is true. The majority of African emigrant nurses were
publicly trained, and their departure is seen as being damaging to their domestic health services.
This situation would be improved if the burden of the education of these health specialists could
be shifted in part to private institutions. The question arises from this comparison is which
policy is more reasonable?
Worldwide hunt for talents
There are two visible trends in the selection policies and screening mechanisms in
receiving countries. Firstly, those with ageing populations give priority to the young or to those
likely to have many children. Secondly, countries in which particular labour markets are already
oversupplied with workers give priority to people with different occupations in order to protect
domestic workers and to meet the demands of the other labour markets and the needs of society
as a whole. The quality-selective immigration policies that have been introduced in many OECD
countries grade candidates according to their prospective ”contribution to the host country, more
or less explicitly identifying the potential ‘winners’ and ‘losers’ in a particular destination”.
Several countries, including Australia, Canada and New Zealand, use points systems to evaluate
each individual's profile, in terms of education, occupation, language proficiency and age. In
destinations where there are no such transparent systems, the selection process may be perceived
by candidates as being more arbitrary, meaning that they are uncertain when they leave as to
whether their capabilities predestine them to be “winners”. In the EU countries, immigration
policies are less clear but a level of expectation may arise among the relatives of émigrés as
European countries are still oriented towards traditional targets such as asylum seekers and
applicants who wish to be reunited with family members. However, there is some evidence
suggesting that European countries are also leaning towards becoming quality-selective. The
French Weil Report on Immigration published in 1997 explicitly recommends giving priority to
the immigration of highly-educated workers. Another example is Germany's plan, announced in
2000, to recruit 10,000 additional specialists in the field of information technology. The EU
directive on the admission of highly-skilled migrants aims to avoid the negative brain drain
effects on developing countries, especially in Africa. In the form of a proposal, the document
advocates ethical recruitment standards to limit – if not ban – active recruitment by Member
States in developing countries which already suffer from a serious brain drain, and contains
measures to facilitate circular migration. Nevertheless, it depends on the particular country how
efficient the screening is and to what extent the developing country will lose out from the
departure of its best talent. This fact should not be merely a source of blame for the two winning
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sides (the receiving country and the migrant). The crucial thing is to find answers, for the benefit
of those remaining behind (both states and communities), as to the reasons for the migration of
“the best and brightest” and whether it is to be a temporary or a permanent loss (Risse, 2009).
Reasons for and results of skilled movement
The reasons for the migration of key workers are shaped on the one hand by a
combination of the economic inequalities and political and social situations in poor countries and
on the other by the recruitment policies of governments in the developed world. These pull and
push factors in tandem thus lead to the brain drain of skilled professionals. Crucial factors that
pull professionals to developed countries are better remuneration and working conditions, safe
and desirable living conditions and opportunities for intellectual growth. These are accompanied
by other factors which may also simplify the decision to leave: the availability of information
about employment opportunities abroad, easy access to cheap communication technologies,
being a member of a target group defined in a foreign recruitment policy, and the availability of
assistance in finding suitable positions and support in completing visa applications etc. The key
push factors driving them out include: poor living conditions, low remuneration,
lack of
professional development opportunities, lack of clear career development paths, low intellectual
stimulation, disastrously poor governance, widespread poverty, nepotism and corruption in
recruitment and promotion, insecurity or violence in the workplace, political unrest and tensions,
military conflicts and civil wars. In the case of those failing to return to their home countries
after training or working abroad, the above listed factors are complemented by a heightened
awareness of the inequalities and deficiencies, gained abroad from numerous comparisons from
personal experience in daily life. These include the presence and condition of the infrastructure
and systems relevant to their professional lives, career structures, work cultures, social status,
recognition of talents and scope for their use, quality of education for children and the overall
standards of living and lifestyles.
Fan and Stark identified three possible negative short and long term consequences of the
international migration of skilled workers: loss of the skilled, “educated unemployment” and
“overeducation”. The first of these is the most obvious and is consistent with the ‘traditional’
view that migration leads to a reduction in the ‘stock’ of better-educated individuals, which in
turn reduces the average income in the developing country. In general, the emigration of talent
may give a positive signal which motivates others in the sending country to become more
educated, thus raising the human capital and possibly promoting growth. But the outcome in the
short term may be equally negative, as educated individuals who would otherwise have taken
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jobs are lured into further education only to end up unemployed, thereby creating “educated
unemployment”. The related effect of overeducation occurs
when large numbers of new
graduates are introduced into a small economy with limited or low-paying entry positions. As a
result, “many of these individuals end up remaining in the country and the country's economy
cannot absorb them, then these individuals’ overeducation is socially inefficient” (Fan and Stark,
2007).
Good sides of the phenomenon?
The rich literature published about the brain drain has described and analyzed the pull
and push factors leading in tandem to a brain drain of highly-trained professionals and has
usually concluded that brain drain results in mostly or exclusively negative effects and harmful
losses. The traditional brain drain literature has viewed the exodus of human capital as a “curse”
for developing countries, leading to increased inequality at the international level, with the rich
countries getting richer at the expense of the poorer countries. Especially difficult situation in
health sector in some developing countries, combined with high outflow of their doctors and
nurses was a subject of numerous alarming publications (Chen and Boufford, 2006, Mills, et al.
2008). Nevertheless some authors has recognized that the moderate brain drain does bring
certain benefits. These include not only remittances but exchange of knowledge, foreign direct
investment and increased trade, as a result of diaspora activity, as well as skills, know-how and
work culture brought by return migrants from their host countries. Last years of XX century
brought also the “new brain drain” or “new beneficial brain drain” literature claiming that the
brain drain has a big impact on the number of skilled individuals in a sending country. Driven to
achieving education and professionalism by the perspective of emigration they form intellectual
potential. As not all of them leave the country, a part of this extended human capital stays and
generates
economic welfare and growth for their nation. Emerging statistical and anecdotal
evidence indicates that there are significant positive effects associated with the global skills flow.
Benefits accompanying brain drain were analyzed in the works of Mountford (1997), Stark et
al. (1997), Stark et al. (2004), Beine et al. ( 2001, 2003), Docquier and Rapoport (2007). Thanks
to recent findings, it is now acknowledged that the international movement of educated people
may have positive effects on the sending economy in terms of increased domestic enrolment in
education and significant financial contributions through the remittances they send home. When
the movement is back and forth it results in a transfer of technology and know-how whereby
foreign models, solutions, and practices may be adopted locally in order to create a wealthier
society. The investment in the home country of capital accumulated abroad may provide essential
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impetus to new businesses and activities. Additionally, “diaspora may demand goods and
services that remind them of home, which in turn generates new avenues of trade”. All this may
lead to a growth in employment and incomes and a reduction in poverty. Moreover, if it is not
exactly a positive, compensation can be drawn from the fact that the children of émigrés are
educated abroad, although they may come back as adults, thus reducing the burden on the state
education system. It has also been noted that there is a correlation between the levels of direct
foreign investment from wealthier countries and the numbers of émigré graduates residing in
these host countries.
Remittances, diasporas and return flows may partly or wholly offset the consequences of
skilled emigration. Puri and Ritzema (2000) reviewed and discussed the existing research on
remittances. The problem with such research lies in the impossibility of separating out the
volumes of remittances coming from migrants in different skill groups. Remittances vary
systematically with respect to income, planned duration of stay, and the conditions in the sending
country in general and in households in particular. Anecdotal evidence indicates that skilled
migrants earn more and respectively send more money home, but this is called into question by
other common truths that skilled immigrant families are likely to already be relatively well off in
their home countries and that educated workers may be less likely to remit as they tend to remain
in their destination country much longer and take their families along with them. (Faini, 2006).
According to the World Bank's Global Economic Prospects report, the value of officially
recorded remittances exceeded 232 billion dollars in 2005. Furthermore, it is estimated that
remittances sent through informal channels could increase this figure by up to 50%. The
importance of this is colossal - the total value of remittance flows is larger than that of official
worldwide development aid. The countries receiving the most recorded remittances are India
(21.7 billion dollars), China (21.3 billion dollars), Mexico (18.1 billion dollars), and the
Philippines (11.6 billion dollars). Countries for which remittances account for the largest
proportion of GDP are Tonga (31%), Moldova (27.1%), Lesotho (25.8%), Haiti (24.8%), and
Bosnia and Herzegovina (22.5%).
Several studies have indicated that remittances increase educational expenditure in origin
households (Adams 2003), reduce the likelihood of children dropping out of school and increase
the number of children, in particular girls, who complete their schooling. However, a negative
impact on schooling
is observed where migration is dominated by low skilled, often
undocumented, workers and where the receiving market does not expect people of a certain
origin to be educated. For instance, “a Mexican or a Moroccan cleaner with a university
education in Spain or the United States is unlikely to earn significantly more than a colleague
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with only a primary education. There is indeed some evidence from Mexican household surveys
indicating that international migration has a negative effect on the level of schooling of children”
(McKenzie and Rapoport 2006).
Beneficial gain?
In general, individuals who decide to return are persuaded by at least five types of
reasons. Firstly, by sentiment - when the immigrant prefers to live, to socialize, to bring up
children and to consume in the home country, and to live a less hectic lifestyle and to enjoy the
prestige that the money he/she has earned brings him/her at home. Secondly, by economic
reasons
- when prices are lower at home and when the purchasing power of the capital
accumulated aboard is higher there. Thirdly, by ambition - when the human capital acquired
abroad is valued and welcomed, making the returnee someone important and respected by conationals and local authorities etc.. Fourthly, by security – deemed as the sustainability and
constancy of his/her activity after return – as an employee, as an entrepreneur or in selfemployment. And lastly, some returnees may come back also when they realized a mistake when “the anticipated income gain does not materialize, or being away proves more of a hardship
than expected, the emigrant may later reverse the decision to live abroad” (Kapur and McHale,
2005). Such a reverse may occur due to oversight and a lack of realism on the part of the
emigrant or due to unforeseeable changes in circumstances at home or abroad.
Some authors claim that returners tend to be those who are less skilled, and very rarely
those who are the best. Cohen and Haberfeld (2001) found that “Israeli immigrants returning
from the United States are likely to be negatively selected from those Israelis who emigrated in
the first place. In sum, studies of return migration suggest that those who return may be those that
have performed relatively poorly when abroad; the best migrants tend to stay. Of course, these
observations do not necessarily hold true for all different migrant groups or countries” (Ha, at al.,
2009).
Shiff contests the “new brain drain” idea. He argues that the assumption - that by raising
the return to education, a brain drain generates a brain gain that in certain conditions, is larger
than the brain drain itself, and that such a net brain gain results in an increase in welfare and
growth due to education's positive externalities - is mainly theoretical and “based on static
partial equilibrium analysis”. According to Schiff the size of the brain gain is smaller than
suggested in that literature, the impact on welfare and growth is significantly smaller as well,
there is a significantly greater than reported in that literature, likelihood of a negative impact on
welfare and growth, an increase in the stock of human capital may have as well a negative impact
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on welfare and growth. Schiff concludes that the new brain drain literature offers no solution to
the most severe brain drain problems. This includes the exodus of healthcare providers from SubSahara Africa and the Caribbean - the world's poorest regions (Maurice Schiff, 2005).
The situation in the health sector
In looking for positives arising from the global skill flow we should not lose sight of the
difficult situation in the health sector in some developing countries. However, we should add the
qualification that the outflow of medical staff is not the only reason for the problems in this
sector in these parts of the world. Healthcare is generally under-provided there and its
accessibility also tends to be skewed towards urban and relatively privileged consumers.
Chen and Boufford call the movement of physicians from poor to rich countries “fatal
flows’ . Indeed, the statistics are striking: “Ghana, with 0.09 physician per thousand population,
sends doctors to the United Kingdom, which has 18 times as many physicians per capita. The
United States, with 5% of the world's population, employs 11% of the globe's physicians, and its
demand is growing”. This happens because the medical systems in the United States and other
developed countries are “heavily dependent on imported workers — for hospital staffing,
coverage of underserved areas, and meeting gaps in skill levels. U.S. medical schools turn out a
relatively stable 17,000 graduates annually, but the demand for residency staffing exceeds this
number by 30%. This gap is filled by international medical graduates, most of whom will attain
citizenship or permanent residence and remain in the United States to practice medicine” (Chen
and Boufford, 2006) However, countries that intentionally export skilled medical personnel,
such as the Philippines, tolerate "brain drain" in exchange for financial remittances, a lowering of
their high unemployment rates, and the possibility of establishing scientific connections.
When health professionals emigrate, there is a negative effect not only on treatment but
also on health promotion, disease prevention, and rehabilitation for those remaining behind, thus
influencing their levels of health, and their productivity and general welfare. Apart from the
economic losses (investment in education of doctors and nurses, their service and tax collection
from their incomes), Kirigia at al. identified other losses of a social and moral nature. One of
them is the loss of supervisors and mentors for health sciences trainees associated with the
departure of practising doctors and senior nurses who would otherwise supervise staff in
peripheral facilities or train and counsel new employees and students doing internships there.
Using the example of the Kenyan hierarchical national referral system, the authors also point out
its loss in functionality due to the uncontrolled movement of patients (not initiated or regulated
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by health professionals) who bypass the cost-effective peripheral health units (usually the first to
be avoided) and seek more expensive care in tertiary and provincial hospitals. This loss of role
models and guardians of human rights occurs particularly in rural areas. The authors argued that
health professionals who are posted there, “by virtue of being the most educated, often bore the
burden of assuring that the human rights of their actual and potential clients were respected and
protected in the course of their clinical work and research carried out by others”. By acting in this
way they are viewed as examples to be imitated and followed. Then there is the loss of
entrepreneurs and employers because of the tendency of health practitioners to set up private
clinics, hospitals, pharmacies and non-health-related businesses, such as retail and wholesale
outlets. Doctors also give employment to housemaids, gardeners and security guards at their
residences. Lastly, according to the authors, senior medical personnel are “generally respected as
being above corruption, they advocate for quality public schools, they provide a market for
consumer goods, and they contribute to political, social and economic stability”, and are thus an
important element of the middle class which is lost to the country as a result of migration.
(Kirigia at al. , 2006)
Measuring the scope of the healthcare brain drain leads to the argument that wealthy
countries have a moral obligation to reduce the flow of healthcare workers from the developing to
the developed world. (Hooper, 2008). Mills at al. presented statistics showing the shortages of
healthcare staff in sub-Saharan Africa, where, on average, one physician serves 8,000 people. In
the worst affected countries, such as Malawi, the physician-to-population ratio is one to 50,000
people compared to the minimum acceptable care level of one per 5,000 (the WHO’s Health for
All standard ). A comparison of these figures with the ratios in developed countries (the UK, for
example, has over 100 times more physicians per population than Malawi, while almost one in
ten doctors working in the UK is from Africa) led the authors to ask dramatically: “should active
recruitment of health Professional from sub-Saharan Africa be viewed as a crime?” (Mills at al. ,
2008) Advertising in the targeted country’s newspapers and journals, together with personal
emails and letters, internet sites and recruitment workshops lure doctors, nurses and pharmacists
to leave their countries. Active recruitment is more effective the more it offers: guaranteed
earnings, legal assistance in immigration and relocation expenses all make the decision to leave
easier.
There is a public discourse about the actual effects of brain drain of medical staff. While
some publications and communications accuse receiving countries of depriving Africa of its
human resources, thus causing “debility, morbidity, human suffering and premature death” there
are also voices that talk about unjustified lamenting, the overestimation of losses and the
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confusing of effects with the real “underlying causes”. According to Clemens, “The level of
medical care provided by doctors in Africa depends on a vast array of factors that have little or
nothing to do with international movement - such as scant wages in the public health service,
poor or absent rural service incentives, few other performance incentives of any kind, a lack of
adequate medical supplies and pharmaceuticals, a mismatch between medical training and the
health problems of the poorest, weak transportation infrastructure, or abysmal sanitation
systems”. He then reflects on the question as to why countries such as Kenya, Mozambique and
Ethiopia do not improve the domestic effectiveness of the available physicians in remote and
rural regions. Just 8% of Kenya's population live in the capital, Nairobi, but the city is home to
66% of its physicians. The comparable figures for Mozambique and Maputo and Ethiopia and
Addis Ababa are 10% and 51%, and 5% and 50% respectively. Does this congregation of
physicians in the richer urban areas differ in its ultimate effect – a lack of doctors where they are
badly needed - from the one of departure abroad? Or does the emigration of doctors kill people
in Africa? Clemens gives his answer by stating that there is no scientifically-proven relationship
between the departure of physicians and nurses and poor health statistics as measured by
indicators such as child mortality: “African countries with the largest number of their physicians
residing abroad in the rich country are typically those with the lowest child mortality, and vice
versa. This suggests that whatever is determining whether or not African children live or die,
other factors besides international migration of physicians are vastly more important” (Clemens,
2009). The debate about the African health sector brain drain is passionate and intense, and full
of noble concerns while voices of liberal rationalism are marginalised. Nonetheless, many
discussants try to be objective: “We can not and should not prevent completely the migration of
doctors and nurses. Medicine has a strong tradition of international collaboration, with doctors
moving around the globe to gain further training and different clinical experience. Indeed, we
like to think that international exchange and diversity enrich us all. This is a romantic delusion.
We gain in the North, but developing countries lose out by losing their doctors permanently”
(Johnson, 2005).
Individual human rights and the common good
The ability to move freely from place to place is essential for a life to be lived with
dignity. The United Nations Universal Declaration of Human Rights states that all people have
the unqualified right to leave any country. Skilled migrants are not “owned” by their home
countries, and should have the same rights to freedom of movement as professionals in rich
countries. This standpoint implies the moral importance of expanding the choices of skilled
13
people and permitting their mobility “as long as it does not illegitimately affect the freedom of
others”. Concerns about brain drain mostly reveal a singular focus on the national perspective,
ignoring the rights of the individual. These include the right to better oneself by migrating from
environments which offer little prospects for job satisfaction and individual development to
others where one's work is valued and fairly remunerated. The price paid by an individual for his
or her choice is often sufficiently high – the exchange of a familiar environment for an unknown
and uncertain one, the disruption of family life and loneliness – to render any attacks on their
decision invalid.
In the recent debate on brain drain, uncomfortable questions about human and property
rights have arisen. Clemens, for instance, asks: "Why the positive externalities of an Indian
engineer are considered the property of the Indian nation as a whole, while any negative
externalities that person exerts are not national property but exclusively belong to the individual?
(…) Why coercing French nurses to go to Africa is considered immoral even if that coercion
might cause deaths to be avoided, but coercing African physicians to be in Africa is considered
moral?” (Clemens 2007).
Two strategies aimed at stopping departures – taxing emigration and bonding graduates
who have obtained a state education – are widely viewed as a particular form of social justice.
Closing the door to the outside as an act “towards equity” means destroying precious
opportunities available to very few, instead of finding a solution for those who are left behind. In
1974, the emigration tax proposed by Bhagwati and Hamada to be collected by the receiving,
developed country party and transmitted
to the sending, developing country proved to be
technically problematic. The idea is still alive, although Desai, Kapur and McHale (2009)
suggested further investigations rather than presenting operational proposals. According to
Clemens, such a tax is justified “by a series of unexamined assumptions about property rights:
that individuals own their negative externalities but not their positive externalities; that groups of
people own individuals’ positive externalities; and that only groups of people born near skilled
workers’ birthplace own their positive externalities, while groups born far away do not”. When it
comes to bonding, he proposes firstly analysing inconsistencies in the arguments such as the
following: “few modern societies would consider it acceptable to require a lifetime of work in
poor conditions in exchange for a government scholarship, for this would constitute the unlimited
ownership of a person by the state” (Clemens, 2009).
Beside emerging proposals for the creation of an independent, international organization
to regulate the flow of people across borders, there are voices arguing that people should be
allowed to take care of themselves, forgetting the national contexts. The supporters of this
14
position argue that individual development may be of greater value than international actions:
“the propensity and ability for people to help themselves seems to be far greater than the ability
of the international community to make resources available for development”( Luthria 2009)
The individualist approach to international movements presented above is rather isolated
amongst the more common concerns that migration can adversely affect the basis of social
cohesion, and that the loss of skilled workers can wreck the chances of poor countries of
sustaining the provision of services and goods that are essential for development (Chen and
Boufford (2005), Mills, et al (2008), and UNCTAD (2007) and that is why the movement from
poor countries should be limited or at least controlled.
Stereotypes versus findings
According to de Haas et al “the real question is whether such skilled labour would have
been productive if migrants had stayed. This is too often taken for granted”. In Mediterranean
and North African
countries such as Morrocco, Egypt, Jordan and Yemen there is mass
unemployment and frustration among university graduates, which is often suggested to be a
cause of radicalism in the region. It is thus important to “disentangle cause and effect - high
skilled individuals migrate because of a lack of meaningful employment and career opportunities
and migration is not a cause but result of poor conditions”( de Haas, 2009)
Another important issue to be internalized is that a “migration decision is the proximate
cause of a skilled person’s departure, but this choice is in turn caused by a complex web of
underlying forces”. These forces include: poor working conditions as a result of years of underinvestment, a lack of training, low salaries, demoralisation, institutional failure, corruption,
political repression, a mismatch between national higher education curricula and local needs, and
institutional obstacles to the self-financing of education. Stopping, limiting, and impeding
potential emigrants might be a treatment for the symptoms, but it does not cure the illness. There
is therefore a need to focus on the underlying causes of emigration in each particular country
instead of blaming their nationals who leave because of those causes or the countries which
attract them so successfully because of those causes. A recent study using a new database of
health worker emigration from Africa suggested that low health staffing levels and poor public
health conditions are the result of factors entirely unrelated to international movements of highly
trained health professionals (Clemens 2007). Many developing countries face mass
unemployment among the highly skilled, which is the partial result of misguided education
policies which do not reflect the true skill and knowledge needs of developing economies. There
is often an over-investment in higher education and an underinvestment in primary and
15
secondary education and vocational training. “This all casts some doubt on the assumption that
the emigration of the highly skilled would automatically represent a loss. In such situations, it
may not come as a surprise that many higher educated people wish to emigrate to improve their
overall well-being and that also many governments consider emigration as a useful economic
safety valve in order to relieve political tensions” (Clemens 2007). Large numbers of skilled
workers within many countries depart the rural areas in search of better earnings in cities,
opportunities to maintain and upgrade their professional knowledge, comfortable working
conditions with others who are skilled and talented, and an environment which is more secure
and healthy for themselves and their families.
In the debate about brain drain, passionate arguments are countered with reserved ones,
conventional wisdom and popular perceptions clash with research findings, and straightforward
reasoning collides with thoughtful investigation. Chen and Boufford have talked of “fatal flows”
(2005), and Bach of the “catastrophe” in Africa’s human resources (2008), while Mills’ et al.
(2008) have called for the international recruiting of health professionals from developing
countries to be treated as a crime against humanity. In all of these and other public statements,
the message is clear: “to some degree, skilled-worker migration causes impoverishment, disease,
and death”(…) If this is true, then stopping skilled-worker migration per se must increase wealth,
improve health, and lengthen life - for if stopping migration per se did not help solve the
problem, then something else must be causing the problem (Clemens, 2009 ). Some countries
have introduced strong policy measures to limit migration. Does this solve the problem? The
OECD report of 2007 concludes that “the global health workforce crisis goes far beyond the
migration issue” because “the health sector needs for human resources in developing countries
exceed the numbers of immigrant health workers in the OECD.” At the same time, an
observation of the performance of personnel in the health sector and the operation of the health
systems themselves incline one to the conclusion that both the staff and the systems “would be
extremely inadequate even if outflows of health professionals were somehow reduced” (Kinfu et
al. (2009). However, the common wisdom that tells us that attracting skilled emigration is
stealing human capital (and therefore killing people) from poor countries is widespread. An
interesting quote of Clemens addresses this conviction: “emigration from a developing country is
an active choice made by a person from a developing country. The language used in discussions
of ‘brain drain’ frequently negates this simple fact by baselessly defining migration to be
something that active people in destination countries ‘do’ to passive migrants from developing
countries.(…) This is the case when skilled workers are said to be ‘exported’, ‘taken’, ‘poached’,
‘stolen’, or ‘sent’. These are all transitive verbs whose direct objects are passive recipients of an
16
action taken by someone else. Few people would speak of an American nurse who chooses to
work in the Philippines as having been ‘exported’, since a person from a rich country is assumed
to have agency in the migration decision - even if that person’s decision was influenced by a
government action such as Peace Corps sponsorship. But it is common to speak of a Filipino
nurse in America as having been ‘exported’, placing the migration decision in the hands of some
unnamed other person who is not the migrant” (Clemens 2007)
Recommendations
The brain drain literature suggest that different diagnoses need to be made and different
measures should be tailored to three target groups: potential skilled émigrés, those who have
already departed and students applying for foreign grants for education.
Simply blocking migration is neither effective nor ethical, since freedom of movement is
a basic human right. Moreover, if the regulations are seen as too punitive they may be selfdefeating in propelling one-way permanent movement and ensuring a later lack of co-operation.
The solution is to “train, retain, and sustain” workforces through national plans that improve
salaries and working conditions, revitalize education, and mobilize paraprofessional and
community workers whose services are more cost-effective and who are less likely to emigrate.
Making it worthwhile for highly-trained professionals to stay is much more difficult. The third
way of dealing with the problem is to replace them with competent locals at a rate as fast as or
faster than the rate of their departure. The realisation of these tasks will depend on the global
community's provision of appropriate financial and technical aid” (Chen and Boufford, 2006).
Freedom of movement is especially important in countries with oppressive political
regimes like Eritrea .The Scholar Rescue Fund provides fellowships for professors, researchers
and lecturers whose lives and work are ravaged by fear, conflict and repression. Scholars are
often persecuted for specific reasons, such as writing and researching about sensitive topics,
while others face persecution purely due to general anti-intellectualism in their countries. Such
scholarships permit them to find temporary refuge at universities and colleges anywhere in the
world, enabling them to pursue academic work and to continue to share their knowledge with
students, colleagues, and the community at large. The assumption is that when conditions
improve, these scholars will return home to help rebuild their universities and societies.
Solving the problem of brain drain requires the phenomenon to be reconsidered and
uncomfortable questions to be answered. To limit movement or tackle underlying causes? To
address proximate effects or long-term reasons? To continue free higher on or to allow and
accredit private training and permit the financial sector to create educational loans for students
17
who then pay fees? Still the majority of doctors, nurses and teachers in developing countries
receive substantial public subsidies for their training and then leave. In sectors such as business,
administration, and engineering certification and regulation allow for the establishing of private
and foreign “offshore” universities, where potential future migrants do not burden modest states
budgets. Some countries will be in need of changes to their educational policies. The first of
these is to make the number of tertiary-educated graduates fit more closely to the number of
suitable work positions offered in the country. The absence of such a correlation is highly visible
in Morocco, where “decades of government job guarantees for graduates have induced students
to seek any degree, regardless of its utility in the production, since a degree, by itself, has long
been a guarantee of a government job. Governments can no longer provide the necessary jobs,
while policies impede private sector job creation" (de Haas, 2006). Secondly, curricula should be
changed in order to address the most urgent needs of the particular country. A difficult question
needs to be answered: should developing countries continue to educate (subsidized) high-class
professionals or instead train paraprofessionals with skills tuned directly to local needs, targeting
sectors and regions suffering from labour shortages? Rational and reasonable solutions may
appear sound and realistic but their implementation may prove to be problematic: “subsidizing
skills apt for the international market is an important underlying cause of professional
emigration, and therefore of migration’s proximate impacts. Subsidizing skills for local needs is a
preferable alternative to the more traditional method of ‘train and trap’. A common objection to
proposals of this type is that people in poor countries deserve ‘the best’ health professionals and
teachers, and task shifting robs them of these. But surely ‘the best’ service providers are those
who are present and whose skills are best adapted to the pressing needs of the worst served
populations” (Clemens, 2009). Introducing a study loans system, however, may be counterproductive. A decision to work overseas is often precipitated by the need to repay large student
debts. In New Zealand, for example, a strong correlation was noted between the size of a
student’s loan debt and the probability that that student would be working overseas within a year
of graduation to pay the loan back.
Many countries simultaneously have shortages in some professions and large numbers
of professionals in the same sectors unemployed. Unemployment is higher among university
graduates than among primary school graduates in Nigeria (Dabalen et al. 2000), as well as in
Morocco, Jordan, and Egypt (Said 2001). This paradoxical situation sometimes occurs due to
regulatory barriers that complicate the hiring of skilled workers into public service, such as legal
requirements that all providers of a certain service be full civil servants with de-facto lifetime
employment (and other regulations reviewed by Djankov and Ramalho (2009). This issue does
18
not affect all developing countries and industry sectors in the same way, therefore any solutions
and policy responses need to be tailored to the specific needs and challenges of each affected
country.
With regards to the second group - those who have already departed - incentive packages
that encourage professionals to return after completing their education abroad are becoming more
common. In addition to the promise of competitive salaries and the prospect of good working
conditions, some countries have established national research grants and endowments. Yet again,
however, because of the financial constraints and political pressures in many developing
countries, these local incentives can be difficult to sustain. Moreover, returning "migrants may,
paradoxically, be extremely difficult to reintegrate into their countries of origin and may also be
more vulnerable to unemployment in their countries of origin than people who have not
migrated”(EU-ACP, 2009). Some of these efforts to attract professionals (and talented graduates)
back to their countries of origin may not, therefore, bring the expected results. Many of the
expatriates who have become well-off and accustomed to life in the host country and do not have
sentimental or family reasons to draw them back may not wish to return. The objective, then, is
to create links through which they could be used effectively and productively in the development
of their homeland, without their physical return. The creation of intellectual and scientific
diaspora networks aimed at establishing and maintaining productive communication and
exchanges between members living abroad and their counterparts in their home country is one
way of securing their contribution to the country's economic, political and social development.
Scientific diasporas may publish and disseminate, among their members and academics at home
country, newsletters, digests and periodicals with publications written by network members. In
this way, the host country does not lose these skilled professionals, whose links with their
country of origin may also in turn create opportunities for the host country. This may incline host
countries to help, facilitate or support the diasporas on their territories. Kapur and McHale
recommend “ to ensure that emigrants remain economically and socially connected to their
former homes, which include policies that affect the probability of return. The purpose here is to
maximize the benefits from having a well-connected diaspora and the capital-augmented return.
Receiving and sending countries can make it easier for emigrants to travel, send remittances, and
make investments. They can also help in solving the collective action problems inherent in
organizing a diaspora” (Kapur and McHale, 2005).
Approaches to emigrants vary by country and depend on the size of the emigrating
population, the relations between the home and destination countries, and the existence of homecountry policies that can help to make use of their skills. The following cases are examples of
19
policies aimed at encouraging the temporary return of skilled migrants. The government of
Taiwan, for instance, has actively offered return incentives to skilled workers abroad, such as the
creation of the Hinschu Science-based Industrial Park. This followed the attractive job
opportunities and political freedoms at home which encouraged the return migration of skilled
Taiwanese workers in the 1980s and 1990s (O’Neil, 2003). In Africa, “Temporary Return of
Qualified Nationals” and “Migration for Development in Africa” are two programs that enable
interested skilled workers abroad to transfer knowledge and skills to their countries of origin
through short-term positions in key ministries and other organizations. Another good example is
the Ghana “Skills Bank” that was launched in the United States in order to recruit Ghanaian
professionals living abroad for limited periods of work in Ghana. Additionally, the UN’s
“Transfer of Knowledge Through Expatriate Nationals” program (TOKTEN) has for many years
played a similar role in Lebanon, Palestine, Sudan, Afghanistan, Liberia, Rwanda and many
other countries. The development impacts of these programs, however, are difficult to assess and
have not been systematically evaluated. Kapur and McHale have discussed actions for which
receiving countries can come to an understanding with sending countries and then put into
practice: “one way to increase the probability of return is to make visas temporary without the
possibility of leading to permanent status. The idea is that young people build skills, savings, and
social networks while abroad and then return to use their accumulated human, financial, and
social capital to the benefit of the home country. Such policies seem fair if the migrants
understand the terms of their visa from the outset. Indeed, time limitations are perfectly
legitimate for short stays. But seeing that many people quickly put down roots in their adopted
countries, we think that medium- to long-term temporary and nonconvertible visas are not
humane policy. A better approach is to create incentives to return as opposed to prohibitions on
staying. For instance, governments could allow emigrants to return again at a later time if things
do not work out, make social security entitlements portable, sponsor the return of people with
badly needed skills, put money in special accounts during the migrant’s stay that can only be
accessed on return, or ask the country of origin to provide information on opportunities at home”
(Kapur and McHale, 2005).
Trends in international skill flows
There are several trends in the brain drain/gain equilibrium which can be observed in the
contemporary globalized world. Here are presented twelve global patterns of brain drain that
seems to be true for majority countries in the world.
20
1. Skilled workers leave smaller countries and those where incomes are lower. Brain
drain is truly massive in a minority of countries and in specific sectors.
There is little risk of brain drain for countries with high demographic potential such as
China and India, which, despite having the highest numbers of skilled migrants working in
industrialized countries, experience a much lower rate of loss of highly-skilled individuals,
compared to ACP countries, where scientific communities are much smaller. There are positive
correlations between low percentages of highly-educated workers in the population and low
productivity (as measured by GDP per capita) on the one hand and loss of relatively more skilled
workers on the other. The statistics show a constant skills outflow from the world’s poorest
countries. Data from the year 2000 concerning the number of skilled arrivals to OECD countries
place 81 countries in the group with a skilled immigration ratio of 15%, and 34 countries in the
group with a ratio of over 33%. It is only this latter group that is threatened by the negative
effects of brain drain. In 2003, Adams concluded that international migration does not tend to
remove such a high proportion of the best educated. In two-thirds of the 33 major emigration
countries he surveyed, less than 10% of the tertiary-educated population had migrated. The
emigration of highly-educated migrants only seems to be massive in a limited number of smaller
countries and in specific sectors, such as healthcare. According to the mainstream media the
situation in some countries looks grim: more than half of the trained doctors from the small states
of Antigua, Grenada, Haiti, Jamaica, Trinidad and Tobago, and Guyana work abroad. There are
similarly high proportions in the conflict-torn African states of Mozambique, Angola, Sierra
Leone, Liberia and Congo, as well as the poor but English-speaking Tanzania, Kenya and Ghana.
These countries have also lost considerable proportions of their highly-educated populations as a
whole, with 67% of university-educated Haitians, 72% of Jamaicans, 27% of Kenyans and 33%
of Ghanaians living abroad. Conversely, larger countries such as India or Nigeria have only a
small proportion of their total graduates working abroad, although their numbers are larger in
absolute terms. (BBC , 2008).
2. Educated professionals leave the places where they are scarcest. Human capital flows
to places where it is already abundant.
Brain drain is currently characterized by a ”demand pull” on the side of the receiving
countries, whose immigration policies are determined according to domestic needs and labourmarket conditions, regardless of the consequences for the immigrants’ origin countries (Beine at
al. 2008). Statistics show that the ratios of particular professionals available in the whole
population is growing in wealthy countries and is decreasing in the remote and rural areas of
poor countries (due to both domestic and international migration). For example, net importers of
21
health professionals such as Australia and Canada have more than 200 physicians and 800 nurses
per 100,000 people, whereas Ghana, a net exporter of health professionals, has only 6,2
physicians and 72 nurses per 100,000, which translates to 16,129 people per physician and 1,389
people per nurse.
3. Skilled workers earn much more abroad. Emigration leads to a life-changing
improvement in living standards.
Skilled workers earn less – adjusted for purchasing power – in developing countries than
in developed ones. A 2001 study of immigrants to the USA showed that, on average, men
experience a 68% increase in earnings and women a 62% increase. With time they experience far
larger wage differentials (Commander, Kangasniemi and Winters, 2002). Skilled migration
between advanced countries is often temporary, while migrants from developing countries are
generally more likely to stay in the host country than migrants from advanced countries. This is
presumably caused by the larger gap in remuneration and related to the bigger improvement in
living standards.
4. Skilled workers earn, save, invest and invent relatively more when they are in their
home countries. This in turn causes economic growth.
Skilled professionals are relatively highly-paid (with the exception of teachers in public
primary and secondary schools). Through the higher taxes that they pay, they make an important
contribution to the accumulation of national wealth, which can be used by the state for various
development purposes. If, for example, money is loaned to entrepreneurs, it may lever other
businesses, thus contributing to the country's development as well as generating further wealth
for the state, from interest paid on the loans.
5. Diaspora networks can create mutual
benefits by creating high-tech businesses,
international trade and capital flow, but the results depend on the openness of the business and
political environments.
Fostering diasporas is a promising alternative, tapping into the knowledge and experience
of expatriates and the financial resources they enjoy in their adopted countries and converting
them into benefits for the home countries. Over the last decade many countries all over the
developing world have used their expatriate experts, scientists and engineers for progress at
home. Since the early 1990s various African governments have asked their diplomatic missions
abroad to reach out to diaspora populations. The New Partnership for Africa's Development aims
to promote such collaboration between Africans abroad with their domestic populations. Meyer
and Brown have identified 41 expatriate knowledge networks around the world which have the
explicit purpose of connecting their expatriate members with their countrymen at home to
22
exchange knowledge and skills. There are also many more diasporic societies with a more
general purpose. Some of the more notable are : ALAS - Latin American Association of
Scientists, ANA - Association of Nigerians Abroad, ASTA - Arab Scientists and Technologists
Abroad, ATPAC - Association of Thai Professionals in America and Canada, ATPER Association of Thai Professionals in Europe, ATPIJ Association of Thai Professionals in Japan,
BGN - Brain Gain Network, CESASC - Chinese American Engineers and Scientists Association
of Southern California, CHISA - Chinese Scholars Abroad, FORS - Forum for Science and
Reform, IRSA Irish Research Scientists Association, JANET - Japanese Associate Network,
MARS - Moroccan Association of Researchers and Scholars, SANSA - South African Network
of Skills Abroad, SIPA - Silicon Valley Indian Professionals Association, SCBA - Society of
Chinese Bioscientists in America (Meyer and Brown, 1999). The success of the diasporas
approach depends on the openness of the business and political environments, as is demonstrated
by a comparison of the effectiveness of the diaspora networks of India, Taiwan and Israel as
opposed to those of Russia, Vietnam and Iran.
6. The migration of certain educated individuals may damage the social welfare of those
who stay behind in the short term but improves it in the long term.
It is never the case that all highly-educated people in a developing country emigrate. A
beneficial effect of brain-drain is the creation of an increased incentive for people who
subsequently stay in their home countries to improve their levels of education (Mountford
(1997), Stark, Helmenstein and Prskawetz (1997), Beine, Docquier and Rapaport (2001a),
Commander, Kangasniemi,
Winters (2002). The World Migration Report 2005, by the
International Organization for Migration, examines the costs and benefits of migration for
societies, governments and migrants, focusing particularly on the interrelations among migration
and labour markets, development, integration, health and institutional structures. A key finding
is that the costs and benefits of migration vary widely from situation to situation, which makes
generalizations about the complex effects of international migration difficult. The benefits as
well as the risks of skilled migration must be considered coolly without proposing any "one-sizefits-all" migration management policy (McKinley, 2005). Migration, remittances and domestic
labour-market outcomes are jointly determined and the result of their interaction may bring
positive effects. For the last two decades, the conception about the migration of skills has
evolved, putting stronger emphasis on brain gain, and the expatriate skilled population may now
be considered as a potential asset instead of a definite loss. Some studies have tried to identify
the circumstances under which a developing country can benefit from skilled migration. They
have identified several factors of major importance: sectoral aspects of migration and the way
23
migrants are screened in the receiving country, the size of the sending country, the duration of
the migration and the effectiveness of diasporas in transferring their knowledge and skills.
7. The skilled are welcomed almost everywhere with few exceptions.
A 2007 survey investigated the policies implemented by host countries with regards to
highly-skilled workers. The responses indicated that only five countries (Bhutan, Botswana,
Jordan, Saudi Arabia and the United Arab Emirates) have policies in place to reduce the numbers
of skilled workers arriving (Facchini and Mayda, 2009). Among the countries which are totally
closed to permanent migration are the Republic of Korea for low-skilled workers and the UAE,
Egypt and India for both high- and low-skilled migrants (Klugman, Jeni, and Isabel Medalho
Pereira, "Assessment of National Migration Policies . An emerging picture on admissions,
treatment and enforcement in developing and developed countries" United Nations Development
Programme, Human Development Research Paper 2009/48.
8. The perception of skilled migration is better than that of unskilled migration.
Skilled natives prefer an immigration policy that admits unskilled foreign workers, as this
policy will increase the skilled wage. On the other hand, the arrival of unskilled immigrants and
the persistence of skill levels over generations may give rise to a situation in which the unskilled
workers become the political majority, and therefore vote for policies that benefit them as a
group.
In contrast, the results of a UN survey suggest that government policies are also
favourable to skilled migrants in countries where skilled labour is “abundant”. There are three
possible reasons for this result. First, the great majority of individuals, as citizens and voters,
prefer skilled migration to unskilled migration, irrespective of whether they themselves are
skilled or unskilled. Secondly, high income countries may prefer highly-skilled migrant workers
for intuitive political reasons, i.e. skilled native voters will likely favour and oppose the
admission of skilled and unskilled migrants respectively, as the latter will tend to vote for
policies that favour unskilled individuals (Ortega 2005). Third, the cultural assimilation of
highly-skilled migrants is easier than of low-skilled migrants ((Facchini and Mayda, 2009).
9. Circular migration occurs in parallel to the mainstream of one-directional or return
migration.
It is still a relatively exclusive privilege to be able to move back and forth freely between
one’s home and destination countries. Having secure residential status in both countries, these
individuals can benefit from the following advantages: the avoidance of having to make a
definitive choice of country, the maintenance of significant ties in both locations, the differences
in earnings and business profits, and the more favourable conditions for living and for raising and
educating children. The status of those with dual citizenship or permanent residency permission
24
as described above is quite different from the status of those who are able to circulate, but not
entirely freely. This situation occurs where the terms of their visas or contracts require them to
leave the destination country after a specified period, obliging them to return home but allowing
them the possibility of a repeat stay. Another situation is that of European students, teachers and
researchers, who, thanks to the EU’s internal educational and research policy, are able to spend
part of their student and working lives outside their home countries in the spirit of academic
freedom of movement. (Newland, 2009).
10. The main south-north direction of brain drain is accompanied by marginal but
worrying trends in some developed countries
The well-known south-north dimension of brain drain is accompanied by its north-north
and south-south equivalents. Countries that traditionally receive migrants, such as Australia,
New Zealand and Great Britain, are seriously investigating their real or perceived brain drains,
and are considering options for attracting back their highly-skilled and talented émigrés
(Glassand and Choy, 2001).
11. It is scientists and engineers involved in research and development activities (rather
than health professionals, whose brain drain is the most visible and debated) who are the major
engines of wealth and development.
Scientists and engineers are the key performers of R&D aimed at increasing the stock
of knowledge and creating new applications in order to ensure sustainable development. Their
work contributes to a better understanding of policy-relevant issues such as climate change,
growth in resource consumption rates, demographic trends, and environmental degradation.
They join foreign companies, research centres and multinational corporations and also circulate
within international institutions and non-governmental organisations,
as well as move to
independent consultancy offered abroad. They make a wide contribution to the advancement of
science, and foster innovative and far-reaching technological developments in their adopted
countries.
12. The flow of skilled migrants will increase rather than decrease in the short to medium
term.
Economic and human development improves people’s capabilities and raises their
aspirations and therefore tends to stimulate a future increase in emigration. While in the
developed world the demand for skilled and unskilled immigrant labour will persist, the forces of
globalisation and socio-economic development in poor countries are likely to further increase
people’s competences and their desire to migrate. “As long as Western economies keep growing,
25
it is more likely that (regular and/or irregular) low skilled labour migration will persist or perhaps
even increase, while highly skilled labourers will continue to be welcomed" (de Haas, 2007)
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