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Symposium 2012

Proposal - How the Training of Emigrant Professionals Can Be Financed by Destination Countries

The Challenge

While the world economy continues to become more global, international labor mobility remains severely restricted for all but those with rare or high skills. Many people in developing countries would ...

While the world economy continues to become more global, international labor mobility remains severely restricted for all but those with rare or high skills. Many people in developing countries would like to emigrate legally to work abroad but they do not qualify for admission to destination countries. This is because policy-makers typically focus on the net national economic impact when considering reforms of their labor migration policies and they naturally respond to public opinion about that impact.

Rich nations facing a shortage of skilled workers should partner with technical schools in neighboring developing countries to foster a mutually beneficial exchange of skills and opportunities, at no cost to the sending country.

In the familiar narrative of “brain drain”, rich countries are said to rob the developing world of talent trained with their limited resources. Perhaps the most widely discussed skill flow from poor to rich countries is the migration of health workers, who are in high demand all over the world, in both rich and poor countries alike. Malawi and other migrant-origin countries invest in training nurses, many of whom then migrate to the United Kingdom and other destination-countries. Malawi is seen to lose valuable human capital, receiving nothing in return.

This simple narrative does not capture the full effects of emigration on the origin country. Professional opportunities for migrants are valuable, and creating those opportunities is part of the reason for higher education everywhere. The opportunity to migrate raises the value of skills, raising the demand for nurse training. In principle, if this reaction is sufficiently large, the number of professionals in the origin country could rise—net of departures. And many migrant health workers return ideas, money, and service to their home countries. Yet they face hostile migration policies in the destination and origin countries, and receive little to no support from international agencies and the development community.

At the heart of this resistance is the idea that this skill flow represents an illegitimate transfer from poor to rich. To address this concern in the context of a global shortage of nurses, I propose that popular destination countries like Britain, France and the United States partner with countries in neighboring regions to finance ex ante the training of health workers in their countries of origin, and guarantee them destination-country employment upon graduation. The source country’s investments will then supplement foreign financing and expand capacity for training health workers. This increase in capacity and funding will expand the pool of health workers, for example to those who would not otherwise be able to afford the training fees.

Finally and perhaps most important for the policy maker in the source country, the emigration of workers will not cost their taxpayers. The financing costs are a fraction of the value of the worker, and program costs would be minimal in relation to the foreign aid budget. For example, it costs around US$10,000 to train a nurse in Malawi, while the average starting salary for a professional nurse in the United Kingdom is US$51,504 per year.[1] Note well: This is not a proposal for ex post compensation of training costs for prior emigrants, but a proposal for ex ante financing of emigrants training. Ex post compensation is fraught with difficulties—including monitoring the expenditure of the money, and estimating ‘costs’ occasioned by those who migrate after years of work.

Some existing programs come close to such a financing model. AusAID partners with technical schools in the pacific islands like Vanuatu and Papua New Guinea to train semi-skilled workers in a range of occupations required in the Pacific Islands Forum – a group of countries that includes Australia and New Zealand. They provide scholarships and courses but utilize existing infrastructure in the source country – so there are no large up front capital costs.   The Japan-Indonesia Economic Partnership Agreement (JIEPA) lays out a similar scheme for training nurses from Indonesia to work in Japan. Nurses from Indonesia are given three or four-year visas to work in Japan upon completing Japanese-language courses and passing certification exams. Japan aimed to recruit 400 nurses in two years after signing the bilateral agreement in 2008.

Both these programs are in their early stages and have run into road blocks. So far the APTC has only managed to place about 2% of their graduates in positions abroad. The JIEPA also fell short of their recruitment targets due to logistical issues in implementing the new program. We can see from their early experiences that these are initiatives that require coordination between multiple actors within the state to succeed. The aid agency must 1) work with immigration to ensure that the graduates qualify for entry, 2) ensure that the training leads to certification that will be recognized widely, and 3) align the scholarships with the recruiting requirements of the industry. For now, as a result of viewing migration, health worker shortages, and development as separate issues, policy makers in the developed world are missing this golden opportunity for a “triple-win”.

We can adopt this model to partnerships between Europe and the African region, US and the Caribbean, Japan and the East Asia/Pacific region. The European Commission, for instance, estimates a shortage of roughly 500,000 nurses by the year 2020 to address the needs of an aging population. The health care needs of Europe, the North America, and Japan cannot be met by local human resources alone. Bilateral agreements for ex ante finance of technical training in migrant-origin countries would be a step towards addressing this widening gap in a manner that shifts the balance sheet towards greater gains from migration for all parties.



[1] Training cost in Malawi is from Muula et al., “The financial losses from the migration of nurses from Malawi.” Wage in UK is from OECD Health Data 2011.

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