SCALING UP INVESTMENTS IN HEALTH WORKFORCE TO PREVENT BRAIN DRAIN AND PROMOTE HEALTH SECURITY IN AFRICA AND THE GLOBAL SOUTH [current concerns 2-002]

 current concerns 2-002

SCALING UP INVESTMENTS IN HEALTH WORKFORCE TO PREVENT BRAIN DRAIN AND PROMOTE HEALTH SECURITY IN AFRICA AND THE GLOBAL SOUTH
-by Dr. Uzodinma Adirieje / +2347015530362 (WhatsApp) / druzoadirieje2015@gmail.com

 

 

The health workforce is the heartbeat of any health system. Without doctors, nurses, midwives, community health workers, laboratory scientists, pharmacists, and other frontline health professionals, even the best-equipped hospitals are lifeless structures. Yet, across Africa and the Global South, a silent crisis continues to undermine progress in health, sustainable development, and human security, namely: the depletion of health workers through underinvestment and unchecked brain drain. As the world recovers from the COVID-19 pandemic and prepares for future health threats, it is imperative that nations in low- and middle-income regions, especially Africa and the Global South—scale up sustainable investments in the health workforce. Such strategic action will not only mitigate the mass migration of skilled professionals but will also bolster national and regional health security.

 

The Health Workforce Crisis in Africa and the Global South

 

Africa accounts for 25% of the global disease burden but has only 3% of the world’s health workers, according to the World Health Organization (WHO). This shocking disparity is compounded by poor working conditions, low wages, job insecurity, unsafe environments, limited career development opportunities, and insufficient investments in education and training. Consequently, health professionals are migrating in droves to countries in the Global North where they find better employment prospects. The United Kingdom, United States, Canada, and Australia have increasingly relied on recruiting foreign-trained nurses and doctors—many of them from Africa—to plug their own shortages. While this benefits the receiving countries, it severely weakens already fragile health systems in source countries. The cost of training a doctor in Nigeria, for instance, is estimated at over $30,000. When these professionals emigrate, it amounts to a massive loss of public investment, with no guarantee of returns to their home countries. Moreover, their departure creates gaps in service delivery, deepens inequities, and diminishes the health system’s ability to respond to emergencies—threatening both health and human security.

 

Why Brain Drain Matters for Health Security

 

Health security refers to the activities required to minimize the danger and impact of acute public health events that endanger people's health across geographical regions. As COVID-19 demonstrated, weak health systems in one country can have global repercussions.

A robust, well-distributed, and motivated health workforce is essential for early detection, prevention, preparedness, and response to public health emergencies. Without adequate staff in health facilities, diseases go undetected, outbreaks worsen, vaccination programs falter, and maternal and child health services decline. In conflict-affected or climate-vulnerable regions, where displacement and disasters are increasing, the need for resilient health systems is even greater. Yet, brain drain erodes this resilience by draining local capacity and increasing dependence on humanitarian aid.

 

Rethinking Investment in the Health Workforce

 

To reverse this trend, governments, development partners, and stakeholders must adopt a multi-dimensional investment strategy that prioritizes retention, quality training, and career fulfillment. Scaling up investments should include:

 

1. Increased Public Financing for Health
Governments must commit at least 15% of their annual budgets to health, as pledged in the Abuja Declaration, and allocate a significant portion to human resources for health (HRH). This includes funding for salaries, benefits, protective equipment, continuing education, and health worker safety.

2. Education and Training Reforms
Expand and improve medical, nursing, and allied health training institutions. Introduce competency-based curricula, modern facilities, digital learning, and faculty development. Scholarships and incentives should target rural and underserved communities to build a pipeline of locally trained professionals.

3. Retention Strategies and Career Pathways
Provide competitive remuneration, clear promotion pathways, research opportunities, and professional development. Establish safe, enabling working conditions and mental health support. Countries like Rwanda and Ethiopia have shown how well-structured retention policies can keep professionals engaged and motivated.

4. Regulation of International Recruitment
African and Global South countries should engage diplomatically to advocate for ethical recruitment practices under WHO’s Global Code of Practice. Developed countries should provide compensation or reinvestment packages when they recruit large numbers of professionals from vulnerable countries.

5. Deployment and Distribution Equity
Investments must ensure equitable distribution of health workers between urban and rural areas. Strong health information systems and workforce mapping can help optimize deployments and prevent urban bias.

6. Harnessing Diaspora Engagement
Instead of resisting all forms of migration, governments can create frameworks for diaspora contribution, including telemedicine, knowledge transfer, short-term returns, and virtual mentoring.

 

The Role of Regional and Global Cooperation

 

Africa and the Global South cannot face this challenge alone. International organizations, donor agencies, and the private sector must act in solidarity by:

a.       Funding HRH-focused projects and South-South cooperation

2. Supporting regional training and health workforce observatories
3. Investing in digital health infrastructure
4. Facilitating joint health security capacity-building programs

Platforms such as the Africa CDC, WHO-AFRO, and regional economic communities (ECOWAS, SADC, EAC, etc.) must mainstream health workforce development into their health security and universal health coverage (UHC) agendas.

 

A Strategic Imperative, not a Luxury

 

Investing in the health workforce is not a luxury—it is a strategic imperative for development, security, and resilience. Healthy citizens contribute to economic growth, education, and productivity. A country with a strong health workforce is better equipped to withstand pandemics, respond to disasters, and meet the Sustainable Development Goals (SDGs).

Moreover, creating decent jobs in the health sector addresses youth unemployment, gender inequality, and rural poverty. According to the WHO, investments in the health and social care sectors can yield a triple return—improved health outcomes, economic growth, and gender equality.

 

Conclusion: A Call to Action

 

Africa and the Global South stand at a critical crossroads. The choice is stark: continue to hemorrhage skilled professionals or commit to bold, sustained investment in the health workforce. The latter option offers a path to health sovereignty, resilience, and dignity.

Governments must act with urgency. Civil society must demand accountability. Development partners must align their financing with national workforce priorities. And the global community must recognize that health security anywhere depends on a strong health workforce everywhere. It is time to move from rhetoric to results. Scaling up investment in the health workforce is our collective insurance policy against future crises—and a moral obligation to those who dedicate their lives to saving others.

 

 

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, development planning, project management, sustainable development goals (SDGs), governance, health/community systems strengthening, policy advocacy, and monitoring and evaluation (M&E). He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South.