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