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HIV Pandemic, Medical Brain Drain, and Economic Development in Sub-Saharan Africa

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  • Alok Bhargava
  • Frédéric Docquier

Abstract

Country-level longitudinal data at three-year intervals over 1990--2004 are used to analyze the factors affecting emigration of physicians from Sub-Saharan countries and the effects of this medical brain drain on life expectancy and number of deaths due to AIDS. Data are compiled on emigrating African physicians from 16 receiving Organisation for Economic Co-operation and Development (OECD) countries. A comprehensive longitudinal database is developed by merging the medical brain drain variables with recent data on HIV prevalence rates, public health expenditures, physicians' wages, and economic and demographic variables. A triangular system of equations is estimated in a random effects framework using five time observations for medical brain drain rates, life expectancy, and number of deaths due to AIDS, taking into account the interdependence of these variables. Lower wages and higher HIV prevalence rates are strongly associated with the brain drain of physicians from Sub-Saharan African to OECD countries. In countries in which the HIV prevalence rate exceeds 3 percent, a doubling of the medical brain drain rate is associated with a 20 percent increase in adult deaths from AIDS; medical brain drain does not appear to affect life expectancy. These findings underscore the need to improve economic conditions for physicians in order to retain physicians in Sub-Saharan Africa, especially as antiretroviral treatment becomes more widely available. Copyright The Author 2008. Published by Oxford University Press on behalf of the International Bank for Reconstruction and Development / the world bank . All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org, Oxford University Press.

Suggested Citation

  • Alok Bhargava & Frédéric Docquier, 2008. "HIV Pandemic, Medical Brain Drain, and Economic Development in Sub-Saharan Africa," World Bank Economic Review, World Bank Group, vol. 22(2), pages 345-366, May.
  • Handle: RePEc:oup:wbecrv:v:22:y:2008:i:2:p:345-366
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    Citations

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    Cited by:

    1. Docquier Frédéric & Rapoport Hillel, 2009. "Documenting the Brain Drain of “La Crème de la Crème”: Three Case-Studies on International Migration at the Upper Tail of the Education Distribution," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 229(6), pages 679-705, December.
    2. Anghel, Remus Gabriel & Botezat, Alina & Cosciug, Anatolie & Manafi, Ioana & Roman, Monica, 2016. "International migration, return migration, and their effects. A comprehensive review on the Romanian case," MPRA Paper 75528, University Library of Munich, Germany, revised Dec 2016.
    3. Artjoms IVLEVS & Jaime DE MELO, 2015. "FDI, the Brain Drain and Trade: Channels and Evidence," World Scientific Book Chapters,in: Developing Countries in the World Economy, chapter 21, pages 533-551 World Scientific Publishing Co. Pte. Ltd..
    4. Yasser Moullan, 2009. "Can Health Foreign Assistance Break the Medical Brain Drain ?," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00399306, HAL.
    5. John Gibson & David McKenzie, 2011. "Eight Questions about Brain Drain," Journal of Economic Perspectives, American Economic Association, vol. 25(3), pages 107-128, Summer.
    6. repec:ilo:ilowps:486992 is not listed on IDEAS
    7. John Gibson & David McKenzie, 2012. "The Economic Consequences of ‘Brain Drain’ of the Best and Brightest: Microeconomic Evidence from Five Countries," Economic Journal, Royal Economic Society, vol. 122(560), pages 339-375, May.
    8. Kevin J. A. Thomas, 2016. "Highly Skilled Migration from Africa to the US: Exit Mechanisms, Demographic Determinants, and the Role of Socioeconomic Trends," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 35(6), pages 825-849, December.
    9. Alassane DRABO & Christian EBEKE, 2010. "Remittances, Public Health Spending and Foreign Aid in the Access to Health Care Services in Developing Countries," Working Papers 201004, CERDI.
    10. Arnaud Bourgain & Patrice Pieretti & Benteng Zou, 2008. "The Shortage of Medical Workers in Sub-Saharan Africa and Substitution Policy," CREA Discussion Paper Series 08-13, Center for Research in Economic Analysis, University of Luxembourg.
    11. Okeke, Edward N., 2013. "Brain drain: Do economic conditions “push” doctors out of developing countries?," Social Science & Medicine, Elsevier, vol. 98(C), pages 169-178.
    12. repec:ilo:ilowps:486369 is not listed on IDEAS
    13. Docquier, Frédéric, 2006. "Brain Drain and Inequality Across Nations," IZA Discussion Papers 2440, Institute for the Study of Labor (IZA).
    14. Makulec, Agnieszka., 2014. "Philippines' bilateral labour arrangements on health-care professional migration : in search of meaning," ILO Working Papers 994869923402676, International Labour Organization.

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