Taming the brain drain: a challenge for public health systems in Southern Africa

In southern Africa, rapid out-migration of health professionals is compounding the problems of health systems already faced with budget constraints and the impacts of HIV/AIDS. These negative effects are unlikely to be offset by remittances from abroad. The same dynamics that affect the international migration of health professionals operate within nations, for instance as they move from public to private systems. "Push," "pull," and "stick" factors contribute to the migration. Some Canadian provinces have emerged as key destinations. The authors outline a program of research on how Canada and the international community might address the negative impacts of the brain drain. Policy options have been identified, but implementation may be complicated by provisions of GATS, fundamental economic disparities, and domestic political priorities.