The World Health Organisation (WHO) has warned increasing numbers of much needed health workers are being recruited by rich and middle income countries from poorer nations.

Fifty-five countries now rank below the global median in terms of their density of doctors, nurses and midwives per capita, according to a new WHO report.The report, titled ‘Health workforce support and safeguards 2023’ said eight more countries in the global south over past year now have dangerously low numbers of healthcare workers in the wake of the COVID pandemic.

It said both rich and poor countries suffered during the COVID pandemic due to healthcare worker shortages, but rich countries were able to import more workers.

The WHO report tracked countries where the number of professionally trained healthcare workers falls below the global median of 49 per 10,000 population.

The report found the negative health, economic and social impacts of COVID-19, coupled with the increased demand for healthcare workers in high-income countries experienced during the pandemic, likely helped trigger more outward migration of healthcare workers from countries that are already suffering from low health workforce densities.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said: “Health workers are the backbone of every health system, and yet 55 countries with some of the world’s most fragile health systems do not have enough and many are losing their health workers to international migration.”

He said the outward migration of healthcare workers from low or middle income countries in search of better wages and working conditions is a longstanding issue, which has only become more serious as the global workforce becomes more mobile generally. 

The proportion of foreign-trained physicians increased from 32 per cent in 2010 to 36 per cent in 2020 in eight OECD countries already blessed with a high density of healthcare workers.

The report said African countries were hardest hit by the health care brain drain.

Among the countries that have recently joined the list of nations with vulnerable health workforces are Rwanda, Comoros, Zambia and Zimbabwe.

In the Asia-Pacific, they include Timor-Leste, the Lao People’s Democratic Republic, Samoa and Tuvalu.

Among all 55 countries with sub-par numbers of health care workers, 37 are WHO’s Africa region, eight in the Western Pacific region, six in the Eastern Mediterranean region, three in south-east Asia region and one country in the agency’s Americas region, the report found.  All of these countries have a healthcare workforce density of less than 49 workers per 10,000 people. 

The WHO has recommended that healthcare workers migration agreements signed between two governments should explicitly ensure that benefits to the source country are “commensurate and proportionate” to the benefits accrued by the healthcare system of the destination country. 

It also recommends that such safeguards be applied to all low and middle income countries, regardless of their ranking on the list.