Editor—Respondents to Levy's article on the brain drain in the developing world1 have focused on the role of corrupt politicians and unstable governments in the developing world as the major push factor driving health staff abroad. This is only a part of the picture.
Countries whose gross domestic product per head is less than the expenditure of the NHS per head2 cannot possibly compete in terms of salaries and resources without considerable external help. The West must face up to its role in maintaining the economic disparities that give rise to this problem.
Meanwhile the health services of 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 continue when opportunity beckons from elsewhere.
Competing interests: None declared.
References
- 1.Levy L. The first world's role in the third world brain drain. BMJ 2003;327: 170. (19 July.) [Google Scholar]
- 2.World Health Organization. World health report 2002. Geneva: WHO, 2002.