Nature Editorial in praise of health worker brain drain

In its March 14th online issue, the Nature's editorial argues that there is benefit to sending countries from migrating health professionals. It cites recent study by an economist, Michael Clemens, of the Center for Global Development who claims that there is a "clear correlation between emigration and the state of the public healthcare system." Countries with more health professional emigrants have better health systems, according to Mr. Clemens. The editorial piece gave several points of arguments why losing countries are also gaining. It concludes by stating that "the notion that other places have necessarily suffered a corresponding loss — or that emigration is a zero-sum game — is misplaced."

The original article by Michael Clemens entitled "Do Visas Kill? Health Effects of African Health Professional Emigration" is available at the CGDEV website ( The abstract is provided below:

"The emigration of highly skilled workers can in theory lower social welfare in the migrant-sending country. If such workers produce a good whose consumption conveys a positive externality of such as nurses and doctors in a very poor country of the loss can be greater, and welfare can even decline globally. Policies to impede emigration thus have the potential to raise sending-country and global welfare. This study uses a new database of health worker emigration from Africa to test whether exogenous decreases in emigration raise the number of domestic health professionals, increase the mass availability of basic primary care, or improve a range of public health outcomes. It identifies the effect through two separate natural quasi-experiments arising from the colonial division of the African continent. These produce exogenous changes in emigration comparable to those that would result from different immigration policies in principal receiving countries. The results suggest that Africa is generally low staffing levels and poor public health conditions are the result of factors entirely unrelated to international movements of health professionals. A simple model proposes that such results would be explained by segmentation of health workforce labor markets in the sending countries. The results further suggest that emigration has caused a greater production of health workers in Africa."