"Brain drain" redirects here. For other uses, see Brain drain (disambiguation).
Human capital flight refers to the emigration of highly skilled or well-educated individuals. The net benefits of human capital flight for the sending country are sometimes referred to as a "brain gain" whereas the net costs are sometimes referred to as a "brain drain".
Research shows that there are significant economic benefits of human capital flight both for the migrants themselves and those who remain in the country of origin. It has been found that emigration of skilled individuals to the developing world contributes to greater education and innovation in the developing world. Research also suggests that emigration, remittances and return migration can have a positive impact on democratization and the quality political institutions in the country of origin. Claims of a "brain drain" remain largely unsupported in academic research, with some scholars describing it as a "myth".
There are several types of human capital flight:
- Organizational: The flight of talented, creative, and highly qualified employees from large corporations that occurs when employees perceive the direction and leadership of the company to be unstable or stagnant, and thus, unable to keep up with their personal and professional ambitions.
- Geographical: The flight of highly trained individuals and college graduates from their area of residence.
- Industrial: The movement of traditionally skilled workers from one sector of an industry to another.
As with other human migration, the social environment is often considered to be a key reason for this population shift. In source countries, lack of opportunities, political instability or oppression, economic depression, health risks and more contribute to human capital flight, whereas host countries usually offer rich opportunities, political stability and freedom, a developed economy and better living conditions that attract talent. At the individual level, family influences (relatives living overseas, for example), as well as personal preferences, career ambitions and other motivating factors, can be considered.
Origins and uses
The term "brain drain" was coined by the Royal Society to describe the emigration of "scientists and technologists" to North America from post-warEurope. Another source indicates that this term was first used in the United Kingdom to describe the influx of Indian scientists and engineers. Although the term originally referred to technology workers leaving a nation, the meaning has broadened into "the departure of educated or professional people from one country, economic sector, or field for another, usually for better pay or living conditions".
"Brain-drain‟ is a phenomenon where, relative to the remaining population, a substantial number of more educated (numerate, literate) persons emigrate.
Given that the term brain drain is a pejorative and infers that skilled emigration is bad for the country of origin, some scholars recommend against using the term in favor of more neutral and scientific terms. After all, research indicates that there may be net human capital gains, a "brain gain", for the sending country in opportunities for emigration.
The positive effects of human capital flight are sometimes referred to as "brain gain" whereas the negative effects are sometimes referred to as "brain drain". The notion of the "brain drain" is largely unsupported in the academic literature. According to economist Michael Clemens, it has not been shown that restrictions on high-skill emigration reduce shortages in the countries of origin. According to development economist Justin Sandefur, "there is no study out there... showing any empirical evidence that migration restrictions have contributed to development." Hein de Haas, Professor of Sociology at the University of Amsterdam, describes the brain drain as a "myth". However, according to Catholic University of Louvain economist Frederic Docquier, human capital flight has an adverse impact on most developing countries, even if it can be beneficial for some developing countries. Whether a country experiences a "brain gain" or "brain drain" depends on factors such as composition of migration, level of development, and demographic aspects including its population size, language, and geographic location.
Research suggests that migration (both low-and high-skilled) is beneficial both to the receiving and sending countries. According to one study, welfare increases in both types of countries: "welfare impact of observed levels of migration is substantial, at about 5% to 10% for the main receiving countries and about 10% in countries with large incoming remittances". According to economists Michael Clemens and Lant Pratchett, "permitting people to move from low-productivity places to high-productivity places appears to be by far the most efficient generalized policy tool, at the margin, for poverty reduction". A successful two-year in situ anti-poverty program, for instance, helps poor people make in a year what is the equivalent of working one day in the developed world. Research on a migration lottery that allowed Tongans to move to New Zealand found that the lottery winners saw a 263% increase in income from migrating (after only one year in New Zealand) relative to the unsuccessful lottery entrants. A 2017 study of Mexican immigrant households in the United States found that by virtue of moving to the United States, the households increase their incomes more than fivefold immediately. The study also found that the "average gains accruing to migrants surpass those of even the most successful current programs of economic development."
Remittances increase living standards in the country of origin. Remittances are a large share of GDP in many developing countries, and have been shown to increase the wellbeing of receiving families. In the case of Haiti, the 670,000 adult Haitians living in the OECD sent home about $1,700 per migrant per year. That’s well over double Haiti’s $670 per capita GDP. A study on remittances to Mexico found that remittances lead to a substantial increase in the availability of public services in Mexico, surpassing government spending in some localities. A 2017 study found that remittances can significantly alleviate poverty after natural disasters. Research shows that more educated and higher earning emigrants remit more. Some research shows that the remittance effect is not strong enough to make the remaining natives in countries with high emigration flows better off. A 2016 NBER paper suggests that emigration from Italy in the wake of the 2008 Global Financial Crisis reduced political change in Italy.
Return migration can also be a boost to the economy of developing states, as the migrants bring back newly acquired skills, savings and assets.
Studies show that the elimination of barriers to migration would have profound effects on world GDP, with estimates of gains ranging between 67–147.3%. Research also finds that migration leads to greater trade in goods and services between the sending and receiving countries. Using 130 years of data on historical migrations to the United States, one study finds "that a doubling of the number of residents with ancestry from a given foreign country relative to the mean increases by 4.2 percentage points the probability that at least one local firm invests in that country, and increases by 31% the number of employees at domestic recipients of FDI from that country. The size of these effects increases with the ethnic diversity of the local population, the geographic distance to the origin country, and the ethno-linguistic fractionalization of the origin country." Emigrants have been found to significantly boost foreign direct investment (FDI) back to their country of origin. According to one review study, the overall evidence shows that emigration helps developing countries integrate into the global economy.
A 2016 study reviewing the literature on migration and economic growth "shows that migrants contribute to the integration of their country into the world market, which can be particularly important for economic growth in developing countries." Research suggests that emigration causes an increase in the wages of those who remain in the country of origin. A 2014 survey of the existing literature on emigration finds that a 10 percent emigrant supply shock would increase wages in the sending country by 2–5.5%. A study of emigration from Poland shows that it led to a slight increase in wages for high- and medium-skilled workers for remaining Poles. A 2013 study finds that emigration from Eastern Europe after the 2004 EU enlargement increased the wages of remaining young workers in the country of origin by 6%, while it had no effect on the wages of old workers. The wages of Lithuanian men increased as a result of post-EU enlargement emigration. Return migration is associated with greater household firm revenues.
Education and innovation
Research finds that emigration and low migration barriers has net positive effects on human capital formation in the sending countries. This means that there is a "brain gain" instead of a "brain drain" to emigration. One study finds that sending countries benefit indirectly in the long-run on the emigration of skilled workers because those skilled workers are able to innovate more in developed countries, which the sending countries are able to benefit on as a positive externality. Greater emigration of skilled workers consequently leads to greater economic growth and welfare improvements in the long-run. According to economist Michael Clemens, it has not been shown that restrictions on high-skill emigration reduce shortages in the countries of origin.
A 2017 paper found that the emigration opportunities to the United States for high-skilled Indians provided by the H-1B visa programme contributed to the growth of the Indian IT sector. A greater number of Indians were induced to enroll in computer science programs in order to move to the United States, and a large number of these Indians never moved to the United States (due to caps in the H-1B programme) or returned to India after the completion of their visas. One 2011 study finds that emigration has mixed effects on innovation in the sending country, boosting the number of important innovations but reducing the number of average inventions.
Democracy, human rights and liberal values
Research also suggests that emigration, remittances and return migration can have a positive impact on political institutions and democratization in the country of origin. Research shows that exposure to emigrants boosts turnout. Research also shows that remittances can lower the risk of civil war in the country of origin. Migration leads to lower levels of terrorism. Return migration from countries with liberal gender norms has been associated with the transfer of liberal gender norms to the home country. A 2009 study finds that foreigners educated in democracies foster democracy in their home countries. Studies find that leaders who were educated in the West are significantly more likely to improve their country's democracy prospects. A 2016 study found that Chinese immigrants exposed to Western media censored in China became more critical of their home government’s performance on the issues covered in the media and less trusting in official discourse. A 2014 study found that remittances decreased corruption in democratic states.
A 2015 study finds that the emigration of women in rural China reduces son preference.
Neoplatonic academy philosophers move
After Justinian closed the Platonic Academy in AD 529, according to the historian Agathias, its remaining members sought protection from the Sassanid ruler, Khosrau I, carrying with them precious scrolls of literature, philosophy, and to a lesser degree, science. After the peace treaty between the Persian and the Byzantine empires in 532 guaranteed their personal security, some members of this group found sanctuary in the Pagan stronghold of Harran, near Edessa. One of the last leading figures of this group was Simplicius, a pupil of Damascius, the last head of the Athenian school. The students of an academy-in-exile may have survived into the ninth century, long enough to facilitate the Arabic revival of the Neoplatonist commentary tradition in Baghdad.
Spanish expulsion of Jews and Moors
After the end of the Catholic reconquest of Spain, the Catholic Monarchs pursued a religiously uniform kingdom. Jews were expelled from the country in 1492. As they dominated financial services in the country, their expulsion was instrumental in causing future economic problems, for example the need for foreign bankers such as the Fugger family and others from Genoa. On 7 January 1492, the King ordered the expulsion of all the Jews from Spain — from the kingdoms of Castile, Catalonia, Aragon, Galicia, Majorca, Minorca, the Basque provinces, the islands of Sardinia and Sicily, and the Kingdom of Valencia. Before that, the Queen had also expelled them from the Kingdom of Andalusia.
The war against Turks and North African Moors affected internal policy in the uprising of the Alpujarras (1568–1571) and motivated the expulsion of the Moriscos in 1609. Despite being a minority group, they were a key part of the farming sector and trained artisans. Their departure contributed to economic decline in some regions of Spain. This way, the conservative aristocracy increased its power over economically developed provinces.
Huguenot exodus from France (17th century)
In 1685, Louis XIV revoked the Edict of Nantes and declared Protestantism to be illegal in the Edict of Fontainebleau. After this, many Huguenots (estimates range from 200,000 to 1,000,000) fled to surrounding Protestant countries: England, the Netherlands, Switzerland, Norway, Denmark and Prussia — whose Calvinist great elector, Frederick William, welcomed them to help rebuild his war-ravaged and under-populated country. Many went to the Dutch colony at the Cape (South Africa), where they were instrumental in establishing a wine industry. At least 10,000 went to Ireland, where they were assimilated into the Protestant minority during the plantations.
Many Huguenots and their descendants prospered. Henri Basnage de Beauval fled France and settled in the Netherlands, where he became an influential writer and historian. Abel Boyer, another noted writer, settled in London and became a tutor to the British Royal Family. Henry Fourdrinier, the descendant of Huguenot settlers in England, founded the modern paper industry. Augustin Courtauld fled to England, settling in Essex and established a dynasty that founded the British silk industry. Noted Swiss mathematician Gabriel Cramer was born in Geneva to Huguenot refugees. Sir John Houblon, the first Governor of the Bank of England, was born into a Huguenot family in London. Isaac Barré, the son of Huguenot settlers in Ireland, became an influential British soldier and politician. Gustav and Peter Carl Fabergé, the descendants of Huguenot refugees, founded the world-famous Fabergé company in Russia, maker of the famous Faberge eggs.
The exodus of Huguenots from France created a brain drain, as Huguenots accounted for a disproportionate number of entrepreneurial, artisan, and technical occupations in the country. The loss of this technical expertise was a blow from which the kingdom did not fully recover for many years.
Antisemitism in pre-WWII Europe (1933–1943)
Antisemitic feelings and laws in Europe through the 1930s and 1940s, culminating in the Holocaust, caused an exodus of intelligentsia. Notable examples are:
Besides Jews, Nazi persecution extended to liberals and socialists in Germany, further contributing to emigration. Refugees in New York City founded the University in Exile. The Bauhaus, perhaps the most important arts and design school of the 20th century, was forced to close down during the Nazi regime because of their liberal and socialist leanings, which the Nazis considered degenerate. The school had already been shut down in Weimar because of its political stance, but moved to Dessau prior to the closing. Following this abandonment, two of the three pioneers of modern architecture, Mies Van Der Rohe and Walter Gropius, left Germany for America (while Le Corbusier stayed in France). They introduced the European Modern movement to the American public and fostered the international style in architecture and design, helping to transform design education at American universities and influencing later architects. A 2014 study in the American Economic Review found that German Jewish Émigrés in the US boosted innovation in the US.
19th century Eastern Europe migration
Mid-19th century Eastern European migration was significantly shaped by religious factors. The Jewish minority experienced strong discrimination in the Russian Empire during this period, which reached its maximum in the pogrom waves of the 1880s. During the 1880s, the mass exodus of more than two million Russian Jews began. Already before, a migration stream of Jewish people started which was characterized by highly skilled individuals. This pronounced selectivity was not caused by economic incentives, but by political persecution.
Eastern Europe under Eastern Bloc
Main articles: Eastern Bloc emigration and defection and Eastern Bloc
By 1922, the Soviet Union had issued restrictions making emigration of its citizens to other countries almost impossible. Soviet Premier Nikita Khrushchev later stated, "We were scared, really scared. We were afraid the thaw might unleash a flood, which we wouldn't be able to control and which could drown us. How could it drown us? It could have overflowed the banks of the Soviet riverbed and formed a tidal wave which would have washed away all the barriers and retaining walls of our society." After Soviet occupation of Eastern Europe at the end of World War II, the majority of those living in the countries of the Eastern Bloc aspired to independence and wanted the Soviets to leave. By the early 1950s, the approach of the Soviet Union to restricting emigration was emulated by most of the rest of the Eastern Bloc, including East Germany.
Even after the closing of the Inner German border officially in 1952, the border between the sectors of East Berlin and West Berlin remained considerably more accessible than the rest of the border because it was administered by all four occupying powers. The Berlin sector border was essentially a "loophole" through which East Bloc citizens could still emigrate. The 3.5 million East Germans, called Republikflüchtlinge, who had left by 1961 totalled approximately 20% of the entire East German population. The emigrants tended to be young and well-educated, leading to the brain drain feared by officials in East Germany.Yuri Andropov, then the CPSU director of Relations with Communist and Workers' Parties of Socialist Countries, decided on 28 August 1958 to write an urgent letter to the Central Committee about the 50% increase in the number of East German intelligentsia among the refugees. Andropov reported that, while the East German leadership stated that they were leaving for economic reasons, testimony from refugees indicated that the reasons were more political than material. He stated, "the flight of the intelligentsia has reached a particularly critical phase." The direct cost of labour force losses has been estimated at $7 billion to $9 billion, with East German party leader Walter Ulbricht later claiming that West Germany owed him $17 billion in compensation, including reparations as well as labour force losses. In addition, the drain of East Germany's young population potentially cost it over 22.5 billion marks in lost educational investment. In August 1961, East Germany erected a barbed-wire barrier that would eventually be expanded by construction into the Berlin Wall, effectively closing the loophole.
Human capital flight phenomena in Europe fall into two distinct trends. The first is an outflow of highly qualified scientists from 'Western Europe' mostly to the United States. The second is a migration of skilled workers from 'Central' and 'Southeastern Europe' into 'Western Europe', within the EU. While in some countries the trend may be slowing, certain Southeast European countries such as Italy continue to experience extremely high rates of human capital flight. The European Union has noted a net loss of highly skilled workers and introduced a "blue card" policy – much like the American green card – which "seeks to draw an additional 20 million workers from Asia, Africa and the Americas in the next two decades".
Although the EU recognizes a need for extensive immigration to mitigate the effects of an aging population, nationalist political parties have gained support in many European countries by calling for stronger laws restricting immigration. Immigrants are perceived as a burden on the state and cause of social problems like increased crime rates and major cultural differences.
In 2006, over 250,000 Europeans emigrated to the United States (164,285),Australia (40,455),Canada (37,946) and New Zealand (30,262).Germany alone saw 155,290 people leave the country (though mostly to destinations within Europe). This is the highest rate of worker emigration since reunification, and was equal to the rate in the aftermath of World War II.Portugal has experienced the largest human capital flight in Western Europe. The country has lost 19.5% of its qualified population and is struggling to absorb sufficient skilled immigrants to compensate for losses to Australia, Canada, Switzerland, Germany and Austria.
Central and Eastern Europe
Central and Eastern European countries have expressed concerns about extensive migration of skilled labourers to Ireland and the United Kingdom. Lithuania, for example, has lost about 100,000 citizens since 2003, many of them young and well-educated, to emigration to Ireland in particular. (Ireland itself used to experience high rates of human capital flight to the United States, Great Britain and Canada before the Celtic Tiger economic programmes.) A similar phenomenon occurred in Poland after its entry into the European Union. In the first year of its EU membership, 100,000 Poles registered to work in England, joining an estimated 750,000 residents of Polish descent. Research conducted by PKO Bank Polski, Poland's largest retail bank, shows that 63% of Polish immigrants to the UK were aged between 24 and 35, with 40% possessing a university degree. However, with the rapid growth of salaries in Poland, its booming economy, the strong value of the złoty, and decreasing unemployment (which fell from 14.2% in May 2006 to 8% in March 2008), the flight of Polish workers slowed. In 2008 and early 2009 people who came back outnumbered those leaving the country. The exodus is likely to continue, however.
The rapid but small-scale departure of highly skilled workers from Southeastern Europe has caused concern about those nations developing towards inclusion in the European Union. This has sparked programmes to curb the outflow by encouraging skilled technicians and scientists to remain in the region to work on international projects.
Serbia is one of the top countries that have experienced human capital flight from the fall of communist regime. In 1991, people started emigrating to the closest countries, Italy and Greece, and with the passing of years began going farther, to the United Kingdom, Canada and the United States. In the last 10 years, educated people and professionals have been leaving the country and going to other countries where they feel they can have better possibilities for better and secure lives. This is a concern for Albania as well, as it is losing its skilled-workers and professionals.
Greece, Ireland, Italy, Portugal and Spain
Many citizens of the countries most stricken by the economic crisis in Europe have emigrated, many of them to Australia, Brazil, Germany, United Kingdom, Chile, Ecuador, Angola and Argentina.
In the 1960s, many skilled and educated people emigrated from Turkey, including many doctors and engineers. This emigration wave is believed to have been triggered by political instability, including the 1960 military coup. In later decades, into the 2000s, many Turkish professionals emigrated, and students studying overseas chose to remain abroad, mainly due to better economic opportunities. This human capital flight was given national media attention, and in 2000, the government formed a task force to investigate the "brain drain" problem.
There are a considerable number of people leaving the United Kingdom for other countries, especially Australia and the United States. In the 2000s, some 3.5 million people emigrated from the UK. Most of this emigration was to seek work in a more favourable economic climate. Many young university graduates are among those leaving, which has caused this phenomenon to be labelled the "talent drain".
Business industries expressed worries that Brexit poses significant risk of causing brain drain.
Countries in Africa have lost a tremendous amount of their educated and skilled populations as a result of emigration to more developed countries, which has harmed the ability of such nations to get out of poverty. Nigeria, Kenya, and Ethiopia are believed to be the most affected. According to the United Nations Development Programme, Ethiopia lost 75% of its skilled workforce between 1980 and 1991.
South African President Thabo Mbeki said in his 1998 'African Renaissance' speech:
"In our world in which the generation of new knowledge and its application to change the human condition is the engine which moves human society further away from barbarism, do we not have need to recall Africa's hundreds of thousands of intellectuals back from their places of emigration in Western Europe and North America, to rejoin those who remain still within our shores!
I dream of the day when these, the African mathematicians and computer specialists in Washington and New York, the African physicists, engineers, doctors, business managers and economists, will return from London and Manchester and Paris and Brussels to add to the African pool of brain power, to enquire into and find solutions to Africa's problems and challenges, to open the African door to the world of knowledge, to elevate Africa's place within the universe of research the information of new knowledge, education and information."
Africarecruit is a joint initiative by NEPAD and the Commonwealth Business Council to recruit professional expatriate Africans to take employment back in Africa after working overseas.
In response to growing debate over the human capital flight of health care professionals, especially from lower income countries to some higher income countries, in 2010 the World Health Organization adopted the Global Code of Practice on the International Recruitment of Health Personnel, a policy framework for all countries for the ethical international recruitment of doctors, nurses and other health professionals.
African human capital flight has begun to reverse itself due to rapid growth and development in many African nations, and the emergence of an African middle class. Between 2001 and 2010, six of the world's ten fastest-growing economies were in Africa, and between 2011 and 2015, Africa's economic growth is expected to outpace Asia's. This, together with increased development, introduction of technologies such as fast Internet and mobile phones, a better-educated population, and the environment for business driven by new tech start-up companies, has resulted in many expatriates from Africa returning to their home countries, and more Africans staying at home to work.
The trend for young doctors and nurses to seek higher salaries and better working conditions, mainly in higher income countries of the West, is having serious impacts on the health care sector in Ghana. Ghana currently has about 3,600 doctors—one for every 6,700 inhabitants. This compares with one doctor per 430 people in the United States. Many of the country's trained doctors and nurses leave to work in countries such as Britain, the United States, Jamaica and Canada. It is estimated that up to 68% of the country's trained medical staff left between 1993 and 2000, and according to Ghana's official statistics institute, in the period 1999 to 2004, 448 doctors, or 54% of those trained in the period, left to work abroad.
Main article: Economy of South Africa § Brain drain
Along with many African nations, South Africa has been experiencing human capital flight in the past 20 years, since the end of apartheid. This is believed to be potentially damaging for the regional economy, and is arguably detrimental to the wellbeing of the region's poor majority, desperately reliant on the health care infrastructure because of the HIV/AIDS epidemic. The skills drain in South Africa tends to reflect racial contours exacerbated by Black Economic Empowerment policies, and has thus resulted in large White South African communities abroad. The problem is further highlighted by South Africa's request in 2001 of Canada to stop recruiting its doctors and other highly skilled medical personnel.
For the medical sector, the loss of return from investment for all doctors emigrating from South Africa is $1.41bn. The benefit to destination countries is huge: $2.7bn for the United Kingdom alone, without compensation.
More recently, in a case of reverse brain drain a net 359,000 highly skilled South Africans returned to South Africa from foreign work assignments over a five-year period from 2008 to 2013. This was catalysed by the global financial crisis of 2007-8 and perceptions of a higher quality of life in South Africa relative to the countries to which they had first emigrated. It is estimated that around 37% of those who returned are professionals such as lawyers, doctors, engineers and accountants.
During the Iraq War, especially during the early years, the lack of basic services and security fed an outflow of professionals from Iraq that began under Saddam Hussein, under whose rule four million Iraqis are believed to have left the country. In particular, the exodus was fed by the violence that plagued Iraq, which by 2006 had seen 89 university professors and senior lecturers killed.
Main article: Brain drain in Iran
In 2006, the International Monetary Fund ranked Iran "first in brain drain among 61 developing and less developed countries (LDC)" In the early 1990s, more than 150,000 Iranians emigrated, and an estimated 25% of Iranians with post-secondary education were residing in developed countries of the OECD. In 2009, the International Monetary Fund reported that 150,000-180,000 Iranians emigrate annually, with up to 62% of Iran's academic elite having emigrated, and that the yearly exodus is equivalent to an annual capital loss of $50 billion. Better possibilities for job markets is thought to be the motivation for absolute majority of the human capital flight while a small few stated their reasons as in search of more social or political freedom.
Main article: Yerida
Israel has experienced varying levels of emigration throughout its history, with the majority of Israeli expatriates moving to the United States. Currently, some 330,000 native-born Israelis (including 230,000 Israeli Jews) are estimated to be living abroad, while the number of immigrants to Israel who later left is unclear. According to public opinion polls, the main motives for leaving Israel have not been the political and security situation, but include desire for higher living standards, pursuit of work opportunities and/or professional advancement, and higher education. Many Israelis with degrees in scientific or engineering fields have emigrated abroad, largely due to lack of job opportunities. From Israel's establishment in May 1948 to December 2006, about 400,000 doctors and academics left Israel. In 2009, Israel's Council for Higher Education informed the Knesset's Education Committee that 25% of Israel's academics were living overseas, and that Israel had the highest human capital flight rate in the world. However, an OECD estimate put the highly educated Israeli emigrant rate at 5.3 per 1,000 highly educated Israelis, meaning that Israel actually retains more of its highly educated population than many other developed countries.
In addition, the majority of Israelis who emigrate eventually return after extended periods abroad. In 2007, the Israeli government began a programme to encourage Israelis living abroad to return; since then, the number of returning Israelis has doubled, and in 2010, Israeli expatriates, including academics, researchers, technical professionals, and business managers, began returning in record numbers. Israel launched additional programmes to open new opportunities in scientific fields to encourage Israeli scientists and researchers living abroad to return home. These programmes have since succeeded in luring many Israeli scientists back home.
By 2010, the Arab countries were experiencing human capital flight, according to reports from the United Nations and Arab League. About one million Arab experts and specialists were living in developed countries, and the rate of return was extremely low. The reasons for this included attraction to opportunities in technical and scientific fields in the West and an absence of job opportunities in the Arab world, as well as wars and political turmoil that have plagued many Arab nations.
In 2012, human capital flight was showing signs of reversing, with many young students choosing to stay and more individuals from abroad returning. In particular, many young professionals are becoming entrepreneurs and starting their own businesses rather than going abroad to work for companies in Western countries. This was partially a result of the Arab Spring, after which many Arab countries began viewing science as the driving force for development, and as a result stepped up their science programmes. Another reason may be the ongoing global recession.
There has been high rates of human capital flight from Malaysia. Major pull factors have included better career opportunities abroad and compensation, while major push factors included corruption, social inequality, educational opportunities,racial inequality such as the government's Bumiputeraaffirmative action policies. As of 2011, Bernama has reported that there are a million talented Malaysians working overseas. Recently human capital flight has increased in pace: 305,000 Malaysians migrated overseas between March 2008 and August 2009, compared to 140,000 in 2007. Non-Bumiputeras, particularly Malaysian Indians and Malaysian Chinese, were over-represented in these statistics. Popular destinations included Singapore, Australia, the United States and the United Kingdom. This is reported to have caused Malaysia's economic growth rate to fall to an average of 4.6% per annum in the 2000s compared to 7.2% in the 1990s.
In 1946, colonialism in the Philippines ended with the election of Manuel Roxas. The Philippines’ infrastructure and economy had been devastated by World War II, contributing to serious national health problems and uneven wealth distribution. As part of reconstruction efforts for the newly independent state, education of nurses was encouraged to combat the low ratio of 1 nurse per 12,000 Filipinos and to help raise national health care standards. However Roxas, having spent his last 3 years as the secretary of finance and chairman of the National Economic Council and a number of other Filipino companies, was particularly concerned with the country’s financial (rather than health) problems. The lack of government funding for rural community clinics and hospitals, as well as low wages, continued to perpetuate low nurse retention rates in rural areas and slow economic recovery. When the United States relaxed their Immigration Act laws in 1965, labor export emerged as a possible solution for the Philippines.
Labour export from the 1960s on
Since the 1960s and 1970s, the Philippines has been the largest supplier of nurses to the United States, in addition to export labour supplied to the UK and Saudi Arabia. In 1965, with a recovering post-WWII economy and facing labor shortages, the United States introduced a new occupational clause to the Immigration Act. The clause encouraged migration of skilled labour into sectors experiencing a shortage, particularly nursing, as well relaxing restrictions on race and origin. This was seen as an opportunity for mass Filipino labour exportation by the Filipino government, and was followed by a boom in public and private nursing educational programmes. Seeking access through the U.S. government-sponsored Exchange Visitors Programme (EVP), workers were encouraged to go abroad to learn more skills and earn higher pay, sending remittance payments back home. Nursing being regarded as a highly feminized profession, labour migrants have been predominantly female and young (25–30 years of age).
Pursuing economic gains through labour migration over infrastructural financing and improvement, the Philippines still faced slow economic growth during the 1970s and 1980s. With continuously rising demand for nurses in the international service sector and overseas, the Filipino government aggressively furthered their educational programmes under President Ferdinand Marcos, elected at this time. Although complete statistical data can be difficult to collect, studies done in the 1970s show 13,500 nurses (or 85% of all Filipino nurses) had left the country to pursue work elsewhere. Additionally, public and private nursing school programmes multiplied from a reported 17 nursing schools in 1950, to 140 nursing schools in 1970.
Studies show stark wage discrepancies between the Philippines and developed countries such as the US and the UK. This has led Filipino government officials to note that remittances sent home may be seen as more economically valuable than pursuit of local work. Around the turn of the 20th century, the average monthly wage of Filipino nurses who remained in their home country was between 550 - 1000 pesos per month (roughly $70 – 140 US at that time). In comparison, the average nurse working in the U.S. was receiving $800 – 1400 US per month.
However, scholars have noted that economic disparities in the Philippines have not been eased in the past decades. Although remittance payments account for a large portion of Filipino GDP ($290.5 million US in 1978, increased to $10.7 billion US in 2005),
Brain drain is defined as the migration of health personnel in search of the better standard of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. This migration of health professionals for better opportunities, both within countries and across international borders, is of growing concern worldwide because of its impact on health systems in developing countries. Why do talented people leave their countries and go abroad? What are the consequences of such migrations especially on the educational sector? What policies can be adopted to stem such movements from developing countries to developed countries?
This article seeks to raise questions, identify key issues and provide solutions which would enable immigrant health professionals to share their knowledge, skills and innovative capacities and thereby enhancing the economic development of their countries.
Brain drain is the migration of skilled human resources for trade, education, etc.1 Trained health professionals are needed in every part of the world. However, better standards of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in the developed countries attract talent from less developed areas. The majority of migration is from developing to developed countries. This is of growing concern worldwide because of its impact on the health systems in developing countries. These countries have invested in the education and training of young health professionals. This translates into a loss of considerable resources when these people migrate, with the direct benefit accruing to the recipient states who have not forked out the cost of educating them. The intellectuals of any country are some of the most expensive resources because of their training in terms of material cost and time, and most importantly, because of lost opportunity.
In 2000 almost 175 million people, or 2.9% of the world’s population, were living outside their country of birth for more than a year. Of these, about 65 million were economically active.2 This form of migration has in the past involved many health professionals3: nurses and physicians have sought employment abroad for many reasons including high unemployment in their home country.
International migration first emerged as a major public health concern in the 1940s when many European professionals emigrated to the UK and USA.4 In the 1970s, the World Health Organization (WHO) published a detailed 40-country study on the magnitude and flow of the health professionals.5 According to this report, close to 90% of all migrating physicians, were moving to just five countries: Australia, Canada, Germany, UK and USA.5
In 1972, about 6% of the world’s physicians (140 000) were located outside their countries of origin. Over three-quarters were found in only three countries: in order of magnitude, the USA, UK and Canada.6 The main donor countries reflected colonial and linguistic ties, with a dominance of Asian countries: India, Pakistan and Sri Lanka. By linking the number of physicians per 10 000 population to gross domestic product (GDP) per capita, the countries that produced more physicians than they had the capacity to absorb were identified7 as Egypt, India, Pakistan, Philippines and South Korea. However, the lack of reliable data and the difficulties of defining whether a migrant is ‘permanent’ or ‘temporary’ still exist.
One may claim that this migration from developing countries is both useful and unavoidable. There are definite advantages—enabling the migrant to spend time in other countries—but at the same time, the very low emigration rate of professionals from USA or UK may be as disturbing a sign as the high rates of immigration to these countries.
Young, well-educated, healthy individuals are most likely to migrate, especially in pursuit of higher education and economic improvement.8,9 The distinction between ‘push’ and ‘pull’ factors has been recognized.10 Continuing disparities in working conditions between richer and poorer countries offer a greater ‘pull’ towards the more developed countries. The role of governments and recruitment agencies in systematically encouraging the migration of health professionals increases the pull.10 Migrant health professionals are faced with a combination of economic, social and psychological factors, and family choices11, and reflect the ‘push–pull’ nature of the choices underpinning these ‘journeys of hope’. De-motivating working conditions, coupled with low salaries, are set against the likelihood of prosperity for themselves and their families, work in well-equipped hospitals, and the opportunity for professional development.12
In many cases, the country is not only losing its investment in the education of health professionals, but also the contribution of these workers to health care. For example, healthcare expenditure in India is 3% of GDP compared to 13% of GDP in the USA and the ratio of doctor to patients in India is 1:2083 compared to the USA where the ratio is 1:500.13 Moreover, in many developing countries healthcare systems are suffering from years of underinvestment, which, for health professionals, has resulted in low wages, poor working conditions, a lack of leadership and very few incentives.14
Employers in receiving countries take a different position; they have their own shortages of skilled people in specific fields and can drain a developing country of expertise by providing job opportunities.15 Kupfer et al. provided the strategies to discourage migration to the USA, a major recipient country.16 However, keeping the social, political and economic conditions in the developing countries in mind, can we stop the brain drain? Probably not!
Higher education is one of the principal conduits of permanent emigration.17 The majority of doctors acquire specialized and postgraduate professional qualifications in the host country. Half of the foreign-born graduate students in France, UK and USA remain there after completing their studies.18 Among the doctoral graduates in science and engineering in the USA in 1995, 79% of those from India and 88% from China remained in the USA.19 The recent study on brain drain from 24 major countries published by the World Bank20 also presented data on South Asian immigration to the USA (Table 1). Migration to OECD (Organization for Economic Cooperation and Development) countries is also shown in Table 2. Yet more data showing the momentum and demand for skilled people by high tech and research and development (R&D) industries illustrating accelerated flows of highly skilled workers to OECD countries are shown in Figure 1.
Employment of scientists and engineers with doctoral degrees in academia in the USA, 1973–1999. (Adopted from National Science Board. Science and engineering indicators, 2002 [www.nsf.gov/sbe/srs/seind02/start.htm])
Number of South Asian immigrants (age 25 and older) to the USA by level of educational attainment, 2000
These statistics suggest that if developing countries provided world-class education and training opportunities, as well as opportunities for career advancement and employment, the migratory flow could be reduced.21 However, in reality, this may not make much difference. On the plus side, foreign-born graduates acquire expensive skills which are not available within their countries. On the negative side, these skills and knowledge never migrate back to their own countries.
Besides the pull–push factors described earlier, some researchers from developing countries cite other reasons for not returning after training which include: lack of research funding; poor facilities; limited career structures; poor intellectual stimulation; threats of violence; and lack of good education for children in their home country.20 Incentives for migrants to return to developing countries have been insufficient to override the limitations at home—both real and perceived—and the attraction of opportunities found abroad. Many of these countries have made significant investments in infrastructure and education but have not achieved the scientific development, technological and innovative capability either to retain or to recover the human capital that they have generated. Is there a solution to this problem? This raises the question of whether one can justify losing human capital or whether one should make the additional investment in science and technology and bring about the innovations that will stop the loss and convert it into wealth generation.
CONVERTING BRAIN DRAIN INTO WISDOM GAIN
Developing countries, especially South Asia, are now the main source of healthcare migration to developed countries. This trend has led to concerns that the outflow of healthcare professionals is adversely affecting the healthcare system in developing countries and, hence, the health of the population. As a result, decision-makers in source countries are searching for policy options to slow down and even reverse the outflow of healthcare professionals. Is it possible to do so? Maybe not, bearing in mind the current political and economic situations of the source countries and globalization. The increasing demand for health care in the higher income countries is fuelled to a large extent by demographic trends, e.g. the ageing of the baby-boom generation.22
The opening up of international borders for goods and labour, a key strategy in the current liberal global economy, is accompanied by a linguistic shift from ‘human capital flight’ and ‘brain drain’ to ‘professional mobility’ or ‘brain circulation’.22 Solutions should therefore be based on this wider perspective, interrelating health workforce imbalances between, but also within developing and developed countries.
At current levels, wage differentials between source and destination country are so large that small increases in healthcare wages in source countries are unlikely to affect significantly the supply of healthcare migrants. According to the results of a study in Pakistan, a small proportion of people funded for a doctorate face on return major nonfinancial disincentives for good performance.23 Thus the financial component of such flows is only part of the picture and in some cases not the major push or pull factor. Moreover, there is a need to review the social, political, and economic reasons behind the exodus, and to provide security and opportunities for further development locally. Lowering of standards should not be accepted; instead local conditions should be reviewed and rectified.
CONTRIBUTIONS BY SHARING KNOWLEDGE AND SKILLS TO DEVELOPING COUNTRIES
It is time to understand and accept that health professionals’ mobility is part of life in the 21st century. Countries need to recognize that they compete with the best institutions in the world for quality manpower. It is time to bury the archaic concept of brain drain and turn to assessing the performance of health professionals and systems, wherever they are in the world. The turn of the 21st century has not only brought technology, but also modes by which scientists around the world can be connected in no time. In this globalized world the physical location of a person may or may not have any relation to the ability to make an impact on human health. Health professionals in the developed world may have most of their work portfolios in the developing world. Easy communication, quick travel, and greater collaborations between developed and developing countries are increasingly more common and we need to develop ways in which foreign professionals can contribute to their countries of origin.
Remittances from expatriates living abroad constitute a significant proportion of foreign revenue for many developing countries.24 In Bangladesh for example US$ 2 billion is received from citizens who have emigrated overseas, and these remittances are the second largest source of foreign revenue.25 The transfer and management of remittance revenues are potentially exploitable factors in plumbing the brain drain. Formalizing the transfer of remittances might permit the generation of revenues that could be invested nationally in the social and economic development of the developing home country. However, the magnitude and economic importance of remittances, economic development and growth, and ultimately social equity, depend on the endogenous capacity of each nation’s human resources. If only a small percentage of the multimillion dollar sums sent home by emigrants could be invested in research and development, might not opportunities for highly skilled and educated nationals improve at home? And would this not in turn spur economic development? Maybe to some extent—but without resources and skills, this may not have a huge impact on health and disease prevention.
It has been estimated that foreign scientists from developing countries who are involved in research and development produce 4.5 more publications and 10 times more patents than their counterparts at home.26 Why is there such a vast difference in productive capacity? The context and conditions in which science and technology are able to prosper require political decisions, funding, infrastructure, technical support, and a scientific community; these are generally unavailable in developing countries. The value and effectiveness of individuals depends on their connection to the people, institutions and organizations that enable knowledge creation, and together constitute a propitious environment. These expatriate scientists and healthcare professionals can contribute their knowledge, clinical and research skills to their native countries by developing collaborative training programmes, research projects and teaching their own countrymen. This requires the commitment of foreign scientists and receptiveness at the other end. Scientists, political leaders and decision-makers in developing and developed countries, and international development agencies, need to appreciate the social and synergistic nature of knowledge sharing so that policies and education systems are designed to promote and enable research and development.
Healthcare services are a rapidly growing sector of the world economy and trade in health services has created diverse means of accessing these services across borders. For example, information technology can provide telemedicine services and telepreventive services. These information technologies can be used as a mode of sharing knowledge and research skills in a cost-effective manner.
One such large network is already in place called supercourse [www.pitt.edu/∼super1]27 which has connected more than 20 000 scientists, healthcare professionals and researchers together through IT connectivity, and they share their knowledge in the form of teaching lectures (currently there are more than 2000 lectures) for free to a global audience. A similar kind of connectivity needs to be developed by expatriate citizens who can contribute their knowledge and skills to their countries of origin without any major costs. Policies are needed to ensure that these favourable outcomes are realized as an equitable access to the benefits of the international trade in health services.
The availability of both high-quality education and opportunities in research are the keys to retaining and attracting regional talent. The steps taken by China towards becoming a leader in biological research and biotechnology illustrate the empowerment. The scientific leadership positioned China to become the only developing country participating in the Human Genome Project.28 Experience gained through the participation of its institutions in the Human Genome Project (including large-scale sequencing, the use of bioinformatics and the coordination of multi-centre research protocols) provided the platform for developing biotechnology that can be applied to human diseases and agriculture. The opportunities generated by the Chinese in biotechnology attract both international collaboration in joint ventures and gifted scientists from China and abroad.
A similar example can be replicated in other developing countries with the help of their foreign expatriate citizens who have developed skills in research that are needed in their native countries. This approach to creating targeted educational opportunity together with political decision and investment in science and technology infrastructure provides a good example of a resourceful way of redirecting the brain drain. It is tempting to think that such on-site programmes involving national talent at home and abroad coupled with creative distance learning strategies could create networks of expatriates thus enabling their countries of origin to gain access to a world-class education in specific disciplines in the developing world.
Scientists who have emigrated for several reasons are recoverable assets who can play a part in developing opportunities at home. However, recovery requires the opening of diverse and creative conduits. The health services in the developing world must be supported to maintain their skilled personnel. Only when health staff, whatever their cadre, have the tools they require to do their job, training opportunities, a network of supportive colleagues, and recognition for the difficult job they do, are they likely to feel motivated to stay put when opportunity beckons from elsewhere. Foreign professionals could be used to develop innovative graduate education opportunities at home and technology to be transfered to areas of national priorities for research and development. Ultimately, involving individuals who are living abroad in creating opportunities at home favours both the retention and repatriation of national talent. Building an enlightened leadership and an enabling national scientific community, with the help of expatriate citizens, for the coherent development of scientific and technological capacity in developing countries will be mutually beneficial.
We are grateful to all Aga Khan University alumni at AKU Karachi, Pakistan and AKU USA for their valuable help.
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