The Right to Health, State Responsibility and Global Justice
The greatest moral concerns in the international migration of health workers are its harmful effects on health systems and health outcomes in very poor countries. Poor countries face a vastly greater burden of preventable and treatable morbidity and mortality than rich countries. And yet the world’s poorest countries have grossly inadequate numbers of health workers to serve the health needs of their populations. Relatively speaking, rich countries have health workers in abundance, although many of them also face shortages of domestically trained health workers. The human resources for health crisis is one of the contributing factors to the enormous and abhorrent inequality in health opportunities and outcomes between the global rich and the global poor. This problem is compounded by the fact that many of the world’s poorest countries are failing to see a return on the investment they make in the training of much-needed health workers because many of them migrate to richer countries. The loss of just a few health workers from a critically understaffed health system in a very poor country can have a massive impact on the health services left behind. This is implicitly a question not only of need in poor countries but also of inequality. The substantial financial and health returns are accruing to the health systems, populations and governments of richer countries, which are financially and institutionally equipped to train health workers with far greater ease at the expense of poorer countries.
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