The World Health Organization got it right.
Next week the WHO Executive Board will meet to discuss a new code of practice for health worker recruitment. Initially I was sure that this would include urging limits or bans on recruitment from most developing countries, as the code of practice for the British National Health Service does.
But I was wrong: When I read the draft WHO code of practice (pdf), I was delighted to see that it contains nothing of the kind. Instead, it is all about ensuring that internationally recruited health workers know what they're getting into, get treated fairly, and don't get exploited, and that states monitor heath worker movement so they can plan accordingly. All great ideas.
In fact, the draft code goes out of its way to condemn coercive limitations on health workers' movement:
Nothing in this code should be interpreted as impinging on the rights of health personnel to migrate to countries that wish to admit and employ them.
Refreshingly, it stresses that the way to keep health workers in developing countries is to give them safe and dignified working conditions, rather than coerce them to stay by taking away job opportunities abroad via recruitment bans:
Member States should recognize that improving the social and economic status of health personnel, their living and working conditions, their opportunities for employment and their career prospects is an important means of overcoming existing shortages and improving retention of a skilled health workforce.
Three cheers. Maybe, starting in 2009, "ethical recruitment" will cease to be tacitly understood as "less or no recruitment", and come to mean what it should mean: "recruitment as if health workers were people".
In one place the Code of Practice could have been better: Unfortunately, it espouses "a self-sufficient health workforce" as a proper goal of all countries in the world. I often point out that "self-sufficiency" in health workers means, by definition, zero immigration of health workers. Zero immigration for any type of person is not a proper goal of any country, and it is certainly not ethical (were any of your ancestors international migrants?). If the US were to be "self-sufficient" in all important sectors, that would mean no immigrant farm workers (surely food is an important sector too), and no immigrant Information Technology workers.
If you feel that the WHO should be pushing recruitment bans, I urge you to consider the ethical consequences of hiding information from people in poor countries about the kind of high-paying jobs that people in rich countries take for granted --- for this is what a recruitment ban is. I've discussed related issues in other blog posts and a research paper entitled "Do Visas Kill?"
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise.
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