1. WORLD BANK RESEARCH PROGRAM on MEDICAL BRAIN DRAIN Çaglar Özden Senior Economist Development Research Group

2. Brain Drain

3. The Benefits Remittances Diaspora effects Incentives for higher levels of education Brain Circulation The Costs The Cost of Education Loss of Positive Spillovers – benefits to people other than the migrant Productivity spillovers Services to population – education and healthcare Innovation and creativity Institution building Skilled Migration

4. Skilled Migration - Africa Share of Migrants by Education Attainment: 2000 0% 20% 40% 60% 80% 100% AfricaGhanaCote d'Ivoire TogoBeninBurkina Faso NigeriaNigerSierra Leone Guinea secondarytertiary

5. Skilled Migration - Africa Share of Labor Force by Education Attainment: 2000 0% 5% 10% 15% 20% 25% 30% AfricaGhanaCote d'Ivoire TogoBeninBurkina Faso NigeriaNigerSierra Leone Guinea secondarytertiary

6. Physician Migration Dataset What do we actually know??

7. Migration Soccer Players vs Doctors Total Number by Origin 0 250 500 750 1000 1992199319941995199619971998199920002001200220032004200520062007 Rest of AfricaNigeriaCameroonGhanaSenegalSouth AfricaIvory Coast

8. Migration Soccer Players vs Doctors Total Number By Origin 0 2,000 4,000 6,000 8,000 10,000 19911992199319941995199619971998199920002001200220032004 OthersNigeriaSudanGhanaEthiopiaZimbabweKenya

9. Migration Soccer Players vs Doctors Total Number By Destination 0 250 500 750 1000 19911992199319941995199619971998199920002001200220032004200520062007 Rest of EuropeFranceBelgiumPortugal EnglandTurkeyNetherlands

10. Migration Soccer Players vs Doctors Total Number by Destination 0 2,000 4,000 6,000 8,000 10,000 1991199319951997199920012003 RestUKUSAAustraliaCanadaFrance

11. Migration Soccer Players vs Doctors Migration Rate 0% 10% 20% 30% 40% 50% 19911992199319941995199619971998199920002001200220032004 EthiopiaGhanaLiberiaMalawiSomaliaZimbabwe

12. Migration Soccer Player vs Doctors What are the differences between Soccer players and Doctors?

13. Migration Soccer Players vs Doctors What are the differences between Soccer players and Doctors? Salaries? Social Externalities? Lifestyle? Talent? Looks?

14. Migration Soccer Players vs Doctors Senegal vs. France 2002 World Cup

15. Migration Soccer Players vs Doctors What are the differences between Soccer players and Doctors? Opportunity Cost of Production/Replacement

16. Migration Migration of Doctors is not the ‘disease’ It is the ‘symptom’

17. Migration Skilled people leave because of - Professional opportunities - Income gain - Political Instability - Under-appreciation

18. Migration Who Leaves? Preliminary Data from Ghana

19. It is not a recent issue! Age Range 40 56 18 3 30-3940-4950-5960-69

20. Gender Dimension Gender distribution 0 20 40 60 80 100 FemaleMale

21. Role of Networks?? Siblings abroad 62 13 21 13 14 No sibling1234+

22. Social Status Education level of Father 19 20 22 51 3 No education Primary school Secondary school bachelor's degree professional degree

23. Remittances Remittances- Average: $6,800 4 24 18 14 12 >$1$1-$5$5-$9$9-$15$15+ $ Thousands

24. Migration What should we do? Treat the symptom or cure the disease?

25. Migration What should we do? Treat the symptom or cure the disease? Take away Passports Punish the recruiters Pay Higher salaries back at home Make migrants pay for their education Make migrants feel guilty

26. Migration …or is High Level of Skilled Migration a result of wrong education and health policies?

27. Migration What is equitable, economically efficient and pro-development? Two–tiered education system? One for the Global Market, one for the local market where the first finances the latter? Migrant tax – coordinated w/ Destination countries? Recruitment Tax? Brain Circulation?

28. Migration No Easy Answers!! Ask The British!! UK is the country with the Highest level of skilled migration today!