Why are countries ignoring the WHO ‘red list’?
In March, the World Health Organisation published an updated list of 55 countries that have reached a critical point when it comes to shortages in their health care workforces. The implication – or ‘recommendation’ – is that wealthier western nations in particular need to cool it when it comes to actively recruiting nurses and doctors from selected countries.
But such a recommendation may not have much impact. The message seems to have fallen on deaf ears, as many wealthier countries are amping up their recruitment from emerging markets to plug the gap created by their own shrinking workforces and ageing populations.
The Health Workforce Support and Safeguards List 2023 report is published every three years. The most recent edition names 37 countries in Africa, three in South-East Asia, eight in the Western Pacific, six in the Eastern Mediterranean, and one in the Americas.
One of the African countries is Ghana. Earlier this month the International Council of Nurses expressed concerns to the BBC about the sheer scale of departures from Ghana to the UK, calling the situation “out of control”. Four months ago, German ministers were in the African country, scoping out the possibilities for similar arrangements.
Six or seven higher income countries appear to be driving intense recruitment from some of the weakest and most vulnerable nations who really can’t afford to lose their healthcare workforce. After all, ageing demographics aren’t only affecting the West.
Of course, from the perspective of the worker on the ground, the pull is strong. Income can be up to seven times higher and the UK – say – is becoming a destination of choice for nurses and doctors in Zimbabwe too.
If the only plan is to continue plucking the best from elsewhere, inequalities between richer and poorer countries will inevitably be exacerbated and the long-term consequences could be grave.
One potential course of events is that emerging markets resort to more aggressive resistance. Nigeria is also on the red list having famously experienced a slow, steady drain of talent. In response, the government has attempted to impose a five-year mandatory service policy. You can read more about the push back on the brain drain here.
There are serious ethical issues with aggressively pursuing a policy which worsens the exodus of talent which some countries are seeing. On top of this, it also risks further straining relations.
The next updated list is expected in 2026 and 2029, but if the situation warrants it, they could become more regular according to the WHO. Click here to see the list in its entirety.
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